Audiological Tests Used in the Evaluation of the Effects of Solvents on the Human Auditory System: A Mixed Methods Review.

This study aimed to scope the literature, identify knowledge gaps, appraise results, and synthesize the evidence on the audiological evaluation of workers exposed to solvents. We searched Medline, PubMed, Embase, CINAHL, and NIOSHTIC-2 up to March 22, 2021. Using Covidence, two authors independently assessed study eligibility, risk of bias, and extracted data. National Institute of Health Quality Assessment Tools was used in the quality evaluation of included studies; the Downs and Black checklist was used to assess the risk of bias. Of 454 located references, 37 were included. Twenty-five tests were studied: two tests to measure hearing thresholds, one test to measure word recognition in quiet, six electroacoustic procedures, four electrophysiological tests, and twelve behavioral tests to assess auditory processing skills. Two studies used the Amsterdam Inventory for Auditory Disability and Handicap. The quality of individual studies was mostly considered moderate, but the overall quality of evidence was considered low. The discrepancies between studies and differences in the methodologies/outcomes prevent recommending a specific test battery to assess the auditory effects of occupational solvents. Decisions on audiological tests for patients with a history of solvent exposures require the integration of the most current research evidence with clinical expertise and stakeholder perspectives.

Efeito da infecção por COVID-19 na via auditiva até tronco encefálico / Effect of COVID-19 infection on the auditory pathway to the brainstem / Efecto de la infección por COVID-19en la vía auditiva hacia el tronco del encéfalo

Introdução: A COVID-19 pode afetar o sistema auditivo, justificando a avaliação da audição de indivíduos infectados. Objetivo: analisar a via auditiva até o tronco encefálico de indivíduos acometidos por COVID-19 comparados ao grupo controle. Método: Estudo observacional transversal analítico realizado em uma amostra não probabilística de adultos que tiveram COVID-19, que foram comparados com um grupo controle, sem queixa auditiva. A avaliação consistiu em: medidas de imitância acústica, audiometria tonal liminar (ATL), emissões otoacústicas evocadas por estímulo transiente (EOET) e potencial evocado auditivo de tronco encefálico (PEATE). Resultados: Foram avaliados 77 indivíduos, sendo, 41 participantes do grupo COVID-19 (idade média de 26,3) e 36 do grupo controle (idade média de 25,8). Os limiares auditivos estavam dentro dos padrões da normalidade para todos os indivíduos do grupo COVID-19, sendo significativamente maiores para as frequências de 1000, 2000 e 3000 Hz à direita. A amplitude das EOET foi significativamente menor na banda de frequência de 1500 à direita. Houve correlação significativa e negativa para as frequências de 1000 Hz e 3000 Hz à direita e para as frequências de 1000, 2000 e 3000 Hz à esquerda, entre EOET e ATL. Foi verificado aumento da latência absoluta da onda I, do PEATE, na orelha esquerda. Conclusão: a COVID-19 afetou locais específicos do sistema auditivo. Houve diminuição da acuidade auditiva e do funcionamento das células ciliadas externas da cóclea, bem como aumento do tempo de condução neural do som na porção distal do VII par craniano à esquerda. (AU)

Introduction: COVID-19 can affect the auditory system, justifying the evaluation of the hearing of infected individuals. Objective: to analyze the auditory pathway to the brainstem of individuals affected by COVID-19 compared to the control group. Method: Analytical cross-sectional observational study carried out in a non-probabilistic sample of adults who had COVID-19, who were compared with a control group, without hearing complaints. The evaluation consisted of: acoustic immittance measurements, pure tone audiometry (PTA), transient stimulus-evoked otoacoustic emissions (TEOAE) and brainstem auditory evoked potential (BAEP). Results: 77 individuals were evaluated, 41 participants in the COVID-19 group (average age of 26.3) and 36 in the control group (average age of 25.8). Hearing thresholds were within normal limits for all individuals in the COVID-19 group, being significantly higher for the frequencies of 1000, 2000 and 3000 Hz on the right. TEOAE amplitude was significantly lower in the 1500 frequency band on the right. There was a significant and negative correlation for the frequencies of 1000 Hz and 3000 Hz on the right and for the frequencies of 1000, 2000 and 3000 Hz on the left, between TEOAE and PTA. An increase in the absolute latency of wave I, of the BAEP, was observed in the left ear. Conclusion: COVID-19 affected specific locations in the auditory system. There was a decrease in auditory acuity and the functioning of the outer hair cells of the cochlea, as well as an increase in the neural conduction time of sound in the distal portion of the VII cranial nerve on the left. (AU)

