Characterization of interstimulus interaction in the multiple auditory steady-state responses at high sound levels.

Multiple auditory steady-state response (MASSR) is recommended to estimate hearing thresholds in difficult-to-test individuals. The multiple stimuli that evoke MASSR may present an interstimulus interaction (ISI) that is able to distort the generation of responses. No consensus exists on the effects of the ISI in MASSR when dealing with high sound level stimuli or cases of sensorineural hearing loss. This study investigated the effects of ISI on the amplitude and detectability of auditory steady-state responses, with a focus at and above 65 dB sound pressure level (SPL). Normal hearing (NH) and sensorineural hearing impaired (SNHI) adults were tested with different stimulus types [amplitude modulation (AM) One octave chirp (OC), and a weighted OC (WOC)], stimulus levels, and modalities (single or multiple stimuli). ISI typically attenuated response amplitude of a control stimulus caused by an interference stimulus one octave above the control stimulus. At and above 80 dB SPL, attenuations of around 50% decreased the number of detectable responses near SNHI thresholds, especially for OC and WOC. AM stimuli obtained a higher detection rate than OC and WOC when presented 10 dB above the behavioral hearing threshold of SNHI participants. Using OC in MASSR when assessing elevated thresholds might diminish accuracy on threshold estimation, and extend test duration.

Assessment of otoacoustic emission suppression in women with migraine and phonophobia.

Given that the medial olivocochlear efferent system reduces the amplitude of otoacoustic emissions (OAE), the aim of this study was to establish whether such a pathway is affected in women with migraine and phonophobia by means of OAE suppression testing. In this prospective case-control study, 55 women (29 with migraine and phonophobia and 26 healthy women) were subjected to transient-evoked otoacoustic emission (TEOAE) testing at frequencies from 1 to 4 kHz. The amplitudes of the TEOAE response before and after exposure to contralateral noise and the magnitude of TEOAE suppression were assessed. The average TEOAE amplitudes in conditions with and without exposure to contralateral noise were not significantly different between the groups. However, the magnitude of TEOAE suppression was lower in the group with migraine; that difference was only statistically significant for frequencies 1 and 1.5 kHz (p = 0.042 and p = 0.004, respectively). In this study, women with migraine and phonophobia exhibited deficits in OAE suppression, which points to a disorder affecting the medial olivocochlear efferent system.

Behavioral Assessment of Central Auditory Processing in Turner Syndrome.

Introduction Turner syndrome (TS) affects ∼ 1 in 2,500 live births. The presence of hearing alterations is one of the comorbidities found in this syndrome. Objective The present study aimed to evaluate the central auditory abilities in TS and to associate the alterations found with the cytogenetic pattern of the syndrome. Methods We included children and adults aged 9 to 39 years old, diagnosed with TS, with numerical or structural alterations of sex chromosomes in their karyotype. A battery of behavioral tests of central auditory processing (CAP) was performed, including a test within the modalities: monoaural low-redundancy, dichotic listening, binaural interaction, and temporal processing (resolution and ordering). We studied auditory skills in the total sample and in the sample stratified by age, divided into groups: G1 (9 to 13 years old), G2 (14 to 19 years old), and G3 (20 to 31 years old). For the association of the cytogenetic pattern, the division was T1 (chromosome monosomy X), and T2 (other TS cytogenetic patterns). Statistical analysis presented data expressed as median and interquartile range for numerical data and as frequency and percentage for categorical data. Results We found alterations in four auditory skills in the three age groups, but there was a statistically significant difference between the age groups only in the Gaps in Noise Test (GIN) ( p -value = 0.009). Regarding karyotype, a greater number of alterations in the T1 cytogenetic pattern (chromosome monosomy X) was observed in four auditory skills, but without a statistically significant difference. Conclusion The alterations found point to an impairment in CAP in TS.

A Study on the Reference Values and Cutoff Criteria of Masking Level Difference for Children Aged 7-12 Years.

The Masking Level Difference (MLD) test is one of the main instruments for investigating binaural interaction. Studies with children aged 7-12 years still disagree about the influence of age on test performance and present discordant reference values. This study aimed to verify the effect of age on the performance of children aged 7-12 years in the MLD test and to establish reference values and cutoff criteria for this age group. Fifty-nine children with normal hearing were organized in three groups according to their age: 7-8 (n = 20), 9-10 (n = 20), and 11-12 (n = 19) years. The participants completed the MLD test by Auditec®. The Kruskal-Wallis statistical test was used to compare groups. Reference values were obtained by calculating mean, standard deviation, median, mode, and percentiles, while the cutoff criterion was obtained by subtracting two standard deviations from the mean. No statistically significant differences were observed between the groups regarding the MLD test measures. The mean MLD was 10.51 ± 1.84 dB and the cutoff point was set at 7 dB. Thus, reference values for the MLD test were established for children aged 7-12 years, who presented no effect of age on test performance.

