Hidden Hearing Loss, Cochlear Synaptopathy and Occupational Noise / Pérdida Auditiva Oculta, Sinaptopatía Coclear y Ruido Ocupacional

Introducción: La sinaptopatía coclear por exposición a ruido (SCER) es definida como una alteración funcional transitoria o permanente de las sinapsis en cinta de las células pilosas internas de la cóclea. Este artículo tiene el objetivo de comentar la utilidad de la identificación temprana de la pérdida auditiva oculta por SCER basado en marcadores audiológicos y en la metodología usada en grupos clínicos para su búsqueda.Método: Revisión de la literatura relacionada en bases científicas y la narración descriptiva de los resultados.Resultados: La SCER produce una pérdida auditiva oculta en pacientes con audiograma normal, principalmente obreros o individuos expuestos a niveles de ruido intenso. Los principales estudios de identificación de la SCER han sido realizados principalmente en estudiantes universitarios o en músicos.Conclusiones: Son necesarios ajustes en la política de salud auditiva para una amplia identificación temprana de la SCER en las poblaciones en riesgo para la pérdida auditiva oculta y luchar por una regulación del daño. (AU)

Introduction: Cochlear synaptopathy after noise exposure (CSNE) is defined as the transient or permanent func-tional damage to the ribbon synapsis of the inner hair cells of the cochlea. This article has the objective of comment the usefulness of early identification of the hidden hearing loss after CSNE based on audiological markers and in changes in the clinical methodology in clinical groups for its searching.Method: Review of related literature in scientific databases and narrative description of results.Results: CSNE results in a hidden hearing loss in patients with normal pitch audiogram, mainly workers or indi-viduals exposed to high noise levels. The main studies of identification have been performed mainly in groups of students from college or musicians.Conclusions: Is necessary adjustments in hearing health policy for an wide early identification of CSNE in at risk populations for the identification of the hidden hearing loss and fight for its damage regulation. (AU)

Hidden Hearing Loss, Cochlear Synaptopathy and Occupational Noise / Pérdida Auditiva Oculta, Sinaptopatía Coclear y Ruido Ocupacional

Introducción: La sinaptopatía coclear por exposición a ruido (SCER) es definida como una alteración funcional transitoria o permanente de las sinapsis en cinta de las células pilosas internas de la cóclea. Este artículo tiene el objetivo de comentar la utilidad de la identificación temprana de la pérdida auditiva oculta por SCER basado en marcadores audiológicos y en la metodología usada en grupos clínicos para su búsqueda.Método: Revisión de la literatura relacionada en bases científicas y la narración descriptiva de los resultados.Resultados: La SCER produce una pérdida auditiva oculta en pacientes con audiograma normal, principalmente obreros o individuos expuestos a niveles de ruido intenso. Los principales estudios de identificación de la SCER han sido realizados principalmente en estudiantes universitarios o en músicos.Conclusiones: Son necesarios ajustes en la política de salud auditiva para una amplia identificación temprana de la SCER en las poblaciones en riesgo para la pérdida auditiva oculta y luchar por una regulación del daño (AU)

Introduction: Cochlear synaptopathy after noise exposure (CSNE) is defined as the transient or permanent func-tional damage to the ribbon synapsis of the inner hair cells of the cochlea. This article has the objective of comment the usefulness of early identification of the hidden hearing loss after CSNE based on audiological markers and in changes in the clinical methodology in clinical groups for its searching.Method: Review of related literature in scientific databases and narrative description of results.Results: CSNE results in a hidden hearing loss in patients with normal pitch audiogram, mainly workers or indi-viduals exposed to high noise levels. The main studies of identification have been performed mainly in groups of students from college or musicians.Conclusions: Is necessary adjustments in hearing health policy for an wide early identification of CSNE in at risk populations for the identification of the hidden hearing loss and fight for its damage regulation (AU)

Right cerebral hemisphere and central auditory processing in children with developmental dyslexia / El hemisferio cerebral derecho y el procesamiento auditivo central en ninos con dislexia del desarrollo

Objective We hypothesized that if the right hemisphere auditory processing abilities can be altered in children with developmental dyslexia (DD), we can detect dysfunction using specific tests. Method We performed an analytical comparative cross-sectional study. We studied 20 right-handed children with DD and 20 healthy right-handed control subjects (CS). Children in both groups were age, gender, and school-grade matched. Focusing on the right hemisphere’s contribution, we utilized tests to measure alterations in central auditory processing (CAP), such as determination of frequency patterns; sound duration; music pitch recognition; and identification of environmental sounds. We compared results among the two groups. Results Children with DD showed lower performance than CS in all CAP subtests, including those that preferentially engaged the cerebral right hemisphere. Conclusion Our data suggests a significant contribution of the right hemisphere in alterations of CAP in children with DD. Thus, right hemisphere CAP must be considered for examination and rehabilitation of children with DD. .

