Identification of Serologic Markers for School-Aged Children With Congenital Rubella Syndrome.

BACKGROUND: Congenital rubella syndrome (CRS) case identification is challenging in older children since laboratory markers of congenital rubella virus (RUBV) infection do not persist beyond age 12 months. METHODS: We enrolled children with CRS born between 1998 and 2003 and compared their immune responses to RUBV with those of their mothers and a group of similarly aged children without CRS. Demographic data and sera were collected. Sera were tested for anti-RUBV immunoglobulin G (IgG), IgG avidity, and IgG response to the 3 viral structural proteins (E1, E2, and C), reflected by immunoblot fluorescent signals. RESULTS: We enrolled 32 children with CRS, 31 mothers, and 62 children without CRS. The immunoblot signal strength to C and the ratio of the C signal to the RUBV-specific IgG concentration were higher (P < .029 for both) and the ratio of the E1 signal to the RUBV-specific IgG concentration lower (P = .001) in children with CRS, compared with their mothers. Compared with children without CRS, children with CRS had more RUBV-specific IgG (P < .001), a stronger C signal (P < .001), and a stronger E2 signal (P ≤ .001). Two classification rules for children with versus children without CRS gave 100% specificity with >65% sensitivity. CONCLUSIONS: This study was the first to establish classification rules for identifying CRS in school-aged children, using laboratory biomarkers. These biomarkers should allow improved burden of disease estimates and monitoring of CRS control programs.

[Awareness of cancer diagnosis does not lead to depression in palliative care patients]. / O conhecimento do diagnóstico de câncer não leva à depressão em pacientes sob cuidados paliativos.

OBJECTIVE: Characterize the profile of patients under palliative care at this institution and evaluate the prevalence of depression in these patients. METHODS: Sixty two cancer patients under palliative care, who had answered three questionnaires: one regarding their demographic characteristics, another to evaluate their quality of life and the Beck's depression inventory were surveyed. RESULTS: Of these patients, 68% presented with some degree of depression. Most of them were aware of their diagnosis (87.1%), did not talk to their physicians on other subjects but their disease (81.18%), were satisfied with their treatment (93.33%) and with the support they received (95.70%). Pain, fatigue, weakness and sleep disturbances were the most frequently reported symptoms. There was a significant correlation between presence of depression and not knowing the diagnosis (p=0.008), being admitted to the hospital (p=0.0019) and not having ever received oncologic treatment. CONCLUSION: Patients under palliative care at this institution, despite being satisfied with the treatment, reported poor communication with their physicians and presented with a high rate of depression. Awareness of their diagnosis and having received prior oncologic treatment (p=0.07) correlated significantly and inversely with having depression.

[Incidence of the burnout syndrome among Brazilian cancer physicians]. / A síndrome da estafa profissional em médicos cancerologistas brasileiros.

BACKGROUND: The Burnout syndrome can be characterized by abnormalities in three domains: emotional exhaustion (EE), depersonalization (DP) and lack of personal realization (PR). In the medical profession, oncologists are especially prone to this syndrome. This study evaluates its prevalence among cancer physicians in Brazil correlating it to their demographic, work related variables and seeks possible solutions to prevent burnout. METHODS: We mailed three questionnaires (Maslach burnout inventory, general and opinion questionnaires) to all 645 members of the Brazilian Cancer Society and received 136 responses after 10 weeks. RESULTS: The response rate was of 21%. The burnout syndrome was present at moderate or severe levels in all three domains analyzed in 15.7% of the physicians. For each of these the frequency of moderate or severe dysfunction was analyzed and found to be present in 55.8% for EE, 96.1% for DP and 23.4% for RP. Practicing physical activity or having a hobby correlated significantly with lower levels of EE (p = 0.008) while working only for the private sector correlated with higher DP scores (p = 0.021). Cancer physicians pointed out that less paper work (73.5%) and a lower patient load (72.7%) were the most important factors for prevention of this syndrome. CONCLUSION: Burnout syndrome is frequent among Brazilian cancer physicians and further studies should be conducted to evaluate its prevalence and prevention among other sub specialists.

Retrolabyrinthine approach for cochlear nerve preservation in neurofibromatosis type 2 and simultaneous cochlear implantation.