Masking Level Difference: test-retest reliability assessment in normal hearing female university students. / Masking Level Difference: avaliação da confiabilidade teste-reteste em estudantes universitárias normo-ouvintes.

PURPOSE: To verify the test-retest reliability of the Masking Level Difference in normal hearing female university students. METHODS: Prospective descriptive study with 78 young female adults without hearing complaints, submitted to the compact disc version of the Masking Level Difference by Auditec of Saint Louis. The threshold was determined by the difference between signal-to-noise ratios at hearing thresholds found in the antiphasic and homophasic conditions. The test was applied by the same examiner in two moments (test and retest) with an interval of seven to 14 days between them. Inferential statistical analysis included comparison of test and retest situations using Student's t test for paired samples, calculation of the intraclass correlation coefficient and calculation of 95% confidence intervals for signal-to-noise ratios at hearing thresholds found in the antiphasic and homophasic conditions and for masking level difference. RESULTS: The average signal-to-noise ratio at hearing threshold ​​in the homophasic condition was -12.59 dB and -12.46 dB in the Test and Retest situations, respectively, and -21.54 dB and -21.08 dB in the antiphasic condition. The average value ​​in the final Masking Level Difference result was 8.95 dB in the Test and 8.74 dB in the Retest. Intraclass correlation coefficient values ​​obtained were 0.436, 0.625 and 0.577 for homophasic, antiphasic and Masking Level Difference conditions, respectively. CONCLUSION: The Masking Level Difference showed moderate test-retest reliability in normal hearing adults female university students.

OBJETIVO: Verificar a confiabilidade teste-reteste do Masking Level Difference em estudantes universitárias normo-ouvintes. MÉTODO: Estudo prospectivo descritivo com 78 adultos jovens do gênero feminino sem queixas auditivas, submetidas à versão, em compact disc, do Masking Level Difference da Auditec of Saint Louis. O Masking Level Difference foi determinado por meio da diferença entre as relações sinal-ruído nos limiares auditivos encontrados nas condições antifásica e homofásica. O teste foi aplicado pelo mesmo examinador em dois momentos (teste e reteste) com intervalo de sete a 14 dias entre eles. A análise estatística inferencial incluiu comparação das situações teste e reteste por meio do teste t de Student para amostras pareadas, cálculo do coeficiente de correlação intraclasse e dos intervalos de confiança de 95% para as relações sinal/ruído nos limiares auditivos nas condições antifásica e homofásica e para o cálculo do Masking Level Difference. RESULTADOS: A média da relação sinal-ruído no limiar auditivo na condição homofásica foi -12,59 dB e -12,46 dB nas situações teste e reteste, respectivamente, e -21,54 dB e -21,08 dB na condição antifásica. A média do Masking Level Difference foi 8,95 dB no teste e 8,74 dB no reteste. Os coeficientes de correlação intraclasse obtidos foram 0,436, 0,625 e 0,577 para as condições homofásica, antifásica e Masking Level Difference, respectivamente. CONCLUSÃO: O teste Masking Level Difference mostrou grau moderado de confiabilidade teste-reteste em estudantes universitárias normo-ouvintes.

Efferent Auditory Pathways Inhibition in Turner syndrome. / Efeito inibitório da via auditiva eferente na síndrome de Turner.

PURPOSE: The goal of this study is to investigate the efferent auditory pathways inhibition in Turner's syndrome and to relate it to the cytogenetic profile. METHODS: This is a cross-sectional study with a comparison group. A sample with 94 participants divided into two groups: The study group was a sample of 40 patients diagnosed with Turner's syndrome (17.6 years of age). The control group was composed of 54 volunteers (18.9 years of age), female, without syndrome. The selected individuals were submitted to efferent auditory pathways inhibition research. RESULTS: The mean of the inhibitory effect of the efferent auditory pathway in the study group in the right ear was 0.4 dB and in the comparison group it was 1.9 dB, however in the left ear the mean of the inhibitory effect of the efferent auditory pathway was 1.4 dB in the study group and 0.8 dB in the comparison group. The inhibitory effect of the efferent auditory pathway was present in 14 individuals with monosomy and in 15 with other cytogenetic alterations. CONCLUSIONS: In the study group, the efferent auditory pathways inhibition value was significantly higher in the left ear and significantly lower than the control group in the right ear. There was no significant difference in efferent auditory pathways inhibition of right ear and left ear between the karyotype types.

