The impact of COVID-19 pandemic on acute otitis media among the pediatric population.

BACKGROUND: The incidence of respiratory diseases has dropped during the school closures at the COVID-19 pandemic including acute otitis media (AOM) among the pediatric population. METHODS: This study included 2090 patients under 12 years old, that were diagnosed with AOM between March 2019 and February 2021 at the otolaryngology and pediatrics emergency room at a public tertiary hospital in Sao Paulo, Brazil. RESULTS: There was a significant drop in number of AOM cases diagnosed during the quarantine. The group before the pandemic represents 87,2% of the total attendings and the first two months of quarantine had the major attendance discrepancy between the same period during pre-pandemic times. CONCLUSION: Quarantine isolation measures and school closures may have helped reduce not only the coronavirus spread but also other infectious diseases such as AOM among the pediatric population.

An update on COVID-19 for the otorhinolaryngologist - a Brazilian Association of Otolaryngology and Cervicofacial Surgery (ABORL-CCF) Position Statement / Atualização sobre o COVID-19 para o otorrinolaringologista - um documento sobre a posição da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF)

Abstract Introduction: We are facing a pandemic with a great impact worldwide, as a result of the rapid spread of the novel coronavirus (COVID-19). The medical community is still getting to know behavior of this virus and the consequences from a population point of view. All this knowledge is extremely dynamic, so some behaviors are still not well established. Otorhinolaryngologists have a central role in the management of this situation, in which they must assess the patient, avoid contamination to and by health professionals and other patients. Thus, the recommendations of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery (ABORL-CCF) have the main objective of reducing the spread of the new coronavirus during otorhinolaryngological care and assisting in the management of these patients. Methods: Review of the main recommendations of national and international scientific societies, decisions by government agencies and class councils. The topics will be related to the general aspects of COVID-19, personal protective equipment, care in patient assistance, endoscopic exam routines and the management of sinonasal, otological and pediatric evaluations related to COVID-19. Results: The use of personal protective equipment is considered crucial in routine ENT care. We recommend postponing appointments, exams and elective surgeries to reduce the spread of COVID-19. Similarly, we recommend changing routines in several areas of otolaryngology. Additionally, guidance is provided on the use of telemedicine resources during the pandemic period. Conclusions: We are still at the beginning of the COVID-19 pandemic and scientific evidence is still scarce and incomplete, so these ABORL-CCF recommendations for otorhinolaryngologists may be updated based on new knowledge and the pattern of the new coronavirus spread.

Resumo: Introdução: Estamos diante de uma pandemia de grande impacto mundial como resultado da rápida propagação do novo coronavírus, COVID-19. A comunidade médica está ainda conhecendo o comportamento desse vírus e as repercussões do ponto de vista populacional. Todo esse conhecimento é extremamente dinâmico, por isso algumas condutas ainda não estão bem estabelecidas. O otorrinolaringologista tem um papel central no manejo dessa situação em que deve avaliar o paciente e evitar a contaminação dos profissionais da saúde e dos demais pacientes. Dessa forma, as recomendações da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF) têm por objetivo principal reduzir a propagação do novo coronavírus durante o atendimento otorrinolaringológico e auxiliar no manejo desses pacientes. Método: Revisão das principais recomendações das sociedades científicas nacionais, internacionais, decisões de órgãos governamentais e de conselhos de classe. Os tópicos serão relativos aos aspectos gerais do COVID-19, equipamentos de proteção individual, cuidados no atendimento ao paciente, as rotinas dos exames endoscópicos e o manejo de aspectos nasossinusais, otológicos e pediátricos relacionados ao COVID-19. Resultados: É considerado crucial o uso de equipamento de proteção individual no atendimento otorrinolaringológico de rotina. Recomendamos postergar atendimentos, exames e cirurgias eletivas para diminuir a propagação do COVID-19. Da mesma forma, recomendamos mudança de rotinas em diversas áreas da otorrinolaringologia. Além disso, orientações sobre o uso do recurso da telemedicina durante o período de vigência da pandemia. Conclusões: Estamos ainda no início da pandemia do COVID-19 e as evidências científicas são ainda escassas, por isso essas recomendações da ABORL-CCF para os otorrinolaringologistas podem sofrer atualizações baseadas nos novos conhecimentos e no padrão de disseminação do novo coronavírus.