Introducción: COVID-19 puede afectar el sistema auditivo, justificando la evaluación de la audición de individuos infectados. Objetivo: analizar la vía auditiva hacia el tronco encefálico de individuos afectados por COVID-19 en comparación con el grupo control. Método: Estudio observacional analítico transversal realizado en una muestra no probabilística de adultos que padecieron COVID-19, quienes fueron comparados con un grupo control, sin escuchar quejas. La evaluación consistió en: mediciones de inmitancia acústica, audiometría de tonos puros (ATP), otoemisiones acústicas provocadas por estímulos transitorios (OAET) y potenciales evocados auditivos del tronco encefálico (PEATE). Resultados: Se evaluaron 77 individuos, 41 participantes en el grupo COVID-19 (edad promedio de 26,3 años) y 36 en el grupo control (edad promedio de 25,8 años). Los umbrales de audición estaban dentro de los límites normales para todos los individuos del grupo de COVID-19, siendo significativamente más altos para las frecuencias de 1000, 2000 y 3000 Hz de la derecha. La amplitud de OAET fue significativamente menor en la banda de frecuencia de 1500 de la derecha. Hubo correlación significativa y negativa para las frecuencias de 1000 Hz y 3000 Hz a la derecha y para las frecuencias de 1000, 2000 y 3000 Hz a la izquierda, entre OAET y ATP. Se observó un aumento de la latencia absoluta de la onda I, del PEATE, en el oído izquierdo. Conclusión: COVID-19 afectó ubicaciones específicas del sistema auditivo. Hubo una disminución de la agudeza auditiva y del funcionamiento de las células ciliadas externas de la cóclea, así como un aumento del tiempo de conducción neural del sonido en la porción distal del VII par craneal izquierdo. (AU)

Temporary and Permanent Auditory Effects Associated with Occupational Coexposure to Low Levels of Noise and Solvents.

This study aimed to assess temporary and permanent auditory effects associated with occupational coexposure to low levels of noise and solvents. Cross-sectional study with 25 printing industry workers simultaneously exposed to low noise (<80 dBA TWA) and low levels of solvents. The control group consisted of 29 industry workers without the selected exposures. Participants answered a questionnaire and underwent auditory tests. Auditory fatigue was measured by comparing the acoustic reflex threshold before and after the workday. Workers coexposed to solvents and noise showed significantly worse results in auditory tests in comparison with the participants in the control group. Auditory brainstem response results showed differences in III−V interpeak intervals (p = 0.046 in right ear; p = 0.039 in left ear). Mean dichotic digits scores (exposed = 89.5 ± 13.33; controls = 96.40 ± 4.46) were only different in the left ear (p = 0.054). The comparison of pre and postacoustic reflex testing indicated mean differences (p = 0.032) between the exposed (4.58 ± 6.8) and controls (0 ± 4.62) groups. This study provides evidence of a possible temporary effect (hearing fatigue) at the level of the acoustic reflex of the stapedius muscle. The permanent effects were identified mainly at the level of the high brainstem and in the auditory ability of binaural integration.

[Self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents: a population-based study]. / Dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores: um estudo de base populacional.

This study's objective was to estimate the association between self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents in Brazilian workers. This was a cross-sectional study with data from the Brazilian National Health Survey (PNS-2013). The dependent variable was self-reported hearing impairment, and three principal exposures were analyzed: noise, industrial dust, and chemical substances. Logistic regression was performed, estimating crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI). The principal exposure variables were adjusted for each other and by covariables sex, age, workplace, time on the job, and hypertension. 36,442 workers participated in the study. Higher prevalence of hearing impairment was seen in workers exposed to industrial dust (9.9%) (p < 0.001). The older the worker and the longer the time on the job, the higher the prevalence of hearing impairment (p < 0.001). In the adjusted analysis, workers exposed to noise showed 1.65 higher odds of reporting difficulty hearing, when compared to unexposed individuals (p < 0.001). The same was true for workers exposed to industrial dust (OR = 1.36) (p = 0.012). No association was observed between the outcome and exposure to chemical substances (p = 0.120). There was an association between hearing impairment and occupational exposure to noise and industrial dust in Brazilian workers. This emphasizes the importance of strengthening public policies for hearing health and the development of measures for prevention and auditory monitoring in the workplace.

