Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.985
Filtrar
1.
Medicine (Baltimore) ; 98(50): e18253, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852093

RESUMO

RATIONALE: Molecular mechanism underlying the autosomal recessive non-syndromic hearing loss (ARNSHL) is still plausible. Pathogenic mutations of the gap junction beta 2 protein (GJB2) are reported to be the primary causes of ARNSHL. PATIENT CONCERNS: A propositus was diagnosed as ARNSHL with bilateral congenital profound hearing loss. DIAGNOSIS: With microarray and target gene sequencing testing methods, a novel GJB2 mutant was found to be associated with ARNSHL in this Han Chinese family. INTERVENTIONS/OUTCOMES: Based on the finding in this research, prenatal screening of GJB2 mutation and genetic counseling are recommended to this family for their next pregnancy. Our interventions allow the family to plan informatively. LESSONS: In this family, we discovered 2 heterozygous carriers of c.113T>C variation in the GJB2 gene. The propositus, who had profound hearing loss, had inherited the c.113T>C variation from his normal mother and the c.235delC from his father.


Assuntos
Conexinas/genética , DNA/genética , Surdez/genética , Grupos Étnicos , Mutação , Adulto , China/epidemiologia , Conexinas/metabolismo , Análise Mutacional de DNA , Surdez/diagnóstico , Surdez/etnologia , Feminino , Humanos , Lactente , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Linhagem , Prevalência
2.
J Int Adv Otol ; 15(2): 215-221, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31418713

RESUMO

OBJECTIVES: This study aims to compare the electrical auditory brainstem response (EABR) following cochlear implant (CI) surgery in pediatric subjects with cochlear malformation and a normal cochlea, in order to assess the sensitivity of EABR and to evaluate the surgery outcome. MATERIALS AND METHODS: A total of 26 pediatric subjects who were deaf and scheduled for CI surgery were enrolled into this case control study. Group A (n=20) included subjects with a normo-conformed cochlea. Group B (n=6) included subjects with cochlear malformation. Subjects were evaluated with EABR immediately (T0) and 6 months (T1) post-CI surgery. The EABR Waves III and V average amplitude and latency were compared across time, separately for each group, and across groups, separately for each time. RESULTS: Auditory brainstem response (ABR) could only be recorded in Group A. We were able to record EABR from all subjects at T0 and T1, and waves III and V were present in all the recorded signals. There were no statistically significant differences between T0 and T1 in EABR Waves III and V in terms of average amplitude and latency in neither group. When comparing Groups A and B, the only statistically significant difference was the average amplitude of wave V, both at T0 and T1. CONCLUSION: EABR is a valid tool to measure the auditory nerve integrity after CI surgery in patients with a normal and malformed cochlea, as shown by its ability to measure waves III and V when ABR is absent. The EABR testing should be performed before and after CI surgery, and EABR should be used as a measure of outcome, especially in patients with a malformed cochlea.


Assuntos
Cóclea/anormalidades , Implantes Cocleares , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Estudos de Casos e Controles , Pré-Escolar , Cóclea/cirurgia , Nervo Coclear/fisiologia , Surdez/fisiopatologia , Surdez/cirurgia , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Complicações Pós-Operatórias/fisiopatologia , Tempo de Reação/fisiologia , Tomografia Computadorizada por Raios X
3.
J Int Adv Otol ; 15(2): 253-256, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31418714

RESUMO

OBJECTIVES: The perceptual characteristics of tinnitus are usually assessed by a matching procedure, where loudness and pitch of an external sound are matched to those of the tinnitus percept. The duration discrimination test (DDT), differential limen for intensity (DLI) and differential limen for frequency (DLF) are relatively simple psychoacoustic methods of measuring differential sensitivity. MATERIALS AND METHODS: 15 participants with normal or minimal hearing loss with tinnitus in the age range of 18 to 40 years were enrolled in the present study. Pure tone audiometry (PTA), immittance audiometry and otoacoustic emissions were done to diagnose the degree of hearing loss. Duration discrimination test (DDT), differential limen for intensity (DLI) and differential limen for frequency (DLF) was administered on all the participants using MATLAB software (MLP toolbox) at the matched tinnitus frequency, half an octave below - above the frequency. RESULTS: The results show that there was a significant increase in DDT, DLI and DLF thresholds at the tinnitus frequency compared to half an octave above and below the matched frequency. The result suggests that differential sensitivity abilities regarding frequency, intensity, and duration are affected at the tinnitus frequency in individuals with tinnitus. CONCLUSION: The results of the study suggest that the differential sensitivity ability is affected in individuals with tinnitus especially at the frequency of tinnitus.


