Osteoporosis and hearing loss: findings from the Korea National Health and Nutrition Examination Survey 2009-2011 / Osteoporose e perda auditiva: resultados da Pesquisa Nacional do Exame de Saúde e Nutrição da Coreia de 2009 a 2011

Abstract Introduction: Age-related hearing impairment is the most common sensory dysfunction in older adults. In osteoporosis, the mass of the ossicles will be decreased, affecting the bone density of the cochlea, and interfering with the sound transmission to the cochlea. Age related hearing loss might be closely related to osteoporosis. Objective: To determine the relationship between age-related hearing impairment and osteoporosis by investigating the relationship between hearing loss and cortical bone density evaluated from femur neck bone mineral density. Methods: We used data from the Korea National Health and Nutrition Examination Survey to examine the associations between osteoporosis and age-related hearing impairment from 2009 to 2011. Total number of participants was 4861 including 2273 men and 2588 women aged 50 years or older. Osteoporosis was defined as a bone mineral density 2.5 standard deviations below according to the World Health Organization diagnostic classification. Age-related hearing impairment was defined as the pure-tone averages of test frequencies 0.5, 1, 2, and 4 kHz at a threshold of 40 dB or higher on the more impaired hearing side. Results: Total femur T-score (p < 0.001), lumbar-spine T-score (p < 0.001) and, femur neck T-score (p < 0.001) were significantly lower in the osteoporosis group compared to the normal group. Thresholds of pure-tone averages were significantly different in normal compared to osteopenia, and osteoporosis groups. In addition, there were significantly higher pure-tone averages thresholds in the osteoporosis group compared to other groups (p < 0.001). After adjusting for all covariates, the odds ratio for hearing loss was significantly increased by 1.7 fold with reduced femur neck bone mineral density (p < 0.01). However, lumbar spine bone mineral density was not statistically associated with hearing loss (p = 0.22). Conclusion: Our results suggest that osteoporosis is significantly associated with a risk of hearing loss. In addition, femur neck bone mineral density was significantly correlated with hearing loss, but lumbar spine bone mineral density was not.

Resumo Introdução: A perda auditiva associada ao envelhecimento é a disfunção sensorial mais comum em idosos. Na osteoporose, a massa dos ossículos diminui e afeta a densidade óssea da cóclea, o que irá interferir na transmissão do som para a mesma. A perda auditiva associada à idade pode estar intimamente relacionada à osteoporose. Objetivo: Determinar a relação entre deficiência auditiva relacionada à idade e osteoporose, investigar a relação entre perda auditiva e densidade óssea cortical avaliada a partir da densidade mineral óssea do colo do fêmur. Método: Utilizamos dados da Korea National Health and Nutrition Examination Survey para examinar as associações entre osteoporose e perda auditiva associada ao envelhecimento de 2009 a 2011. O número total de participantes foi de 4.861, incluiu 2.273 homens e 2.588 mulheres com 50 anos ou mais. A osteoporose foi definida como densidade mineral óssea com 2,5 desvios-padrão abaixo da média, de acordo com a classificação diagnóstica da Organização Mundial da Saúde. A perda auditiva associada ao envelhecimento foi definida como as médias de tom puro das frequências de teste de 0,5, 1, 2 e 4 kHz a um limiar de 40 dB ou superior no lado da audição mais afetado. Resultados: O T-score total do fêmur (p < 0,001), o T-score da coluna lombar (p < 0,001) e o T-score do colo do fêmur (p < 0,001) foram significantemente menores no grupo com osteoporose em comparação ao grupo normal. Os limiares de médias de tom puro foram significantemente diferentes nos grupos normais em comparação com aqueles com osteopenia e osteoporose. Além disso, houve limiares significantemente maiores de médias de tom puro no grupo com osteoporose em comparação com os outros grupos (p < 0,001). Após o ajuste para todas as covariáveis, a odds ratio da perda auditiva mostrou estar significantemente aumentada em 1,7 vez com densidade mineral óssea reduzida no colo do fêmur (p < 0,01). No entanto, a densidade mineral óssea da coluna L não se associou estatisticamente à perda auditiva (p = 0,22). Conclusão: Nossos resultados sugerem que a osteoporose está significantemente associada ao risco de perda auditiva. Além disso, a densidade mineral óssea da coluna lombar não se correlacionou com a perda auditiva, apenas a densidade mineral óssea do colo do fêmur foi significantemente correlacionada.