INTRODUCTION: Few cases of cochlear implantation (CI) in neurofibromatosis type 2 (NF2) patients had been reported in the literature. The approaches described were translabyrinthine, retrosigmoid or middle cranial fossa. OBJECTIVES: To describe a case of a NF2- deafened-patient who underwent to vestibular schwannoma resection via RLA with cochlear nerve preservation and CI through the round window, at the same surgical time. Resumed Report: A 36-year-old woman with severe bilateral hearing loss due to NF2 was submitted to vestibular schwannoma resection and simultaneous CI. Functional assessment of cochlear nerve was performed by electrical promontory stimulation. Complete tumor removal was accomplishment via RLA with anatomic and functional cochlear and facial nerve preservation. Cochlear electrode array was partially inserted via round window. Sound field hearing threshold improvement was achieved. Mean tonal threshold was 46.2 dB HL. The patient could only detect environmental sounds and human voice but cannot discriminate vowels, words nor do sentences at 2 years of follow-up. CONCLUSION: Cochlear implantation is a feasible auditory restoration option in NF2 when cochlear anatomic and functional nerve preservation is achieved. The RLA is adequate for this purpose and features as an option for hearing preservation in NF2 patients.

Neurofibromatosis 2: hearing restoration options.

UNLABELLED: Neurofibromatosis 2 (NF2) is an autosomal dominant disease in which hearing loss is predominant. Auditory restoration is possible using cochlear implants (CI) or auditory brainstem implant (ABI). OBJECTIVE: To assess the auditory results of CI and ABI in NF2 patients and review the literature. METHODS: Four NF2 patients were prospectively evaluated. They were submitted to tumor resection followed by ipsilateral CI or ABI depending on cochlear nerve preservation. Long term auditory results were described for CI (12 months) and ABI (48 months). RESULTS: All patients achieved auditory perception improvements in their hearing thresholds. The CI patient does not recognize vowels or sentences. The 3 ABI patients discriminate 70% of vowels and 86% in the 4-choice test. One of them does not recognize sentences. The other two recognize 100% of closed sentences and 10% and 20% of open sentences. CONCLUSION: The choice of implant type to restore hearing to NF2 patients will relay on anatomical and functional cochlear nerve preservation during tumor resection surgery. Although our experience was different, the literature shows that if this condition is achieved, CI will offer better auditory results. If not, ABI is recommended.

Surgical complications in 550 consecutive cochlear implantation.

UNLABELLED: Cochlear implantation is a safe and reliable method for auditory restoration in patients with severe to profound hearing loss. OBJECTIVE: To describe the surgical complications of cochlear implantation. MATERIALS AND METHODS: Information from 591 consecutive multichannel cochlear implant surgeries were retrospectively analyzed. All patients were followed-up for at least one year. Forty-one patients were excluded because of missing data, follow-up loss or middle fossa approach. RESULTS: Of 550 cochlear implantation analyzed, 341 were performed in children or adolescents, and 209 in adults. The mean hearing loss time was 6.3 ± 6.7 years for prelingual loss and 12.1 ± 11.6 years for postlingual. Mean follow-up was 3.9 ± 2.8 years. Major complications occurred in 8.9% and minor in 7.8%. Problems during electrode insertion (3.8%) were the most frequent major complication followed by flap dehiscence (1.4%). Temporary facial palsy (2.2%), canal-wall lesion (2.2%) and tympanic membrane lesion (1.8%) were the more frequent minor complications. No death occurred. CONCLUSION: There was a low rate of surgical complications, most of them been successfully managed. These results confirm that cochlear implant is a safe surgery and most surgical complications can be managed with conservative measures or minimal intervention.

Retrolabyrinthine approach for surgical placement of auditory brainstem implants in children.

CONCLUSION: The extended retrolabyrinthine approach (RLA) is a safe and reliable approach for auditory brainstem placement in children. The surgical landmarks to reach cochlear nucleus are adequately exposed by this approach. OBJECTIVE: To describe a new approach option for auditory brainstem implants (ABIs) in children, highlighting the anatomical landmarks to appropriately expose the foramen of Luschka. METHODS: Three prelingually deafened children consecutively operated for ABIs via the RLA. RESULTS: ABI placement via the RLA was successfully performed in all children without any further complications except multidirectional nystagmus in one child. The RLA we employed differed from that used for vestibular schwannoma only in the removal of the posterior semicircular canal. The lateral and superior semicircular canals and the vestibule remained intact, and there was no need to expose the dura of the internal auditory meatus. The jugular bulb was completely exposed to allow adequate visualization of the ninth cranial nerve and cerebellar flocculus.

Endoscopic anatomy of the approaches to the sellar area and planum sphenoidale.