An update on COVID-19 for the otorhinolaryngologist - a Brazilian Association of Otolaryngology and Cervicofacial Surgery (ABORL-CCF) Position Statement.

INTRODUCTION: We are facing a pandemic with a great impact worldwide, as a result of the rapid spread of the novel coronavirus (COVID-19). The medical community is still getting to know behavior of this virus and the consequences from a population point of view. All this knowledge is extremely dynamic, so some behaviors are still not well established. Otorhinolaryngologists have a central role in the management of this situation, in which they must assess the patient, avoid contamination to and by health professionals and other patients. Thus, the recommendations of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery (ABORL-CCF) have the main objective of reducing the spread of the new coronavirus during otorhinolaryngological care and assisting in the management of these patients. METHODS: Review of the main recommendations of national and international scientific societies, decisions by government agencies and class councils. The topics will be related to the general aspects of COVID-19, personal protective equipment, care in patient assistance, endoscopic exam routines and the management of sinonasal, otological and pediatric evaluations related to COVID-19. RESULTS: The use of personal protective equipment is considered crucial in routine ENT care. We recommend postponing appointments, exams and elective surgeries to reduce the spread of COVID-19. Similarly, we recommend changing routines in several areas of otolaryngology. Additionally, guidance is provided on the use of telemedicine resources during the pandemic period. CONCLUSIONS: We are still at the beginning of the COVID-19 pandemic and scientific evidence is still scarce and incomplete, so these ABORL-CCF recommendations for otorhinolaryngologists may be updated based on new knowledge and the pattern of the new coronavirus spread.

Correlation Between Sensorineural Hearing Loss and Chronic Otorrhea.

Many studies have been trying to correlate chronic otorrhea, both in children and in adults, with the sensorineural hearing loss in the affected ear, but have been obtaining contradictory results. This loss might be due to the likely toxicity of the bacteria involved, effects of inflammatory cytokines, or constant use of ototoxic antibiotics. All the studies evaluated up to the present date compared the affected ear with the normal contralateral ear. From the digitized archive of otological surgery files of the Department of Otorhinolaryngology, the ears of patients with chronic otorrhea were evaluated visually and compared with the normal contralateral ears. Ears with otorrhea were also compared to ears with dry tympanic perforation of other patients. Ears with suppuration were evaluated for cholesteatoma. The duration of otorrhea was taken into account. The sensorineural hearing threshold was evaluated for the frequencies of 500, 1000, 2000, and 4000 Hz. A total of 98 patients with chronic otorrhea and 60 with dry tympanic membrane perforation were evaluated. From a statistical study, a correlation between sensorineural hearing loss and the chronic otorrhea was observed, in comparison both with contralateral normal ears and with dry perforated ears of other patients. There was no relationship with the duration of suppuration or with whether this was due to cholesteatoma. Sensorineural hearing loss occurs in ears with chronic otorrhea. The duration of otorrhea and the etiology of suppuration did not influence the hearing loss. The great majority of otorrhea cases begin during childhood.

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel / Como evitar o uso inadequado de antibióticos nas infecções de vias aéreas superiores? Posição de um painel de especialistas

Abstract Introduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.

Resumo Introdução: A resistência bacteriana a antibióticos nos processos infecciosos é um fato crescente nos últimos anos, especialmente devido ao seu uso inapropriado. Ao longo dos anos vem se tornando um grave problema de saúde pública devido ao prolongamento do tempo de internação, elevação dos custos de tratamento e aumento da mortalidade relacionada às doenças infecciosas. Quase a metade das prescrições de antibióticos em unidades de pronto atendimento é destinada ao tratamento de alguma infecção de vias aéreas superiores, especialmente rinossinusites, otite média aguda supurada e faringotonsilites agudas, sendo que uma significativa parcela dessas prescrições é inapropriada. Nesse contexto, os otorrinolaringologistas têm um papel fundamental na orientação de pacientes e colegas não especialistas, para o uso adequado e racional de antibióticos frente a essas situações clínicas. Objetivos: Realizar uma revisão das atuais recomendações de utilização de antibióticos nas otites médias, rinossinusites e faringotonsilites agudas adaptadas à realidade nacional. Método: Revisão na base PubMed das principais recomendações internacionais de tratamentos das infecções de vias aéreas superiores, seguido de discussão com um painel de especialistas. Resultados: Os antibióticos devem ser utilizados de maneira criteriosa nas infecções agudas de vias aéreas superiores não complicadas, a depender da gravidade da apresentação clínica e dos potenciais riscos associados de complicações supurativas e não supurativas. Conclusões: Constantes revisões a respeito do tratamento das principais infecções agudas são necessárias para que sejam tomadas medidas coletivas no uso racional e apropriado de antibióticos. Somente com orientação e transformações no comportamento de médicos e pacientes é que haverá mudanças do paradigma de que toda infecção de vias aéreas superiores deva ser tratada com antibióticos, minimizando por consequência os efeitos de seu uso inadequado.

