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The Klippel-Feil syndrome is a congenital anatomical defect which occurs due to the failure of fusion of two or more cervical vertebrae at the neck region. Features include a short neck, low hairline at the back of the head, and restricted movement of the upper spine. This case study includes audiological test battery of a 3 years old with Klippel-Feil syndrome with features of hearing impairment, severely dysplastic internal acoustic meatus [IAM] along with delayed speech and language development. A detailed audiological evaluation was done and the management options were been further discussed. Key words: Klippel-Feil syndrome, hearing loss, CI, ABI.

Purpose The current study aimed to compare the specificity of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in isolation and in combination, with varying pass/refer criteria for DPOAE technology. Method A longitudinal, repeated-measures design was employed. The current study sample comprised 91 of the initial 325 participants who returned for the repeat screening and diagnostic audiological assessment within a risk-based newborn hearing screening program. Results TEOAE screening had the highest specificity in comparison to DPOAE screening at the initial and repeat screening, irrespective of differences in DPOAE pass/refer criteria. DPOAE screening had a slightly higher specificity, with a three out of six rather than the four out of six frequency pass criteria. Conclusions Pass/refer criteria alone do not influence referral rates and specificity. Instead, consideration of other factors in combination with these criteria is important. More research is required in terms of the sensitivity and specificity of OAE screening technology using repeated-measures and diagnostic audiological evaluation as the gold standard.

Introduction de Lange Syndrome is an autosomal dominant disorder which was initially described by Vrolik (1849) in a child with severe oligodactayly. Case Report A case of 2y2m/Female child came for speech and hearing evaluation. Audiological examination (BOA, DPOAE, ABR /BAER) and Speech-Language Evaluation, Psychological Examination were done by expertise clinicians. Previously, the child was diagnosed with de Lange Syndrome. Audiological evaluation diagnosed the child to have moderately severe hearing loss. After speech and language evaluation the child was detected with speech language disorder. After psychological evaluation the child was diagnosed with severe developmental delay and having low IQ range. Discussion de Lange syndrome is an autosomal dominant developmental disorder characterized by the sample number of characteristics which requires more rehabilitation options have to be planned. Unfortunately, there is dearth of literature that addresses the characteristics, assessment and intervention of individuals with de Lange syndrome.

BackgroundTraumatic brain injury (TBI) is a pathology frequently causing mortality or serious sequelae. About 20% of individuals with TBI will have some degree of auditory alteration. The aim of the present study was to use behavioural and electrophysiological assessments to analyse the hearing of a patient with TBI.Case reportA young male adult who had suffered severe TBI caused by a motorcycle accident was evaluated. The patient underwent a peripheral hearing evaluation and electrophysiological assessment. Pure tone audiometry revealed profound sensorineural hearing loss in the left ear and normal hearing in the right. In the electrophysiological assessment, an ABR click test showed the presence of a response in the right ear at 80 dB HL but no response in the left ear at 90 dB HL. Evaluation of the Middle Latency Response revealed the presence of both an electrode effect (C3) and an ear effect (A1). The P300 wave showed an event-related potential within normal limits in the right ear and no responses in the left.ConclusionsThe present case study verifies the importance of assessing the peripheral and central auditory nervous system in cases of patients with a history of TBI. It reinforces the need for diagnosis and audiological monitoring of these patients.

Introduction Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage. Objectives The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints. Methods The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions. Results Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases. Conclusion Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.