OBJETIVO: investigar o efeito inibitório da via auditiva eferente na síndrome de Turner e relacionar com o perfil citogenético. MÉTODO: estudo descritivo transversal com grupo de comparação. Amostra: Grupo estudo formado por 40 pacientes com síndrome de Turner (17,6 anos); e Grupo controle constituído por 54 indivíduos (18,9 anos), do sexo feminino sem síndrome. Os indivíduos selecionados foram submetidos à pesquisa do efeito inibitório da via auditiva eferente. RESULTADOS: A média do Efeito inibitório da via auditiva eferente no grupo estudo na orelha direita foi 0,4 dB e no grupo comparação foi de 1,9 dB, entretanto na orelha esquerda a média do efeito inibitório da via auditiva eferente foi 1,4 dB no grupo estudo e 0,8 dB no grupo comparação. O efeito inibitório da via auditiva eferente foi presente em 14 indivíduos com monossomia e em 15 com outras alterações citogenéticas. CONCLUSÃO: No grupo estudo o valor do efeito inibitório da via auditiva eferente foi significantemente maior na orelha esquerda e significativamente menor que o grupo controle na direita. Não houve diferença significativa no efeito inibitório da via auditiva eferente entre os tipos de cariótipo.

Association between cytogenetic alteration and the audiometric profile of individuals with Turner syndrome.

INTRODUCTION: Turner syndrome is a frequent genetic disorder that affects female individuals and covers a large phenotypic variability. Scientific literature suggests an association between hearing loss and Turner syndrome, but it remains a controversial topic. OBJECTIVE: To associate the cytogenetic alteration with the audiometric profile of individuals with Turner syndrome. METHODS: Cross-sectional study, with a hospital-based, convenience sample. Patients diagnosed with Turner syndrome were included and those with difficulty understanding the audiometry and/or other associated syndromes were excluded. The participants were studied with pure tone audiometry. RESULTS: Of the 65 patients included, 36.9% had X chromosome monosomy and 63.0% had other alterations. Regarding the audiometry, 64.6% had normal thresholds and 35.3% had hearing impairment. Of these, 30.4% had hybrid hearing loss, 26.0% alteration at 6 and/or 8kHz, 17.3% had conductive hearing loss, 13.0% sensorineural loss and 13.0% had mixed hearing loss. We observed that the mild degree was the most frequent one. There was no statistically significant association between the cytogenetic type of Turner syndrome and the presence or absence of hearing loss, or with the type and degree of hearing loss. CONCLUSION: The cytogenetic alteration in Turner syndrome was not associated with the audiometric profile, which showed variability regarding the type and degree of hearing loss.

Comparative study of audiometrics tests on metallurgical workers exposed to noise only as well as noise associated to the handling of chemical products.

UNLABELLED: Exposure to ototoxic chemical products in the presence or absence of noise can cause irreversible injury to the hearing of workers for a significantly short period of exposure period. AIM: to perform a comparative study, through audiometric tests, in workers exposed to noise only and noise associated with chemical products. MATERIALS AND METHODS: 155 steel workers (18 - 50 years) exposed to noise (group I), and exposed to noise and chemical products (group II) for a period that varies from 3 to 20 years. RESULTS: significant difference in the rate of occupational hearing loss in the right ear between groups I (3.6%) and II (15.5%). A significantly higher rate of occupational hearing loss in group II (18.3%) and I (6%). With respect to the average time of exposure to aggressive agents, group I was exposed by a significantly higher time. Retrospective study. DISCUSSION: The fact that the right ear was more affected in group II is controversial and should be better investigated in the future, since some studies show that the left ear would be more prone to noise-induced hearing loss. CONCLUSION: group II had proportionally a higher rate of hearing loss when compared with group I, even after having been exposed to aggressive agents for a lower average time.

Behavioral Assessment of Central Auditory Processing in Turner Syndrome

Abstract Introduction Turner syndrome (TS) affects ~ 1 in 2,500 live births. The presence of hearing alterations is one of the comorbidities found in this syndrome. Objective The present study aimed to evaluate the central auditory abilities in TS and to associate the alterations found with the cytogenetic pattern of the syndrome. Methods We included children and adults aged 9 to 39 years old, diagnosed with TS, with numerical or structural alterations of sex chromosomes in their karyotype. A battery of behavioral tests of central auditory processing (CAP) was performed, including a test within the modalities: monoaural low-redundancy, dichotic listening, binaural interaction, and temporal processing (resolution and ordering). We studied auditory skills in the total sample and in the sample stratified by age, divided into groups: G1 (9 to 13 years old), G2 (14 to 19 years old), and G3 (20 to 31 years old). For the association of the cytogenetic pattern, the division was T1 (chromosome monosomy X), and T2 (other TS cytogenetic patterns). Statistical analysis presented data expressed as median and interquartile range for numerical data and as frequency and percentage for categorical data. Results We found alterations in four auditory skills in the three age groups, but there was a statistically significant difference between the age groups only in the Gaps in Noise Test (GIN) (p-value = 0.009). Regarding karyotype, a greater number of alterations in the T1 cytogenetic pattern (chromosome monosomy X) was observed in four auditory skills, but without a statistically significant difference. Conclusion The alterations found point to an impairment in CAP in TS.