How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel.

INTRODUCTION: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. OBJECTIVES: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. METHODS: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. RESULTS: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. CONCLUSIONS: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.

Correlation between sensorineural hearing loss and chronic otorrhea.

Many studies have attempted to correlate chronic otorrhea in children and in adults with the sensorineural hearing loss in the affected ear, with contradictory results. This loss might be the result of the likely toxicity of the bacteria involved, effects of inflammatory cytokines, or constant use of ototoxic antibiotics. All studies evaluated to date compared the affected ear with the normal contralateral ear. From the digitized archive of otologic surgery files of the Department of Otorhinolaryngology at Santa Casa de São Paulo School of Medical Sciences, the ears of patients with chronic otorrhea were evaluated visually and compared with the normal contralateral ears. Ears with otorrhea were also compared with ears of other patients with dry tympanic perforation. Ears with suppuration were evaluated for cholesteatoma. The duration of otorrhea was considered. The sensorineural hearing threshold was evaluated for the frequencies of 500, 1,000, 2,000, and 4,000 Hz. A total of 98 patients with chronic otorrhea and 60 with dry tympanic membrane perforation were evaluated. A correlation between sensorineural hearing loss and chronic otorrhea was observed when compared with both contralateral normal ears and dry perforated ears of other patients. No relationship between hearing loss and the duration of suppuration or cholesteatoma was found. Sensorineural hearing loss occurs in ears with chronic otorrhea. The duration of otorrhea and the etiology of suppuration did not influence the hearing loss.

Análise dos resultados da triagem auditiva neonatal no município de Batatais / Newborn hearing screenin in Batatais county: analysis of results

Objetivo: Analisar os resultados do Programa de Triagem Auditiva Neonatal, no Munícipio de Batatais. Métodos: a casuística desta pesquisa foi composta por 4017 bebês avaliados, dos 4422 nascidos. O procedimento utilizado foi o exame de emissões otoacústicas transientes. Os dados foram retirados do banco de dados da instituição que realiza a triagem. Resultados: os achados mostraram falha em 365 bebês no teste, mas apenas 22 falhas no reteste, dos quais 4 foram diagnosticados como perda auditiva sensorioneural. O risco encontrado foi uso de antibiótico ototóxico. Conclusão: O programa de triagem auditiva da cidade de Batatais mostrou se efetivo ainda que realizado de forma ambulatorial. Acreditamos que isso se deva ao atrelamento do teste do pezinho e a realização exclusiva em uma única instituição, que é referência em atenção à saúde na cidade. Observou-se falha na TAN em apenas 0,5% dos bebês avaliados.((AU)

Purpose: analyse the results of the newborn hearing screening program in the county of Batatais. Methods: the sample of this research consisted of 4017 newborns assessed, in 4422 newborns. The procedure used was the examination of transient evoked otoacoustic emissions. The data were taken from the database of the institution that performs the hearing screening. Results: the findings showed failure in 365 newborns in the test, but, only 22 flaws in the retesting of which 4 were diagnosed with sensorineural hearing loss. The use of ototoxic antibiotics was the only risk factor observed. Conclusion: the hearing screening program in the city of Batatais seemed to be effective even if done on an outpatient basis. We believe that this is due to linkage of newborn screening and exclusive fulfillment in a single institution which is a benchmark in health care in the city. There was failure to TAN in only 0.5% of the assessed newborns. (AU)

[Objective comparison between perforation and hearing loss]. / Comparação objetiva entre perfuração timpânica e perda auditiva.