UNLABELLED: The productive work between otolaryngologists and neurosurgeons has resulted in the emergence of endoscopic endonasal skull base surgery. The goal of the present study is to describe the endoscopic anatomy of the endonasal approach to the sellar region and planum sphenoidale, highlighting the key points of the surgical approach and the neurovascular landmarks. METHOD: Descriptive study of the endoscopic endonasal dissection of 9 fresh cadavers with exposure of the anatomic structures. RESULTS: The endoscopic endonasal ethmoidectomy and sphenoidotomy allows an expanded access to the sellar area and planum sphenoidale. The surface anatomy of the sphenoid sinus is easily identifiable and provides safe landmarks, guiding the intracranial dissection. CONCLUSION: The endoscopic endonasal approach to the skull base by the ENT and neurosurgeon is feasible, but it requires adequate anatomical knowledge and endoscopic skills for its realization, which can be obtained by practicing in cadavers.

Retrolabyrinthine approach for cochlear nerve preservation in neurofibromatosis type 2 and simultaneous cochlear implantation

Few cases of cochlear implantation (CI) in neurofibromatosis type 2 (NF2) patients had been reported in the literature. The approaches described were translabyrinthine, retrosigmoid or middle cranial fossa. OBJECTIVES: To describe a case of a NF2- deafened-patient who underwent to vestibular schwannoma resection via RLA with cochlear nerve preservation and CI through the round window, at the same surgical time. RESUMED REPORT: A 36-year-old woman with severe bilateral hearing loss due to NF2 was submitted to vestibular schwannoma resection and simultaneous CI. Functional assessment of cochlear nerve was performed by electrical promontory stimulation. Complete tumor removal was accomplishment via RLA with anatomic and functional cochlear and facial nerve preservation. Cochlear electrode array was partially inserted via round window. Sound field hearing threshold improvement was achieved. Mean tonal threshold was 46.2 dB HL. The patient could only detect environmental sounds and human voice but cannot discriminate vowels, words nor do sentences at 2 years of follow-up. CONCLUSION: Cochlear implantation is a feasible auditory restoration option in NF2 when cochlear anatomic and functional nerve preservation is achieved. The RLA is adequate for this purpose and features as an option for hearing preservation in NF2 patients...

Complicações em 550 cirurgias consecutivas de implante coclear / Surgical complications in 550 consecutive cochlear implantation

A cirurgia de implante coclear (IC) é método seguro e factível de restaurar audição em pacientes com surdez grave a profunda. OBJETIVO: Descrever complicações do IC. MATERIAL E MÉTODOS: Dados de 591 IC com tempo de seguimento de pelo menos 1 ano foram retrospectivamente analisados. Foram excluídos 41 pacientes por dados incompletos, acesso via fossa media ou perda de seguimento. RESULTADOS: Dos 550 IC analisados, 341 foram realizados em crianças e adolescentes e 209 em adultos. O tempo médio de surdez foi de 6,3 ± 6,7 anos para pré-linguais e 12,1 ± 11,6 anos para os pós-linguais. O tempo médio de seguimento foi 3,9 ± 2,8 anos. Complicações maiores ocorreram em 8,9% casos e menores em 7,8%. Problemas durante a inserção do feixe de eletrodos (3,8%) foi a complicação maior mais frequente, seguido pela deiscência de ferida operatória (1,4%). Paralisia facial temporária (2,2%), lesão muro facial (2,2%) e lesão de membrana timpânica (1,8%) foram as complicações menores mais frequentes. Nenhum óbito foi observado. CONCLUSÃO: Complicações cirúrgicas tiveram baixa ocorrência, sendo a maioria solucionada com sucesso. Esses resultados confirmam que o IC é uma cirurgia segura e a maioria das complicações cirúrgicas pode ser manejada com medidas conservadoras ou intervenções menores.

Cochlear implantation is a safe and reliable method for auditory restoration in patients with severe to profound hearing loss. OBJECTIVE:To describe the surgical complications of cochlear implantation. MATERIALS AND METHODS: Information from 591 consecutive multichannel cochlear implant surgeries were retrospectively analyzed. All patients were followed-up for at least one year. Forty-one patients were excluded because of missing data, follow-up loss or middle fossa approach. RESULTS: Of 550 cochlear implantation analyzed, 341 were performed in children or adolescents, and 209 in adults. The mean hearing loss time was 6.3 ± 6.7 years for prelingual loss and 12.1 ± 11.6 years for postlingual. Mean follow-up was 3.9 ± 2.8 years. Major complications occurred in 8.9% and minor in 7.8%. Problems during electrode insertion (3.8%) were the most frequent major complication followed by flap dehiscence (1.4%). Temporary facial palsy (2.2%), canal-wall lesion (2.2%) and tympanic membrane lesion (1.8%) were the more frequent minor complications. No death occurred. CONCLUSION: There was a low rate of surgical complications, most of them been successfully managed. These results confirm that cochlear implant is a safe surgery and most surgical complications can be managed with conservative measures or minimal intervention.