O objetivo deste estudo foi estimar a associação entre dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores em trabalhadores brasileiros. Trata-se de um estudo transversal realizado com dados da Pesquisa Nacional de Saúde (PNS-2013). A variável dependente foi a dificuldade auditiva autorreferida, e foram analisadas três exposições principais: ruído, poeira industrial e substâncias químicas. Realizou-se análise de regressão logística, estimando-se as odds ratio (OR) brutas e ajustadas, com intervalos de 95% de confiança (IC95%). As variáveis principais de exposição foram ajustadas entre si e pelas covariáveis sexo, idade, ambiente de trabalho, tempo de trabalho e hipertensão arterial. Participaram deste estudo 36.442 trabalhadores. Maior prevalência de dificuldade auditiva foi observada em indivíduos expostos à poeira industrial (9,9%) (p < 0,001). Além disso, quanto maior a idade do trabalhador e tempo de trabalho, maior foi a prevalência do desfecho (p < 0,001). Na análise ajustada, trabalhadores expostos a ruído apresentaram 1,65 vez mais chance de referir dificuldade auditiva, quando comparados aos indivíduos não expostos (p < 0,001). O mesmo ocorreu com trabalhadores expostos à poeira industrial (OR = 1,36) (p = 0,012). Não foi observada associação entre o desfecho e a variável exposição a substâncias químicas (p = 0,120). Observou-se associação entre dificuldade auditiva e exposição ocupacional a ruído e à poeira industrial em trabalhadores brasileiros. Reforçam-se a importância do aprimoramento de políticas públicas em saúde auditiva e o desenvolvimento de ações voltadas à prevenção e ao monitoramento auditivo em ambiente ocupacional.

El objetivo de este estudio fue estimar la asociación entre dificultad auditiva autoinformada y la exposición ocupacional a agentes otoagresores en trabajadores brasileños. Se trata de un estudio transversal, realizado con datos de la Encuesta Nacional de Salud (PNS-2013). La variable dependiente fue la dificultad auditiva autoinformada y se analizaron tres exposiciones principales: ruido, polvo industrial y substancias químicas. Se realizó un análisis de regresión logística, estimándose las odds ratio (OR) brutas y ajustadas, con intervalos de un 95% de confianza (IC95%). Las variables principales de exposición fueron ajustadas entre sí y por las covariables: sexo, edad, ambiente de trabajo, tiempo de trabajo e hipertensión arterial. Participaron en este estudio 36.442 trabajadores. La mayor prevalencia de dificultad auditiva se observó en individuos expuestos al polvo industrial (9,9%) (p < 0,001). Asimismo, cuanto mayor era la edad del trabajador y tiempo de trabajo, mayor fue la prevalencia del desenlace (p < 0,001). En el análisis ajustado, los trabajadores expuestos a ruido presentaron 1,65 veces más oportunidad de informar de dificultad auditiva, cuando se comparan con los individuos no expuestos (p < 0,001). Lo mismo sucedió con trabajadores expuestos a polvo industrial (OR = 1,36) (p = 0,012). No se observó una asociación entre el desenlace y la variable exposición a sustancias químicas (p = 0,120). Se observó una asociación entre dificultad auditiva y exposición ocupacional a ruido y polvo industrial en trabajadores brasileños. Se refuerza la importancia del perfeccionamiento de políticas públicas en salud auditiva y desarrollo de acciones dirigidas a la prevención y monitoreo auditivo en el entorno laboral.

Dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores: um estudo de base populacional / Self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents: a population-based study / Dificultad auditiva autoinformada y exposición ocupacional a agentes otoagresores: un estudio de base poblacional

O objetivo deste estudo foi estimar a associação entre dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores em trabalhadores brasileiros. Trata-se de um estudo transversal realizado com dados da Pesquisa Nacional de Saúde (PNS-2013). A variável dependente foi a dificuldade auditiva autorreferida, e foram analisadas três exposições principais: ruído, poeira industrial e substâncias químicas. Realizou-se análise de regressão logística, estimando-se as odds ratio (OR) brutas e ajustadas, com intervalos de 95% de confiança (IC95%). As variáveis principais de exposição foram ajustadas entre si e pelas covariáveis sexo, idade, ambiente de trabalho, tempo de trabalho e hipertensão arterial. Participaram deste estudo 36.442 trabalhadores. Maior prevalência de dificuldade auditiva foi observada em indivíduos expostos à poeira industrial (9,9%) (p < 0,001). Além disso, quanto maior a idade do trabalhador e tempo de trabalho, maior foi a prevalência do desfecho (p < 0,001). Na análise ajustada, trabalhadores expostos a ruído apresentaram 1,65 vez mais chance de referir dificuldade auditiva, quando comparados aos indivíduos não expostos (p < 0,001). O mesmo ocorreu com trabalhadores expostos à poeira industrial (OR = 1,36) (p = 0,012). Não foi observada associação entre o desfecho e a variável exposição a substâncias químicas (p = 0,120). Observou-se associação entre dificuldade auditiva e exposição ocupacional a ruído e à poeira industrial em trabalhadores brasileiros. Reforçam-se a importância do aprimoramento de políticas públicas em saúde auditiva e o desenvolvimento de ações voltadas à prevenção e ao monitoramento auditivo em ambiente ocupacional.