Objectivo Examinamos si las habilidades del procesamiento auditivo central (PAC) del hemisferio derecho se encuentran alteradas en niños con dislexia del desarrollo (DD), por medio de pruebas específicas. Método Realizamos un estudio comparativo transversal. Estudiamos 20 niños diestros con DD y 20 niños controles (C) sanos. Los niños de ambos grupos fueron pareados por edad, género y grado escolar. Utilizamos varias pruebas para medir alteraciones del PAC, tales como: determinación de patrones de frecuencia; duración del sonido; reconocimiento de tono musical e identificación de sonidos ambientales, enfatizando la contribución del hemisferio derecho. Comparamos los resultados entre los niños con DD y C. Resultados Los niños con DD mostraron menores puntuaciones que los C en todas las subpruebas del PAC, incluyendo aquellas que involucran preferencialmente al hemisferio cerebral derecho. Conclusión Los datos obtenidos sugieren una contribución significativa del hemisferio derecho para producir alteraciones del PAC en niños con DD. Por lo tanto, las PAC que involucran al hemisferio derecho deben ser consideradas en la evaluación y rehabilitación de niño s con DD. .

Evaluación de pruebas psicoacústicas y de potenciales relacionados a eventos P300 en adultos mayores con hiperhomocisteinemia / Evaluation of psychoacoustic tests and P300 event-related potentials in elderly patients with hyperhomocysteinemia

Introducción y objetivos: La hiperhomocisteinemia como un factor de riesgo para el daño auditivo, el daño neuronal y el deterioro cognitivo en los pacientes adultos mayores es controvertido y se encuentra limitado por un pequeño número de estudios. El objetivo de este trabajo es determinar si los pacientes adultos mayores con hiperhomocisteinemia presentan mayor riesgo de desarrollar alteraciones en los procesos centrales de la audición frente a un grupo de pacientes con niveles de homocisteína adecuados, y definir el comportamiento de las pruebas psicoacústicas y de potenciales de latencia larga (P300) en estos grupos. Método: Estudio transversal, comparativo y analítico. Se formó un grupo de pacientes con hiperhomocisteinemia y un grupo control con valores normales de homocisteína. A todos los pacientes se les realizó audiometría tonal, impedanciometría y una selección de pruebas psicoacústicas (dígitos dicóticos, palabras filtradas pasa bajo, palabra en ruido y diferencia en niveles de enmascaramiento), así como potenciales evocados auditivos de tallo cerebral y P300. Resultados: Los pacientes con hiperhomocisteinemia presentaron valores en la prueba de diferencia en los niveles de enmascaramiento superiores a los del grupo control (p = 0,049), así como latencias más prologadas en los P300 (p = 0,000). Conclusiones: La hiperhomocisteinemia es un factor que altera las funciones auditivas centrales. Las pruebas psicoacústicas alteradas junto con la alteración en las pruebas electrofisiológicas sugieren que la porción central de la vía auditiva está afectada en los pacientes con hiperhomocisteinemia (AU)

Introduction and objectives: Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. Methods: This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. Results: Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=0.049) and more protracted latency in P300 (P=0.000). Conclusions: Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia (AU)

Evaluation of psychoacoustic tests and P300 event-related potentials in elderly patients with hyperhomocysteinemia.

INTRODUCTION AND OBJECTIVES: Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. METHODS: This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. RESULTS: Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=.049) and more protracted latency in P300 (P=.000). CONCLUSIONS: Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia.

Right cerebral hemisphere and central auditory processing in children with developmental dyslexia.

OBJECTIVE: We hypothesized that if the right hemisphere auditory processing abilities can be altered in children with developmental dyslexia (DD), we can detect dysfunction using specific tests. METHOD: We performed an analytical comparative cross-sectional study. We studied 20 right-handed children with DD and 20 healthy right-handed control subjects (CS). Children in both groups were age, gender, and school-grade matched. Focusing on the right hemisphere's contribution, we utilized tests to measure alterations in central auditory processing (CAP), such as determination of frequency patterns; sound duration; music pitch recognition; and identification of environmental sounds. We compared results among the two groups. RESULTS: Children with DD showed lower performance than CS in all CAP subtests, including those that preferentially engaged the cerebral right hemisphere. CONCLUSION: Our data suggests a significant contribution of the right hemisphere in alterations of CAP in children with DD. Thus, right hemisphere CAP must be considered for examination and rehabilitation of children with DD.