Neurofibromatose 2: opções de restauração auditiva / Neurofibromatosis 2: hearing restoration options

Neurofibromatose 2 (NF2) é uma doença autossômica dominante que, invariavelmente, cursa com surdez. Restauração auditiva pode ser realizada por meio do implante coclear (IC) ou implante auditivo de tronco encefálico (ABI). OBJETIVO: Avaliar resultados auditivos de IC e ABI em pacientes com NF2 e revisão de literatura. MÉTODO: Foram avaliados prospectivamente quatro pacientes com NF2 submetidos à exérese tumoral e implantação de IC ou ABI ipsilateral simultâneo, dependendo se o nervo coclear foi preservado ou não cirurgicamente. São descritos resultados auditivos em longo prazo (12-48 meses). RESULTADOS: Todos pacientes implantados obtiveram percepção sonora, com melhora dos limiares tonais. A paciente com IC não discrimina vogais nem sentenças. Os três pacientes com ABI apresentam discriminação média de vogais de 70% e teste 4-choice 86%. Um paciente não discrimina sentenças. Os outros dois discriminam 100% de sentenças em formato fechado e em formato aberto 10% e 20%. CONCLUSÃO: A escolha do tipo de implante usado na restauração auditiva de portadores NF2 dependerá da preservação anatômica e funcional do nervo coclear na cirurgia de ressecção tumoral. Embora nossa experiência mostre o contrário, a literatura mostra que, se essa condição for alcançada, IC fornecerá melhores resultados auditivos. Caso contrário, ABI trará maiores benefícios.

Neurofibromatosis 2 (NF2) is an autosomal dominant disease in which hearing loss is predominant. Auditory restoration is possible using cochlear implants (CI) or auditory brainstem implant (ABI). OBJECTIVE: To assess the auditory results of CI and ABI in NF2 patients and review the literature. METHODS: Four NF2 patients were prospectively evaluated. They were submitted to tumor resection followed by ipsilateral CI or ABI depending on cochlear nerve preservation. Long term auditory results were described for CI (12 months) and ABI (48 months). RESULTS: All patients achieved auditory perception improvements in their hearing thresholds. The CI patient does not recognize vowels or sentences. The 3 ABI patients discriminate 70% of vowels and 86% in the 4-choice test. One of them does not recognize sentences. The other two recognize 100% of closed sentences and 10% and 20% of open sentences. CONCLUSION: The choice of implant type to restore hearing to NF2 patients will relay on anatomical and functional cochlear nerve preservation during tumor resection surgery. Although our experience was different, the literature shows that if this condition is achieved, CI will offer better auditory results. If not, ABI is recommended.

Endoscopic anatomy of the approaches to the sellar area and planum sphenoidale / Anatomia endoscópica do acesso à região selar e plano esfenoidal

The productive work between otolaryngologists and neurosurgeons has resulted in the emergence of endoscopic endonasal skull base surgery. The goal of the present study is to describe the endoscopic anatomy of the endonasal approach to the sellar region and planum sphenoidale, highlighting the key points of the surgical approach and the neurovascular landmarks. METHOD: Descriptive study of the endoscopic endonasal dissection of 9 fresh cadavers with exposure of the anatomic structures. RESULTS: The endoscopic endonasal ethmoidectomy and sphenoidotomy allows an expanded access to the sellar area and planum sphenoidale. The surface anatomy of the sphenoid sinus is easily identifiable and provides safe landmarks, guiding the intracranial dissection. CONCLUSION: The endoscopic endonasal approach to the skull base by the ENT and neurosurgeon is feasible, but it requires adequate anatomical knowledge and endoscopic skills for its realization, which can be obtained by practicing in cadavers.