This study's objective was to estimate the association between self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents in Brazilian workers. This was a cross-sectional study with data from the Brazilian National Health Survey (PNS-2013). The dependent variable was self-reported hearing impairment, and three principal exposures were analyzed: noise, industrial dust, and chemical substances. Logistic regression was performed, estimating crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI). The principal exposure variables were adjusted for each other and by covariables sex, age, workplace, time on the job, and hypertension. 36,442 workers participated in the study. Higher prevalence of hearing impairment was seen in workers exposed to industrial dust (9.9%) (p < 0.001). The older the worker and the longer the time on the job, the higher the prevalence of hearing impairment (p < 0.001). In the adjusted analysis, workers exposed to noise showed 1.65 higher odds of reporting difficulty hearing, when compared to unexposed individuals (p < 0.001). The same was true for workers exposed to industrial dust (OR = 1.36) (p = 0.012). No association was observed between the outcome and exposure to chemical substances (p = 0.120). There was an association between hearing impairment and occupational exposure to noise and industrial dust in Brazilian workers. This emphasizes the importance of strengthening public policies for hearing health and the development of measures for prevention and auditory monitoring in the workplace.

El objetivo de este estudio fue estimar la asociación entre dificultad auditiva autoinformada y la exposición ocupacional a agentes otoagresores en trabajadores brasileños. Se trata de un estudio transversal, realizado con datos de la Encuesta Nacional de Salud (PNS-2013). La variable dependiente fue la dificultad auditiva autoinformada y se analizaron tres exposiciones principales: ruido, polvo industrial y substancias químicas. Se realizó un análisis de regresión logística, estimándose las odds ratio (OR) brutas y ajustadas, con intervalos de un 95% de confianza (IC95%). Las variables principales de exposición fueron ajustadas entre sí y por las covariables: sexo, edad, ambiente de trabajo, tiempo de trabajo e hipertensión arterial. Participaron en este estudio 36.442 trabajadores. La mayor prevalencia de dificultad auditiva se observó en individuos expuestos al polvo industrial (9,9%) (p < 0,001). Asimismo, cuanto mayor era la edad del trabajador y tiempo de trabajo, mayor fue la prevalencia del desenlace (p < 0,001). En el análisis ajustado, los trabajadores expuestos a ruido presentaron 1,65 veces más oportunidad de informar de dificultad auditiva, cuando se comparan con los individuos no expuestos (p < 0,001). Lo mismo sucedió con trabajadores expuestos a polvo industrial (OR = 1,36) (p = 0,012). No se observó una asociación entre el desenlace y la variable exposición a sustancias químicas (p = 0,120). Se observó una asociación entre dificultad auditiva y exposición ocupacional a ruido y polvo industrial en trabajadores brasileños. Se refuerza la importancia del perfeccionamiento de políticas públicas en salud auditiva y desarrollo de acciones dirigidas a la prevención y monitoreo auditivo en el entorno laboral.

Auditory system dysfunction in Brazilian gasoline station workers.

Objective: To examine the auditory system of Brazilian gasoline station workers using an extensive audiological test battery. Design: This was a cross-sectional study. The audiological evaluation included a questionnaire, pure-tone audiometry, acoustic immittance tests, transient-evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), auditory brainstem response (ABR) and P300 auditory-evoked potentials. Study sample: A total of 77 Brazilian gasoline station workers were evaluated, and their results were compared with those of 36 participants who were not exposed to chemicals or noise at work. The gasoline station employees worked in 18 different gas stations, and the noise area measurements from all gas stations revealed time-weighted averages below 85 dBA. Results: Of the 77 gasoline station workers evaluated, 67.5% had audiometric results within the normal range, but 59.7% reported difficulties in communication in noisy places. Gasoline station workers showed significantly poorer results than non-exposed control participants in one or more conditions of each of the audiological tests used, except P300. Conclusions: The results suggest that the gasoline station workers have both peripheral and central auditory dysfunctions that could be partly explained by their exposure to gasoline.

Study of the prevalence of impaired hearing and its determinants in the city of Itajaí, Santa Catarina State, Brazil.

UNLABELLED: The number of people with impaired hearing is increasing; knowing its magnitude is essential for public health. OBJECTIVE: To study the prevalence and determinants of impaired hearing in Itajaí/SC. METHODS: A population-based survey based on a World Health Organization protocol. Field research was carried out from July 2008 to 2011. Procedures for evaluating hearing in households: questionnaire, measurement of noise, otoscopy, pure tone audiometry at 1000, 2000, and 4000 Hz, tympanometry, and acoustic reflexes: individuals above 4 years; children under 4 years: evoked otoacoustic emissions (OAE), cocleo-palpebral reflex(CPR), tympanometry, and acoustic reflexes. In the elderly population a questionnaire of perception of hearing loss was applied. RESULTS: The study sample consisted of 379 individuals--45.38% were males and 54.62% were females. Age-range: 11.34% up to 10 years; 64.39% 10 to 60 years, 24.27% over 60 years. Evaluation of the best hearing ear showed that 74.1% of residents had normal hearing, 18.9% had mild hearing loss, 5.1% had moderate hearing loss, 1.9% had severe hearing loss. Disabling impaired hearing was detected in 26 subjects: one child (otitis media); four adults (one otitis, one noise-induced, two idiopathic); 21 elderlies (presbyacusis). Of eight children under 4 years all presented CPR, three were normal examinations, two had absent OAE bilaterally, one had absent OAE in the right ear and one in the left ear. CONCLUSION: The prevalence of disabling impaired hearing in Itajaí was 7%; the highest prevalence was in the 50-year and above age group--the main cause was presbyacusis.