Assuntos
Perda Auditiva/fisiopatologia , Zumbido/fisiopatologia , Adolescente , Adulto , Audiometria de Tons Puros/métodos , Limiar Auditivo/fisiologia , Feminino , Humanos , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Nível de Discriminação Sonora/fisiologia , Adulto Jovem
4.
Int Tinnitus J ; 23(1): 17-25, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31469523

RESUMO

INTRODUCTION: Tinnitus is defined as the perception of sound that results completely from activity within the nervous system without any corresponding mechanical, vibratory activity within the cochlea, and not related to external stimulation of any kind. It disrupts the daily life of 1 out of every 200 adults. The source of tinnitus generation is not limited to the peripheral auditory system. However, there are abnormalities seen in BERA in tinnitus patients depicting auditory pathway involvement. Oto-acoustic emissions are mechanical vibrations generated in the cochlea, which are evaluated by TEOAE and DPOAE whereas BERA evaluates both cochlea and brainstem auditory pathway for any conduction abnormalities. The aim of the study is to analyze the changes in OAE and BERA in patients suffering from tinnitus with normal hearing, which may help us to understand the patho-physiology of tinnitus. METHODS: This is a prospective study conducted in a tertiary care hospital in Northern India between 1st December 2015 to 31st July 2017. All patients of tinnitus with normal hearing were included in the study group, whereas Individuals with normal hearing with no other ear complaints were included in control group. Total 160 Ears were evaluated with 80 ears in both study and control group each. Patients with PTA >25dB, age >55 years or any chronic medical illness were excluded from the study. RESULTS: 80 individuals (46 Males and 34 Females) were divided into study and control Group (80 Ears each). Tinnitus was bilateral in 28 subjects (53.84%) and unilateral in 24 subjects (46.16%). Both control and study group showed significant difference in TEOAE and DPOAE study. In TEOAE, 8 (10%) ears in control group and 30 ears (37.5%) in study group showed test result as REFER whereas in DPOAE 10 (12.5%) ears in control group and 35 (43.8%) ears showed test result as REFER. All these result were statistically significant. In BERA the latency of wave I was significantly prolonged in study group as compared to control group, while difference between all other parameters between the two groups was insignificant. CONCLUSIONS: There were various significant abnormalities seen in parameters of Oto-Acoustic Emissions (OAE) and Brainstem Evoked Response Audiometry (BERA). So these tests should be included in the test battery for the screening of patients complaining of tinnitus even with normal hearing.


Assuntos
Audiometria de Resposta Evocada/métodos , Audiometria de Tons Puros/métodos , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Emissões Otoacústicas Espontâneas/fisiologia , Zumbido/diagnóstico , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Valores de Referência , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Centros de Atenção Terciária
5.
Int Tinnitus J ; 23(1): 31-36, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31469525

RESUMO

Children hospitalized in Neonatal Intensive Care Units (NICU) present an increased risk for Sensorineural Hearing Loss (SNHL) due to prematurity, hypoxia-ischemia, hyperventilation, low birth weight and the use of ototoxic drugs. The aim of this study was to assess the prevalence of SNHL in newborns hospitalized in a NICU using Transient Evoked Otoacoustic Emissions (TEOAE) and Automated Auditory Brainstem Responses (A-ABR) and analyze the associated risk factors. A sample of 153 newborns hospitalized in NICU underwent TEOAE, A-ABR and clinical ABR to evaluate the presence of hearing deficits. Prevalence of SNHL was calculated and odds ratio for specific risk factors was measured. One-hundred fifteen babies (86.7%) presented normal hearing at TEOAE and A-ABR. Fifteen children had a REFER response at TEOAE and a PASS response at A-ABR. Twenty-five children (16.3%) had a REFER A-ABR and were addressed to clinical ABR. A diagnosis of SNHL was made in 12 (7.8%) newborns. An increased risk of SNHL was observed in preterm children <28 weeks (p=0.0135), in children with neurological disorders (p=0.02), that underwent surgery (p=0.0002), affected from premature retinopathy (p=0.0006), craniofacial malformation (p=0.007) and that had sepsis (p=0.04). Additional risk factors for SNHL in our sample were a maternal disease during pregnancy (p=0.0011), cesarean delivery (p<0.0001) and a twin pregnancy (p<0.0001). SNHL in newborns is correlated with hospitalization in NICU. An accurate hearing screening associated to a rigorous clinical medical collection of data is necessary to promptly identify cases of SNHL in children with a special attention to those hospitalized in NICU and plan proper intervention.


Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Perda Auditiva Neurossensorial/congênito , Perda Auditiva Neurossensorial/diagnóstico , Recém-Nascido Prematuro , Triagem Neonatal/métodos , Emissões Otoacústicas Espontâneas/fisiologia , Feminino , Seguimentos , Testes Auditivos/métodos , Humanos , Recém-Nascido , Doenças do Prematuro/diagnóstico , Doenças do Prematuro/epidemiologia , Unidades de Terapia Intensiva Neonatal , Masculino , Prevalência , Medição de Risco , Índice de Gravidade de Doença
6.
Am J Audiol ; 28(2S): 508-515, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31461336

RESUMO

Purpose The study aimed to assess the relationship between the level-dependent function of efferent inhibition and speech perception in noise across different intensities of suppressor and across different signal-to-noise ratios (SNRs) of speech. Method Twenty-six young normal-hearing adults participated in the study. Contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) was measured for 3 levels of suppressor (40, 50, and 60 dB SPL). Speech identification score (SIS) was measured at 5 ipsilateral SNR conditions (quiet, 0, -5, -10, and -15 dB), with and without contralateral broadband noise at 3 levels (40, 50, and 60 dB SPL). Furthermore, SNR-50 was measured with and without the same 3 levels of contralateral broadband noise. Results The results showed that the suppression magnitude of TEOAE increased with an increase in suppressor level. However, neither SIS nor SNR-50 was influenced by the contralateral noise. In addition, SIS and SNR-50 did not show significant correlation with contralateral suppression of TEOAEs. This was true at all the SNRs and contralateral noise levels used in the study. Conclusions The findings suggest that the intensity of noise directly influences medial olivocochlear bundle-mediated efferent inhibition. However, the role of the medial olivocochlear bundle in regulating speech perception in noise needs to be revisited. Supplemental Material https://doi.org/10.23641/asha.9336353.


Assuntos
Cóclea/fisiologia , Inibição Neural/fisiologia , Emissões Otoacústicas Espontâneas/fisiologia , Percepção da Fala/fisiologia , Complexo Olivar Superior/fisiologia , Estimulação Acústica , Adolescente , Adulto , Vias Eferentes/fisiologia , Feminino , Humanos , Masculino , Ruído , Razão Sinal-Ruído , Adulto Jovem
7.
Artigo em Chinês | MEDLINE | ID: mdl-31315363

RESUMO

Objective: To investigate residual hearing of children severe and profound sensorineural deafness in whom wave V was not found in auditory brainstem response(ABR) testing, and to emphasize the importance of objective audiological tests. Methods: Two hundred and fifty-two children who were admitted to the Second Affiliated Hospital of Zhengzhou University between January 2015 and April 2018, with an average age of 20 months from 72 days to 4 years, received a full battery of objective audiological tests consisting of distortion product otoacoustic emission(DPOAEs), tympanometry, auditory brainstem responses(ABRs), 40 Hz auditory event related potential(40 HzAERP) and auditory steady-state response(ASSRs).There were 159 males(318 ears) and 93 females(186 ears). Residual hearing obtained by 40 HzAERP、ASSR of 252 children with sensorineural deafness was studied in relation to the absence of wave V in click ABR. SPSS 16.0 software was used to analyze the data. Results: Four hundred and forty-four ears of 504 ears have residual hearing of different degrees at different frequencies(88.1%),60 ears (11.9%) were found in whom responses was not found in 40 HzAERP、ASSR testing; Seventy-two ears(14.3%) in 38 patients were tested cochlear microphonic potentials (CMs). Conclusion: In children hearing evaluations,a full battery of objective audiological tests could better investigate residual hearing; The CMs were tested could provide the Audiotery Neuropathy diagnosis in infants with OAEs and ABR absent.


Assuntos
Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/fisiopatologia , Testes Auditivos/métodos , Limiar Auditivo , Pré-Escolar , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Feminino , Audição/fisiologia , Humanos , Lactente , Masculino , Emissões Otoacústicas Espontâneas/fisiologia
8.
Physiol Int ; 106(2): 151-157, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262207

RESUMO

The medial olivocochlear efferent (MOCE) branch synapses with outer hair cells (OHCs), and the efferent pathway can be activated via a contralateral acoustic stimulus (CAS). The activation of MOCE can change OHC motile responses and convert signals that are capable of controlling the sensitivity of the peripheral hearing system in a frequency-specific manner. The aim of this study was to examine the MOCE system activity in professional musicians using transient evoked otoacoustic emission test and CAS. Musician group showed stronger suppression in all frequency bands in the presence of CAS.