Osteoporosis and hearing loss: findings from the Korea National Health and Nutrition Examination Survey 2009-2011.

INTRODUCTION: Age-related hearing impairment is the most common sensory dysfunction in older adults. In osteoporosis, the mass of the ossicles will be decreased, affecting the bone density of the cochlea, and interfering with the sound transmission to the cochlea. Age related hearing loss might be closely related to osteoporosis. OBJECTIVE: To determine the relationship between age-related hearing impairment and osteoporosis by investigating the relationship between hearing loss and cortical bone density evaluated from femur neck bone mineral density. METHODS: We used data from the Korea National Health and Nutrition Examination Survey to examine the associations between osteoporosis and age-related hearing impairment from 2009 to 2011. Total number of participants was 4861 including 2273 men and 2588 women aged 50 years or older. Osteoporosis was defined as a bone mineral density 2.5 standard deviations below according to the World Health Organization diagnostic classification. Age-related hearing impairment was defined as the pure-tone averages of test frequencies 0.5, 1, 2, and 4kHz at a threshold of 40dB or higher on the more impaired hearing side. RESULTS: Total femur T-score (p<0.001), lumbar-spine T-score (p<0.001) and, femur neck T-score (p<0.001) were significantly lower in the osteoporosis group compared to the normal group. Thresholds of pure-tone averages were significantly different in normal compared to osteopenia, and osteoporosis groups. In addition, there were significantly higher pure-tone averages thresholds in the osteoporosis group compared to other groups (p<0.001). After adjusting for all covariates, the odds ratio for hearing loss was significantly increased by 1.7 fold with reduced femur neck bone mineral density (p<0.01). However, lumbar spine bone mineral density was not statistically associated with hearing loss (p=0.22). CONCLUSION: Our results suggest that osteoporosis is significantly associated with a risk of hearing loss. In addition, femur neck bone mineral density was significantly correlated with hearing loss, but lumbar spine bone mineral density was not.

Efectos ototóxicos del cisplatino y su relación con la aparición de hipoacusia en pacientes con cáncer de cuello uterino / Ototoxic effects of cisplatin and its relationship with the appearance of hypoacusia in patients with cervical cancer

Con el objetivo de determinar los efectos ototóxicos del cisplatino y su relación con la aparición de hipoacusia en pacientes con cáncer de cuello uterino que asistieron al Servicio Autónomo de Oncología del estado Lara durante el lapso octubre 2017-febrero 2018, se realizó un estudio descriptivo transversal en 16 pacientes siendo las más afectadas el grupo de edad entre 36-45 años (43,2%). Los síntomas auditivos antes de iniciar el tratamiento fueron pérdida de la audición (6,2%); después del primero y segundo ciclo de quimioterapia se reportaron acúfenos (62,5% y 68,7%, respectivamente) siendo en la mayoría del tipo agudo (60% y 81,8% respectivamente) y pérdida de la audición (37,5% y 31,2% respectivamente). Los valores audiométricos al inicio fueron hipoacusia superficial para 25db (31,2%) y 30db (25%) en cambio, después del primero y segundo ciclo, fue hipoacusia superficial de tipo neurosensorial a predominio de frecuencias agudas con valores de 35db (31,2%) y de 40db (31,2%), respectivamente. Los hallazgos audiométricos mostraron que 56,2% de las pacientes presentaban hipoacusia superficial al inicio; pero luego se reportó 50% de pacientes con hipoacusia superficial de tipo neurosensorial a predominio de frecuencias agudas, posterior a ambos ciclos. Los resultados obtenidos permiten identificar de forma temprana las pacientes susceptibles de desarrollar hipoacusia posterior al tratamiento adyuvante con cisplatino(AU)