INTRODUCTION: There appears to be no relationship between the size of tympanic perforations and hearing loss. Some studies in the literature have assessed this connection, with conflicting data and without proper methodology, especially concerning the measurement of the size of the perforation, which was performed in a subjective manner. OBJECTIVE: To evaluate the size of tympanic perforations and to relate them to hearing loss in four different sound frequencies through the use of an objective method. METHODS: Transversal retrospective study. The present study evaluated 187 perforations through digital imaging, calculated the percentages of the tympanic membrane that was perforated using ImageScope software version 11.1.2.760 and correlated perforations' size with hearing loss at four frequencies. RESULTS: Data were statistically analyzed using Pearson's correlation test. CONCLUSION: There was no significant relationship between the size of tympanic perforations and hearing loss in the four analyzed frequencies.

Objective comparison between perforation and hearing loss / Comparação objetiva entre perfuração timpânica e perda auditiva

INTRODUCTION: There appears to be no relationship between the size of tympanic perforations and hearing loss. Some studies in the literature have assessed this connection, with conflicting data and without proper methodology, especially concerning the measurement of the size of the perforation, which was performed in a subjective manner. OBJECTIVE: To evaluate the size of tympanic perforations and to relate them to hearing loss in four different sound frequencies through the use of an objective method. METHODS: Transversal retrospective study. The present study evaluated 187 perforations through digital imaging, calculated the percentages of the tympanic membrane that was perforated using ImageScope software version 11.1.2.760 and correlated perforations size with hearing loss at four frequencies. RESULTS: Data were statistically analyzed using Pearson's correlation test. CONCLUSION: There was no significant relationship between the size of tympanic perforations and hearing loss in the four analyzed frequencies. .

INTRODUÇÃO: Parece não haver relação entre o tamanho das perfurações timpânicas e a perda auditiva. Alguns trabalhos na literatura estudaram esta relação, com dados conflitantes e sem uso adequado da metodologia empregada, principalmente quanto à medição do tamanho da perfuração que se faz de modo subjetivo. OBJETIVO: Analisar através de um método objetivo o tamanho dessas perfurações e relacioná-las com perdas auditivas em quatro frequências sonoras. MÉTODO: Estudo retrospectivo de corte transversal. Foram avaliadas 187 perfurações timpânicas através de digitalização de imagem, medidas porcentualmente com o uso do software ImageScope Version 11.1.2.760 e correlacionadas com os limiares auditivos em quatro frequências. RESULTADOS: Os dados foram avaliados estatisticamente pelo teste de correlação de Pearson, que não demonstrou correlação entre o tamanho da perfuração timpânica e o grau de perda auditiva. CONCLUSÃO: Não há relação significativa entre o tamanho das perfurações timpânicas e as quatro frequências estudadas. .

Correlação entre o perfil audiométrico, idade e o tempo de atividade em motoristas de ônibus / Correlation between audiometric profile, age and working time in bus drivers

OBJETIVO: relacionar o perfil audiométrico dos motoristas de ônibus com as variáveis idade e tempo de atividade. MÉTODO: foi realizado um estudo de Coorte retrospectivo, individual, comparativo, utilizando dados da avaliação audiológica de motoristas de ônibus de Porto Alegre e região metropolitana. RESULTADOS: foram avaliados 1113 motoristas com média de 40,33 anos de idade, e média de tempo de serviço de 4,16 anos. Observou-se perda auditiva neurossensorial bilateral na faixa de 3 a 6KHz, com tendência de maior alteração dos limiares auditivos para a orelha esquerda na faixa de 0,5 a 2 KHz. Os trabalhadores com mais idade e tempo de serviço foram os mais afetados, principalmente na faixa de frequências altas. CONCLUSÃO: observou-se uma piora nos limiares auditivos em frequências agudas em relação ao tempo de serviço quando comparados os resultados entre a primeira e última avaliação de cada trabalhador.