Estudo da prevalência e fatores determinantes da deficiência auditiva no município de Itajaí, SC / Study of the prevalence of impaired hearing and its determinants in the city of Itajaí, Santa Catarina State, Brazil

O número de pessoas com deficiência auditiva vem aumentando e o conhecimento de sua magnitude é fundamental no planejamento das gestões públicas em saúde. OBJETIVO: Estudar a prevalência e os determinantes da deficiência auditiva no Município de Itajaí/SC. MÉTODOS: O estudo foi de amostragem populacional, seguindo protocolo da Organização Mundial de Saúde. A pesquisa de campo foi realizada entre julho de 2008 e 2011. Procedimentos realizados nos domicílios: questionário, medição do ruído, otoscopia, limiares auditivos em 1000, 2000 e 4000 Hertz, timpanometria e reflexos acústicos: indivíduos acima de 4 anos; crianças até 4 anos: emissões otoacústicas evocadas (OEA), reflexo cócleo-palpebral (RCP), timpanometria e reflexos acústicos. Nos idosos, aplicou-se questionário de percepção da perda auditiva. RESULTADOS: A amostra foi constituída por 379 indivíduos; 45,38% do sexo masculino e 54,62% feminino. Quanto às faixas-etárias: 11,34% até 10 anos; 64,39% 10 a 60 anos e 24,27% acima de 60 anos. Avaliando-se a audição da melhor orelha, os moradores apresentaram: 74,1% audição normal, 18,9% deficiência auditiva leve, 5,1% moderada, 1,9% grave. As deficiências auditivas incapacitantes foram detectadas em 26 indivíduos: uma criança (otite média); quatro adultos (um otite média, um induzido por ruído, dois idiopáticas); 21 idosos (presbiacusia). Das oito crianças menores de 4 anos avaliadas, todas apresentaram RCP presente, três exames normais, duas OEA ausentes bilateralmente, uma OEA ausentes à direita e uma ausentes à esquerda. CONCLUSÃO: A prevalência de deficiência auditiva incapacitante em Itajaí foi de 7%, com predominância acima dos 50 anos e tendo como principal causa a presbiacusia.

The number of people with impaired hearing is increasing; knowing its magnitude is essential for public health. OBJECTIVE: To study the prevalence and determinants of impaired hearing in Itajaí/SC. METHODS: A population-based survey based on a World Health Organization protocol. Field research was carried out from July 2008 to 2011. Procedures for evaluating hearing in households: questionnaire, measurement of noise, otoscopy, pure tone audiometry at 1000, 2000, and 4000 Hz, tympanometry, and acoustic reflexes: individuals above 4 years; children under 4 years: evoked otoacoustic emissions (OAE), cocleo-palpebral reflex(CPR), tympanometry, and acoustic reflexes. In the elderly population a questionnaire of perception of hearing loss was applied. RESULTS: The study sample consisted of 379 individuals - 45.38% were males and 54.62% were females. Age-range: 11.34% up to 10 years; 64.39% 10 to 60 years, 24.27% over 60 years. Evaluation of the best hearing ear showed that 74.1% of residents had normal hearing, 18.9% had mild hearing loss, 5.1% had moderate hearing loss, 1.9% had severe hearing loss. Disabling impaired hearing was detected in 26 subjects: one child (otitis media); four adults (one otitis, one noise-induced, two idiopathic); 21 elderlies (presbyacusis). Of eight children under 4 years all presented CPR, three were normal examinations, two had absent OAE bilaterally, one had absent OAE in the right ear and one in the left ear. CONCLUSION: The prevalence of disabling impaired hearing in Itajaí was 7%; the highest prevalence was in the 50-year and above age group - the main cause was presbyacusis.