With the objective of determining the ototoxic effects of cisplatin and its relationship with the onset of hearing loss in patients with cervical cancer who attended the Autonomous Oncology Service of Lara state, during the period October 2017-February 2018; A cross-sectional descriptive study was conducted, obtaining 16 patients, being the most affected the age group between 36-45 years (43.25%), and the ranges of 25-35 years and 46-55 years (25%, respectively) . Hearing symptoms before starting treatment were hearing loss (6.25%); After the first and second cycle, tinnitus was reported (62.5% and 68.75%), being most of the acute type (60% and 81.81%) and hearing loss (37.5% and 31%). 25%). The audiometric values at the beginning were superficial hypoacusis for 25db (31.25%) and 30db (25%); however, after the first and second cycle was hearing loss Surface-type neurosensory with a curve suggestive of grade I acoustic trauma with values of 35db (31.25%) and 40db (31.25%), respectively. The audiometric findings showed that 56.25% had superficial hearing loss at baseline; but, then, 50% were reported with superficial sensorineural hearing loss with a curve suggestive of grade I acoustic trauma, after both cycles. The results obtained allow the early identification of patients susceptible to developing hearing loss after adjuvant treatment with cisplatin(AU)

The relationship between senile hearing loss and vestibular activity / Relação entre perda auditiva senil e atividade vestibular

Abstract Introduction: A considerable high number of SNHL patients also suffer from dizziness and related vestibular symptoms. Objective: To evaluate the association of vestibular dysfunction and sensorineural hearing loss (SNHL) in adult patients. Methods: Prospective, double-blinded, controlled studies composed by 63 adult patients without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with pure tone audiometry and the vestibular system was tested with vestibular evoked myogenic potential (VEMP). Patients were divided into two groups: a study group (patients with SNHL) and a control group (patients without SNHL). VEMP results of the groups were calculated and compared. Results: Mean P1 (23.54) and N1 (30.70) latencies were prolonged in the study group (p < 0.001) and the amplitudes of the study group were significantly reduced (p < 0.001). Both parameters of the VEMP test were abnormal in the study group when compared to the control group. Conclusions: These findings suggest that age-related SNHL may be accompanied by vestibular weakness without any possible predisposing factors for vestibulopathy.

Resumo Introdução: Um número considerável de pacientes com PANS também sofre de tonturas e sintomas vestibulares relacionados. Objetivo: Avaliar a associação entre disfunção vestibular e perda auditiva neurossensorial (PANS) em pacientes adultos. Método: Estudo prospectivo, duplo-cego e controlado com 63 pacientes adultos, sem quaisquer sintomas vestibulares ou doença vestibular diagnosticada. A audição foi avaliada por meio de audiometria tonal e o sistema vestibular, com potenciais evocados miogênicos vestibulares (PEMV). Os pacientes foram divididos em dois grupos: grupo de estudo (pacientes com PANS) e grupo de controle (pacientes sem PANS). Os resultados dos PEMV dos grupos foram calculados e comparados. Resultados: As latências médias de P1 (23,54) e N1 (30,70) encontravam-se prolongadas no grupo de estudo (p < 0,001), e as amplitudes no grupo de estudo estavam significantemente reduzidas (p < 0,001). Ambos os parâmetros do teste de PEMV foram anormais no grupo de estudo quando comparados aos do grupo controle. Conclusões: Nossas achados sugerem que a PANS relacionada à idade pode ser acompanhada por hipofunção vestibular, mesmo na ausência de possíveis fatores predisponentes para vestibulopatia.

Enmascaramiento clínico: una revisión de la literatura / Clinical masking: a literature review

Son diversos los métodos planteados para aplicar enmascaramiento, de esta forma es necesario revisar la literatura en búsqueda de consenso. Se revisaron críticamente los métodos utilizados y recomendados por la literatura y sociedades internacionales, en torno a la aplicación de enmascaramiento. Se consultó entre agosto y noviembre de 2015 en PUBMED, SciELO y Google Scholar por estudios acerca de métodos de enmascaramiento utilizados en audiometría. También se revisaron las guías de organizaciones internacionales y lo publicado en libros relacionados con el área de audiología. El método de "La Meseta" es el más referenciado, siendo modificado posteriormente. Existen variaciones en criterios de atenuación interaural, necesidad de enmascaramiento, enmascaramiento inicial, incrementos para obtener la meseta y niveles del efecto de oclusión. Se concluye que la literatura muestra diferencias al momento de decidir cuándo enmascarar y cómo hacerlo. No obstante, se puede establecer criterios comunes en relación a los niveles de atenuación interaural, cuándo enmascarar, valores de efecto de oclusión y metodología. El método de "La Meseta" sigue siendo el más recomendado. La modificación realizada por Yacullo es la más referenciada y recomendada en la literatura actual.