PURPOSE: to relate the audiometric profile of bus drivers with age and time activity. METHOD: this is a retrospective Cohort study, individual, comparative, using data from the audiological evaluation of bus drivers in Porto Alegre and its metropolitan area. RESULTS: there were 1113 drivers with an average of 40.33 years and average service time of 4.16 years. Bilateral sensorineural hearing loss were found in the range of 3 to 6 KHz, with a trend of biggest change in hearing thresholds for the left ear in the range from 05 to 2 KHz. Workers with more time of service and age were the most affected, mainly in the range of high frequencies. CONCLUSION: there was a worsening in hearing thresholds at high frequencies in relation to time of service when comparing the results between the first and the last evaluation of each worker.

Programa de triagem auditiva neonatal: resultados de um hospital universitário de Porto Alegre / Newborn hearing screening program: results from a university in Porto Alegre

Objetivo: Apresentar resultados obtidos no Programa de triagem auditiva neonatal (PTAN) e verificar se estão dentro das recomendações do Comitê Brasileiro sobre Perdas Auditivas na Infância para a Triagem Auditiva Neonatal Universal (TANU). Métodos: Estudos analíticos retrospectivos, de corte transversal, foram analisados exames realizados no período de junho de 2009 até junho de 2010. Resultados: No período analisado, nasceram 7.229 bebês. Destes 7.001 (96,8%) realizaram a Triagem Auditiva Neonatal (TAN), 853 (11%) foram encaminhados para o reteste, 81 (9%) não compareceram e 145 (18,8%) foram encaminhados para o ambulatório de Otorrinolaringologia para o início da avaliação médica e fonoaudiológica especializada. Conclusão: Verificando a recomendação do CBPAI podemos concluir que esta maternidade alcança os 95% de cobertura do exame, ultrapassa os índices preconizados de falso-positivos (reteste) e de encaminhamento para avaliação audiológica completa.

Objective: To evaluate the results of a neonatal hearing screening program (NHSP) and analyze whether they meet the recommendations of the Brazilian Committee on Hearing Loss in Children (CBPAI) for universal newborn hearing screening (UNHS). Methods: This cross-sectional retrospective study analyzed examinations conducted from June 2009 to June 2010. Results: Of the 7,229 babies born during the study time, 7,001 (96.8%) underwent newborn hearing screening (NHS): 853 (11%) were referred for retesting, 81 (9%) did not show up for results, and 145 (18.8%) were referred to an otolaryngologist to start specialized medical evaluations and speech therapy. Conclusion: According to CBPAI recommendation of CBPAI, this maternity ward reaches 95% coverage of the test and exceeds the recommended rates of false positive results (retest) and referral for full hearing assessment.

Spontaneous pneumoventricle following bariatric surgery: case report and review of literature

Pneumoventricle is a common postoperative event following posterior fossa approach, or any transventricular approach, with a benign evolution, rarely life-threatning. However, spontaneous pneumoventricle is a rare condition, almost always secondary to cerebrospinal fluid (CSF) leakage, with possible worse evolution. We describe a 57-year-old woman, previously healthy, submitted 7 months ago to a bariatric surgery, losing 110 pounds (50 Kg) since that, who developed 1 month ago headache, hemiparesis and incontinence, secondary to a spontaneous pneumoventricle. (au)

O pneumoventrículo é um evento comum no pós-operatório de cirurgias de fossa posterior, ou acessos transventriculares, com uma evolução benigna, raramente letal. Já o pneumoventrículo espontâneo é uma condição rara, quase sempre associado com fístula liquórica, com possível pior prognóstico. Neste trabalho descrevemos uma mulher de 57 anos, previamente hígida, submetida há 7 meses a uma cirurgia bariátrica, perdendo 50 Kg desde então, que há 1 mês apresentou cefaléia, hemiparesia e incontinência vesical, secundárias a um pneumoventrículo espontâneo.

Oculomotricity parameters in digital nystagmography among children with and without learning disorders.