Sequential analysis as a tool for detection of amikacin ototoxicity in the treatment of multidrug-resistant tuberculosis.

OBJECTIVE: To investigate early detection of amikacin-induced ototoxicity in a population treated for multidrug-resistant tuberculosis (MDR-TB), by means of three different tests: pure-tone audiometry (PTA); high-frequency audiometry (HFA); and distortion-product otoacoustic emission (DPOAE) testing. METHODS: This was a longitudinal prospective cohort study involving patients aged 18-69 years with a diagnosis of MDR-TB who had to receive amikacin for six months as part of their antituberculosis drug regimen for the first time. Hearing was assessed before treatment initiation and at two and six months after treatment initiation. Sequential statistics were used to analyze the results. RESULTS: We included 61 patients, but the final population consisted of 10 patients (7 men and 3 women) because of sequential analysis. Comparison of the test results obtained at two and six months after treatment initiation with those obtained at baseline revealed that HFA at two months and PTA at six months detected hearing threshold shifts consistent with ototoxicity. However, DPOAE testing did not detect such shifts. CONCLUSIONS: The statistical method used in this study makes it possible to conclude that, over the six-month period, amikacin-associated hearing threshold shifts were detected by HFA and PTA, and that DPOAE testing was not efficient in detecting such shifts.

The efficiency of otoacoustic emissions and pure-tone audiometry in the detection of temporary auditory changes after exposure to high sound pressure levels.

UNLABELLED: Exposure to noise has a harmful effect on the auditory health of workers. AIM: The main goal of this paper was to establish the role of pure-tone audiometry and evoked transient otoacoustic emissions in the detection of small temporary auditory changes after exposure to high sound pressure levels. STUDY DESIGN: A cross-sectional cohort study. MATERIAL AND METHODS: 30 otologically normal subjects aged between 20 and 35 years were submitted to pure-tone audiometry and evoked transiente otoacoustic emissions before and after 5 hours of exposure to high sound pressure levels (between 80 and 90 dB). RESULTS: For pure-tone audiometry the largest changes occurred at high frequencies--from 3 KHz to 8 KHz after exposure. The evoked transient otoacoustic emissions showed reduced reproductibility from 1 KHz to 4 KHz after exposure to noise. CONCLUSION: We noted that both pure-tone audiometry and evoked transient otoacoustic emissions had a role in detecting statistically significant changes in the auditory threshold and in reproductibility, after exposure to high sound pressure levels.

Analisys of high frequency auditory thresholds in individuals aged between 18 and 29 years with no otological complaints.

UNLABELLED: Recent studies analyzing audibility thresholds at frequencies over 8 KHz have brought new perspectives on the investigation of auditory damage. These studies, however, have not yet reached a consensus on normal standards for auditory thresholds at these frequencies. AIM: To analyze the results of high frequency auditory thresholds in individuals aged between 18 and 29 years with no otological complaints. TYPE OF STUDY: A prospective, cross-sectional study. METHODS: 60 conventional audiometries were done and 51 of these exams were within normal limits in individuals aged 18 to 29 years. These selected individuals underwent high-frequency audiometry using the AMPLAID 460 device and Sennheiser HD 520 II earphones, and thresholds were obtained in dB HL Results: There was no significant difference in auditory thresholds between males and females. High-frequency auditory thresholds were obtained for individuals with no otological complaint, aged between 18 and 29 years. CONCLUSION: It has been suggested that such data could be used as a normal reference for further studies with similar standard equipment, to analyze auditory alterations presented in young individuals.

The importance of audiometric monitoring in patients with multidrug-resistant tuberculosis.