Adequate use of masking is key in the correct diagnosis of hearing loss. Various methods are suggested regarding the application of clinical masking, hence the need to review literature in order to reach a consensus. To critically review the specialized literature and international societies' recommendations regarding clinical masking. From August to November 2015, PUBMED, SciELO and Google Scholar articles on clinical masking methods used in tonal audiometries were consulted, as well as international organization guidelines, and literature in the area of Audiology. Hood's plateau method, later revised, received the most references. The modified versions consider the number of increments needed to determine the true threshold, and the occlusion effect. Optimized methods show the variations regarding interaural attenuation, need for masking, initial masking level, increments to reach "The Plateau", and the occlusion effect. Literature shows differences regarding when and how to use masking; however, common criteria can be established with reference to the levels of interaural attenuation, when to use masking, occlusion effect values and methodology. The plateau method proposed by Hood is still the most recommended. Yacullo's optimization is currently the one with the most references and recommendations in specialized literature.

Otologic and audiologic characteristics of type 2 diabetics in a tertiary health institution in Nigeria / Características audiológicas e otológicas de diabéticos tipo 2 em uma instituição de saúde terciária na Nigéria

ABSTRACT INTRODUCTION: This cross-sectional comparative study was carried out at the Diabetes outpatient clinic of LAUTECH Teaching Hospital (LTH) Ogbomoso, Nigeria. OBJECTIVE: This study assessed patterns of otologic diseases and auditory acuity among type 2 diabetics and determinants of these findings among diabetics. METHODS: Ninety-seven consenting patients with clinical diagnosis of diabetes mellitus (194 ears) were matched for age and sex with ninety non-diabetic patients (180 ears). These patients were screened using otoscopy and pure tone audiometry over a 6-month period. RESULTS: The study reported a crude prevalence rate of 21.6% hearing loss in T2DM patients. The most common type of otologic disease that showed significant association with T2DM patients was otitis media with effusion (p = 0.027). T2DM was significantly associated with abnormal audiometric findings (p = 0.022), particularly sensorineural hearing loss (p = 0.022), of the moderate grade (p = 0.057). There were no differences of the audilogical findings for any particular ear, and no differential affectation of frequency range was observed. Coexisting hypertension and poor glycaemic control were significantly associated with aggravation of the hearing of the T2DM patients (p < 0.001, and p = 0.009 respectively). CONCLUSION: T2DM had appreciable effects on hearing acuity. T2DM was significantly associated with the type and the degree of the hearing loss. The need for screening of hearing acuity of T2DM patients, in order to detect early changes, and promptly offer an adequate management and remedial measures was emphasized in this study.

Resumo Introdução: Este estudo de caso-controle foi realizado no Ambulatório de Diabetes do LAUTECH Teaching Hospital (LTH), em Ogbomoso, Nigéria. Objetivos: Este estudo avaliou os padrões de doenças otológicas e acuidade auditiva entre os diabéticos tipo 2 e os fatores determinantes desses achados entre os diabéticos. Método: Ao todo, 97 pacientes com diagnóstico clínico de diabetes melito (194 orelhas) deram seu consentimento e foram pareados por idade e sexo, com 90 pacientes não diabéticos (180 orelhas). Eles foram avaliados por otoscopia e audiometria tonal liminar por um períodode seis meses. Resultados: O estudo relatou uma taxa de prevalência bruta de 21,6% de perda auditiva em pacientes com DM2. O tipo mais comum de doença otológica, afetando significativamente pacientes com DM2, foi otite média com efusão (p = 0,027). A DM2 foi associada com achados audiométricos alterados (p = 0,022), principalmente perda auditiva neurossensorial (p = 0,012), de grau moderado (p = 0,057). Não houve predileção dos efeitos da DM2 para uma das orelhas em particular, e também não houve efeito diferencial da faixa de frequência. A coexistência de hipertensão e controle glicêmico inadequado associou-se significativamente à piora da audição dos pacientes com DM2 (p < 0,001 e p = 0,009, respectivamente). Conclusão: A DM2 mostrou apresentar efeitos significantes na acuidade auditiva afetando significativamente o tipo e o grau da disacusia. Este estudo mostrou a necessidade de avaliação da acuidade auditiva de pacientes com DM2, a fim de detectar as alterações iniciais, e poder rapidamente oferecer medidas corretivas adequadas.