Síndrome de Sjögren comportamiento clínico y audiológico en función de la edad / Sjögren's syndrome: Audiological and clinical behaviour in terms of age

Introducción y objetivo: Determinar el comportamiento clínico y audiológico por grupos de edad en el síndrome de Sjögren (SS) considerando que esta es la segunda enfermedad reumatológica autoinmune más frecuente. Material y método: Se trata de 29 pacientes con SS con historia clínica y estudios audiológicos. Diseño prospectivo, descriptivo y transversal. Resultados: La edad promedio es de 41 años, todos los pacientes que presentaron hipoacusia en la audiometría tonal convencional fueron de tipo sensorial. En frecuencias altas 66% de los pacientes no tienen respuesta a 20kHz y el 48% para la frecuencia de 16kHz. En logoaudiometría e impedanciometría los resultados fueron los esperados para los umbrales auditivos. Conclusiones: El daño auditivo relacionado con SS probablemente se ubica en el oído interno. Estos pacientes deben estar informados por su médico tratante del riesgo de presentar daño auditivo como complicación de su enfermedad. La valoración audiológica se debe realizar de forma periódica para identificar precozmente los posibles daños audiológicos (AU)

Introduction and objective: To determine the clinical and audiological behaviour per age group in Sjögren's Syndrome (SS), considering that it is the second most frequent autoimmune rheumatic disease. Material and method: The study included 29 patients with SS with clinical history and audiological studies. The design was prospective, descriptive and transversal. Results: Average patient age was 41 years. All the patients with hearing loss in conventional tone audiometry were of the sensory type. At high frequencies, 66% of the patients did not respond at 20KHz, and 48% at the frequency of 16KHz. In logoaudiometry and impedancemetry, the results were the ones expected for the auditory thresholds. Conclusions: Auditory damage related to SS is located in the inner ear. Patients must be informed by their physician of the risk of having auditory damage as a complication of the disease. Audiological evaluation must be performed periodically to identify possible audiological damage (AU)

[Sjögren's syndrome: Audiological and clinical behaviour in terms of age]. / Síndrome de Sjögren comportamiento clínico y audiológico en función de la edad.

INTRODUCTION AND OBJECTIVE: To determine the clinical and audiological behaviour per age group in Sjögren's Syndrome (SS), considering that it is the second most frequent autoimmune rheumatic disease. MATERIAL AND METHOD: The study included 29 patients with SS with clinical history and audiological studies. The design was prospective, descriptive and transversal. RESULTS: Average patient age was 41 years. All the patients with hearing loss in conventional tone audiometry were of the sensory type. At high frequencies, 66% of the patients did not respond at 20 KHz, and 48% at the frequency of 16 KHz. In logoaudiometry and impedancemetry, the results were the ones expected for the auditory thresholds. CONCLUSIONS: Auditory damage related to SS is located in the inner ear. Patients must be informed by their physician of the risk of having auditory damage as a complication of the disease. Audiological evaluation must be performed periodically to identify possible audiological damage.

[Peripheral and central audiologic findings in patients with Vogt-Koyanagi-Harada syndrome]. / Hallazgos audiológicos, periféricos y centrales en pacientes con síndrome de Vogt-Koyanagi-Harada.

OBJECTIVE: To identify and describe peripheral and central audiological abnormalities of patients with Vogt Koyanagi Harada syndrome. MATERIALS AND METHODS: Prospective, cross-sectional, observational, descriptive study. Vogt Koyanagi Harada patients referred from an ophthalmologic centre were assessed for signs and symptoms of auditory pathology. Peripheral audiological and central auditory processing tests were performed. To standardize the latter, methodological controls were matched for sex, age and audiometric chart. RESULTS: 21 patients were included (3 male, 18 female), mean age 40.7 years (+/-11.82). Nine of the 21 complained of tinnitus and nine suspected hearing loss. Exclusively or mainly sensorial abnormalities of pure tone audiometric chart were documented in 61.9% (mainly selective troughs at 4 and 8 kHz); 95.3% of patients had deficit in high-frequency audiometry. Five of the patients had sensorial disorders in the speech audiometry. No central auditory processing disorder was seen. CONCLUSIONS: Most of the patients with Vogt Koyanagi Harada syndrome had objective peripheral audiological abnormalities, although few revealed any symptoms.