INTRODUCTION: A total of 771 cases of multidrug-resistant tuberculosis (MDR-TB) were reported in Brazil in 2014. Treatment of MDR-TB with aminoglycosides can produce serious side effects such as permanent and irreversible hearing loss, which occurs in 5-64% of cases, and severely compromise patient quality of life. The goal of this research was to evaluate auditory and vestibular side effects in patients treated for MDR-TB and to identify associations between these complaints and the type of aminoglycoside used. METHODS: We performed a retrospective review of 599 medical records from patients with MDR-TB who were treated at the Hélio Fraga/Fiocruz Reference Center between 2006 and 2010. Cases without auditory or vestibular complaints and patients who were not treated with aminoglycoside drugs were excluded from the study. RESULTS: Of 164 eligible cases, 55 (33.5%) reported an auditory or vestibular complaint and medication was subsequently suspended, although hearing damage was not confirmed in all cases. Audiometric testing confirmed hearing loss in 11 (21.7%) of 12 cases submitted for evaluation. Hearing loss related to ototoxicity was confirmed in 15 (62.5%) cases. Tinnitus was significantly associated with the use of amikacin and streptomycin. CONCLUSIONS: Evaluations of ototoxicity symptoms were not usually reported in the routine care of patients with MDR-TB. Complaints of tinnitus were associated with amikacin and streptomycin use. These results require confirmation in future studies.

Behavioral assessment tests for central hearing skills in individuals with sensorineural hearing loss: an integrative review / Testes para a avaliação comportamental das habilidades auditivas centrais em indivíduos com perdas auditivas neurossensorial: uma revisão integrativa

ABSTRACT Purpose: to identify the most used tests and the changed hearing skills in the central auditory processing of individuals with sensorineural hearing loss. Methods: an integrative literature review conducted between March and August 2021 in PubMed/MEDLINE, LILACS, SciELO, IBECS, and Index Psi Scientific Journals. The review included studies addressing central hearing skills with central auditory processing behavioral tests in subjects with mild to moderate sensorineural hearing loss. Two independent reviewers made the study selection, data extraction, and qualitative synthesis. The selection aimed at verifying whether the studies answered the research question. Literature Review: 39 studies were found for full-text reading; after applying the eligibility criteria, 13 studies were included in the review. Participants diagnosed with sensorineural hearing loss predominantly had hearing changes in verbal tests, in comparison with normal standards for individuals without hearing loss. Thus, the most changed skills are the ones that depend on speech sound discrimination. Conclusion: the Staggered Spondaic Word Test predominated among the most used behavioral tests, while the most researched central auditory skills were binaural integration and binaural separation.

RESUMO Objetivo: identificar os testes mais utilizados e as habilidades auditivas alteradas no processamento auditivo central, em indivíduos com perda auditiva neurossensorial. Métodos: revisão de literatura integrativa, realizada de março a agosto de 2021 nas bases de dados: PubMed/Medline, Lilacs, Scielo, IBECS e Index Psicologia Periódicos técnico-científicos. Foram incluídos estudos que realizaram a pesquisa das habilidades auditivas centrais, através do teste comportamental do processamento auditivo central, em sujeitos portadores de perda auditiva neurossensorial, de grau leve a moderado. A seleção, extração e síntese qualitativa foram realizadas por dois revisores independentes. A seleção teve como objetivo verificar se os estudos contemplavam a pergunta do estudo. Revisão da Literatura: foram encontrados 39 estudos para leitura do texto na íntegra e, ao aplicar os critérios de elegibilidade, foram incluídos 13 estudos. Observou-se que os participantes diagnosticados com perda auditiva neurossensorial apresentam predomínio de alteração auditiva em testes verbais quando comparados aos padrões de normalidade estabelecidos para indivíduos sem perda. Sendo assim, as habilidades mais alteradas são as que dependem da discriminação dos sons da fala. Conclusão: entre os testes comportamentais mais utilizados, predominou o teste SSW. Quanto as habilidades auditivas centrais mais pesquisadas foram integração binaural e separação binaural.

Efeito inibitório da via auditiva eferente na síndrome de Turner / Efferent Auditory Pathways Inhibition in Turner syndrome

RESUMO Objetivo investigar o efeito inibitório da via auditiva eferente na síndrome de Turner e relacionar com o perfil citogenético. Método estudo descritivo transversal com grupo de comparação. Amostra: Grupo estudo formado por 40 pacientes com síndrome de Turner (17,6 anos); e Grupo controle constituído por 54 indivíduos (18,9 anos), do sexo feminino sem síndrome. Os indivíduos selecionados foram submetidos à pesquisa do efeito inibitório da via auditiva eferente. Resultados A média do Efeito inibitório da via auditiva eferente no grupo estudo na orelha direita foi 0,4 dB e no grupo comparação foi de 1,9 dB, entretanto na orelha esquerda a média do efeito inibitório da via auditiva eferente foi 1,4 dB no grupo estudo e 0,8 dB no grupo comparação. O efeito inibitório da via auditiva eferente foi presente em 14 indivíduos com monossomia e em 15 com outras alterações citogenéticas. Conclusão No grupo estudo o valor do efeito inibitório da via auditiva eferente foi significantemente maior na orelha esquerda e significativamente menor que o grupo controle na direita. Não houve diferença significativa no efeito inibitório da via auditiva eferente entre os tipos de cariótipo.