Otologic and audiologic characteristics of type 2 diabetics in a tertiary health institution in Nigeria.

INTRODUCTION: This cross-sectional comparative study was carried out at the Diabetes outpatient clinic of LAUTECH Teaching Hospital (LTH) Ogbomoso, Nigeria. OBJECTIVE: This study assessed patterns of otologic diseases and auditory acuity among type 2 diabetics and determinants of these findings among diabetics. METHODS: Ninety-seven consenting patients with clinical diagnosis of diabetes mellitus (194 ears) were matched for age and sex with ninety non-diabetic patients (180 ears). These patients were screened using otoscopy and pure tone audiometry over a 6-month period. RESULTS: The study reported a crude prevalence rate of 21.6% hearing loss in T2DM patients. The most common type of otologic disease that showed significant association with T2DM patients was otitis media with effusion (p=0.027). T2DM was significantly associated with abnormal audiometric findings (p=0.022), particularly sensorineural hearing loss (p=0.022), of the moderate grade (p=0.057). There were no differences of the audilogical findings for any particular ear, and no differential affectation of frequency range was observed. Coexisting hypertension and poor glycaemic control were significantly associated with aggravation of the hearing of the T2DM patients (p< 0.001, and p=0.009 respectively). CONCLUSION: T2DM had appreciable effects on hearing acuity. T2DM was significantly associated with the type and the degree of the hearing loss. The need for screening of hearing acuity of T2DM patients, in order to detect early changes, and promptly offer an adequate management and remedial measures was emphasized in this study.

The relationship between senile hearing loss and vestibular activity.

INTRODUCTION: A considerable high number of SNHL patients also suffer from dizziness and related vestibular symptoms. OBJECTIVE: To evaluate the association of vestibular dysfunction and sensorineural hearing loss (SNHL) in adult patients. METHODS: Prospective, double-blinded, controlled studies composed by 63 adult patients without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with pure tone audiometry and the vestibular system was tested with vestibular evoked myogenic potential (VEMP). Patients were divided into two groups: a study group (patients with SNHL) and a control group (patients without SNHL). VEMP results of the groups were calculated and compared. RESULTS: Mean P1 (23.54) and N1 (30.70) latencies were prolonged in the study group (p<0.001) and the amplitudes of the study group were significantly reduced (p<0.001). Both parameters of the VEMP test were abnormal in the study group when compared to the control group. CONCLUSIONS: These findings suggest that age-related SNHL may be accompanied by vestibular weakness without any possible predisposing factors for vestibulopathy.

[A comparative study on efficacy of glucocorticoids, mineralocorticoids and vasoactive drugs on reversing hearing loss in patients suffering idiopathic sensorineural cochlear hypoacusis. A preliminary clinical trial]. / Estudio comparativo de la eficacia de los glucocorticoides, mineralocorticoides y vasodilatadores en la recuperación auditiva de pacientes que padecen hipoacusia neurosensorial idiopática de localización coclear. Ensayo clínico preliminar.

INTRODUCTION AND OBJECTIVES: Sensory neural hearing loss (SNHL) is a disorder characterised by an important deterioration of the auditory function. Re-establishing normal ion homeostasis of the endolymph could be related to hearing recovery and it might be mediated by mineralocorticoids. The main purpose of this preliminary, randomized controlled clinical trial was assessing the recovery of idiopathic sensory neural cochlear hearing loss (SNHL) by comparing the efficacy of 2 types of steroids versus vasodilators. MATERIAL AND METHODS: The 3-month intervention involved 70 patients, allocated into 4 different groups: a control with no medication, consisting of 14 patients (8 men and 6 women); a vasodilator group of 21 patients (11 men and 10 women); a glucocorticoid group with 16 patients (10 men and 6 women); and a mineralocorticoid therapy group, consisting of 19 patients (11 men and 8 women). The level of hearing loss and its topography were estimated using Liminal Tone Audiometry (LTA) and Auditory Brainstem Response (ABR). RESULTS: Our research found overall greater efficacy of mineralocorticoids versus glucocorticoids and vasodilators. There was better response in women than in men and it was higher from the left ear, regardless of patient gender. CONCLUSIONS: The hearing gain was significantly superior in the mineralocorticoid group, followed by the glucocorticoid group. However, the responses to vasodilators were lesser and of low statistical significance.