Assuntos
Cóclea/fisiologia , Núcleo Olivar/fisiologia , Estimulação Acústica/métodos , Adulto , Vias Auditivas/fisiologia , Vias Eferentes/fisiologia , Feminino , Audição/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Música , Emissões Otoacústicas Espontâneas/fisiologia , Adulto Jovem
9.
Int J Pediatr Otorhinolaryngol ; 124: 203-207, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31212168

RESUMO

OBJECTIVE: To investigate the signal amplitudes of transient evoked otoacoustic emissions (TEOAE) in neonates and infants diagnosed with congenital hypothyroidism (HC) and verify their association with clinical and laboratory aspects. METHODS: A cross-sectional study with a convenience sample of 22 individuals with congenital hypothyroidism and a group of 22 individuals without the disease, neonates and infants, aged 0-12 months. The TEOAE amplitudes were evaluated in both groups and compared using the Mann-Whitney test. The existence of association between TEOAE amplitudes and clinical-laboratory variables was verified through the Spearman correlation coefficient. RESULTS: There were no statistically significant differences between TEOAE amplitudes between the two groups. There was an association between the amplitudes of TEOAE and serum levels of thyroid stimulating hormone (TSH) and free thyroxine (T4) in the diagnostic test. CONCLUSIONS: The existence of an association between serum levels of TSH and free T4 in the diagnostic test and the amplitudes of TEOAE suggests the influence of these hormones on the auditory function.


Assuntos
Cóclea/fisiopatologia , Hipotireoidismo Congênito/fisiopatologia , Hipotireoidismo Congênito/complicações , Estudos Transversais , Potenciais Evocados Auditivos/fisiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Testes de Função Tireóidea , Tiroxina
10.
Int J Pediatr Otorhinolaryngol ; 123: 146-150, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31103744

RESUMO

OBJECTIVE: To explore the effects of exchange transfusion on auditory neuropathy spectrum disorder (ANSD) in neonates with severe hyperbilirubinemia (SH). METHODS: The clinical data of 2216 SH neonates who met the standard of exchange transfusion and 732 non severe-hyperbilirubinemia (NSH) neonates in the same period who did not require exchange transfusion in the neonatology department of Childrens' Hospital of Chongqing Medical University between January 2010 and December 2015 were retrospectively analyzed. In addition, the SH neonates were further divided into the exchange transfusion group and photography group. Hearing screening was conducted on all neonates using transiently evoked otoacoustic emission (TEOAE) and auto auditory brainstem response (AABR), and neonates who failed the above screening were performed diagnostic hearing test. And then neonates diagnosed with hearing disorder were followed up for 2-5 years. RESULTS: The pass rates of hearing screening were 80.58%, 79.71% and 87.84% in the phototherapy group, exchange transfusion group and NSH group respectively, with a significant difference(P < 0.05). Hearing loss was diagnosed in 10.15%, 12.39% and 8.54% of neonates in the phototherapy group, exchange transfusion group and NSH group. After follow-up, ultimate incidence rates of ANSD were 11.96%, 11.57% and 2.4% respectively in the 3 groups, with a significant difference (P < 0.05). CONCLUSIONS: SH is one of risk factors for ANSD. SH neonates have a lower incidence of ANSD in the exchange transfusion group than in the phototherapy group. Neonates who meet the standards of exchange transfusion adopt this therapy in early stage, which can quickly decrease bilirubin level and ultimately reduce incidence of ANSD.


Assuntos
Transfusão Total , Perda Auditiva Central/epidemiologia , Hiperbilirrubinemia Neonatal/terapia , Audiometria , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Feminino , Perda Auditiva Central/diagnóstico , Testes Auditivos , Humanos , Hiperbilirrubinemia Neonatal/complicações , Incidência , Recém-Nascido , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Estudos Retrospectivos , Fatores de Risco
11.
Int J Pediatr Otorhinolaryngol ; 123: 195-201, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31129459

RESUMO

OBJECTIVES: Distortion product otoacoustic emissions (DPOAEs) are a time-efficient, non-invasive means of assessing the integrity of active inner ear mechanics. Unfortunately, the presence of even relatively minor conductive hearing loss (CHL) has been suggested to reduce the clinical utility of DPOAEs significantly. The primary aims of this study were to systematically evaluate the impact of CHL on DPOAE amplitude and to determine if ear-specific primary tone level manipulations can be used to mitigate CHL impact and recover DPOAE measurability. METHODS: For 30 young adults (57 ears) with normal hearing, DPOAEs were obtained for f2 = 1-6 kHz. Observed DPOAE amplitudes were used to generate ear- and frequency-specific models with the primary tone levels, L1 and L2, as inputs and predicted DPOAE amplitude, LDP, as output. These models were then used to simulate the effect of CHL (0-15 dB), as well as L1 manipulations (0-15 dB), on DPOAE measurability. RESULTS: Mean LDP for every CHL condition was significantly different from that for all other conditions (p = <.001), with a mean LDP attenuation of 8.7 dB for every 5 dB increase in CHL. Mean DPOAE measurability in response to a standard clinical stimulation paradigm of L1/L2 = 65/55 (dB SPL) was determined to be 99%, 84%, 37%, and 9% in the presence of 0, 5, 10, and 15 dB CHL, respectively. In the presence of 10 dB CHL, altering L1 resulted in an approximately 25% increase in DPOAE responses. CONCLUSION: Subclinical CHL loss is sufficient to significantly impair DPOAE measurability in a meaningful proportion of otherwise healthy ears. However, through strategic alteration of primary tone levels, the clinician can mitigate CHL impact and at least partially recover DPOAE measurability.