ABSTRACT Purpose The goal of this study is to investigate the efferent auditory pathways inhibition in Turner's syndrome and to relate it to the cytogenetic profile. Methods This is a cross-sectional study with a comparison group. A sample with 94 participants divided into two groups: The study group was a sample of 40 patients diagnosed with Turner's syndrome (17.6 years of age). The control group was composed of 54 volunteers (18.9 years of age), female, without syndrome. The selected individuals were submitted to efferent auditory pathways inhibition research. Results The mean of the inhibitory effect of the efferent auditory pathway in the study group in the right ear was 0.4 dB and in the comparison group it was 1.9 dB, however in the left ear the mean of the inhibitory effect of the efferent auditory pathway was 1.4 dB in the study group and 0.8 dB in the comparison group. The inhibitory effect of the efferent auditory pathway was present in 14 individuals with monosomy and in 15 with other cytogenetic alterations. Conclusions In the study group, the efferent auditory pathways inhibition value was significantly higher in the left ear and significantly lower than the control group in the right ear. There was no significant difference in efferent auditory pathways inhibition of right ear and left ear between the karyotype types.

Cochlear function in students exposed to pesticides. / Função coclear em escolares expostos aos agrotóxicos.

PURPOSE: To estimate the degree of association between exposure to pesticides and the risk of alteration in cochlear function in students exposed to pesticides. METHODS: This study evaluated individuals aged 8 to 30, of both genders, residing in an area of heavy pesticide use in the town of Nova Friburgo, Rio de Janeiro State. Each study participant answered a questionnaire to assess their degree of pesticide exposure. To evaluate cochlear function, audiometry exams were performed, including transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs). RESULTS: The TEOAE responses were on average lower at higher frequencies, especially at 2.0 and 4.0 kHz, and lower at these frequencies among the most exposed individuals. A similar pattern was observed for DPOAE responses. The lowest response level in the DPOAE tests was observed at the frequency of 6 kHz in the group with the highest exposure score. The proportion of failures observed at more than one frequency in the TEOAE tests on the right ear was significantly higher in the highest exposure group when compared to the lowest exposure group. In the DPOAE test, the rate of failure was also greater in the group with highest exposure when compared to that of lowest exposure. CONCLUSION: The results suggest that exposure to pesticides can significantly contribute to alterations in cochlear function in individuals with preserved audiometric thresholds.

Hearing screening analysis in children exposed to the Zika virus / Análise da triagem auditiva de crianças expostas ao vírus Zika

ABSTRACT Purpose: to analyze the results of neonatal hearing screening examinations in newborns with and without microcephaly, exposed to the Zika virus, without other risk indicators for hearing loss, and verify the association between screening results, sample characteristics, and the gestational trimester when exposure took place. Methods: a descriptive cross-sectional study. Subjects included in the study had no risk indicator for hearing loss other than microcephaly, and presented, along with their mothers, positive RT-PCR results, respectively at birth and during pregnancy. The transient evoked otoacoustic emission and brainstem auditory evoked potential examinations were applied by the researcher between March 2016 and December 2017. Newborns failed the screening when they failed at least one retest in at least one ear. The data were descriptively analyzed, using the Fisher exact test; p-values equal to or lower than 0.05 were considered significant. Results: out of the 45 subjects, 30 (66.7%) were females, 6.7% were likely to have sensorineural hearing loss, with or without auditory neuropathy spectrum disorder - which was possibly present in only one ear of one of these three subjects. Failure in the screening was statistically significant in subjects with at least one of the congenital Zika syndrome characteristics and subjects with subcortical calcification and brain cortex thinning, macular chorioretinal atrophy with focal pigmentary mottling, and hypertonia with symptoms of extrapyramidal involvement. The gestational trimester of exposure was associated with screening results. Conclusion: the responses in screening point to the possibility of hearing loss in newborns with and without microcephaly, whereas the presence of microcephaly was not significant to examination failures. Exposure in the first gestational trimester indicated a possible relationship with screening failures.

RESUMO Objetivo: analisar os resultados dos exames de triagem auditiva neonatal de recém-nascidos sem e com microcefalia expostos ao vírus Zika, que não apresentaram outros indicadores de risco para deficiência auditiva e verificar a associação entre o resultado da triagem, as características da amostra e o trimestre gestacional em que ocorreu a exposição. Métodos: estudo descritivo de corte transversal. Fizeram parte do estudo sujeitos sem indicadores de risco para deficiência auditiva, com exceção da microcefalia, cujas mães apresentaram na gestação o exame RT-PCR positivo e sujeitos que tiveram o RT-PCR positivo, ao nascimento. Os exames de Emissões Otoacústicas Transientes e Potencial Evocado Auditivo de Tronco Encefálico foram aplicados, pela pesquisadora, entre março de 2016 e dezembro de 2017. O recém-nato foi considerado reprovado na triagem quando apresentou falha em pelo menos um reteste, em ao menos uma orelha. Os dados foram analisados de forma descritiva e utilizando-se o teste estatístico exato de Fisher, p valor menor ou igual a 0,05 foi considerado significante. Resultados: dos 45 sujeitos, 30 (66,7%) eram do sexo feminino, 6,7% apresentaram a probabilidade de alteração do tipo sensorioneural, com ou sem espectro da neuropatia auditiva e somente um dentre esses três sujeitos apresentou uma das orelhas com chance do espectro da neuropatia auditiva, isoladamente. A falha na triagem foi estatisticamente significativa, nos sujeitos que apresentavam pelo menos uma característica da Síndrome da Zika Congênita e nos sujeitos com calcificação subcortical com afilamento do córtex cerebral, atrofia coriorretiniana macular com moteado pigmentar focal e hipertonia com sintomas de envolvimento extrapiramidal. Houve associação do trimestre gestacional da exposição com o resultado de triagem. Conclusão: as respostas verificadas pela triagem apontam para a possibilidade de alteração auditiva em recém-nascidos sem e com microcefalia, onde a presença da microcefalia não foi significante para falha nos exames. A exposição no primeiro trimestre gestacional indicou uma possível relação com falhas na triagem.

Masking Level Difference: avaliação da confiabilidade teste-reteste em estudantes universitárias normo-ouvintes / Masking Level Difference: test-retest reliability assessment in normal hearing female university students

RESUMO Objetivo Verificar a confiabilidade teste-reteste do Masking Level Difference em estudantes universitárias normo-ouvintes. Método Estudo prospectivo descritivo com 78 adultos jovens do gênero feminino sem queixas auditivas, submetidas à versão, em compact disc, do Masking Level Difference da Auditec of Saint Louis. O Masking Level Difference foi determinado por meio da diferença entre as relações sinal-ruído nos limiares auditivos encontrados nas condições antifásica e homofásica. O teste foi aplicado pelo mesmo examinador em dois momentos (teste e reteste) com intervalo de sete a 14 dias entre eles. A análise estatística inferencial incluiu comparação das situações teste e reteste por meio do teste t de Student para amostras pareadas, cálculo do coeficiente de correlação intraclasse e dos intervalos de confiança de 95% para as relações sinal/ruído nos limiares auditivos nas condições antifásica e homofásica e para o cálculo do Masking Level Difference. Resultados A média da relação sinal-ruído no limiar auditivo na condição homofásica foi -12,59 dB e -12,46 dB nas situações teste e reteste, respectivamente, e -21,54 dB e -21,08 dB na condição antifásica. A média do Masking Level Difference foi 8,95 dB no teste e 8,74 dB no reteste. Os coeficientes de correlação intraclasse obtidos foram 0,436, 0,625 e 0,577 para as condições homofásica, antifásica e Masking Level Difference, respectivamente. Conclusão O teste Masking Level Difference mostrou grau moderado de confiabilidade teste-reteste em estudantes universitárias normo-ouvintes.

ABSTRACT Purpose To verify the test-retest reliability of the Masking Level Difference in normal hearing female university students. Methods Prospective descriptive study with 78 young female adults without hearing complaints, submitted to the compact disc version of the Masking Level Difference by Auditec of Saint Louis. The threshold was determined by the difference between signal-to-noise ratios at hearing thresholds found in the antiphasic and homophasic conditions. The test was applied by the same examiner in two moments (test and retest) with an interval of seven to 14 days between them. Inferential statistical analysis included comparison of test and retest situations using Student's t test for paired samples, calculation of the intraclass correlation coefficient and calculation of 95% confidence intervals for signal-to-noise ratios at hearing thresholds found in the antiphasic and homophasic conditions and for masking level difference. Results The average signal-to-noise ratio at hearing threshold ​​in the homophasic condition was -12.59 dB and -12.46 dB in the Test and Retest situations, respectively, and -21.54 dB and -21.08 dB in the antiphasic condition. The average value ​​in the final Masking Level Difference result was 8.95 dB in the Test and 8.74 dB in the Retest. Intraclass correlation coefficient values ​​obtained were 0.436, 0.625 and 0.577 for homophasic, antiphasic and Masking Level Difference conditions, respectively. Conclusion The Masking Level Difference showed moderate test-retest reliability in normal hearing adults female university students.

Assessment of frequency specific auditory steady-state response using amplitude modulation with 2-order exponential envelope.

This study investigated the performance of Frequency Specific Auditory Steady-State Response (FS-ASSR) detection elicited by the amplitude modulated tone with 2-order exponential envelope (AM2), using objective response detection (ORD) techniques of Spectral F-Test (SFT) and Magnitude Squared Coherence (MSC). ASSRs from 24 normal hearing adults were obtained during binaural multi-tone stimulation of amplitude-modulation (AM) and AM2 at intensities of 60, 45 and 30 dBSPL. The carrier frequencies were 500, 1000, 2000, and 4000 Hz, modulated between 77 and 105 Hz. AM2 achieve FS-ASSR amplitudes higher than AM by 16%, 18% and 12% at 60, 45 and 30 dBSPL, respectively, with a major increase at 500 Hz (22.5%). AMS2PL increased the Detection Rate (DR) up to 8.3% at 500 Hz for 30 dBSPL, which is particularly beneficial for FS-ASSR detection near the hearing threshold. In addition, responses in 1000 and 4000 Hz were consistently increased. The MSC and SFT presented no differences in Detection Rate (DR). False Detection Rate (FDR) was close to 5% for both techniques and tones. Detection times to reach DR over 90% were 3.5 and 4.9 min at 60 and 45 dBSPL, respectively. Further investigation concerning efficient multiple FS-ASSR is still necessary, such as testing subjects with hearing loss.

Association between cytogenetic alteration and the audiometric profile of individuals with Turner syndrome / Relação entre alteração citogenética e o perfil audiométrico de indivíduos com síndrome de Turner

Abstract Introduction: Turner syndrome is a frequent genetic disorder that affects female individuals and covers a large phenotypic variability. Scientific literature suggests an association between hearing loss and Turner syndrome, but it remains a controversial topic. Objective: To associate the cytogenetic alteration with the audiometric profile of individuals with Turner syndrome. Methods: Cross-sectional study, with a hospital-based, convenience sample. Patients diagnosed with Turner syndrome were included and those with difficulty understanding the audiometry and/or other associated syndromes were excluded. The participants were studied with pure tone audiometry. Results: Of the 65 patients included, 36.9% had X chromosome monosomy and 63.0% had other alterations. Regarding the audiometry, 64.6% had normal thresholds and 35.3% had hearing impairment. Of these, 30.4% had hybrid hearing loss, 26.0% alteration at 6 and/or 8 kHz, 17.3% had conductive hearing loss, 13.0% sensorineural loss and 13.0% had mixed hearing loss. We observed that the mild degree was the most frequent one. There was no statistically significant association between the cytogenetic type of Turner syndrome and the presence or absence of hearing loss, or with the type and degree of hearing loss. Conclusion: The cytogenetic alteration in Turner syndrome was not associated with the audiometric profile, which showed variability regarding the type and degree of hearing loss.

Resumo Introdução: A síndrome de Turner é uma alteração frequente e genética que acomete indivíduos do sexo feminino e abrange grande variabilidade fenotípica. A literatura científica sugere uma relação entre perda auditiva e síndrome de Turner, porém ainda é um tema controverso. Objetivo: Relacionar a alteração citogenética com o perfil audiométrico de indivíduos com síndrome de Turner. Método: Estudo transversal, com amostra de conveniência, de base hospitalar. Foram incluídas pacientes com diagnóstico de síndrome de Turner e excluídas as com dificuldade para compreender a audiometria e/ou outras síndromes associadas. As participantes foram submetidas à audiometria tonal. Resultados: Das 65 pacientes incluídas, 36,9% apresentaram monossomia do cromossomo X e 63,0%, outras alterações. Com relação à audiometria, 64,6% apresentaram limiares dentro da normalidade e 35,3% alteração auditiva. Dessas, 30,4% apresentaram perda auditiva híbrida, 26,0% alteração em 6 e/ou 8 KHz; 17,3% perda auditiva condutiva, 13,0% perda neurossensorial e 13,0% perda auditiva mista. Observamos que o grau leve foi o mais frequente. Não foi observada associação estatiscamente significativa entre o tipo citogenético da síndrome de Turner e a presença ou não perda auditiva, ou com o tipo e grau de perda auditiva. Conclusão: A alteração citogenética na síndrome de Turner não teve associação com o perfil audiométrico, o qual apresentou variabilidade quanto ao tipo e grau da perda auditiva.