Relación entre hipoacusia y diabetes mellitus tipo 2 / Relationship between hearing loss and type 2 diabetes mellitus

Introducción: La diabetes mellitus tipo 2 es una enfermedad prevalente en nuestro país. Básicamente en esta, falla la regulación de la glicemia lo que puede provocar diversas complicaciones. Diversos estudios han encontrado que puede causar lesiones a largo plazo en el sistema auditivo pudiendo llegar a causar una hipoacusia de tipo neurosensorial. Objetivo: Conocer si pacientes con diabetes mellitus tipo 2 presentan una hipoacusia sensorio neural mayor de lo esperado. Material y método: Estudio transversal caso control. El grupo comparativo estuvo constituido por 45 pacientes con diabetes mellitus tipo 2 y con 53 pacientes sanos y que constituyen el grupo control. La edad de ambos grupos fluctuó entre 30 a 50 años. Los criterios de exclusión incluyeron a pacientes con trauma acústico, ototóxicos y antecedentes otológicos previos. Además se aplicó una encuesta y un examen otológico para descartar lesiones. A cada paciente se le realizó una audiometría tonal, siempre en las mismas condiciones y por el mismo examinador. Se analizaron en cada oído las frecuencias 128; 256; 512; 1.000; 2.000; 3.000; 4.000; 6.000; 8.000 Hz y el PTPy en intervalos de 5 dB en cada frecuencia. Para el análisis estadístico, se aplicó las pruebas de normalidad de Kolmogorov-Smirnov y Shapiro-Wilk y la prueba no paramétrica de Mann Whitney. Resultados: La media de las edades fue de 40,85 años con desviación estándar 6,33para los controles y 42,62 años con desviación estándar de 5,97 para el grupo de diabéticos. El tiempo de evolución promedio de diabetes fue de 5,03 años. En el análisis de la diferencia en los promedios tonales se observó un deterioro significativo (P <0,05) en el grupo de diabéticos con respecto a los controles en casi todas las frecuencias evaluados y también en el PTP en ambos oídos. La excepción a lo anterior solo se observó en la frecuencia 256 Hz del oído derecho. Conclusiones: Los pacientes con diabetes mellitus tipo 2 de nuestro estudio presentaron una pérdida auditiva tonal estadísticamente significativa al compararlos con el grupo control.

Introduction: Diabetes mellitus is a prevalent disease in Chile, in diabetes glucose dis-regulation can cause organ and system failure. Several studies have found that diabetes can also cause long-term injuries in the auditory system, causing neurosensorial hearing loss. Aim: To associate diabetes mellitus and the potential consequence of hearing loss determined by tonal audiometry. Material and method: Cross-sectional study case-control, with a N = 45 for diabetic patients and N=53 for control subjects, between 30 to 50 years old. We excluded patients with acoustic trauma, ototoxic use or previous otologic history. A questionnaire was applied and otologic examination was done to rule out injuries. Audiometry was performed, analyzing frequencies in each ear 128,256,512,1000,2000,3000,4000, 6000,8000 Hz and PTP. For statistical analysis we applied the nonparametric Mann Whitney test. Results: Mean age was 40.85 years old with standard deviation 6.33 for controls and 42.62years with standard deviation of 5.97 for cases, average duration of diabetes was of 5.03 years. In the analysis of the difference in average pitch there was a higher significant deterioration (P <0.05) in the diabetic group compared to controls in almost all frequency and PTP in both ears, except in the 256 Hz right ear. Conclusions: Patients with diabetes mellitus showed a hearing loss in tonal audiometry compared to individuals without diabetes mellitus.

Enmascaramiento vs Oclusión en la evaluación para el implante BAHA con hipocusia neurosensorial profunda unilateral