O trabalho cooperativo entre otorrinolaringologistas e neurocirurgiões resultou no aprimoramento das técnicas cirúrgicas e no surgimento da cirurgia endoscópica endonasal da base do crânio. O estudo tem como objetivo descrever a anatomia endoscópica do acesso endonasal da região selar e plano esfenoidal, destacando os pontos fundamentais do acesso cirúrgico e referências neuro-vasculares. MÉTODO: Estudo descritivo da dissecção endoscópica endonasal de 9 cadáveres frescos com exposição das estruturas anatômicas. RESULTADOS: A etmoidectomia e esfenoidotomia endonasal endoscópica permite um acesso estendido à região selar e plano esfenoidal. A anatomia de superfície do seio esfenoidal é facilmente identificada e fornece pontos de referência seguros, guiando a dissecção intracraniana. CONCLUSÃO: O acesso endoscópico endonasal para a base do crânio pelo otorrinolaringologista e neurocirurgião é perfeitamente viável, mas para isso o conhecimento anatômico da região e de seus pontos de referência é essencial, o que pode ser obtido pelo treinamento em cadáveres.

Abscesso retrofaríngeo de evolução tardia após ingesta de corpo estranho / Late evolution retropharyngeal abscess after ingestion of foreign body

Introdução: As complicações relacionadas à ingesta de corpos estranhos, como o abscesso retrofaríngeo, são de baixa prevalência, no entanto potencialmente graves. Objetivo: Apresentar um caso de abscesso retrofaríngeo de evolução tardia após ingesta de corpo estranho. Relato de Caso: Paciente do sexo feminino apresentando disfagia, dor a movimentação cervical e sensação de corpo estranho em faringe, cerca de um mês após remoção de corpo estranho no nível do músculo cricofaríngeo. Apesar de não apresentar febre ou leucocitose, devido à leve dificuldade de mobilização cervical e perda da crepitação laríngea foram realizados radiografia simples e tomografia computadorizada de pescoço, que demonstravam sinais de abscesso retrofaríngeo. Drenagem cirúrgica do abscesso e antibioticoterapia conduziram a boa evolução do quadro e reversão dos sintomas. Conclusão: Abscesso retrofaríngeo pode ocorrer várias semanas após ingesta de corpo estranho. Ausência de febre e leucocitose não exclui o diagnóstico mesmo em pacientes imunocompetentes. Um alto grau de suspeição conduz à realização de exames diagnósticos e conduta adequados.

Introduction: The complications relating to the ingestion of foreign bodies, such as retropharyngeal abscess, are of low prevalence, but potentially severe. Objective: To present one case of late evolution retropharyngeal abscess after ingestion of foreign body. Case Report: Female patient presenting with dysphagia, pain upon cervical motion and sensation of foreign body in the pharynx, about one month after removal of foreign body from the level of the cricopharyngeal muscle. In spite of not having fever or leukocytosis, due to the slight difficulty for cervical move and loss of the laryngeal crepitation, simple radiography and computed tomography were carried out in the neck, which showed signs of retropharyngeal abscess. Surgical draining of the abscess and antibiotic therapy led to good evolution of the case and symptoms reversion. Conclusion: The retropharyngeal abscess may occur during several weeks after ingestion of a foreign body. The absence of fever and leukocytosis does not exclude the diagnosis even in immunocompetent patients. A high degree of suspicion leads to the performance of diagnostic exams and suitable procedures.

O conhecimento do diagnóstico de câncer não leva à depressão em pacientes sob cuidados paliativos / Awareness of cancer diagnosis does not lead to depression in palliative care patients

OBJETIVOS: Traçar o perfil e identificar a prevalência de depressão nos pacientes sob cuidados paliativos no Serviço de Oncologia da Faculdade de Medicina do ABC. MÉTODOS: Entrevistamos 62 pacientes oncológicos em cuidados paliativos que responderam a três questionários: questionário geral contendo variáveis demográficas, questionário estruturado para pacientes oncológicos em cuidados terminais para avaliação de sua qualidade de vida e inventário de depressão de Beck. RESULTADOS: Observamos que 68 por cento dos pacientes tinham algum grau de depressão. A maioria dos pacientes sabia seu diagnóstico (87,1 por cento), estava satisfeito com o tratamento (93,33 por cento), sentia-se satisfeito com o apoio recebido (95,7 por cento) e referiu não conversar com seus médicos sobre outros assuntos além de sua saúde (81,18 por cento). Os sintomas mais freqüentes foram dor, cansaço, fraqueza e alterações do sono. Encontramos que o fato de não saber o diagnóstico (p=0,008), estar internado (p=0,0019) e não ter recebido tratamento oncológico (p=0,007) se correlacionam significativamente com níveis mais altos de depressão. CONCLUSÃO: Pacientes sob cuidados paliativos em nosso meio, apesar de geralmente satisfeitos com seu cuidado, relatam pobre comunicação com seu médico e apresentam uma alta taxa de depressão. Saber o seu diagnóstico e ter recebido tratamento oncológico se correlacionam inversamente com a presença de depressão.