UNLABELLED: The saccadic pathway involves numerous regions of the brain cortex, the cerebellum and the brainstem. Saccadic movement latency, velocity and precision parameters assess the efficacy of central nervous system (CNS) control over rapid eye movements. Very few disorders which alter the CNS are missed when these parameters are carefully measured using a computer. Pendular tracking assesses the integrity of the oculomotor system in controlling slow eye movements - vulnerable to CNS and vestibular system dysfunctions. Optokinetic nystagmus represents a stereoceptive response which compensates environment movements by psycho-optical inputs. AIMS: to compare the oculomotricity values found in children with and without learning complaints. MATERIALS AND METHODS: prospective study. We included in the study 28 children of both genders, within the age range between 8 and 12 years, with learning disorders (study group) and 15 without (control group). We carried out the fixed and randomized saccadic movement tests, pendular tracking study and optokinetic nystagmus. RESULTS: There was a statistically significant difference between the groups concerning the randomized saccadic movement velocity parameters and in the pendular tracking test. CONCLUSION: The children with learning disorders presented alterations in some oculomotricity tests when compared to children without complaints.

Oculomotricity parameters in digital nystagmography among children with and without learning disorders / Parâmetros de oculomotricidade à nistagmografia digital em crianças com e sem distúrbios de aprendizagem

The saccadic pathway involves numerous regions of the brain cortex, the cerebellum and the brainstem. Saccadic movement latency, velocity and precision parameters assess the efficacy of central nervous system (CNS) control over rapid eye movements. Very few disorders which alter the CNS are missed when these parameters are carefully measured using a computer. Pendular tracking assesses the integrity of the oculomotor system in controlling slow eye movements - vulnerable to CNS and vestibular system dysfunctions. Optokinetic nystagmus represents a stereoceptive response which compensates environment movements by psycho-optical inputs. AIMS: to compare the oculomotricity values found in children with and without learning complaints. MATERIALS AND METHODS: prospective study. We included in the study 28 children of both genders, within the age range between 8 and 12 years, with learning disorders (study group) and 15 without (control group). We carried out the fixed and randomized saccadic movement tests, pendular tracking study and optokinetic nystagmus. RESULTS: There was a statistically significant difference between the groups concerning the randomized saccadic movement velocity parameters and in the pendular tracking test. CONCLUSION: The children with learning disorders presented alterations in some oculomotricity tests when compared to children without complaints.

A via sacádica envolve várias regiões do córtex cerebral, cerebelo e tronco encefálico. Os parâmetros latência, velocidade e precisão dos movimentos sacádicos avaliam a eficiência do controle do sistema nervoso central (SNC) sobre os movimentos rápidos dos olhos. Poucas desordens que alteram o SNC deixam de ser detectadas quando esses parâmetros são medidos com rigor por meio de um computador. O rastreio pendular avalia a integridade do sistema oculomotor no controle dos movimentos oculares lentos, vulneráveis a disfunções do SNC e do sistema vestibular. O nistagmo optocinético representa uma resposta exteroceptiva que compensa os movimentos do meio ambiente por impulsos psico-ópticos. OBJETIVO: Comparar os valores da oculomotricidade encontrados em crianças com e sem queixas de aprendizagem. MATERIAL E MÉTODO: Estudo prospectivo. Foram incluídas no estudo 28 crianças, de ambos os gêneros, faixa etária de 8 a 12, anos com distúrbios de aprendizagem (grupo estudo) e 15 sem (grupo controle). Foram realizados os testes de movimentos sacádicos fixos e randomizados, pesquisa do rastreio pendular e nistagmo optocinético. RESULTADOS: Houve diferença estatisticamente significante entre os grupos nos parâmetros de velocidade dos movimentos sacádicos randomizados e na pesquisa do rastreio pendular. CONCLUSÃO: As crianças com distúrbios de aprendizagem apresentaram alterações em algumas provas de oculomotricidade quando comparadas com crianças sem queixas.

A imunização contra a rubéola no primeiro trimestre de gestação pode levar à perda auditiva? / Can the immunization against rubella take to the hearing loss in the first pregnancy quarter?

TEMA: embora o risco da Síndrome da Rubéola Congênita após a imunização seja pequeno, é necessário assegurar a imunidade das mulheres em idade fértil, especialmente daquelas com risco mais alto de exposição, visando a prevenção. OBJETIVO: esclarecer o risco que a imunização da rubéola apresenta para a audição do recém nascido, no primeiro trimestre de gestação. CONCLUSÃO: os levantamentos realizados por este estudo permitiram concluir que ainda há um grande caminho a ser percorrido em prol da erradicação da rubéola no Brasil, bem como a diminuição dos riscos de surdez neurossensorial causados pela Síndrome da Rubéola Congênita.