Con el objetivo de determinar los umbrales auditivos y contrastarlos con los procedimientos de enmascaramiento mínimo y máximo con los de oclusión en usuarios con hipoacusia neurosensorial profunda unilateral, candidatos a implante BAHA, se tomaron 16 candidatos de la Clínica José A. Rivas, los cuales primero fueron evaluados otológicamente y se les descartó alguna patología retrococlear. Ellos decidieron voluntariamente su participación en la investigación y firmaron el consentimiento informado. Se les realizó otoscopia y membrana timpánica, luego la audiometría que evaluó los umbrales mínimos de audición, adicionalmente se realizó la logoaudiometría y la Inmitancia acústica para corroborar la función del oído medio. Seguidamente se realizó la evaluación de audiometría tonal con el BAHA utilizando en el oído con la hipoacusia el procesador DIVINO en campo libre con el enmascaramiento en donde se aplicó un ruido de 15 dB por encima del umbral en el oído con audición normal y 30 dB por encima del umbral aéreo para el masking máximo. Luego se realizó la oclusión, introduciendo material de impresión cubriendo totalmente el CAE. Para los dos procedimientos se tomaron los umbrales de las frecuencias 500 Hz, 1000 Hz, 2000 Hz y 4000 Hz con el parlante a 0 grados azimut. Se encontraron diferencias importantes entre los dos procedimientos; siendo la oclusión, el mejor procedimiento para la evaluación de implante BAHA.

In order to determine the hearing thresholds and compare them with masking procedures with the minimum and maximum occlusion in users with deep unilateral sensorineural Hypoacusis, 16 BAHA Candidates were taken from the Jose A. Rivas Clinic, who were first evaluated otológically and as a result they got negative any retrocochlear pathology. They decided voluntarily their participation in the research and signed informed consent. It was performed an otoscopy and tympanic membrane, then an audiometry that evaluated their minimal hearing thresholds, in addition it was made a logoaudiometry and an acoustic immittance to corroborate the function of the middle ear. Then an evaluation was developed by doing a tonal audiometry using the BAHA in the ear with hypoacusis using the “DIVINO” processor in an open place with the masking where it was applied a noise of 15 dB above the threshold in the ear with normal hearing and 30 dB above the air threshold for the maximum masking. Then the occlusion was performed by introducing impression material covering the entire CAE. For both procedures the thresholds for the frequencies were 500 Hz, 1000Hz, 2000Hz and 4000Hz with the speaker at 0 degrees azimuth. We found significant differences between the procedures, the occlusion is the best procedure for the evaluation of a BAHA implant.

Estudo audiológico de uma população idosa brasileira / Audiological study of an elderly brazilian population

A população idosa brasileira cresce e representa 8,6 por cento do total populacional. Fatores ambientais, hábitos de vida, sexo e fatores genéticos interferem na evolução da presbiacusia que reduz a qualidade de vida. OBJETIVO: Investigar queixas audiológicas e vestibulares em idosos, executar audiometria tonal, verificar se há diferenças entre os sexos. FORMA DE ESTUDO: Clínico prospectivo de corte transversal. MATERIAL E MÉTODO: 320 pacientes idosos (160 homens e 160 mulheres) foram submetidos a anamnese audiológica e audiometria tonal. Análise estatística dos resultados pelos testes ANOVA, Mann-Whitney e Qui-Quadrado. RESULTADO: As queixas audiológicas e vestibulares (perda auditiva, tinnitus, plenitude auricular, tontura) foram similares entre os sexos (exceção, a tontura: p<0,05); audiometria tonal apresentou diferença significante, com perda auditiva nas altas freqüências entre os homens, e entre as mulheres, curvas descendentes e planas. Esses resultados foram estaticamente significantes (p<0,001). CONCLUSÃO: Os resultados permitem concluir que, quando comparados os sexos, a perda auditiva no idoso possui sintomatologia semelhante, mas apresenta diferenças significativas na audiometria tonal.

The Brazilian elderly population is growing, and already represents 8,6 percent of our total population. Environmental factors, lifestyle, gender and genetics impact the development of presbycusis, which reduces quality of life. AIM: investigate audiologic and vestibular complaints in the elderly; perform tonal audiometry and check to see if there are differences between genders. STUDY: Cross-sectional clinical prospective study. MATERIALS AND METHODS: 320 elderly patients (160 men and 160 women) were submitted to audiologic interview and tonal audiometry. The results were statistically analyzed by the following methods: ANOVA, Mann-Whitney and Chi-Squared. RESULTS: audiologic and vestibular complaints (hearing loss, tinnitus, ear fullness, dizziness) were similar between the genders (except for dizziness: p<0,05); tonal audiometry showed a significant difference, with hearing loss in the high frequencies among men; and among women the curves were descending and flat. These results were statistically significant (P<0,001). CONCLUSION: our results lead us to conclude that, when the genders are compared, hearing loss in the elderly has similar symptoms; however, there are significant differences in tonal audiometry.