Assuntos
Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/fisiopatologia , Emissões Otoacústicas Espontâneas/fisiologia , Estimulação Acústica , Adulto , Limiar Auditivo , Orelha Interna/fisiopatologia , Feminino , Testes Auditivos , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
12.
Anticancer Res ; 39(5): 2453-2458, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31092439

RESUMO

BACKGROUND/AIM: Cisplatin is a highly effective chemotherapeutic agent that is used to treat solid tumors; however, its severe side effects remain a limitation. In particular, the high incidence of cisplatin-induced ototoxicity has attracted interest. Melatonin has been shown to decrease the toxic effects of cisplatin due to its antioxidant activity, and could increase the efficacy of cancer chemotherapy. The aim of this study was to determine the effect of melatonin against ototoxicity in rats treated with cisplatin. MATERIALS AND METHODS: Rats were randomly divided into four groups (saline, melatonin, cisplatin+saline, and melatonin+cisplatin). Distortion-product otoacoustic emission (DPOAE) measurements were carried out on days 1 and 8. RESULTS: There was a decrease in DPOAE amplitudes in the animals that received cisplatin (10 mg/kg); however, the group treated with cisplatin+melatonin presented DPOAE amplitudes comparable to those of the control groups. CONCLUSION: Melatonin can be used as an adjuvant tumor treatment due to its ability to decrease cisplatin-induced ototoxicity.


Assuntos
Antioxidantes/administração & dosagem , Melatonina/administração & dosagem , Neoplasias/tratamento farmacológico , Emissões Otoacústicas Espontâneas/efeitos dos fármacos , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Modelos Animais de Doenças , Humanos , Neoplasias/patologia , Emissões Otoacústicas Espontâneas/fisiologia , Ratos
13.
Int J Pediatr Otorhinolaryngol ; 123: 110-115, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31096068

RESUMO

OBJECTIVES: Aim of this study is to report and discuss the results of 4 years of Newborn hearing screening (NHS) program at the Neonatal Intensive Care Unit (NICU), particularly evaluating the clinical ABR results. METHODS: Retrospective study. NHS data from NICU newborns, admitted for ≥5 days, in the period from January 1st, 2013 and December 31st, 2016, were retrieved and analyzed. NHS results were classified as following: (i) "pass" when both ears for both the a-TEOAE (automated Transient-Evoked Otoacoustic Emissions) and the a-ABR (automated Auditory Brainstem Response) protocol resulted as "pass"; (ii) "fail" when one ear, at either one of the two performed tests resulted as "fail"; (iii) "missing" when the newborns were not tested with both protocols. All "fail" and "missing" newborns were retested (with both tests): in the case of a second "fail" result, a clinical ABR was performed within a period of 3 months. RESULTS: A total of 1191 newborns were screened. From those, 1044/1191 resulted as "pass", 108/1191 as "fail", and 39/1191 as "missing". During the re-testing of these 147 newborns, 43 were assigned as "missing", 63 were assigned as "pass" (showing bilaterally a wave V identifiable within 30 dB nHL) and 25 failed the retest and/or did not present an identifiable wave V within 30 dB nHL. Among the 147 retested infants, we identified a group of 16 subjects who resulted as NHS "refer" and who, during the audiological follow-up, showed either: (i) a unilateral or bilateral wave V identifiable over 30 dB nHL, at the first clinical ABR assessment; or (ii) a bilateral wave V identifiable within 30 dB nHL, in a following clinical ABR test during the first year of life. These 16 subjects were defined to have an 'Auditory Brainstem Maturation' issue. CONCLUSIONS: A possible "maturation" of the ABR response (and therefore of the auditory pathway) has been hypothesised in 16 out of 1191 infants (1.3%). A delay of the auditory pathway maturation in preterm babies compared to term newborns has already been suggested in the literature. A possible delay of the NHS retest could be considered, in selected cases, with significant savings in economic resources and parental anxiety.