BACKGROUND: although congenital rubella syndrome risk after immunization is low, it is required to assert immunity of women in fertile age, especially those in higher risk of exposure aiming at prevention. PURPOSE: to elucidate the risk that rubella immunization in the first three months of gestation presents for the newborn hearing. CONCLUSION: investigations carried out by this study allow us to conclude that there is still a lot to be done in order to eradicate rubella in Brazil, as well as to reduce/decrease risks of neurosensorial deafness caused by CRS.

Objective method for facial motricity grading in healthy individuals and in patients with unilateral peripheral facial palsy.

PURPOSES: This study aimed (a) to associate the House and Brackmann grading system with a method of photographic evaluation and distance measuring between predetermined facial points, (b) to evaluate the objectivity of the method presented, and (c) to establish the grading pattern values for this method and their corresponding degrees in the House and Brackmann grading system. METHODS: This study presents a method for determining distances on each side of the face (eyebrow position and horizontal and vertical positions of mouth angle) related to 2 reference lines drawn from the internal ocular angles in photographs of 5 different facial expressions (at rest, eyes closed, eyebrows raised, smiling, and whistling) of 49 individuals with facial function from normal to total unilateral peripheral facial palsy. RESULTS: With this, an overall percentage of facial asymmetry was established. CONCLUSIONS: 1) It was possible to establish a correlation between the House and Brackmann grading system and a photographic evaluation method with measuring and comparative analysis of distances between predetermined facial points. 2) The method presented is objective. 3) Six percentages were established, which correlate to the 6 degrees of the House and Brackmann grading system. 4) The presented objective method is useful for documentation and following up of patients with peripheral facial palsy, particularly in university or medical training research studies.

Avaliação do processamento auditivo em operadores de telemarketing / Assessment of auditory processing on telemarketing operators

Objetivo: avaliar o processamento auditivo (PA) dos operadores de telemarketing quanto à decodificaçãoauditiva. Método: foram avaliados 20 sujeitos com idade entre 18 e 35 anos, de ambos os gêneros ,com jornada de trabalho de seis horas diárias, e até cinco anos de tempo de serviço na função,usuários de headset monoauricular e sem exposição prévia a ruído ocupacional. O grupo estudadoapresenta limiares auditivos dentro dos padrões de normalidade, timpanometria tipo A e reflexosacústicos presentes. Foi aplicado um questionário com objetivo de colher dados quanto às queixas,hábitos e sensações auditivas e foram realizados os testes de processamento de fala filtrada, RandomGap Detection Test (RGDT) e Masking Level Difference (MLD). Resultados: a análise do estudo foidescritiva, por meio de porcentagem onde observou-se que todos os indivíduos (com idade médiaentre 20 e 32 anos) apresentaram queixas características das desordens do processamento auditivo.Nos testes aplicados foram observadas 45% de alterações no RGDT e 25% no MLD, havendo umaassociação entre os testes de MLD alterados e o perfil de atuação no trabalho. Conclusão: esteestudo sugere que o profissional, operador de telemarketing pode apresentar desordens doprocessamento auditivo, com provável comprometimento da habilidade de interação binaural e resoluçãotemporal as quais mostraram-se alteradas em considerável parte destes indivíduos.

Purpose: to evaluate the auditory processing on telemarketing operators towards their auditorydecodification. Methods: there were evaluated 20 subjects from 18 to 35 years old, both genders, withsix hours a day work journey, and until five years as an operator, users of monoauricular headsets andwithout previous exposition to occupational noise. This group shows auditory thresholds in normalpattern, type A timpanometry, and auditory reflect. A questionnaire was applied to collect some datarelated to their complains, habits, and auditory sensations, and tests of filter speech processing werecarried out, Random Gap Detection Test (RGDT) and Masking Level Difference (MLD). Results: theanalysis by percentage showed that all the subjects (20 to 32-year old on average) showed characteristiccomplaints of auditory processing disorder. In the used tests we observed 45% RGDT and 25% MLDalteration. There was one association of the altered MLD test with the aspect of work performance.Conclusion: the evaluated subjects suggests that the telemarketing operators may show auditoryprocessing disorders with a probable compromising of temporal resolution and binaural interactionabilities that were altered in a considerable portion of these subjects.