O aumento nos níveis de bilirrubina no neonato pode provocar efeitos tóxicos no sistema auditivo, podendo levar à perda auditiva. O objetivo desta revisão foi verificar o impacto da hiperbilirrubinemia na audição de recém-nascidos, relacionando os achados audiológicos aos níveis séricos de bilirrubina. Realizou-se uma revisão sistemática de literatura durante o mês de outubro de 2017, utilizando-se os termos hyperbilirubinemia, jaundice, infant, newborn e hearing loss, nas bases de dados periódicos Capes, Medline e Bireme (SciELO, BBO). Foram identificados 827 estudos, dentre os quais 59 foram selecionados para leitura do texto na íntegra, resultando na seleção de sete artigos que atendiam aos critérios de inclusão e foram considerados relevantes para a amostra deste trabalho. Em todas as pesquisas revisadas, o potencial evocado auditivo de tronco encefálico foi o principal exame audiológico realizado. Em todos os estudos foram observadas alterações nos resultados audiológicos de neonatos com hiperbilirrubinemia. Não houve consenso quanto aos níveis séricos de bilirrubina que podem causar alterações auditivas, porém, a relação entre as alterações audiológicas e os níveis sanguíneos de bilirrubina foi positiva. Percebeu-se a necessidade de estabelecer valores de referência para os níveis de bilirrubina considerados críticos para a ocorrência de alterações audiológicas, assim como de acompanhamento audiológico dos neonatos com hiperbilirrubinemia. The increase in bilirubin levels in newborns can cause toxic effects on the auditory system, which can lead to hearing loss. This review aimed to verify the impact of hyperbilirubinemia in the hearing of newborns, relating audiological findings to serum levels of bilirubin. A literature review was conducted during October 2017, using the terms “hyperbilirubinemia”, “jaundice”, “infant”, “newborn” and “hearing loss”, on databases CAPES journals, MEDLINE and BIREME (SciELO, BBO). 827 studies were identified and 59 were selected for full-text reading, resulting in the selection of seven articles that met the inclusion criteria and were considered relevant to the sample of this study. All the reviewed studies performed brainstem auditory evoked potential as the main test for audiological evaluation. Changes in the audiological findings of neonates with hyperbilirubinemia were observed in all studies. There was no consensus on the serum bilirubin levels that may cause auditory changes; however, the relationship between hearing disorders and blood levels of bilirubin was positive. We identify the need to establish reference values for bilirubin levels considered critical for the occurrence of hearing disorders as well as the audiological follow-up of neonates with hyperbilirubinemia.

To evaluate ordinary behavioral pattern suppression performance of individuals with tinnitus under disruptive effect using Stroop Color Word Interference Test-TBAG Form (SCWT), and to determine the impact of acoustic stimulus on this performance. 40 individuals with subjective tinnitus at Slight and higher severity according to Tinnitus Handicap Inventory (THI) (16 females, 24 males; mean age: 42.02 ± 10.00) (Study group), and 40 healthy individuals (Control group) (18 females, 22 males; mean age: 38.85 ± 10.25) were included in this study. All individuals were subjected to audiological evaluation. SCWT was applied with and without acoustic stimulus (NB noise), and test completion durations were recorded. It was determined that the duration for completion of 5 sections of SCWT, both in the presence of and without acoustic stimulus, was longer in the Study group than the control group. In the presence of acoustic stimulus, it took longer for the individuals with tinnitus to complete sections 4 and 5, and the control group to complete sections 3, 4 and 5 in SCWT in comparison with the lack of acoustic stimulus. It was determined that SCWT performance of the individuals with tinnitus was worse than the individuals without tinnitus, both in the presence of and without acoustic stimulus. It was found that SCWT performances of both groups with acoustic stimulus were better than their test performances without acoustic stimulus.

BACKGROUND Ototoxicity is defined as the pharmacological adverse reaction affecting the inner ear or auditory nerve, characterized by cochlear or vestibular dysfunction. Cisplatin used most frequently in the treatment of malignancies is an ototoxic agent. Evidence has shown that early detection of toxicity through prospective ototoxicity monitoring allows for consideration of treatment modifications to minimize or prevent permanent hearing loss and balance impairment. We wanted to conduct audiological evaluation of patients on chemotherapy with Cisplatin to evaluate the development of hearing loss and report. METHODS A retrospective study was conducted over a period of 3 years. All patients were subjected to thorough ENT examination, audiological evaluation including air and bone thresholds, pure tone average, speech discrimination and DPOAE. In addition, complete haemogram, liver and renal function tests were performed to evaluate the fitness for chemotherapy. Serial audiograms are taken at the end of each cycle up to 06 cycles of chemotherapy. Follow-up audiograms are taken at 03 months and 06 months after completion of chemotherapy. RESULTS Audiological evaluation among the 72 patients before the commencement of chemotherapy showed that 52 patients had normal hearing with air thresholds ranging from 10 to 20 dB with a mean of 14.45 ± 1.05 dB, bone thresholds ranging from 05 to 10 dB with a mean of 09.45 ± 0.35 dB. The pure tone average was ranging from 15 to 20 dB with a mean of 17.15 ± 1.75 dB. The speech discrimination score was 80 to 85%. The DPOAE values were present and normal in all the patients (100%). Among the 52 patients with normal hearing 07/52 (13.46%) had developed moderate hearing loss and among the 20 patients with pre-existing hearing loss, 04 / 20 (20%) patients had developed severe sensorineural hearing loss in this study. CONCLUSIONS Among the 52 patients with normal hearing 07 / 52 (13.46%) had developed moderate hearing loss and among the 20 patients with pre-existing hearing loss, 04 / 20 (20%) patients had developed severe sensorineural hearing loss in this study. Hence audiologic monitoring is important in patients undergoing Cisplatin chemotherapy and post-chemotherapy auditory monitoring is essential to rehabilitate the patients with sensorineural hearing loss.