Assuntos
Tronco Encefálico/crescimento & desenvolvimento , Transtornos da Audição/congênito , Transtornos da Audição/diagnóstico , Testes Auditivos , Doenças do Prematuro/diagnóstico , Triagem Neonatal , Audiologia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Estudos Retrospectivos
14.
J Int Adv Otol ; 15(2): 272-276, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31120424

RESUMO

OBJECTIVES: To evaluate medial olivocochlear efferent system of babies with hyperbilirubinemia with normal auditory brain stem responses. MATERIALS AND METHODS: This was a prospective study in a tertiary referral hospital. The study involved 40 hyperbilirubinemic and 44 healthy newborns. Cochlear and auditory activity of participants was evaluated by transient otoacoustic emissions (TOAEs) and brainstem auditory evoked response components (BAER). Medial olivocochlear (MOC) reflex was evoked with contralateral acoustic stimulation and recorded with TOAEs. RESULTS: A comparison of the MOC reflex activity between two groups with Mann Whitney U test revealed that MOC reflex activity were significantly decreased in the hyberbilirubinemic group for both ears (p<.05). This difference was significant for all frequencies in both ears. There was no significant relation between total serum bilirubin level and MOC reflex activity. CONCLUSION: Hyperbilirubinemic newborns had decreased MOC reflex activity. This may be indicative of future problems in speech discrimination and effective hearing in noisy background. Additional long cohort studies are needed to evaluate the clinical importance of MOC reflex measurements in this group. MOC reflex measurement has the potential to form part of the audiologic evaluation of newborns with hyperbilirubinemia in the future.


Assuntos
Cóclea/fisiologia , Hiperbilirrubinemia/fisiopatologia , Vias Auditivas/fisiologia , Estudos de Casos e Controles , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Tempo de Reação/fisiologia
15.
PLoS One ; 14(1): e0208939, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30615632

RESUMO

Evidence shows that selective attention to visual stimuli modulates the gain of cochlear responses, probably through auditory-cortex descending pathways. At the cerebral cortex level, amplitude and phase changes of neural oscillations have been proposed as a correlate of selective attention. However, whether sensory receptors are also influenced by the oscillatory network during attention tasks remains unknown. Here, we searched for oscillatory attention-related activity at the cochlear receptor level in humans. We used an alternating visual/auditory selective attention task and measured electroencephalographic activity simultaneously to distortion product otoacoustic emissions (a measure of cochlear receptor-cell activity). In order to search for cochlear oscillatory activity, the otoacoustic emission signal, was included as an additional channel in the electroencephalogram analyses. This method allowed us to evaluate dynamic changes in cochlear oscillations within the same range of frequencies (1-35 Hz) in which cognitive effects are commonly observed in electroencephalogram works. We found the presence of low frequency (<10 Hz) brain and cochlear amplifier oscillations during selective attention to visual and auditory stimuli. Notably, switching between auditory and visual attention modulates the amplitude and the temporal order of brain and inner ear oscillations. These results extend the role of the oscillatory activity network during cognition in neural systems to the receptor level.


Assuntos
Cóclea/fisiologia , Emissões Otoacústicas Espontâneas/fisiologia , Adulto , Vias Auditivas/fisiologia , Percepção Auditiva/fisiologia , Encéfalo/fisiologia , Eletroencefalografia , Feminino , Humanos , Adulto Jovem
16.
Braz J Otorhinolaryngol ; 85(2): 206-212, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29409720

RESUMO

INTRODUCTION: The evaluation of cortical auditory evoked potential has been the focus of scientific studies in infants. Some authors have reported that automated response detection is effective in exploring these potentials in infants, but few have reported their efficacy in the search for thresholds. OBJECTIVE: To analyze the latency, amplitude and thresholds of cortical auditory evoked potential using an automatic response detection device in a neonatal population. METHODS: This is a cross-sectional, observational study. Cortical auditory evoked potentials were recorded in response to pure-tone stimuli of the frequencies 500, 1000, 2000 and 4000Hz presented in an intensity range between 0 and 80dB HL using a single channel recording. P1 was performed in an exclusively automated fashion, using Hotelling's T2 statistical test. The latency and amplitude were obtained manually by three examiners. The study comprised 39 neonates up to 28 days old of both sexes with presence of otoacoustic emissions and no risk factors for hearing loss. RESULTS: With the protocol used, cortical auditory evoked potential responses were detected in all subjects at high intensity and thresholds. The mean thresholds were 24.8±10.4dB NA, 25±9.0dB NA, 28±7.8dB NA and 29.4±6.6dB HL for 500, 1000, 2000 and 4000Hz, respectively. CONCLUSION: Reliable responses were obtained in the assessment of cortical auditory potentials in the neonates assessed with a device for automatic response detection.