OBJECTIVE: Characterize the profile of patients under palliative care at this institution and evaluate the prevalence of depression in these patients. METHODS: Sixty two cancer patients under palliative care, who had answered three questionnaires: one regarding their demographic characteristics, another to evaluate their quality of life and the Beck's depression inventory were surveyed. RESULTS: Of these patients, 68 percent presented with some degree of depression. Most of them were aware of their diagnosis (87.1 percent), did not talk to their physicians on other subjects but their disease (81.18 percent), were satisfied with their treatment (93.33 percent) and with the support they received (95.70 percent). Pain, fatigue, weakness and sleep disturbances were the most frequently reported symptoms. There was a significant correlation between presence of depression and not knowing the diagnosis (p=0.008), being admitted to the hospital (p=0.0019) and not having ever received oncologic treatment. CONCLUSION: Patients under palliative care at this institution, despite being satisfied with the treatment, reported poor communication with their physicians and presented with a high rate of depression. Awareness of their diagnosis and having received prior oncologic treatment (p=0.07) correlated significantly and inversely with having depression.

A síndrome da estafa profissional em médicos cancerologistas brasileiros / Incidence of the burnout syndrome among Brazilian cancer physicians

OBJETIVOS: A síndrome da estafa profissional (burnout) é um quadro caracterizado por três dimensões: exaustão emocional (EE), despersonalização (DP) e baixa realização pessoal (RP). Na área médica, os cancerologistas estão particularmente predispostos a esta síndrome. O objetivo deste estudo é avaliar sua prevalência entre cancerologistas brasileiros, correlacionando-a com dados demográficos e características de trabalho destes profissionais, avaliando também quais as suas sugestões para prevenção do quadro. MÉTODOS: Três questionários foram enviados aos 645 membros da Sociedade Brasileira de Cancerologia, por correio, e, após dez semanas, foram recebidas 136 respostas. Os questionários utilizados foram um de opinião, um geral e o inventário de Maslach de exaustão profissional, que avalia as supramencionadas dimensões separadamente, caracterizando-as em níveis leve, moderado ou grave. DISCUSSÃO: A taxa de resposta obtida foi 21 por cento. A síndrome foi observada em níveis moderados ou graves nas três dimensões em 15,7 por cento dos médicos. Para EE, 55,8 por cento apresentaram os níveis moderado ou grave. Para DP, esse número foi de 96,1 por cento e, para RP, 23,4 por cento. Correlacionando o questionário Maslach com os dados demográficos, encontramos significância estatística entre prática de atividade física ou hobby e menores níveis de EE (p=0,008) e trabalhar apenas em instituições privadas com maiores níveis de DP (p=0,021). Os cancerologistas apontaram como alternativas mais relevantes na prevenção da síndrome menos burocracia (73,5 por cento) e limitação do número de pacientes atendidos (72,7 por cento). CONCLUSÃO: A síndrome da estafa profissional é freqüente entre médicos cancerologistas brasileiros, e outros estudos devem ser desenvolvidos para averiguar sua prevalência e prevenção em outras especialidades médicas.

Repercussões auditivas da síndrome alcóolica fetal / Auditory repercurssions od fetal alcohol syndrome

O abuso de álcool durante a gravidez, além de causar impacto individual, familiar e social, causa sérios danos ao recém-nascido. O álcool tem a capacidade de causar grande injúria ao embrião e ao feto, e a Síndrome Alcóolica Fetal é a manifestação mais grave desse processo. O sistema auditivo, assim como o sistema nervoso central, está vulnerável aos efeitos tóxicos do álcool devido ao período embriológico em que se forma, podendo haver deficiência auditiva em diferentes graus em crianças cujas mães fizeram uso de grandes quantidades de álcool no período gestacional. A aquisição e o desenvolvimento da linguagem dependem diretamente da função auditiva, que deve ser acompanhada em crianças acometidas por essa síndrome, destacando-se o papel de pediatras, neurologistas e otorrinolaringologistas nesse processo. O presente trabalho descreve quatro casos de Síndrome Alcóolica Fetal (SAF) e aborda aspectos clínicos e epidemiológicos relevantes dessa síndrome, enfatizando as repercussões auditivas, que têm tido pouco enfoque na literatura científica mundial.