Hallazgos audiológicos, periféricos y centrales en pacientes con síndrome de Vogt-Koyanagi-Harada / Peripheral and central audiologic findings in patients with Vogt-Koyanagi-Harada syndrome

Objetivo: Identificar y describir alteraciones audiológicas periféricas y centrales en pacientes con síndrome de Vogt-Koyanagi-Harada (VKH). Material y métodos: Estudio prospectivo, transversal, observacional y descriptivo. Buscamos en pacientes con VKH, referidos de centro oftalmológico, síntomas y signos de alteración audiológica y realizamos pruebas audiológicas periféricas y de procesos centrales de la audición (PCA). Para estandarizar estas últimas, utilizamos controles metodológicos pareados por edad, sexo y curva audiométrica. Resultados: Incluimos 21 pacientes (3 varones y 18 mujeres), edad promedio: 40,7 años (±11,82). Nueve de los 21 pacientes presentaron acúfeno y en 9 se sospechó hipoacusia. Documentamos alteración, exclusiva o mayoritariamente sensorial, de la audiometría convencional en el 61,9% (mayoritariamente caídas selectivas a 4 y 8kHz) y de altas frecuencias en el 95,3% de los pacientes. Cinco de los 21 pacientes presentaron alteraciones sensoriales de la logoaudiometría. No se concluyó alteración de PCA. Conclusiones: La mayoría de los pacientes con VKH presentaron alteraciones objetivas de la función auditiva periférica, aunque pocos manifestaron sintomatología (AU)

Objective: To identify and describe peripheral and central audiological abnormalities of patients with Vogt Koyanagi Harada syndrome. Materials and methods: Prospective, cross-sectional, observational, descriptive study. Vogt Koyanagi Harada patients referred from an ophthalmologic centre were assessed for signs and symptoms of auditory pathology. Peripheral audiological and central auditory processing tests were performed. To standardize the latter, methodological controls were matched for sex, age and audiometric chart. Results: 21 patients were included (3 male, 18 female), mean age 40.7 years (±11.82). Nine of the 21 complained of tinnitus and nine suspected hearing loss. Exclusively or mainly sensorial abnormalities of pure tone audiometric chart were documented in 61.9% (mainly selective troughs at 4 and 8kHz); 95.3% of patients had deficit in high-frequency audiometry. Five of the patients had sensorial disorders in the speech audiometry. No central auditory processing disorder was seen. Conclusions: Most of the patients with Vogt Koyanagi Harada syndrome had objective peripheral audiological abnormalities, although few revealed any symptoms (AU)

[Auditory and corporal laterality, logoaudiometry, and monaural hearing aid gain]. / Lateralidad auditiva y corporal, logoaudiometría y ganancia del audífono monoaural. Aplicación en hipoacusia bilateral simétrica.

INTRODUCTION AND OBJECTIVE: To identify the auditory or clinical test that has the best correlation with the ear in which we apply the monaural hearing aid in symmetric bilateral hearing loss. MATERIAL AND METHOD: A total of 37 adult patients with symmetric bilateral hearing loss were examined regarding the correlation between the best score in speech discrimination test, corporal laterality, auditory laterality with dichotic digits in Spanish and score for filtered words with monaural hearing aid. RESULTS: The best correlation was obtained between auditory laterality and gain with hearing aid (0.940). CONCLUSIONS: The dichotic test for auditory laterality is a good tool for identifying the best ear in which to apply a monaural hearing aid. The results of this paper suggest the necessity to apply this test in patients before a hearing aid is indicated.

Lateralidad auditiva y corporal, logoaudiometría y ganancia del audífono monoaural. Aplicación en hipoacusia bilateral simétrica / Auditory and corporal laterality, logoaudiometry, and monaural hearing aid gain

Introducción y objetivo: Identificar la correlación de las pruebas audiológicas o clínicas respecto al lado en que se obtiene la mejor ganancia del auxiliar auditivo monoaural en hipoacusia bilateral simétrica. Material y método: Se examinó a 37 pacientes adultos con hipoacusia bilateral simétrica, respecto a la correlación entre la máxima captación fonémica de la logoaudiometría, la lateralidad corporal, la lateralidad auditiva con la prueba de dígitos dióticos en español, la utilidad social de la audición y la ganancia de auxiliares auditivos. Resultados: La correlación más alta se obtuvo para lateralidad auditiva respecto a la ganancia del audífono (0,940). Conclusiones: La prueba de dígitos dióticos para la lateralidad auditiva es útil para identificar el mejor oído para la aplicación monoaural de auxiliar auditivo en casos de hipoacusia bilateral simétrica. Este resultado es importante, ya que indica la necesidad de aplicar la prueba de lateralidad auditiva antes de indicar el uso de auxiliar auditivo

Introduction and objective: To identify the auditory or clinical test that has the best correlation with the ear in which we apply the monaural hearing aid in symmetric bilateral hearing loss. Material and method: A total of 37 adult patients with symmetric bilateral hearing loss were examined regarding the correlation between the best score in speech discrimination test, corporal laterality, auditory laterality with dichotic digits in Spanish and score for filtered words with monaural hearing aid. Results: The best correlation was obtained between auditory laterality and gain with hearing aid (0.940). Conclusions: The dichotic test for auditory laterality is a good tool for identifying the best ear in which to apply a monaural hearing aid. The results of this paper suggest the necessity to apply this test in patients before a hearing aid is indicated