Assuntos
Córtex Auditivo/fisiologia , Potenciais Evocados Auditivos/fisiologia , Recém-Nascido/fisiologia , Análise de Variância , Limiar Auditivo/fisiologia , Estudos Transversais , Feminino , Humanos , Masculino , Emissões Otoacústicas Espontâneas/fisiologia , Valores de Referência , Estatísticas não Paramétricas
17.
Ear Hear ; 40(1): 184-191, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29688962

RESUMO

OBJECTIVES: Auditory neuropathy (AN) is a clinical disorder characterized by the absence of auditory brainstem response and presence of otoacoustic emissions. A gradual loss of otoacoustic emissions has been reported for some cases of AN. Such cases could be diagnosed as cochlear hearing loss and lead to misunderstanding of the pathology when patients first visit clinics after the loss of otoacoustic emissions. The purpose of this study was to investigate the time course of changes in distortion product otoacoustic emissions (DPOAEs) in association with patients' genetic and clinical backgrounds, including the use of hearing aids. DESIGN: DPOAE measurements from 31 patients with AN were assessed. Genetic analyses for GJB2, OTOF, and mitochondrial m.1555A> G and m.3243A> G mutations were conducted for all cases, and the analyses for CDH23 and OPA1 were conducted for the selected cases. Patients who were younger than 10 years of age at the time of AN diagnosis were designated as the pediatric AN group (22 cases), and those who were 18 years of age or older were designated as the adult AN group (9 cases). DPOAE was measured at least twice in all patients. The response rate for DPOAEs was defined and analyzed. RESULTS: The pediatric AN group comprised 10 patients with OTOF mutations, 1 with GJB2 mutations, 1 with OPA1 mutation, and 10 with indefinite causes. Twelve ears (27%) showed no change in DPOAE, 20 ears (46%) showed a decrease in DPOAE, and 12 ears (27%) lost DPOAE. Loss of DPOAE occurred in one ear (2%) at 0 years of age and four ears (9%) at 1 year of age. The time courses of DPOAEs in patients with OTOF mutations were divided into those with early loss and those with no change, indicating that the mechanism for deterioration of DPOAEs includes not only the OTOF mutations but also other common modifier factors. Most, but not all, AN patients who used hearing aids showed deterioration of DPOAEs after the start of using hearing aids. A few AN patients also showed deterioration of DPOAEs before using hearing aids. The adult AN group comprised 2 patients with OPA1 mutations, 2 with OTOF mutations, and 5 with indefinite causes. Four ears (22%) showed no change in DPOAE, 13 ears (72%) showed a decrease, and one ear (6%) showed a loss of DPOAE. Although the ratio of DPOAE decrease was higher in the adult AN group than in the pediatric AN group, the ratio of DPOAE loss was lower in the adult AN group. DPOAE was not lost in all four ears with OPA1 mutations and in all four ears with OTOF mutations in the adult group. CONCLUSIONS: DPOAE was decreased or lost in approximately 70% of pediatric and about 80% of adult AN patients. Eleven percent of pediatric AN patients lost DPOAEs by 1 year of age. Genetic factors were thought to have influenced the time course of DPOAEs in the pediatric AN group. In most adult AN patients, DPOAE was rarely lost regardless of the genetic cause.


Assuntos
Perda Auditiva Central/fisiopatologia , Emissões Otoacústicas Espontâneas/fisiologia , Adolescente , Adulto , Idoso , Caderinas/genética , Criança , Pré-Escolar , Conexinas/genética , Erros de Diagnóstico , Progressão da Doença , Feminino , GTP Fosfo-Hidrolases/genética , Genes Mitocondriais/genética , Perda Auditiva Central/diagnóstico , Perda Auditiva Central/genética , Perda Auditiva Neurossensorial/diagnóstico , Humanos , Lactente , Masculino , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
18.
Ear Hear ; 40(2): 401-417, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29952805