Objective To identify demographic and audiometric predictors of bothersome tinnitus within a large clinical cohort. Study design Retrospective chart review. Setting Tertiary care hospital. Patients 51,989 English-speaking patients between 18 and 80 years of age that received initial audiometric evaluations at the Massachusetts Eye and Ear Infirmary between the years 2000 and 2016. Main outcome measures Patients were categorized according to whether or not tinnitus was the primary reason for their visit. The likelihood of tinnitus as a primary complaint (TPC) was evaluated as a function of age, sex, and audiometric configuration. Patient-reported tinnitus percepts were qualitatively assessed in relation to audiometric configuration. Results Approximately 20% of adults who presented for an initial hearing evaluation reported TPC. The prevalence of TPC increased with advancing age until approximately 50 to 54 years, and then declined thereafter. In general, men were significantly more likely to report TPC than women. TPC was statistically associated with specific audiogram configurations. In particular, TPC was most prevalent for notched and steeply sloping hearing losses, but was relatively uncommon in adults with flat losses. Patients with frequency-restricted threshold shifts often reported tonal tinnitus percepts, while patients with asymmetric configurations tended to report broadband percepts. Conclusions The probability of seeking audiological evaluation for bothersome tinnitus is highest for males, middle-aged patients, and those with notched or high-frequency hearing losses. These findings support the theory that tinnitus arises from sharp discontinuities in peripheral afferent innervation and cochlear amplification, which may induce topographically restricted changes in the central auditory pathway.

İç kulak hastalıkları, bireylerin günlük hayatlarındaki iletişim becerilerini önemli derecede etkileyebilen koklear işitme kaybına yol açabilmektedir. Bu tip işitme kayıplarının etiyolojisi genellikle multidisipliner bir yaklaşımla birlikte planlanan ayrıntılı değerlendirmeler sonucunda belirlenebilmektedir. Koklear işitme kayıpları değerlendirilirken odyolojik değerlendirme sürecinde doğru ve etkili ayırıcı tanı test yöntemlerinin uygulanması, uygun tedavi/rehabilitasyon yöntemlerinin belirlenmesi açısından önem taşımaktadır. Odyologlara kılavuz olması amaçlanan bu derleme makalesinde, iç kulak hastalıklarında görülen genel semptomların ve odyolojik bulguların yanında, sık karşılaşılan patolojilerde uygulanabilecek ayırıcı tanı testleri ve bu testlerin olası sonuçları değerlendirilmiştir., Inner ear diseases can lead to cochlear hearing loss, which can significantly affect the communication skills of individuals in their daily lives. The etiology of this type of hearing loss can usually be determined as a result of detailed evaluations planned with a multidisciplinary approachWhile evaluating cochlear hearing losses, applying correct and effective differential diagnosis test methods in the audiological evaluation process is important in determining the appropriate treatment/rehabilitation methods. In this review article, which is intended as a guide for audiologists, besides the general symptoms and audiological findings seen in inner ear diseases, the differential diagnostic tests that can be applied in common pathologies and the possible results of these tests are evaluated.

Purpose One in 59 children is diagnosed with autism spectrum disorder (ASD). Due to overlapping symptoms between hearing loss and ASD, children who are suspected of having ASD require an audiological evaluation to determine their hearing status for the purpose of differential diagnosis. The purpose of this article is twofold: (a) to increase audiologists' knowledge of ASD by discussing the challenges associated with testing and interpreting clinical data for children with ASD or suspected ASD and (b) to provide visual supports that can be used to facilitate audiological assessment. Method Eight children (ages 4–12 years) were recruited as video model participants. Videos were filmed using scripts that used concise and concrete language while portraying common clinical procedures. Using the video models, corresponding visual schedules were also created. Conclusion Although obtaining reliable hearing data from children with ASD is challenging, incorporating visual supports may facilitate testing. Video models and visual schedules have been created and made freely available for download online under a Creative Commons License (Creative Commons–Attribution-NonCommercial-ShareAlike 4.0 International License). Incorporating visual supports during clinical testing has the potential to reduce the child's and family's stress, as well as to increase the probability of obtaining a reliable and comprehensive audiological evaluation. Future research is warranted to determine the effectiveness and feasibility of implementing these tools in audiology clinics. Supplemental Material https://doi.org/10.23641/asha.10086434

Background: The sensitivity and specificity of the clinical audiological evaluation in newborns are debatable compared to neurophysiological methods of a hearing evaluation. This study aimed to determine the sensitivity and specificity of the cochleopalpebral reflex as a clinical test for hearing screening in newborns. Methods: A case-control study was designed. Newborns discharged from a neonatal intensive care unit (NICU) were included. Brainstem evoked auditory potentials were recorded. A wooden rattle was used to explore the cochleopalpebral reflex. The sensitivity and specificity of the cochleopalpebral reflex were calculated. Continuous data were analyzed with Student’s t-test, with statistically significant p-values < 0.05. Results: We selected 450 newborns who were divided into two groups: group A, with bilateral sensory neural hearing loss (n = 150), and group B, with normal hearing (n = 300). Group A showed a significantly lower gestation age at birth (p = 0.005) compared to group B (32.5 ± 2.6 vs. 34.4 ± 3.5 weeks). In group A, the cochleopalpebral reflex’s sensitivity was 80% using the wooden rattle. In group B, the specificity was 98%. Conclusions: The NICU discharged newborns’ clinical hearing evaluation is not enough to exclude hearing loss. Although it may be the only diagnostic tool for hearing loss in some settings, its limitations should be considered.

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

We are reporting a casewith hearing loss following krait snake bite.Casewasdiagnosed as snake bite and treated in the emergency department and after stabilising she was referred to the oto-rhinolaryngology department for evaluation of sudden hearing loss. Audiological evaluation was carried out to identify degree, type of hearing loss and site of lesion. Puretone audiometry showed bilateral moderate sensory neural hearing loss. Thediagnosis was confirmed with Transient evokedotoacoustic emissions and Click evoked auditory brainstem response testing. From theaboveaudiologicaltests it is evident that the snake bite victim has cochlear hearing loss. This could be due to the venom carried away from the wound by the lymphatics and then is circulated by the bloodstream throughout the body.

Objectives To provide an introduction to the role of audiological evaluations with special reference to patients with skull base disease. Design Review article with case-based overview of the current state of the practice of diagnostic audiology through highlighting the multifaceted clinical toolbox and the value of mechanism-based audiological evaluations that contribute to otologic differential diagnosis. Setting Current state of the practice of diagnostic audiology. Main Outcome Measures Understanding of audiological evaluation results in clinical practice and value of contributions to interdisciplinary teams to identify and quantify dysfunction along the auditory pathway and its subsequent effects. Results Accurate auditory information is best captured with a test battery that consists of various assessment crosschecks and mechanism-driven assessments. Conclusion Audiologists utilize a comprehensive clinical toolbox to gather information for assessment, diagnosis, and management of numerous pathologies. This information, in conjunction with thorough medical review, provides mechanism-specific contributions to the otologic and lateral skull base differential diagnosis.

Background Agricultural activities and exposure to pesticides increase the risk of hearing loss and might reduce cholinesterase activity. Objective To describe and analyze the correlation between hearing screening and plasma and erythrocyte cholinesterase activity relative to rural workers exposed to pesticides. Methods Cross-sectional, quantitative, descriptive and explanatory study conducted with 71 rural workers exposed to pesticides. Data were collected by means of an instrument to characterize exposure to pesticides, hearing screening and blood samples to measure plasma and erythrocyte cholinesterase activity. Results Each participant used three different pesticides, on average, glyphosate being the most frequently mentioned. About 60.6% of the sample exhibited hearing abnormalities and 32.4% complained of tinnitus. Erythrocyte cholinesterase activity was within the normal range in all the cases; one single participant exhibited reduced plasma cholinesterase activity. There was not significant correlation between the hearing screening and cholinesterase levels. Conclusion Audiological evaluation should be included in the assessment of rural workers. Monitoring workers exposed to pesticides should not be restricted to cholinesterase activity alone, because this method is insufficient to detect actual exposure to pesticides.

Objective: to evaluate vitamin D levels in patients with tinnitus and to assess subjectively the efficacy of its supplementation in case of deficiency.Methodology: 35 adult complaint of bilateral tinnitus with the age range from 20 to 50 years were included. All had bilateral normal audiological evaluation. Vitamin D level was assessed and those that had deficiency received supplementation for 3 months. Tinnitus handicap inventory (THI) was taken for the first time to all participants and another time for those received vitamin D supplementation after the 3 months regiment, and comparing the results.Result: From the 35 participants there was 30 subjects had vitamin D deficiency (85.71 %). THI before treatment showed larger numbers in scale 3 then 2, 1, 4 with no patients with scale 5.while THI after treatment showed larger numbers in scale 1 then 2 & 3 with no patients with scale 4 & 5. There was no significant correlation between THI score & Vitamin D level and the age of the participant or the duration of the complaint.Conclusion & recommendations: vitamin D deficiency is common among tinnitus patients. The result of vitamin D supplementation is promising in cases of idiopathic tinnitus. We recommend doing vitamin D assay in patients with idiopathic tinnitus and hence giving vitamin D supplementation in case of deficiency trying to improve the quality of life.

Background This study aimed to report the surgical outcomes of retrograde mastoidectomy with canal wall reconstruction using a bone graft that secured in place using glass ionomer cement (GIC) in adult patients with acquired cholesteatoma. Results This study was conducted on 50 adult patients with acquired cholesteatoma who underwent retrograde mastoidectomy with a reconstruction of canal wall using a bone graft from the mastoid cortex. The preoperative and postoperative audiological evaluation was done; in addition, non-echoplanar (EPI) diffusion-weighted MRI was obtained at least 1 year postoperatively to detect recidivism of cholesteatoma. Recidivism of cholesteatoma was observed in 4/50 ears (8%) using diffusion-weighted MRI and confirmed during revision mastoidectomy. The audiological assessment showed a marked and statistically significant improvement of preoperative ABG from 30 to 21 dB in addition to the improvement of preoperative AC from 42 to 33 dB. ABG of 20 dB or less was achieved in 50% of the ears. No reaction occurred to GIC in all the ears. Conclusions Retrograde mastoidectomy with canal wall reconstruction with bone graft was associated with a low rate of recidivism and significant improvement of the hearing. GIC is safe and effective in stabilization of bone graft in canal wall reconstruction.

To do the audiological evaluation of patients with hypothyroidism and to assess status of hearing after thyroxin replacement therapy (TRT). Two groups were included: a hypothyroidism group (HG, n = 50), and a control group (CG, n = 50). Parameters studied: anominesic data, duration of hypothyroidism, comorbidities, cochleovestibular symptoms, biochemical and hormonal exams (TSH, FT4 and FT3), pure tone audiometry, impendence audiometry and BERA as where required. Mean age of the patients in HG was 26.5 ± 10.4 years. Male/Female ratio was 2.39. All HG patients had altered TSH values and 8% had diminished T4 values. Cochleovestibular symptoms were more common in hypothyroid patients (48%) than control (20%) p value. Pure Tone Audiometric threshold was found higher in 34% of cases. Sensorineural hearing loss was most common (76.46%) compared to conductive and mixed hearing loss. BERA showed significant prolonged absolute peak latency of wave III, inter peak latency (IPL) of wave I–III and reduced amplitude of wave Ia and Va. After thyroxine replacement therapy there was statistically significant improvement in hearing threshold in 46.42% ears (p

Made available in DSpace on 2018-11-12T17:26:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-05-01. Added 1 bitstream(s) on 2018-11-12T17:34:48Z : No. of bitstreams: 1 S1516-18462018000300281.pdf: 351686 bytes, checksum: e2928d3515589009beb4dac20e90965e (MD5) RESUMOObjetivo: descrever os efeitos imediatos do atraso na retroalimentação auditiva sobre as disfluências típicas da gagueira, em indivíduos com gagueira.Métodos: estudo transversal e experimental. Foram analisados trinta indivíduos, de oito a 46 anos, diagnosticados com gagueira do desenvolvimento persistente. Os participantes deveriam apresentar, no mínimo, 3% de disfluências típicas da gagueira e gagueira leve de acordo com o Instrumento de Gravidade da Gagueira. Os procedimentos realizados foram: avaliação audiológica, avaliação da fluência em duas situações de escuta - com retroalimentação auditiva habitual e atrasada - e o Instrumento de Gravidade da Gagueira. O software Fono Tools foi utilizado para provocar o efeito de atraso. A análise dos dados foi realizada por meio da aplicação de testes estatísticos pertinentes.Resultados: não houve diminuição da maioria das disfluências típicas da gagueira. Houve redução estatisticamente significante das repetições de palavras e do fluxo de sílabas por minuto.Conclusão: o atraso na retroalimentação auditiva ocasionou como efeito imediato a redução das repetições de palavras e da taxa de articulação em sílabas por minuto. ABSTRACTObjective: to describe the immediate effects of delayed auditory feedback on stuttering-like disfluencies in people who stutter.Methods: a cross-sectional and experimental study. The effect of delayed auditory feedback was analyzed in thirty individuals, from eight to 46 years old, diagnosed with persistent developmental stuttering. Participants should present at least 3% of stuttering-like disfluencies and mild stuttering according to the Stuttering Severity Instrument. The following procedures were used: audiological evaluation, fluency evaluation in two listening situations - with Non-altered and delayed auditory feedback - and the Stuttering Severity Instrument. The Fono Tools software was used to cause the delay effect. Data analysis was performed using pertinent statistical tests.Results: there was no decrease in most stuttering-like disfluencies. There was a statistically significant reduction in word repetition and flow of syllables per minute.Conclusion: the delay in auditory feedback caused, as an immediate effect, the reduction of word repetition and speech rate, in syllables per minute. Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Filosofia e Ciências Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Filosofia e Ciências

Introdução: O desenvolvimento tecnológico em Audiologia possibilita a criação e aplicação de ferramentas voltadas à reabilitação da pessoa com deficiência auditiva. Todavia, os recentes avanços ainda não abrangem todas as competências necessárias para atender às demandas específicas de pessoas com múltiplas deficiências. Objetivo: Avaliar a tecnologia de rastreamento ocular como auxílio à intervenção interdisciplinar para a reabilitação auditiva de pessoas com múltiplas deficiências no Sistema Único de Saúde - SUS. Método: Trata-se de um estudo de caso, descritivo, exploratório, de natureza qualiquantitativa. Foram realizadas: elaboração de um banco de imagens e construção de um software para o gerenciamento de imagens; aplicação de pilotos para adequação da metodologia; aplicação dos procedimentos desenvolvidos na reabilitação auditiva em seis usuários com múltiplas deficiências. Resultados: O software desenvolvido gerencia 244 imagens validadas, que utilizadas em conjunto com a tecnologia de rastreamento ocular, possibilitou a aplicação da entrevista social e anamnese otorrinolaringológica diretamente aos usuários, assim como, a avaliação audiológica básica, indicação de prótese auditiva, terapia fonoaudiológica e psicológica. As tecnologias propostas foram utilizadas de maneira interdisciplinar, e possibilitaram maior inserção dos usuários em seu processo terapêutico. Conclusão: Este estudo apontou que é viável a associação do software de imagens à tecnologia assistiva de rastreamento ocular para uso em uma parcela de pessoas com múltiplas deficiências, possibilitando obtenção de respostas e maior participação durante a realização dos procedimentos em saúde auditiva.

Introdução: O zumbido pode estar presente em indivíduos com audição normal. Objetivo: Analisar e comparar o zumbido e o incômodo provocado em indivíduos com e sem perda auditiva. Métodos: A amostra foi composta por pacientes que apresentaram zumbido crônico, com audição normal ou perda auditiva. A avaliação foi feita por médico otorrinolaringologista e fonoaudiólogo (avaliação audiológica e questionário Tinittus Handicap Inventory –THI). Resultados: A amostra foi composta por 50 indivíduos com zumbido crônico, divididos em dois grupos (com e sem perda auditiva). As idades variaram entre 29 e 69 anos (média 52,50±9,64 anos). Os grupos eram semelhantes quanto à sexo, idade e localização do zumbido, diferenciando-se somente no que se refere a presença de perda auditiva. Em relação à pontuação no THI, encontrou-se diferença entre os grupos nas escalas funcional, emocional e no THI total. A acufenometria evidenciou diferença entre os grupos no pitch e loudness do zumbido. Conclusão: Indivíduos com perda auditiva apresentaram pontuação maior na escala funcional e emocional, assim como no somatório total do questionário THI evidenciando maior incômodo provocado pelo zumbido. Além disso, o zumbido em tais indivíduos apresentou pitch mais agudo e loudness maior do que encontrados nos indivíduos sem perda auditiva.

Background Aging process is associated with central auditory changes, which may explain some understanding difficulties in elderly. It may be evaluated with the dichotic digits (DD) test, a widely used experimental paradigm for studying interhemispheric interactions. Purpose This study was performed to evaluate dichotic integration ability in the elderly and children populations by comparing it with adults who acted as reference. Research design The study design was a cross-sectional one. It was conducted in Ain Shams University, Faculty of Medicine, Demerdash Hospital, Audiology Unit, for a period of 4 years. The study comprised 75 participants divided into three groups: the adult group, the elderly group, and the pediatric group. Data collection and analysis Basic Audiological Evaluation and the DD test in the free recall condition were carried out in all participants. Results Results of this study suggest that central auditory processing concerning dichotic integration is different in children and elderly individuals when compared with adults. Moreover, there was no significant difference between elderly patients and children. The age had a direct correlation with DD test scores in children, but an inverse correlation in the elderly. Conclusion Dichotic integration as measured using the DD test is similar in the elderly and children, but in opposite directions with regard to its change with age progress.

Background. Bacterial meningitis is one of the most common causes of hearing loss. Hearing loss develops within the first few days following the onset of meningitis, highlighting the importance of early audiology referrals. Post-meningitis hearing loss may lead to cochlear ossification, making traditional cochlear implantation impossible. Objectives. To determine the duration of time from meningitis diagnosis to audiology referral. A second objective was to determine the prevalence and severity of meningitis-related sensorineural hearing loss (SNHL) at Red Cross War Memorial Children’s Hospital (RCWMCH), a paediatric tertiary hospital in Cape Town, South Africa (SA). Methods. A retrospective folder review of all children diagnosed with meningitis and referred for audiological evaluation was conducted over an 18-month period between 1 January 2015 and 30 June 2016. Descriptive statistical methods were used for data analysis. Results. The total number of inpatients diagnosed with unspecified meningitis at RCWMCH between January 2015 and June 2016 was 345. The total number diagnosed with bacterial meningitis was 68. Only 16 children with meningitis (23.5%) were referred to the Department of Audiology at RCWMCH over the 18-month period. Twelve children had confirmed bacterial meningitis. All the children had up-to-date immunisations. The mean (standard deviation) time from diagnosis to audiology referral was 17 weeks (16.9; range 1 - 60). The overall prevalence of hearing loss was 42.8%. Four children (28.5%) were diagnosed with severe to profound SNHL. Conclusions. Less than a quarter of all children diagnosed with bacterial meningitis at RCWMCH over the 18-month study period were referred to audiology. Frequent delays in referrals for audiological assessment following meningitis were noted. This may indicate a lack of awareness on the part of doctors. Healthcare practitioners need to be made aware of the need for prompt audiological testing for children with meningitis. In SA, local guidelines for early diagnosis and monitoring of hearing in children who have had meningitis should be developed in order to improve hearing outcomes.

INTRODUÇÃO: A presbiacúsia acarreta dificuldades na interpretação do sinal sonoro com uma influência acrescida na perceção do discurso na presença de ruído. Pretende-se estudar as habilidades do processamento auditivo central na discriminação da fala no ruído, em pessoas idosas.MATERIAL E MÉTODOS: A amostra foi constituída por 20 sujeitos, com idades compreendidas entre os 67 e os 92 anos. Todos realizaram otoscopia, timpanograma, audiograma tonal simples e teste de fala no ruído. Este estudo é do tipo descritivo-correlacional e transversal.RESULTADOS: A curva audiométrica apresenta declínio significativo (p < 0,001) com o aumento das frequências testadas, a partir da frequência dos 500 Hz, apresentando o ouvido esquerdo melhores resultados do que o ouvido direito, com significância estatística (p = 0,043), apenas nos 250 Hz. No teste de fala no ruído, os resultados do ouvido esquerdo evidenciaram uma média de acertos de 21,5% na relação sinal/ruído de 10 dB, tendo um aumento significativo (p < 0,001) na relação sinal/ruído de 15 dB cuja média de acertos foi 26,3%. O ouvido direito exibe uma média de acertos de 17,3% e de 27,85% na relação sinal/ruído de 10 dB e de 15 dB respetivamente, com um aumento significativo (p = 0,002) na relação sinal/ruído de 15 dB.CONCLUSÃO: Tendo em conta os resultados, em que o teste de fala no ruído apresenta uma média de acertos inferior aos 50% em ambos os ouvidos, chegámos à conclusão que quanto menor for a relação sinal/ruído maiores as dificuldades na compreensão da fala. Assim, a avaliação audiológica da pessoa idosa deve incluir a avaliação periférica e central.

Introduction Frequency-following response with speech stimulus (FFR-speech) is a subcortical potential that satisfactorily evaluates the processing of verbal information. However, there still are differences in the literature regarding its analysis and stimulation protocol. Objective To compare two stimulation protocols for the capture of FFR-speech, to identify the percentage of occurrence of the waves among them and to compare it with the specialized literature, as well as to describe the interpeaks of its waves. Method Considering the eligibility criteria, the sample consisted of 30 normal-hearing adults, with no complaints of speech comprehension. All of them were submitted to a basic audiological evaluation, to brainstem auditory evoked potential with click stimulus, and to FFR-speech. In the latter, 2 types of stimulation were performed, 3 series of 1,000 sweeps, and 2 series of 3,000 sweeps, for subsequent analysis of the resulting wave, in which we tried to mark the peak V followed by valleys A, C, D, E, F, and O. Results Differences in latency and interpeaks were not found between the protocols. In general, a higher occurrence of waves in the stimulation of 2 series of 3,000 sweeps was observed, but only the A valley presented a significant difference. When the values of the waves were compared with the literature, the V and A waves showed fewer occurrences in the present study. Conclusion The protocol of 2 series of 3,000 sweeps was better for FFR-speech in the studied equipment, considering the higher occurrence of waves, even though it is inferior to the specialized literature. Furthermore, it was possible to describe interpeak values and to observe no difference between the studied protocols

Introduction: The hearing function is the cornerstone on which is built the complex system of human communication. The Acute Otitis Media is one of the most common etiologies of hearing loss in children attending school, mainly around 5 years of age. They appear asymptomatic so that only through auditory screening programs can we identify this type of situations early. So, if this type of hearing loss (though often small and temporary) occurs repeatedly, it can cause a negative impact on the auditory processing development, in the acquisition and development of language and in the school success of children. Aim: to determinate the prevalence of hearing loss among the Cape Verdean preschool children in comparison with Portuguese children of the same age and, consequently, to alert the importance of the hearing screening in preschool age. Methods: The sample consisted of 84 preschool children (5 and 6 years old): 42 Portuguese and 42 Cape Verdean. An anamnesis was performed on the parents and / or guardians of the children, an otoscopy, a tympanogram and a Pure Tone Audiogram screening ("pass / fail") at the frequencies of 1000Hz, 2000Hz and 4000Hz. Results: In the present study, no statistically significant differences were found in the results between children of both nationalities. Conclusion: In view of the findings of this study, and of the information acquired, it is important to emphasize that, in addition to dissemination and awareness raising, one of the proposals for Cape Verde is the implementation of neonatal screening programs, followed by the subsequent implementation of preschool and school screenings. It should also be implemented in Portugal in a systematic and obligatory way. info:eu-repo/semantics/publishedVersion

Background: The most common complaint of patients affected by chemotherapy-induced hearing loss is difficulty understanding speech in noisy environments despite the use of hearing aids. Cochlear dead regions, those areas with damaged or absent inner hair cells and dendrites, may account for this type of hearing loss. However, it is unknown whether this condition is associated with cisplatin agents. Objective: The aim of this study was to determine whether cisplatin is associated with hearing loss and cochlear dead regions. Methods: This prospective cross-sectional study was conducted in patients participating in routine audiological monitoring during and after chemotherapy treatment. Adults undergoing audiological evaluation who had completed chemotherapy treatment were invited to participate. Patients were divided into 3 groups according to pure tone thresholds. Group 1 patients had thresholds over 70 dB (HL) at 2,000 Hz and higher frequencies. Group 2 patients had thresholds below 70 dB (HL) up to 2,000 Hz. Patients in the control group had normal thresholds at all frequencies. The threshold equalizing noise test (TEN[HL]) was used to identify cochlear dead regions by repeating thresholds in the presence of TEN noise played from a compact disc. The presence of cochlear dead regions was established when the masked threshold was 10 dB or greater above the TEN level and 10 dB or greater above the absolute threshold at any frequency. Results: Twelve patients were included in study group 1, 10 patients in study group 2, and 7 patients in the control group. Cochlear dead regions were present in all patients with hearing loss and in none of the control group. For groups 1 and 2, mean differences between absolute and masked thresholds were 21 and 16 dB at 500 Hz; 22 and 15 dB at 1,000 Hz; 31 and 17 dB at 2,000 Hz; 32 and 20 dB at 3,000 Hz; and 31 and 21 dB at 4,000 Hz, respectively. Nevertheless, analysis of variance testing with Bonferroni analysis showed a difference between groups 1 and 2 only at 2,000, 3,000, and 4,000 Hz. Conclusion: We found unresponsive or dead cochlear regions in patients who had undergone cisplatin chemotherapy even among patients with mild to moderate hearing loss.

Koklear implantlar konvansiyonel amplifikasyondan fayda göremeyen ileri-çok ileri derecede sensorinöral tip işitme kaybına sahip bireylerde kullanılan ve işitsel sinirin doğrudan elektriksel olarak uyaran sistemlerdir. Koklear implantasyon biyoteknoloji ve tıp dünyasındaki en önemli gelişmelerden birisidir. Çünkü koklear implantasyon kişilere kaybettikleri veya hiç sahip olmadıkları işitme duyusunun yerini tutacak kazanım sağlamakta ve kişilerin yaşam kalitelerine büyük katkıda bulunmaktadır. Bu derlemede; koklear implantasyonun odyolojik, preoperatif, intraoperatif ve postoperatif değerlendirme ve takip süreçleri ile ilgili bilgiler kendi klinik tecrübelerimiz ile harmanlanarak sunulmuştur.

This chapter discusses the classical audiological dimensions – thresholds, discrimination, recruitment, and adaptation – as well as air and bone conduction tests, immittance tests, otoacoustic emissions, and electrical response audiometry. The patterns for different types of hearing loss are also presented, taking into consideration the neurotological aspects of audiological diagnosis.