Caracterização da audição de crianças em um estudo de base populacional no município de Itajaí / SC / Characterization of hearing in children in a population base study in the city of Itajaí / SC

Introdução: A audição é o sistema sensorial que auxilia o ser humano na aquisição e desenvolvimento da linguagem oral, possibilitando sua inserção no ambiente sociocultural. Objetivo: Caracterizar a audição de crianças do nascimento até os 14 anos e 11 meses de idade, residentes em Itajaí. Método: Estudo prospectivo cuja população foi constituída por moradores da área urbana do Município de Itajaí, SC. Foram incluídos na avaliação audiológica todos os indivíduos residentes nas casas sorteadas, sendo excluídos domicílios coletivos, casas comerciais e desabitadas. As crianças com idade superior a quatro anos passavam pela avaliação do meato acústico, triagem audiológica nas frequências de 1.000, 2.000 e 4.000 Hz,pesquisa dos reflexos acústicos e timpanometria. Nas crianças com idade inferior a três anos e 11 meses era realizada avaliação comportamental e emissões otoacústicas transientes. Resultados: Das 119 crianças avaliadas, a ocorrência de algum tipo de deficiência auditiva foi de 16,84% nas crianças acima de quatro anos, analisando a melhor orelha. Não foi encontrado nenhum caso de deficiência auditiva incapacitante. Ao combinar os resultados da avaliação comportamental de crianças com idade até três anos e 11 meses com os resultados da timpanometria da pesquisa dos reflexos acústicos ipsilaterais e emissões otoacústicas transientes,constatou-se a ocorrência de 59,10% de alterações audiológicas, sendo que destas houve, predominantemente, alterações na timpanometria e reflexos acústicos,sugerindo problemas condutivos. Conclusão: Evidencia-se a importância de atuar na promoção e prevenção das perdas auditivas condutivas, buscando propiciar às crianças o desenvolvimento da linguagem e aprendizagem de forma integral e eficaz.

Introduction: Hearing is the sensorial system that helps mankind in the acquisition and development of the oral language and enables their insertion into the socio-cultural environment. Objective: To characterize the hearing of children since birth until 14 years and 11 months of age, living in Itajaí. Method: Prospective study whose population was composed by inhabitants of the urban region of the city of Itajaí, SC. All individuals living in the sorted houses were included in the audiological evaluation, and the collective, commercial and non-inhabited dwellings were excluded. The children older than 4 years old were evaluated as for the acoustic meatus, audiological selection in the frequencies of 1000, 2000 and 4000 Hz, research of acoustic reflexes and tympanometry. In the children younger that 3 years and 11 months the behavioral and transient evoked otoacoustic emissions evaluations were carried out. Results: From the 119 children evaluated, the occurrence of some kind of auditory deficiency was of 16.84% in the children older than four years, in the analysis of the best ear. No case of incapacitating auditory deficiency was found. When we matched the behavioral evaluation results of children aged up to three years and 11 months with the results from the tympanometry of the research of ipsilateral acoustic reflexes and transient otoacoustic emissions, we confirmed the occurrence of 59.10% of audiological alterations, and from these there were alterations predominantly in the tympanometry and acoustic reflexes, which suggested conductive problems. Conclusion: This confirms the importance of acting for the promotion and prevention of conductive hearing losses, by attempting to provide the children with the development of language and learning fully and effectively.

Triagem auditiva neonatal: um estudo na cidade de Curitiba - PR / Newborn hearing screening: a study in Curitiba-PR

OBJETIVO: verificar a prática de Triagem Auditiva Neonatal na cidade de Curitiba-PR. MÉTODOS: inicialmente foi realizado um levantamento do número de maternidades e/ou hospitais com maternidades existentes na cidade de Curitiba, mediante a consulta no Cadastro Nacional de Estabelecimentos de Saúde. Constatou-se a existência de um total de 59 hospitais cadastrados, sendo que três destes são maternidades e 18 são hospitais com maternidade. A partir do levantamento feito, foi estabelecido um contato com o profissional responsável por cada uma das instituições, sendo questionado quanto à existência de um programa de Triagem Auditiva Neonatal e para aqueles que o apresentavam foi entregue um questionário a fim de obter informações a respeito do referido serviço. RESULTADOS: constatou-se que apenas 23,8 por cento das maternidades realizam Triagem Auditiva Neonatal, sendo que destas, 20 por cento é universal para neonatos a termo e 80 por cento universal para neonatos de alto risco. A triagem em todos os serviços é realizada com Emissões Otoacústicas Evocadas por Estímulo Transiente. CONCLUSÃO: mediante o estudo realizado verificou-se que a lei número 14588 - 22/12/2004 não está sendo rigorosamente cumprida. Apesar da demanda aliada à importância da detecção precoce, a Triagem Auditiva Neonatal não é realizada em todas as maternidades existentes e mesmo naquelas nas quais há um fonoaudiólogo e a triagem auditiva é realizada, esta não é universal.

PURPOSE: to check the practice of newborn hearing screening in Curitiba-PR. METHODS: a survey was initially conducted to check the number of existing maternities and hospitals with maternities included in the National Register of Health's Establishments. We found that 59 hospitals were registered; three are maternities and 18 are hospitals that include a maternity. We asked each of the professionals in charge for the institution if some kind of newborn hearing screening was conducted and, for those who had the service, a questionnaire was given in order to collect information on the program. RESULTS: we found that 23.8 percent of the institutions perform newborn hearing screening. In 20 percent of them, this service is universal for full term babies, while in 80 percent of them it is available for premature/high risk babies. All of the services use Transient Evoked Otoacoustic Emissions (TEOAE). CONCLUSION: we concluded that the Brazilian law number 14588 - 22/12/2004 is not being followed. Despite of the need and the importance for early detection of hearing loss, hearing screening is not accomplished in all maternities. In places where such screening takes place, it is not universal.

Mismatch negativity in patients with (central) auditory processing disorders.

UNLABELLED: Mismatch Negativity (MMN) is a long-latency auditory evoked potential that provides an objective index of discrimination skills and auditory sensorial memory. It may, therefore, be used as an electrophysiological evaluation of central auditory processing. AIM: To study MMN in patients with Central Auditory Processing Disorder - CAPD. STUDY METHOD: A prospective clinical study. MATERIAL AND METHOD: Eight individuals with CAPD, aged between nine and 14 years, were evaluated; there was also a control group. MMN was elicited for tone stimuli (tone bursts), differing in terms of frequency (MMNf - standard stimulus: 750 Hz and deviant stimulus: 1,000 Hz ), as well as duration (MMNd - standard stimulus: 100 ms and deviant stimulus: 50 ms; at 1,000 Hz). RESULTS: The presence of MMNf and of MMNd was statistically demonstrated in both groups. No significant statistical differences, however, were observed between MMNf and MMNd latencies and amplitude values in the two groups. Also, no significant statistical differences were observed between the MMNf and the MMNd among the groups. CONCLUSION: The CAPD individuals that were evaluated showed no changes in MMNf or MMNd.

O Mismatch Negativity em pacientes com distúrbios do processamento auditivo (central) / Mismatch negativity in patients with (central) auditory processing disorders

O Mismatch Negativity (MMN) é um potencial evocado auditivo de longa latência que fornece uma medida objetiva das habilidades de discriminação e memória sensorial auditiva. Assim, pode ser utilizado como uma avaliação eletrofisiológica do processamento auditivo (central). OBJETIVO: Estudar o MMN em pacientes com Distúrbios do Processamento Auditivo (Central) - DPA(C). FORMA DO ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Foram avaliados oito sujeitos com DPA(C), na faixa etária de nove a 14 anos, bem como um grupo controle. O MMN foi eliciado para estímulos tonais (tone bursts) diferindo quanto à freqüência (MMNf - estímulo padrão: 750Hz e estímulo diferente: 1000Hz ), bem como quanto à duração (MMNd - estímulo padrão: 100 ms e estímulo diferente: 50 ms; na freqüência de 1000Hz). RESULTADOS: A presença do MMNf e do MMNd foi comprovada estatisticamente em ambos os grupos estudados. Não foram constatadas diferenças significantes estatisticamente entre os valores de latência e de amplitude do MMNf e do MMNd obtidos nos dois grupos. Também não foram verificadas diferenças significantes estatisticamente entre o MMNf e o MMNd em nenhum dos grupos estudados. CONCLUSÃO: Os sujeitos com DPA(C) avaliados não apresentaram alterações no MMNf, nem no MMNd.

Mismatch Negativity (MMN) is a long-latency auditory evoked potential that provides an objective index of discrimination skills and auditory sensorial memory. It may, therefore, be used as an electrophysiological evaluation of central auditory processing. AIM: To study MMN in patients with Central Auditory Processing Disorder - CAPD. STUDY METHOD: A prospective clinical study. MATERIAL AND METHOD: Eight individuals with CAPD, aged between nine and 14 years, were evaluated; there was also a control group. MMN was elicited for tone stimuli (tone bursts), differing in terms of frequency (MMNf - standard stimulus: 750 Hz and deviant stimulus: 1,000 Hz ), as well as duration (MMNd - standard stimulus: 100 ms and deviant stimulus: 50 ms; at 1,000 Hz). RESULTS: The presence of MMNf and of MMNd was statistically demonstrated in both groups. No significant statistical differences, however, were observed between MMNf and MMNd latencies and amplitude values in the two groups. Also, no significant statistical differences were observed between the MMNf and the MMNd among the groups. CONCLUSION: The CAPD individuals that were evaluated showed no changes in MMNf or MMNd.

Newborn hearing screening: the relation between bathing and the retesting rate.

UNLABELLED: One of the goals of a Newborn Hearing Screening Program (NHSP) is to have a low retesting rate. AIM: To investigate the association between the retesting rate and the bath of newborn babies. STUDY DESIGN: cross-sectional contemporary cohort. MATERIALS AND METHODS: Transient otoacoustic emissions (TOE) results have been compared to the information received from the nurse's aide who bathed the babies on the day of the test (373 newborns), and the time interval between the TOE study and the last bath (350 newborns). RESULTS: Significant statistical differences were found in relation to the percentage of retesting when babies were bathed by certain nurse's aides. On the other hand, the percentage of retesting decreased significantly when the time interval between the last bath and the TOE study was longer than 7 hours and 50 minutes. CONCLUSION: Moisture of the external acoustic meatus, caused by inappropriate protection against water during bath, and the short interval between the bath and the ETOE study, could be considered as possible factors causing retesting in NHSP programs.

Triagem Auditiva Neonatal: relação entre banho e índice de reteste / Newborn Hearing Screening: the relation between bathing and the retesting rate

Uma das metas de um Programa de Triagem Auditiva Neonatal (TAN) consiste numa porcentagem baixa de retestes. OBJETIVO: Investigar a relação entre o índice de retestes e o banho do neonato. Forma de Estudo: Coorte contemporânea com corte transversal. MATERIAL E MÉTODO: Os resultados das Emissões Otoacústicas Evocadas por Estímulo Transiente (EOET) foram comparados às informações referentes a auxiliar de enfermagem que ministrou o banho no dia do exame (373 neonatos), bem como ao tempo transcorrido entre a pesquisa das EOET e o último banho (350 neonatos). RESULTADOS: Foram constatadas diferenças significantes estatisticamente entre as porcentagens de encaminhamento para reteste quando o banho foi ministrado por algumas auxiliares de enfermagem. Além disso, a porcentagem de retestes diminuiu significantemente quando o tempo transcorrido entre o último banho e a pesquisa das EOET foi superior a 7 horas e 50 minutos. CONCLUSÃO: A umidade do meato acústico externo, ocasionada por uma proteção inadequada contra a entrada de água no momento do banho e o curto intervalo de tempo entre o banho e a pesquisa das EOET podem ser considerados como possíveis fatores geradores de retestes nos programas de TAN.

One of the goals of a Newborn Hearing Screening Program (NHSP) is to have a low retesting rate. AIM: To investigate the association between the retesting rate and the bath of newborn babies. Study design: cross-sectional contemporary cohort. MATERIALS AND METHODS: Transient otoacoustic emissions (TOE) results have been compared to the information received from the nurse's aide who bathed the babies on the day of the test (373 newborns), and the time interval between the TOE study and the last bath (350 newborns). RESULTS: Significant statistical differences were found in relation to the percentage of retesting when babies were bathed by certain nurse's aides. On the other hand, the percentage of retesting decreased significantly when the time interval between the last bath and the TOE study was longer than 7 hours and 50 minutes. CONCLUSION: Moisture of the external acoustic meatus, caused by inappropriate protection against water during bath, and the short interval between the bath and the ETOE study, could be considered as possible factors causing retesting in NHSP programs.

Effects of temporal grouping on the memory representation of inter-tone relationships.

The length of silence between successive sounds is a dominant cue for temporal grouping of sounds. The present study tested whether the sensory memory representation of inter-tone relationships is dependent on the grouping of tones within a single stream of sound. Subjects were presented with sequences of two alternating tones that differed from each other in frequency. Perception of a sequence made up of tone-pairs was promoted by alternating a short and a long inter-tone interval. Occasional tone repetitions fell either within one tone-pair or across two pairs. We found that detecting tone repetitions was slower for across- than within-pair repetitions (Experiment 1). Also the amplitude of the mismatch negativity (MMN) event-related potential was lower for across-pair repetitions compared with that measured in the control isochronous sequences (Experiment 2). This attenuation of the MMN-amplitude could not be explained by the inter-tone interval differences that existed between the paired and the isochronous conditions (Experiment 3). These results demonstrate that temporal grouping affects the sensory memory representation of inter-tone relationships within a single sound stream.

A paradigm to measure mismatch negativity responses to phonetic and acoustic changes in parallel.

The mismatch negativity (MMN) of the event-related potential has been purported to be an objective index of central auditory processing. The present study tested a new paradigm to measure the MMN responses to phonological changes in parallel with those to simple acoustic changes. Stimulus sequences consisted of repetitive consonant-vowel syllables interspersed with infrequent phonetic changes (in place of articulation or voicing) and repetitive sinusoidal tones with occasional acoustic changes (in frequency or duration). The speech and tone stimuli were delivered to the opposite ears (right and left, respectively) at a stimulus onset asynchrony (SOA) of 300 ms. The MMNs elicited in this new paradigm were compared with those measured in a conventional paradigm, in which the speech and tone stimuli were presented in separate sequences at an identical speech-speech or tone-tone SOA (600 ms) of the new paradigm. The MMNs elicited in the two paradigms had a similar morphology and topography, although the MMNs measured with the new paradigm were slightly smaller for 3 out of 4 types of deviants. The results suggest that the new paradigm enables the measurement of reliable MMNs to phonetic changes in parallel with those to acoustic changes.