RESUMO

OBJECTIVES: This study aims to determine the impact of controlling cochlear-source mechanism on the accuracy with which auditory status is identified using otoacoustic emissions (OAEs) in two groups of subjects with normal hearing (NH) and subjects with mild to moderate hearing loss. DESIGN: Data were collected from 212 subjects with NH and with mild to moderate hearing loss who fell into two categories based on a distortion product OAE (DPOAE) screening protocol: the uncertain-identification group (where errors were likely) and the certain-identification group (where errors were unlikely). DPOAE fine-structure patterns were recorded at intervals surrounding f2 = 1, 2 and 4 kHz (f2/f1 ratio = 1.22), with L2 = 35, 45, and 55 dB SPL (L1/L2 ratio = 10 dB). The discrete cosine transform was used to smooth fine structure, limiting the source contribution to the distortion source only. Reflection-source OAEs were also recorded using amplitude-modulated stimulus frequency OAEs (AM-SFOAE). Area under the relative operating characteristic (AROC) curve was used to quantify test accuracy when the source contribution was controlled versus the condition where both sources contribute. Additionally, failure rate, fixed at 5% for NH ears, as a function of behavioral-threshold category was evaluated. RESULTS: When data for the entire subject group were examined, reducing the reflection-source contribution to the DPOAE did not result in better test performance than the best control condition at any frequency tested. When the subjects with NH were restricted to those with confirmed fine structure, AROC analyses indicated that reducing the reflection-source contribution resulted in several small increases in the accuracy (2%-5%) with which auditory status was identified relative to the best control condition. This improvement was observed for the lowest stimulus levels (i.e., L2 = 35 or 45 dB SPL). In this subset of subjects, distortion-source DPOAEs resulted in more accurate identification of mild hearing loss for a fixed false-positive rate of 5% in NH ears at lower L2's, conditions with poor accuracy in the larger group of subjects. The impact of controlling the source contribution on the identification of moderate losses was less clear in the reduced subject group, with some conditions where the distortion-source DPOAE was more accurate than the control condition and other conditions where there was no change. There was no evidence that reflection-source AM-SFOAEs more accurately identified ears with hearing loss when compared to any of the DPOAE conditions in either the large or reduced group of subjects. CONCLUSION: While improvements in test accuracy were observed for some subjects and some conditions (e.g., mild hearing losses and low stimulus levels in the reduced subset of subjects), these results suggest that restricting cochlear source contribution by "smoothing" DPOAE fine structure is not expected to improve DPOAE test accuracy in a general population of subjects. Likewise, recording reflection-source OAEs using the AM-SFOAE technique would not be expected to more accurately identify hearing status compared to mixed- or single-source DPOAEs.


Assuntos
Cóclea/fisiopatologia , Perda Auditiva Neurossensorial/diagnóstico , Emissões Otoacústicas Espontâneas/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Triagem Neonatal , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Adulto Jovem
19.
Neuroscience ; 407: 41-52, 2019 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-30267832

RESUMO

Noise-induced hidden hearing loss (NIHHL) has attracted great attention in hearing research and clinical audiology since the discovery of significant noise-induced synaptic damage in the absence of permanent threshold shifts (PTS) in animal models. Although the extant evidence for this damage is based on animal models, NIHHL likely occurs in humans as well. This review focuses on three issues concerning NIHHL that are somewhat controversial: (1) whether disrupted synapses can be re-established; (2) whether synaptic damage and repair are responsible for the initial temporal threshold shifts (TTS) and subsequent recovery; and (3) the relationship between the synaptic damage and repair processes and neural coding deficits. We conclude that, after a single, brief noise exposure, (1) the damaged and the totally destroyed synapses can be partially repaired, but the repaired synapses are functionally abnormal; (2) While deficits are observed in some aspects of neural responses related to temporal and intensity coding in the auditory nerve, we did not find strong evidence for hypothesized coding-in-noise deficits; (3) the sensitivity and the usefulness of the envelope following responses to amplitude modulation signals in detecting cochlear synaptopathy is questionable.


Assuntos
Percepção Auditiva/fisiologia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Perda Auditiva Provocada por Ruído/fisiopatologia , Emissões Otoacústicas Espontâneas/fisiologia , Animais , Limiar Auditivo/fisiologia , Humanos , Sinapses/fisiologia
20.
Exp Brain Res ; 237(1): 91-100, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30310938

RESUMO

People with autism spectrum disorder (ASD) frequently show the symptoms of oversensitivity to sound (hyperacusis). Although the previous studies have investigated methods for quantifying hyperacusis in ASD, appropriate physiological signs for quantifying hyperacusis in ASD remain poorly understood. Here, we investigated the relationship of loudness tolerance with the threshold of the stapedial reflex and with contralateral suppression of the distortion product otoacoustic emissions, which has been suggested to be related to hyperacusis in people without ASD. We tested an ASD group and a neurotypical group. The results revealed that only the stapedial reflex threshold was significantly correlated with loudness tolerance in both groups. In addition to reduced loudness tolerance, people with lower stapedial reflex thresholds also exhibited higher scores on the Social Responsiveness Scale-2.


Assuntos
Adaptação Fisiológica/fisiologia , Limiar Auditivo/fisiologia , Transtorno do Espectro Autista/complicações , Hiperacusia/etiologia , Reflexo/fisiologia , Ácido 3,4-Di-Hidroxifenilacético , Estimulação Acústica , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Emissões Otoacústicas Espontâneas/fisiologia , Estapédio/fisiopatologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA