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Objective: This study aimed to investigate the prevalence of autism spectrum disorder and its possible correlations with clinical characteristics in patients with infantile epileptic spasms syndrome in a single center in Brazil. Methods: This retrospective cross-sectional study examined 53 children with the diagnosis of infantile epileptic spasms syndrome prior to an autism spectrum disorder assessment. Participants were divided into two groups based on the presence or absence of autism spectrum disorder. Available variables (sex, medications, median age at onset of infantile epileptic spasms syndrome, and presence of comorbidities) were compared using Mann–Whitney U or chi-square tests. Results: Among the included patients, 12 (23 %) were diagnosed with autism spectrum disorder, corresponding to a relative risk of 0.29 (95 % confidence interval 0.174–0.492). The age at the first seizure ranged from 3 to 15 months, with a mean of 6.65 months. This age significantly differed between participants with autism spectrum disorder (10.58 months) and those without (5.43 months), p

Abstract Background Cranial, facial, nasal, and maxillary widths have been shown to be significantly affected by the individual’s sex. The present study aims to use measurements of dental arch and maxillary skeletal base to determine sex, employing supervised machine learning. Materials and methods Maxillary and mandibular tomographic examinations from 100 patients were analyzed to investigate the inter-premolar width, inter-molar width, maxillary width, inter-pterygoid width, nasal cavity width, nostril width, and maxillary length, obtained through Cone Beam Computed Tomography scans. The following machine learning algorithms were used to build the predictive models: Logistic Regression, Gradient Boosting Classifier, K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Multi-Layer Perceptron Classifier (MLP), Decision Tree, and Random Forest Classifier. A 10-fold cross-validation approach was adopted to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision, and F1 Score were calculated for each model, and Receiver Operating Characteristic (ROC) curves were constructed. Results Univariate analysis showed statistical significance (p

Introduction Spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative diseases.

Purpose: The aim of this study is to assess the effects of respiratory exercises (inspiratory and expiratory) in individuals with sleep bruxism (SB) and associated obstructive sleep apnea (OSA). Methods: This is a double-blind, placebo-controlled randomized clinical trial including individuals with SB and associated respiratory events in OSA. Respiratory physical therapy was performed using inspiratory (Threshold® IMT), expiratory (Threshold® PEP) muscle training, and compared with a placebo group. A total of 30 daily respiratory cycles (inspiration and expiration) were performed five times a week for 12 weeks. Individuals were reassessed at two times, at baseline (T1) and after 12 weeks of training (T2) by means of the Pittsburgh Sleep Quality Index and Polysomnography. Results: Awakening was significantly different (p ≤ 0.05) between the inspiratory group and placebo 12 weeks after respiratory physical therapy. The number of contractions of the masseter muscle differed between the inspiratory, expiratory, and placebo groups (p ≤ 0.05). Conclusion: Respiratory physical therapy for OSA improved awaking levels in 80 and 67% of the number of masseter muscle contractions, when compared to placebo. Trial registration: Brazilian Registry of Clinical Trials (No. RBR-9F6JKM)

The objective of this study was to develop a predictive model using supervised machine learning to determine sex based on the dimensions of the hyoid bone. Lateral cephalometric radiographs of 495 patients were analyzed, collecting the horizontal and vertical dimensions of the hyoid bone, as well as the distance from the hyoid to the mandible. The following algorithms were trained: Logistic Regression, Gradient Boosting Classifier, K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Multilayer Perceptron Classifier (MLP), Decision Tree, AdaBoost Classifier, and Random Forest Classifier. A 5-fold cross-validation approach was used to validate each model. Model evaluation metrics included areas under the curve (AUC), accuracy, recall, precision, F1 score, and ROC curves. The horizontal dimension of the hyoid bone demonstrated the highest predictive power across all evaluated models. The AUC values of the different trained models ranged from 0.81 to 0.86 on test data and from 0.78 to 0.84 in cross-validation, with the random forest classifier achieving the highest accuracy rates. The supervised machine learning model showed good predictive accuracy, indicating the model's potential for sex determination in forensic and anthropological contexts. These findings suggest that the application of artificial intelligence methods can enhance the accuracy of sex estimation, contributing to significant advancements in the field.

ObjectiveThis study aimed to determine the impact of dentofacial deformity on an individual’s chances of being hired for a hypothetical job involving customer service.Materials and methodsFace photographs (frontal and lateral) of 15 patients with moderate to severe dentofacial deformity, taken before and after orthodontic-surgical correction, were selected and randomized between two different questionnaires. In addition, five patients without dentofacial deformity were used as controls in both questionnaires. These questionnaires were taken by adults responsible for hiring personnel to work in commerce and business activities, graduates or postgraduates in business administration, with experience in recruiting and hiring personnel. The evaluation took place using a Likert scale with values ranging from 0 to 10 (in which 0 corresponded to complete disagreement and 10 to complete agreement), considering the following variables in a first impression judgment: honesty, intelligence, productivity at work, and hiring chance. Data were tabulated and statistical analysis was performed using a linear regression model for the explanatory variables that showed statistical significance in the analysis of variance (ANOVA). Effect size through Cohen’s d has been corrected for all comparisons performed.ResultsAll re-examined domains demonstrated statistical differences even when included in a multivariate model (p

ABSTRACT COVID-19 is a viral infection that mainly affects the lower respiratory tract and with the affinity of the Spike protein to the Angiotensin 2 converter enzyme, inducing a prothrombotic state which may lead to compromising of the cardiovascular, central nervous, auditory, and vestibular systems. Viral infections knowingly affect vestibular and auditory systems. This study aimed to present the auditory and vestibular findings of a woman without otoneurological complaints, before the infection with SARS-CoV-2. This is a longitudinal case report, presenting the evolution of the otoneurological clinical picture accompanied by the results of a battery of tests. The results evidenced a unilateral, permanent, cochlear sensorineural hearing loss through altered otoacoustic emissions albeit with normal tonal thresholds, accompanied by peripheral vestibular hypofunction which worsened with time, without any other factor that could justify these findings. This study shows the importance of the complete protocol of tests performed over time for a better understanding of long-time implications of the SARS-CoV-2 infection.

Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objective To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.

ABSTRACT Objective: This systematic review aims to answer the following focus question: “Is there an association between atypical swallowing and malocclusions?”. Methods: Appropriate word combinations were chosen and tailored specifically for each of the following electronic databases: EMBASE, Latin American and Caribbean Literature in Health Sciences (LILACS), LIVIVO, PubMed/Medline, Scopus, Web of Science, and gray literature, without any restrictions, up to February 2021. According to the selection criteria, only cross-sectional studies were included. The following inclusion criteria were considered: a sample composed of children, adolescents, and adults; patients clinically diagnosed with atypical swallowing; patients with normal swallowing; and outcome of interest of atypical swallowing in patients with malocclusion. The data consisted of study characteristics, sample characteristics, results, and conclusion of each study. The risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies, and the certainty of evidence was assessed using the GRADE tool. Results: 4,750 articles were identified. After a two-step selection, four studies were included. A higher frequency of distal occlusion, extreme maxillary overhang, and open bite was related to swallowing disorders; most studies pointed to posterior crossbite as a malocclusion more associated with atypical swallowing. All studies had a moderate to high risk of bias, and the certainty of evidence was very low. Conclusion: The results indicate that atypical swallowing is associated with malocclusions and that posterior crossbite is the main malocclusion found, but only in the young population (3-11 years). Registration: PROSPERO (42020215203).

ABSTRACT Purpose: to map, through a literature survey, which instruments are used to assess swallowing in patients after orotracheal extubation. Methods: available evidence was mapped through six electronic databases and gray literature. There were no restrictions regarding gender, ethnicity of the individuals, language of the studies, time of publication, and diagnosis. Results: the most mentioned protocol in the studies was the Dysphagia Risk Evaluation Protocol and the most cited objective assessment exam was the flexible endoscopic evaluation of swallowing. Conclusion: there is a need for a specific protocol to evaluate this profile of patients, in addition to comparative studies of subjective clinical evaluation and instrumental imaging.

The aim was to determine whether there is a difference in the periodontal aspect (gingival recession, probing pocket depth) of the palatally displaced canine (PDC) compared to the contralateral canine. Also, from a surgical perspective, sought to determine whether there is a difference (surgical duration, postoperative pain) between the surgical techniques. The word combinations were adapted for each electronic database: PubMed, LILACS, Scopus, Web of Science, Cochrane Library and gray literature. Studies that met the following criteria were considered eligible: (P) Patients who received orthodontic-surgical treatment for correction of PDC; (I) Performing orthodontic-surgical treatment for traction of the PDC; (C) Comparison of the tractioned canine with its contralateral or between the two techniques; (O) Gingival recession, probing pocket depth, postoperative complications and surgical duration; (S) Randomized and nonrandomized clinical studies or observational studies. The overall prevalence of gingival recession was estimated to be 10.53% [95% CI, 3.87% - 25.59%; I2 = 88%]. No statistically significant difference (p > 0.05) was found between the means of the variables gingival recession, probing pocket depth and surgical duration. The evidence suggests that traction of palatally displaced canines can be considered a reliable and acceptable procedure.

Abstract Subclinical ventilatory dysfunction is observed in individuals with spinocerebellar ataxias (SCA). No studies have correlated ventilatory dysfunction to clinical and functional decline in SCA2. Objective: To evaluate the relationship between the values of peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and presence of respiratory complaints with age, disease duration, age at onset of symptoms, balance scores, independence in basic (ADL) and instrumental (IADL) Activities of Daily Living (ADLs), and severity of ataxia (SARA) in individuals with SCA2. Methods: Cross-sectional study evaluating age, disease duration, age at onset of symptoms, scores in the Berg Balance Scale and in the SARA, Functional Independence Measure and Lawton’s scale, values of PEF and MIP, and the presence of respiratory complaints. Results: The study included 36 individuals with SCA2, with a mean age of 42.5±2.4 years, disease duration of 7.6±8.2 years, age 33.7±11.5 years at onset of symptoms, and 9.9±10.3 points in the SARA scale. The lowest PEF values correlated with the longer disease duration (p=0.021). The lowest values of PEF and MIP correlated with greater balance impairment (p=0.019 and p=0.045, respectively), increased degree of dependence in the ADL (p=0.006 and p=0.050, respectively) and IADL (p=0.003 and p=0.001, respectively) scales, and highest severity of ataxia (p=0.00 and p=0.017, respectively). Respiratory complaints were observed in 12 (33.3%) individuals and were not related to age, disease duration, age at onset of symptoms, balance, independence, ataxia severity, or PEF and MIP values. Conclusion: Ventilatory dysfunction, even when asymptomatic, is related to balance impairment, independence, and ataxia severity in individuals with SCA2.

Introduction The Sustained Auditory Attention Ability Test (SAAAT) is an instrument used to assess sustained auditory attention in children. Difficulties related to this ability are not unique to children alone, as adults have been observed to present with the same deficits. Therefore, there is a need to adapt instruments like the SAAAT and provide reference values for adults. Objective To assess adult performance on the SAAAT. Methods Approved by the Human Research Ethics Committee under n° 034/2011. The sample consisted of 30 participants aged between 18 and 30 years old (average age = 24.2 years old), female and male. The inclusion criteria were: peripheral hearing within normal limits, type A tympanometric curve, and no attention-related complaints. The participants were submitted to Tonal Audiometry, Logoaudiometry, Immitanciometry and to the SAAAT. Results The following mean values and standard deviations (SD) were observed: inattention = 1.7 (SD = 2.2) and impulsivity = 0.8 (SD = 0.9) error types. For the SAAAT, the mean value for the total error score was 2.4 (SD = 2.6), and for the decrease in vigilance, it was 0.3 (SD = 0.5). When comparing the performance of adults and children, a statistically significant difference was observed for inattention (p = 0.000) and impulsivity (p = 0.001) error types, as well as in the total error score (p = 0.000) and in decreased vigilance (p = 0.0003). Conclusion The performance of adults in the SAAAT differed from the children's parameters, since adults showed lower scores in all variables of the instrument.

Introduction Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability. Objective To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation. Methods A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality. Results a) The instrumental subscale of the questionnaire showed statistically significant result (p = 0.022; 95% CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale (p = 0.011; 95% CI −0.85; −0.17) first and (p = 0.002, 95% CI −0.88; −0.31) second assessments, and the functional subscale was only verified in the second assessment (p = 0.011, 95% CI −0.85; −0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk (p = 0.034, 95% CI −12.5; −0.3) and ski slalom games (p = 0.005, 95% CI −34.8; −6.6). Conclusions Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.

BackgroundNeurodegenerative diseases are sporadic hereditary conditions characterized by progressive dysfunction of the nervous system. Among the symptoms, vestibulopathy is one of the causes of discomfort and a decrease in quality of life. Hereditary spastic paraplegia is a heterogeneous group of hereditary degenerative diseases involving the disorder of a single gene and is characterized by the progressive retrograde degeneration of fibers in the spinal cord.ObjectiveTo determine the benefits of vestibular rehabilitation involving virtual reality by comparing pre intervention and post intervention assessments in individuals with hereditary spastic paraplegia.MethodsIn this randomized controlled clinical trial from the Rebec platform RBR-3jmx67 in which allocation concealment was performed and the evaluators be blinded will be included. The participants will include 40 patients diagnosed with hereditary spastic paraplegia. The interventions will include vestibular rehabilitation with virtual reality using the Wii® console, Wii-Remote and Wii Balance Board (Nintendo), and the studies will include pre- and post intervention assessments. Group I will include twenty volunteers who performed balance games. Group II will include twenty volunteers who performed balance games and muscle strength games. The games lasted from 30 minutes to an hour, and the sessions were performed twice a week for 10 weeks (total: 20 sessions).ResultsThis study provides a definitive assessment of the effectiveness of a virtual reality vestibular rehabilitation program in halting the progression of hereditary spastic paraplegia, and this treatment can be personalized and affordable.ConclusionThe study will determine whether a vestibular rehabilitation program with the Nintendo Wii® involving virtual reality can reduce the progressive effect of hereditary spastic paraplegia and serve as an alternative treatment option that is accessible and inexpensive. Rebec platform trial: RBR-3JMX67.

ABSTRACT Purpose: to demonstrate the feasibility of using the acoustic analysis of swallowing sounds as a combined method in the clinical assessment of tracheostomized patients affected by traumatic brain injury. Methods: an observational, cross-sectional study. A total of 10 adult patients, in the mean age of 43.6 years, participated. They were hospitalized in wards, semi-intensive, or intensive care units, from May to July 2016. The inclusion criterion involved being affected by traumatic brain injury, confirmed with a CT scan. The Speech Therapy Tracheal Decannulation Protocol was used in the clinical assessment, as well as the cervical auscultation with the Doppler sonar. Fisher’s test was used, resulting in no significant relationship (p > 0.05) between the variables analyzed in the two consistencies and decannulation. Results: the presence of an acoustic signal of laryngeal elevation was observed, as well as noise between the swallowings, and acoustic signal suggestive of residue in 50% of the patients for the consistencies tested. When the peak frequency, mean wave time, presence of residue in between swallowings, and acoustic signal suggestive of residues were correlated with decannulation (Table 5), no significant correlation was verified (p > 0.05) between the variables analyzed in the two consistencies and the decannulation. Conclusion: the study suggests that it is feasible to use the Doppler sonar as a combined method in the clinical assessment of dysphagia for the decannulation of patients affected by traumatic brain injury.

Abstract Background Townes-Brocks syndrome (TBS) is a rare autosomal dominant condition characterized by renal, anal, limb, and auditory abnormalities. TBS diagnosis can be challenging in settings where genetic analysis is not readily available. TBS traits overlap with those of Goldenhar and VACTERL syndromes. Case presentation Here, we present the case of a 5-year-old Brazilian boy born with an anorectal abnormality, limb and external ears malformations, genitourinary anomalies, and a congenital heart defect. Genetic analysis revealed a SALL1 nonsense mutation. The case is discussed in the context of the current literature. Conclusions Because of the variability in TBS clinical presentation, genetic analysis is key to the differential diagnosis of TBS relative to phenotypically similar syndromes.

Introduction Spinocerebellar ataxia (SCA) is part of a genetic and clinical heterogeneous group of neurodegenerative diseases characterized by progressive cerebellar ataxia. Objective To describe the results of audiological and electrophysiological hearing evaluations in patients with sporadic ataxia (SA). Methods A retrospective cross-sectional study was carried out with 11 patients submitted to the following procedures: anamnesis, otorhinolaryngological evaluation, tonal and vocal audiometry, acoustic immittance and brainstem auditory evoked potential (BAEP) tests. Results The patients presented with a prevalence of gait imbalance, of dysarthria, and of dysphagia; in the audiometric and BAEPs, four patients presented with alterations; in the acoustic immittance test, five patients presented with alterations, predominantly bilateral. Conclusion The most evident alterations in the audiological evaluation were the prevalence of the descending audiometric configuration between the frequencies of 2 and 4 kHz and the absence of the acoustic reflex between the frequencies of 3 and 4 kHz bilaterally. In the electrophysiological evaluation, the patients presented changes with a prevalence of increased I, III and V wave latencies and the interval in the interpeak I-III, I-V and III-V. In the present study, it was observed that auditory complaints did not have a significant prevalence in this type of ataxia, which does not occur in some types of autosomal recessive and dominant ataxia.

Abstract Introduction Speech tests such as logoaudiometry measure the ability to perceive and recognize oral sounds. The Speech Recognition Index (SRI) is one of the speech tests adopted in clinical routine; it uses standardized live voice and recorded speeches. The live voice speech method can be influenced by intra and interspeaker variability, as well as by regionalism variability, whereas recorded tests show consistency in their presentation. Objective Analyzing results of the SRI test applied to live voice and recorded speeches from Paraná State, in different Brazilian counties. Method The sample comprised 125 individuals, 25 from each county (Rio de Janeiro, Florianópolis, Porto Alegre, Salvador and Curitiba), from both sexes, in the age group 20 to 70 years; the SRI was applied in both techniques. Results The recorded speech method showed prevalence of hit improvement in Rio de Janeiro (40%), Salvador, Porto Alegre and Florianópolis (28%). Individuals from Salvador and Florianópolis subjected to the recorded speech method showed better results in the left ear. Individuals from Rio de Janeiro and Porto Alegre showed satisfactory results in both ears, whereas those from Curitiba did not show statistically significant difference between the left and the right ear. Conclusion The recorded CD application method showed prevalence of hit improvement (%) in the SRI responses in comparison to the live voice speech technique in most of the studied counties. According to the hit rate measured in the herein investigated counties, Rio de Janeiro showed the best results in the recorded speech method.

Abstract Introduction Agrochemicals, also known as pesticides, are widely used in agriculture and in public health. They are organic and inorganic chemical substances with a high level of toxicity not only for the environment, but also for human health. Objective To verify findings on labyrinthine assessment in endemic disease control agents, and to recommend the inclusion of the vestibular exam in the set of tests for pesticide-exposed populations. Methods Descriptive, prospective, cross-sectional study with a sample comprising 15 endemic disease control agents, males, mean age of 51.6 years old (standard deviation [SD] = 5.9). All of the participants were submitted to anamnesis, otorhinolaryngological screening, and vestibular assessment. Results Regarding the most reported complaints, dizziness (73.4%), headache (60%), and tingling in the extremities (53.4%) were observed. The findings of the vestibular exams were normal in 53.3%, while 46.7% showed peripheral vestibular disorder, of which 26.7% were of deficitary type, and 20% of the irritative type. Conclusions: Alteration in the vestibular system was verified in 50% of the workers, with a greater prevalence in the caloric testing. Several disorders related to pesticides intoxication are scientifically known. Actions promoting knowledge and qualification of this population for the proper handling of chemicals are suggested, in addition to the elaboration and inclusion of protocols of vestibular assessment in hearing health programs for the prevention, diagnosis and treatment of vestibular disorders.

RESUMO Objetivo Analisar os achados audiológicos em indivíduos com desordem temporomadibular e comparar esses achados com indivíduos sem desordem temporomanbibular. Métodos A amostra foi composta por 39 participantes adultos, de ambos os gêneros, com diagnóstico prévio de desordem temporomandibular (grupo de estudo) e 39 participantes adultos, sem desordem temporomandibular (grupo controle). Todos os participantes foram submetidos à audiometria tonal limiar em altas frequências, imitanciometria e pesquisa das emissões otoacústicas evocadas por produto de distorção. Resultados Observou-se prevalência de desordem temporomandibular no gênero feminino e a média de idade ficou acima da quarta década de vida. Na audiometria tonal limiar, foi observada ocorrência de perda auditiva do tipo neurossensorial e condutiva, no grupo de estudo, além de piores limiares auditivos em altas frequências. Em ambos os grupos, houve maior ocorrência de curva timpanométrica do tipo A, bem como diferenças entre os grupos na pesquisa do reflexo acústico ipsilateral e contralateral e no registro das emissões otoacústicas evocadas por produto de distorção. Conclusão Indivíduos com desordem temporomandibular apresentam piores resultados nos limiares auditivos, na timpanometria, nos reflexos acústicos ipsilaterais e contralaterais e nas emissões otoacústicas evocadas, quando comparados com o grupo controle.

ABSTRACT Objective: to verify the relationship between otological symptoms and parafunctional habits in individuals with temporomandibular joint dysfunction. Methods: evaluations were based on the clinical records of 768 patients treated at a temporomandibular joint diagnostic center from 2010 to 2016. The inclusion criteria were completely filled out charts of adult patients (> 18 years of age) and the final sample comprised 516 clinical records. The presence/absence of parafunctional habits and otological symptoms (tinnitus, hearing impairment, dizziness, the sensation of plugged ears and imbalance) was recorded. Results: statistically significant associations were found between otological symptoms and both sex and the presence of parafunctional habits, as otological symptoms were more prevalent among women and individuals with at least one parafunctional habit. Conclusion: in the present sample, otological symptoms were positively associated with parafunctional habits in individuals with temporomandibular joint dysfunction.

Abstract Introduction Friedreich's ataxia is a neurodegenerative disease and progressive by nature. It has autosomal recessive inheritance and early onset in most cases. Nystagmus and hearing loss (in some cases) make up some of the common symptoms seen in this disorder. Objective The objective of this study is to examine vestibular disorders in patients with Friedreich ataxia. Methods We conducted a retrospective cross-sectional study. We evaluated 30 patients with ages ranging from six to 72 years (mean age of 38.6 ( ± 14.7). The patients underwent the following procedures: anamnesis, ENT, and vestibular evaluations. Results Clinically, the patients commonly had symptoms of incoordination of movement (66.7%), gait disturbances (56.7%), and dizziness (50%). In vestibular testing, alterations were predominantly evident under caloric testing (73.4%), gaze nystagmus testing (50.1%), rotational chair testing (36.7%), and optokinetic nystagmus testing (33.4%). The presence of alterations occurred under examination in 90% of subjects, with the majority occurring in those with central vestibular dysfunction (70% of the examinations). Conclusion The most evident neurotological symptoms were incoordination of movement, gait disturbances, and dizziness. Alterations in vestibular examinations occurred in 90% of patients, mostly in the caloric test, with a predominance of deficient central vestibular system dysfunction.

Abstract Introduction Agricultural aviation pilots, exposed daily to intense vibration and noise, are likely to develop noise-induced hearing loss (NIHL). Objectives The aim of this study was to investigate the presence of audiograms consistent with NIHL in agricultural aviation pilots who use earplugs and helmets. Methods We conducted a cross-sectional cohort and observational study. The data were taken from the medical records and audiograms of 94 pilots. Results NIHL was identified in 9.5% of individuals with hearing loss by audiograms at 3,000, 4,000, or 6,000 Hz. Normal audiograms were observed in 46.8% of pilots surveyed. Bilateral hearing loss was more frequent than unilateral hearing loss, occurring in 64.8% of cases. Conclusion Although there was a low incidence of audiograms compatible with NIHL in the records of the pilots examined, the disorder still occurs despite the doubled use of individual hearing protection equipment (helmets and earplugs) for agricultural aviation pilots. Nevertheless, even with the use of earplugs and helmets as noise protectors, the data showed that agricultural pilots suffer inner ear damage caused by occupational noise. Prevention and periodic audiologic evaluations must be conducted in noise-exposed occupational groups.

Abstract Introduction The cervical spine is a flexible link between the sensory platform of the skull and torso. The fundamental principle of its operation is due to the balance between muscle strength and flexibility, and any dysfunction of this balance causes neck pain, known as cervicalgia. Objective The objective of this study is to analyze the most prevalent neurotological findings in adults with neck pain. Method A cross-sectional study in which 33 adults from 50 to 83 years of age with neck pain were evaluated and underwent the following procedures: anamnesis, as well as ENT, audiological, and vestibular exams. Results The most evident neurotological symptoms were dizziness (75.7%), tinnitus, neck cracking, tingling in the extremities, and auditory problems (36.3% for each). The most frequently reported clinical symptoms were related to cardiovascular (69.7%), endocrine-metabolic (48.5%), and rheumatic (30.3%) systems. In the audiological assessment, 30 subjects (91.0%) presented hearing impairment in at least one ear, with sensorineural impairment being the most prevalent (88.0%). In the vestibular assessment, there were alterations in 13 subjects (39.0%) found in the caloric test. There was a prevalence of alterations in the peripheral vestibular system with a predominance of irritative peripheral vestibular dysfunction. Conclusion Neurotological complaints were frequent in this population, verifying the importance of these tests in the dysfunctions of the cervical region or the craniocervical junction.

Fishing, one of the oldest productive activities, is an important sector of the Brazilian economy as well as the world economy. To evaluate the vestibular behavior in population of fishermen. It was realized as a retrospective and cross-sectional study. Thirty fishermen [mean age 49.5 (±8.5) years] whose age ranged from 33 years to 67 years were submitted to anamnesis, otorhinolaryngological evaluation, and vestibular examination through the electronystagmography (ENG). The most evident otoneurological symptoms were: Tinnitus (66.7%), dizziness (63.3%), and hearing loss (53.3%). The most evident clinical symptoms were: Fatigue (36.7%), anxiety (23.3%), and depression (16.7%). There were alterations in the vestibular examination of 13 (43.3%) fishermen in the caloric test. There was a prevalence of alteration in the peripheral vestibular system and there was a major frequency of the peripheral vestibular irritative syndrome (30.0%). Conclusion: The otoneurological complaints were frequent in the population studied that verifies the importance of allowing labyrinth examinations and the need for adopting preventive measures related to noise exposure to carbon monoxide (CO), since they can cause and/enhance various manifestations of labyrinthine vestibular impairment that can affect the quality of life of these workers.

O objetivo deste estudo foi verificar as alterações vestibulococleares observadas em um caso de ataxia espinocerebelar tipo 6. O caso foi encaminhado do Hospital de Clínicas para o Laboratório de Otoneurologia de uma Instituição de Ensino e foi submetido aos seguintes procedimentos: anamnese, inspeção otológica, avaliações audiológica e vestibular. O caso retrata uma paciente com diagnóstico genético de ataxia espinocerebelar tipo 6, do sexo feminino, com 57 anos de idade, que referiu desequilíbrio à marcha com tendência a queda para a esquerda, disartria e disfonia. Na avaliação audiológica apresentou configuração audiométrica descendente a partir da frequência de 4kHz e curva timpanométrica do tipo "A" com presença dos reflexos estapedianos bilateralmente. No exame vestibular observou-se na pesquisa da vertigem posicional presença de nistagmo vertical inferior e oblíquo, espontâneo e semiespontâneo múltiplo com características centrais (ausência de latência, paroxismo, fatigabilidade e vertigem), nistagmooptocinético abolido e hiporreflexia à prova calórica. Constataram-se alterações labirínticas que indicaram afecção do sistema vestibular central evidenciando-se a importância dessa avaliação. A existência da possível relação entre os achados com os sintomas vestibulares apresentados pela paciente apontou a relevância do exame labiríntico neste tipo de ataxia uma vez que a presença do nistagmo vertical inferior demonstrou ser frequente neste tipo de patologia.

Abstract Introduction Exposure to music is the subject of many studies because it is related to an individual's professional and social activities. Objectives Evaluate the vestibular behavior in military band musicians. Methods A retrospective cross-sectional study was performed. Nineteen musicians with ages ranging from 21 to 46 years were evaluated (average = 33.7 years and standard deviation = 7.2 years). They underwent anamnesis and vestibular and otolaryngologic evaluation through vectoelectronystagmography. Results The most evident otoneurologic symptoms in the anamnesis were tinnitus (84.2%), hearing difficulties (47.3%), dizziness (36.8%), headache (26.3%), intolerance to intense sounds (21.0%), and earache (15.7%). Seven musicians (37.0%) showed vestibular abnormality, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system, and there was a predominance of irritative peripheral vestibular disorders. Conclusion The alteration in vestibular exam occurred in the caloric test (37.0%). There were changes in the prevalence of peripheral vestibular system with a predominance of irritative vestibular dysfunction. Dizziness was the most significant symptom for the vestibular test in correlation with neurotologic symptoms. The present study made it possible to verify the importance of the labyrinthine test, which demonstrates that this population should be better studied because the systematic exposure to high sound pressure levels may cause major vestibular alterations.

Abstract Introduction Fishing, one of the oldest productive activities, is an important sector of the national and world economy. Aim To evaluate the vestibular behavior in a population of fishermen. Methods In a retrospective and cross-sectional study, 13 fishermen (mean 45.0), between 33 and 62 years of age, were submitted to anamnesis, otorhinolaryngological evaluation, and vestibular exam through the vector electronystagmography. Results The most evident otoneurologic symptoms were hearing loss (76.9%), tinnitus (61.7%), dizziness (46.1%), and headache (46.1%). The most evident clinical symptoms were fatigue (46.1%), depression (23.0%), anxiety (15.3%), insomnia (7.7%), and agitation during sleep (7.7%). There were alterations in the vestibular exam in 5 fishermen (38.5%) discovered in the caloric test. There was a prevalence of alteration in the peripheral vestibular system. There was a major frequency of the peripheral vestibular irritative syndrome. Conclusion The otoneurologic complaints were frequent in the population studied to verify the importance of allowing labyrinth exams and the need for adopting preventive measures relating to noise exposure as well as carbon monoxide exposure, because they can cause and/or enhance various manifestations of labyrinthine vestibular impairment that can affect the quality of life of these workers.

OBJETIVO: Descrever os resultados das avaliações audiológica e eletrofisiológica da audição em pacientes portadores de ataxia espinocerebelar (AEC). MÉTODOS: Foi realizado um estudo retrospectivo de corte transversal no qual se avaliou 43 pacientes portadores de AEC submetidos aos seguintes procedimentos: anamnese e avaliações otorrinolaringológica, audiológica, imitanciométrica e do potencial evocado auditivo de tronco encefálico (PEATE). RESULTADOS: Os pacientes apresentaram prevalência do desequilíbrio à marcha (83,7%), dificuldade para falar (48,8%), tontura (41,8%) e disfagia (39,5%). A perda auditiva foi referida em 27,9% dos casos; no exame audiométrico, 14 pacientes (32,5%) apresentaram alterações; na AEC 3, 33,3%; na AEC 2, 12,5%; na AEC 4, 100,0%; na AEC 6, 100,0%; na AEC 7, 100,0%; na AEC 10, 50,0%; e na AEC indeterminada, 21,4%. No PEATE, 20 pacientes (46,5%) apresentaram alterações, sendo 58,3% na AEC 3, 62,5% na AEC 2, 100,0% na AEC 6, 100,0% na AEC 7, 66,7% na AEC 10 e 14,2% na AEC indeterminada. No exame imitanciométrico, 19 pacientes (44,1%) apresentaram alterações, sendo 50,0% na AEC 3, 50,0% na AEC 2, 100,0% na AEC 4, 100,0% na AEC 6, 100,0% na AEC 7, 33,3% na AEC 10 e 28,5% na AEC indeterminada. CONCLUSÃO: As alterações mais evidenciadas na avaliação audiológica foram o predomínio da configuração audiométrica descendente a partir da frequência de 4 kHz bilateralmente e a ausência do reflexo acústico nas frequências de 3 e 4 kHz bilateralmente. Na avaliação eletrofisiológica, 50% dos pacientes apresentaram alterações com prevalência do aumento das latências das ondas I, III e V e do intervalo nos interpicos I-III, I-V e III-V.

TEMA: a polimiosite é uma enfermidade sistêmica idiopática caracterizada por um processo inflamatório não supurativo que acomete a musculatura esquelética e manifesta-se clinicamente por fraqueza muscular proximal e simétrica. Possui incidência variável, cerca de um caso para cada 100 mil habitantes, havendo predominância no sexo feminino. PROCEDIMENTOS: avaliou-se no Setor de Otoneurologia de uma Instituição, um paciente com diagnóstico de polimiosite, com 60 anos, do sexo feminino, que referiu dificuldade para escutar no ouvido direito, zumbido, ansiedade, insônia, dificuldade nos movimentos do pescoço e dor irradiada para ombros e braços. Foram realizados os seguintes procedimentos: anamnese, inspeção otológica, avaliação audiológica e vestibular. RESULTADOS: a) na avaliação audiológica apresentou, perda auditiva neurossensorial de grau moderado na orelha direita e limiares auditivos dentro dos padrões de normalidade na orelha esquerda; b) na imitanciometria apresentou, curva timpanométrica do tipo "A" e presença dos reflexos estapedianos bilateralmente; c) no exame vestibular observou-se, nistagmo semi-espontâneo do tipo múltiplo e ausência do efeito inibidor da fixação ocular. CONCLUSÃO: observou-se alteração nos exames realizados, principalmente, no exame labiríntico que demonstrou a importância de sua realização e a sensibilidade na captação de alteração que sugeriu envolvimento do sistema nervoso central contribuindo dessa forma, para uma intervenção e acompanhamento terapêutico mais rápido e eficaz.BACKGROUND: polymyositis is an idiopathic systematic disease characterized by a non-suppurative inflammatory process which attacks the skeletal musculature and manifests itself clinically by proximal and symmetrical muscular debility. It shows a variable incidence, approximately one in every hundred thousand inhabitants, predominately in females. PROCEDURES: a patient, 60 years, female and diagnosed with polymyositis was evaluated in the Otoneurology Sector of an Institution, referred having hearing difficulties in the right ear, tinnitus, anxiety, insomnia, difficulties in neck movement and shoulders and arms disseminated pain. The following procedures were carried out: anamnesis, otological inspection, audiological evaluation and vestibular exam. RESULTS: a) in the audiological evaluation there was sensorineural hearing loss from moderate degrees in the right ear and normal hearing thresholds in the left ear; b) in the imitanciometry there was a type "A" tympanometric curve and the presence of the stapedial reflexes, bilaterally; c) in the vestibular exam, semi-spontaneous multiple nystagmus and an absence of the inhibiting effect for ocular fixation were observed. CONCLUSION: alterations were observed in the accomplished exams, mainly in the vestibular exam, which demonstrated the importance for being carried out; and the sensitivity in the acquisition of the alteration which suggested an involvement of the central nervous system, contributing, thus, to a faster and more effective intervention and therapeutic accompaniment.

OBJECTIVE: To describe the alterations observed in electronystagmography (ENG) of patients with spinocerebellar ataxia (SCA) types 2 and 3. METHOD: Sixteen patients were studied and the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluations. RESULTS: The clinical findings in the entire group of patients were: gait disturbances (93.75%), dysarthria (43.75%), headache (43.75%), dizziness (37.50%) and dysphagia (37.50%). In the vestibular exam, the rotatory (62.50%) and caloric (75%) tests were among those which presented the largest indexes of abnormalities; the presence of alterations in the exams was 87.50%, with a predominance of central vestibular disorders in 68.75% of the exams. CONCLUSION: Vestibular exams could be an auxiliary tool to investigate SCAs, besides a precise clinical approach and, particularly, molecular genetic tests.

A audiometria de altas frequências (AAF) é um exame audiológico importante na detecção precoce de perdas auditivas por lesões na base do ducto coclear. Nos últimos anos, a sua utilização foi facilitada pelo fato de os audiômetros comercializados passarem a incorporar frequências superiores a 8 kHz. Porém, existem diferenças relacionadas aos equipamentos utilizados, às metodologias empregadas e/ou aos resultados e interpretação. Assim, o objetivo deste artigo foi analisar a produção científica nacional sobre a aplicação clínica com AAF, para compreender sua utilização atual. Foram pesquisados textos publicados e indexados nas bases de dados LILACS, SciELO e Medline, num período de tempo de dez anos, utilizando como descritor "audiometria de altas frequências/high-frequency audiometry". Encontraram-se 24 artigos científicos nacionais utilizando AAF, cuja população avaliada, em sua maioria, apresentava de 18 a 50 anos de idade; 13 dos estudos determinaram os limiares utilizando como referência decibel nível de audição (dBNA); alguns estudos realizaram a comparação dos limiares auditivos tonais entre grupos para definir a normalidade; os autores relataram diferenças significativas nos limiares auditivos de altas frequências entre as idades. A AAF é utilizada na clínica audiológica para identificação precoce de alterações auditivas e no acompanhamento da audição de sujeitos expostos a drogas ototóxicas e/ou agentes otoagressores.High-frequency audiometry (HFA) is an important audiological test for early detection of hearing losses caused by leasions in the base of the cochlear duct. In recent years, its use was facilitated because audiometers began to identify frequencies higher than 8 kHz. However, there are differences related to the equipment used, the methodologies followed, and/or to the results and their interpretation. Therefore, the aim of this study was to analyze the national scientific production regarding HFA clinical application, to better understand its current use. Articles published and indexed in LILACS, SciELO and Medline databases in the last ten years were researched, using as keyword "audiometria de alta frequência/high-frequency audiometry". Twenty-four Brazilian scientific papers using HFA were found; most studies evaluated participants with ages ranging from 18 to 50 years; 13 studies used decibel hearing level (dBHL) to determine the thresholds; a few studies compared tonal auditory thresholds between groups to define normality; the authors reported significant differences in high frequency auditory thresholds among age ranges. HFA is used in audiological clinic for early identification of auditory alterations and in the auditory follow-up of subjects exposed to ototoxic drugs and/or otoagressive agents.

TEMA: a fibromialgia é uma síndrome musculoesquelética não inflamatória, de caráter crônico, de etiologia desconhecida, caracterizada por dor generalizada, aumento da sensibilidade na palpação e por sintomas como insônia, rigidez, cansaço, doença psicológica, intolerância ao frio e queixas otológicas. PROCEDIMENTOS: avaliaram-se no setor de Otoneurologia de uma Instituição, em setembro de 2008, dois pacientes com diagnóstico de fibromialgia, idades entre 52 e 61 anos, sexo feminino, que referiram: tontura, zumbido, sensação de movimento de objetos, desequilíbrio à marcha, quedas, fadiga, depressão, cefaléia, dificuldade em escutar e em movimentar o pescoço, entre outros. Foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação audiológica e vestibular por meio da vectoeletronistagmografia. RESULTADOS: observaram-se os seguintes achados: Paciente 1 - perda auditiva do tipo neurossensorial a partir de 2KHz na orelha esquerda, limiares auditivos dentro dos padrões de normalidade na orelha direita e hipo-reflexia em valor absoluto à prova calórica 42ºC na orelha direita. Paciente 2 - limiares auditivos dentro dos padrões de normalidade bilateralmente e hiper-reflexia em valor absoluto à prova calórica 42ºC na orelha direita com intensa manifestação neurovegetativa. CONCLUSÃO: os casos apresentados demonstraram a importância das avaliações audiológica e vestibular na contribuição da elaboração de estratégias utilizadas no acompanhamento terapêutico da fibromialgia sugerindo a realização desses exames como rotina clínica.BACKGROUND: fibromyalgia is a non-inflammatory musculoskeletal syndrome, with a chronic nature and unknown aetiology, characterized by widespread pain, increase in sensibility to palpation and by symptoms such as insomnia, stiffness, fatigue, psychological sickness, intolerance to cold and otologic complaints. PROCEDURES: two female patients diagnosed with fibromyalgia, aged 52 to 61 years, were evaluated in the Otoneurology sector of a institution, in September 2008, and consulted for: dizziness, paraesthesia, perception of movement of objects, imbalance on walking, falls, fatigue, depression, headaches, and difficulty in listening and moving the neck. They were submitted to the following procedures: anamnesis, otological inspection, audiologic evaluation and vestibular exam through vectoelectronystagmography. RESULTS: the following discoveries were noted: Patient 1 - hearing loss of the sensorineural type from 2 KHz in the left ear, normal hearing thresholds in the right ear and hypo-reflexia with an absolute value of 42ºC in the caloric test in the right ear. Patient 2 - normal hearing thresholds, bilaterally, and hyper-reflexia with an absolute value of 42ºC in the caloric test in the right ear with an intense neurovegetative manifestation. CONCLUSION: the submitted cases demonstrated the importance of audiologic evaluations and vestibular exams in the contribution to elaboration of strategies used in the therapeutic consolidation of fibromyalgia suggesting the performance of those exams as a clinical routine.

TEMA: a Síndrome da Imunodeficiência Adquirida (SIDA/AIDS) é causada pelo Vírus da Imunodeficiência Humana (VIH/HIV), e resulta numa imunidade reduzida, o que torna o indivíduo mais susceptível a doenças e infecções oportunistas. Com o avanço da doença as estruturas do sistema auditivo central podem ser comprometidas pela ação direta do vírus ou decorrente de infecções secundárias e neoplasias. O portador do HIV/AIDS pode também se tornar mais vulnerável a outras patologias do ouvido. OBJETIVO: o objetivo desta revisão foi exploratório, visando identificar os possíveis pontos de interseção entre distúrbios auditivos e a Síndrome da Imunodeficiência Adquirida. Realizou-se uma revisão da literatura sobre a saúde auditiva dos portadores de HIV/AIDS e foi discutido o impacto potencial de patologias auditivas na qualidade de vida. CONCLUSÃO: a literatura sugere que várias possiveis associações existam entre os distúrbios auditivos e a Síndrome da Imunodeficiência Adquirida e o Vírus da Imunodeficiência Humana. Profissionais de saúde, inclusive aqueles dos serviços públicos no Brasil, deveriam examinar a necessidade de iniciativas de saúde auditiva dirigida aos portadores de HIV/AIDS para prevenir patologias auditivas ou reduzir seu impacto na qualidade de vida.BACKGROUND: Acquired Immunodeficiency Syndrome (or Acquired immune deficiency syndrome or AIDS) is caused by the Human Immunodeficiency Virus (HIV) and results in reduced immunity, leaving affected individuals more susceptible to illness and opportunistic infections. As the disease progresses, structures within the central auditory system can be affected either by the direct action of the virus or as a consequence of secondary infections. Other areas of the auditory system may also be more vulnerable to pathology in people living with HIV or AIDS. PURPOSE: the goal of this review was exploratory, to identify possible points of intersection between auditory disorders and Acquired Immune Deficiency Syndrome. This paper reports the results of a literature review on auditory disorders associated with HIV and AIDS and discusses the potential impact of ear pathologies among HIV/AIDSinfected populations. CONCLUSION: literature suggests several possible types of association between auditory disorders and the Acquired Immune Deficiency Syndrome and the Human Immunodeficiency Virus, and that people with HIV/AIDS may require hearing care interventions. Health professionals, including those from the Brazilian public health system, should examine the need for hearing-related services among HIV/AIDS patients in order to reduce the impact of the disease on daily life activities and prevent insofar, further auditory deterioration.

O objetivo desse estudo foi analisar a eficácia do exercício de reabilitação vestibular em dois casos de esclerose múltipla remitente-recorrente. Ambos os casos foram encaminhados do Hospital de Clínicas para o Laboratório de Otoneurologia de uma instituição de ensino e foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular e aplicação do Dizziness Handicap Inventory pré e pós reabilitação vestibular utilizando-se o protocolo de Cawthorne e Cooksey. No primeiro caso, gênero feminino, 35 anos, tempo de doença de seis anos, referiu tontura há três anos, de intensidade moderada de ocorrência frequente, cefaléia, quedas, desvio de marcha à direita e sensação de desmaio (sic). Apresentou no exame labiríntico, síndrome vestibular periférica deficitária bilateral. No segundo caso, gênero feminino, 49 anos, tempo de doença de dois anos, referiu desvio de marcha à direita, dificuldade e/ou dor ao movimento do pescoço, formigamento de extremidade e alteração vocal. Apresentou no exame labiríntico, síndrome vestibular periférica deficitária à direita. Houve melhora significativa em ambos os casos dos aspectos físico, funcional e emocional do Dizziness Handicap Inventory após a realização da reabilitação vestibular. O protocolo utilizado promoveu melhora na qualidade de vida e auxiliou no processo de compensação vestibular.The aim of the present study was to analyze the effectiveness of vestibular rehabilitation exercises in two cases of remittent-recurrent multiple sclerosis. Both cases were referred from the Clinics Hospital to the Laboratory of Otoneurology of the same institution and were submitted to the following procedures: anamnesis, otological inspection, vestibular evaluation, and application of the Dizziness Handicap Inventory before and after vestibular rehabilitation using the Cawthorne and Cooksey protocol. The first case was a 35-year-old female, diagnosed for six years, who referred frequent dizziness of moderate intensity for three years, headaches, falls, deviation of gait to the right and fainting sensations (sic). In the vestibular exam, she presented bilateral peripheral vestibular deficiency syndrome. The second case was a 49-year-old female, diagnosed for two years, who referred deviation of gait to the right, difficulty and/or pain with neck movement, paraesthesia of the extremities and vocal alteration. In the vestibular exam, she presented peripheral vestibular deficiency syndrome to the right. Both cases had significant improvements regarding physical, functional and emotional aspects of the Dizziness Handicap Inventory after vestibular rehabilitation. The protocol used benefitted the subjects' quality of life and favored the process of vestibular compensation.

OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100%); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3%); there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. CONCLUSION: The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.OBJETIVO: Avaliar a eficácia dos exercícios de reabilitação vestibular (RV) por meio de avaliação pré e pós-aplicação da versão brasileira do questionário Dizziness Handicap Inventory (DHI). MÉTODO: Estudou-se 12 pacientes e realizaram-se os seguintes procedimentos: anamnese, avaliação otorrinolaringológica, vestibular e aplicação do DHI pré e pós RV. RESULTADOS: Do ponto de vista clínico, o tremor de repouso e a instabilidade postural subjetiva foram às queixas motoras mais freqüentes associadas às queixas de vertigem em 12 casos (100%); no exame vestibular, todos os pacientes apresentaram anormalidades, com freqüência das síndromes vestibulares periféricas deficitárias uni e bilaterais em 10 casos (83,3%); houve melhora significativa dos aspectos físico, funcional e emocional do DHI após a realização da RV. CONCLUSÃO: A RV seguindo o protocolo de Cawthorne e Cooksey mostrou-se útil no manejo de queixas subjetivas de diversos aspectos avaliados neste protocolo.

OBJETIVO: verificar os achados vestibulares em pacientes com perda auditiva neurossenssorial usuários de aparelho de amplificação sonora individual. MÉTODOS: vinte pacientes, 11 do sexo feminino e nove do sexo masculino, com idades entre 39 e 85 anos, com perda auditiva neurossenssorial bilateral de grau moderado e severo foram atendidos em uma Instituição de Ensino Superior e submetidos a uma anamnese, inspeção otológica, avaliação audiológica, imitanciometria e ao exame vestibular por meio da vectoeletronistagmografia. RESULTADOS: a) dos 20 pacientes avaliados, 18 (90%) apresentaram queixa de zumbido, 15 (75%) queixa de tontura e oito (40%) queixa de cefaléia; b) houve predomínio de alteração na prova calórica e no sistema vestibular periférico; c) o resultado do exame vestibular esteve alterado em 14 pacientes (70%), sendo, oito casos (40%) de síndrome vestibular periférica irritativa e seis casos (30%) de síndrome vestibular periférica deficitária; d) verificou-se diferença significativa entre o resultado do exame vestibular e o tempo de uso do aparelho de amplificação sonora individual; e) dos cinco pacientes que não referiram nenhum sintoma vestibular, quatro (80%) apresentaram alteração no exame. CONCLUSÃO: ressalta-se a sensibilidade e importância do estudo funcional do sistema do equilíbrio neste tipo de população, uma vez que podem ocorrer alterações na avaliação labiríntica independente da presença de sintomas.PURPOSE: to check vestibular findings in patients with sensoneural hearing loss, hearing aid users. METHODS: 20 patients (eleven females and nine males) aging from 39 to 85-year-old with bilateral sensorineural hearing loss, from moderate to severe degrees, were attended in a higher education institution evaluated by medical history, otological inspections, complete basic conventional audiological evaluations, acoustic impedance tests and vectoeletronystagmography. RESULTS: a) from the 20 evaluated patients, 18 (90%) showed tinnitus complaint, 15 (75%) dizziness complaint and eight (40%) headache complaint; b) There was a prevalence of alterations in the caloric test and in the peripheral vestibular system; c) the results of the vestibular exam showed alterations in 14 patients (70%) being, eight cases (40%) of peripheral vestibular irritative syndromes and six cases (30%) of peripheral vestibular deficiency syndromes; d) we verified significant difference between the vestibular exam results and how long the patient had use the hearing aid; e) from the five patients that did not related vestibular symptoms four (80%) showed alterations in the vestibular exam. CONCLUSION: the importance and sensibility of the functional study regarding the balance system in this type of population must be emphasized because same disorders may occur in the vestibular exam in spite of symptom presence.

OBJETIVO: comparar os resultados do teste denominado limiar de detectabilidade de voz, utilizando-se uma lista de palavras trissilábicas previamente gravadas e à viva voz em indivíduos com audiograma de configuração plana. MÉTODOS: participaram da pesquisa 60 indivíduos (120 orelhas) com exame audiométrico dentro dos padrões da normalidade e audiometria tonal de configuração plana, sem intercorrências auditivas, em faixa etária de 20 a 30 anos. Aplicou-se o teste à viva voz e com material gravado, em cabine tratada acusticamente, por meio do audiômetro AC40 e com o auxílio de um cd player acoplado. RESULTADOS: o limiar de detectabilidade de voz foi encontrado 10 dB melhor que a média tritonal em 35 orelhas (58,5% da amostra) quando realizado a viva-voz e em sete orelhas (11,5%) quando realizado com material gravado; e foi encontrado 5 dB pior que a média tritonal em uma orelha (1,5%) quando realizado a viva-voz e em 23 orelhas (38%) com material gravado. CONCLUSÃO: a) ao utilizar-se material gravado para o estabelecimento do LDV em curvas de configuração plana, deve-se considerar como padrão de normalidade níveis de intensidade iguais à média tritonal ou pior em 5 dB e b) evidenciou-se diferença entre os resultados obtidos com material gravado e a viva voz, o que demonstra a importância da utilização de testes gravados para determinação dos limiares auditivos na logoaudiometria.PURPOSE: to compare the results of the test referred to as voice detection lower thresholds, using a previously-recorded list of trisyllabic words and in live voice in individuals with flat configuration audiogram. METHODS: 60 subjects (120 ears) took part in the study, each with an audiometric exam within normal patterns and tonal audiometry at a flat configuration, without auditory incidents, in the age group going from 20 to 30. The test was given with a live voice and with recorded material, in an acoustically-managed booth, by means of an AC40 audiometer and with the aid of a linked CD player. RESULTS: voice detection lower thresholds were found to be 10 dB better than the tritonal average in 35 ears (57% of the sample) when accomplished by live voice and in 10 ears (17%) when accomplished by recorded material; and were found to be 5 dB worse than the tritonal average in one ear (3%) when accomplished by live voice and in 23 ears (38%) by recorded material. CONCLUSION: a) when using recorded material for the establishment of LDV in flat configuration curves, one should consider intensity levels equal to the tritonal average or 5 dB lower as standards of normality and b) a difference was revealed between the results obtained with recorded material and those from live voices, demonstrating the importance of using recorded tests for determining lower auditory thresholds in logoaudiometry.

OBJETIVO: Verificar a efetividade dos exercícios de reabilitação vestibular na melhora do zumbido e da tontura por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI) e Tinnitus Handicap Inventory (THI), ambos adaptados à população brasileira. MÉTODOS: Avaliaram-se seis pacientes (dois do sexo masculino e quatro do sexo feminino), na faixa etária de 43 a 70 anos. Os pacientes foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular por meio da vectoeletronistagmografia e aplicação dos questionários pré e pós-reabilitação vestibular, utilizando-se o protocolo de Cawthorne e Cooksey. RESULTADOS: a) com relação às queixas mais referidas, observou-se desequilíbrio à marcha (83,3%), dor de cabeça (66,6%) e depressão (66,6%); b) no exame vestibular todos os pacientes apresentaram alteração na prova calórica, sendo a maior freqüência das síndromes vestibulares periféricas irritativas (83,3%); c) constataram-se no exame vestibular dois casos de síndrome vestibular periférica irritativa, dois casos de síndrome vestibular periférica irritativa unilateral; um caso de síndrome vestibular periférica irritativa bilateral e um caso de síndrome vestibular periférica deficitária unilateral; d) na aplicação do DHI, observou-se melhora nos aspectos: funcional e emocional, mantendo-se inalterado o aspecto físico; e) na aplicação do THI, observou-se melhora em todos os aspectos avaliados. CONCLUSÃO: O protocolo utilizado de reabilitação vestibular promoveu diminuição do zumbido e da tontura, melhorando a qualidade de vida dos pacientes.PURPOSE: To verify the effectiveness of vestibular rehabilitation exercises in the improvement of tinnitus and dizziness through an evaluation carried out before and after the administration of the Dizziness Handicap Inventory (DHI) and the Tinnitus Handicap Inventory (DHI) questionnaires, both adapted to the Brazilian population. METHODS: Six patients (two male and four female), with ages ranging from 43 to 70 years, were evaluated. The patients were submitted to the following procedures: anamnesis, otoscopy, vestibular evaluation through vectoelectronystagmography, and administration of the questionnaires, before and after vestibular rehabilitation, using the Cawthorne and Cooksey protocol. RESULTS: a) regarding the most related complaints, imbalance when walking (83,3%), headache (66,6%) and depression (66,6%), were observed; b) in the vestibular exam all the patients showed alterations in the caloric test, and the most frequent syndrome was the irritative peripheral vestibular (83,3%); c) two cases of irritative peripheral vestibular syndrome, two cases of irritative peripheral unilateral vestibular syndrome, one case of irritative peripheral bilateral vestibular syndrome and one case of peripheral deficient unilateral vestibular syndrome were verified in the vestibular exam; d) in the administration of the DHI, an improvement in the functional and emotional aspects were observed, with the physical aspect remaining unchanged; e) in the administration of the THI, an improvement was observed in all the aspects evaluated. CONCLUSION: The protocol of vestibular rehabilitation used in the study, promoted a decrease in tinnitus and dizziness, hence improving the quality of life of the patients.

TEMA: o tremor essencial é familial em cerca de 50% dos casos, com uma herança autossômica, possui início insidioso e é lentamente progressivo. PROCEDIMENTOS: avaliou-se no Setor de Otoneurologia de um Hospital Particular em fevereiro de 2007, uma paciente do sexo feminino, branca, 59 anos, casada, artista plástica, com história de tremor na cabeça desde os dois anos de idade (sic). A paciente relata queixa de tontura há vários meses de origem súbita sem acompanhamento de náusea e/ou queda. Nega perda de força muscular e formigamento em membros superiores e inferiores, rebaixamento da acuidade auditiva e zumbido. A paciente relata que um de seus filhos possuiu tremor nas mãos há dois anos e avós maternos e paternos com Parkinson. Realizaram-se os seguintes procedimentos: anamnese, inspeção otológica e avaliação vestibular por meio da vectoeletronistagmografia. RESULTADOS: observaram-se os seguintes achados ao exame vestibular: nistagmo de posicionamento com características centrais, nistagmo espontâneo presente com os olhos abertos, nistagmo semi-espontâneo do tipo múltiplo e hiper-reflexia em valor absoluto à prova calórica 20ºC (OD e OE). CONCLUSÃO: o exame vestibular mostrou-se sensível e importante para captar alterações em provas que sugerissem envolvimento do sistema nervoso central.BACKGROUND: essential tremors are family-related in about 50% of the cases with an autosomal inheritance and they register an insidious beginning with a slow progression. PROCEDURE: a 59 year old, white female patient, married and whose occupation is a plastic artist with a history of head tremors since she was two years (sic) old was evaluated in the Otoneurology sector of a private hospital, during the period from February 2007. The patient had been complaining of dizziness from unknown origin for several months without accompanying nausea and/or falls. She denied any loss of muscular strength or tingling in her upper and lower members and neither any lowering of her auditory sharpness nor buzzing. The patient informed that one of her children suffered hand tremors two years ago and also that both grandparents had Parkinson’s disease. The following procedures were performed: anamnesis, otological inspection and vestibular evaluation through vectoelectronystagmography. RESULTS: the following findings from the vestibular exam were observed: positioning nystagmus with central characteristics, spontaneous nystagmus with the eyes open, semi-spontaneous nystagmus of the multiple and hyperreflexia type in readings absolute to the caloric test at 20ºC (RE and LE). CONCLUSION: the vestibular exam was shown to be sensitive and important for garnering alterations in tests that suggested involvement of the central nervous system.

OBJETIVO: investigar o conhecimento, a valorização da detecção precoce da deficiência auditiva pelos profissionais da saúde envolvidos no período pré e pós gestacional e verificar o conhecimento das mães sobre a importância da triagem auditiva neonatal. MÉTODOS: o instrumento da pesquisa constituiu-se de três questionários com perguntas fechadas e específicas aos profissionais envolvidos; pediatras, ginecologistas/obstetras e enfermeiros, além das mães dos bebês nascidos em uma maternidade na cidade de Maringá/PR, no período de janeiro a fevereiro/2005. RESULTADOS: observou-se no questionário realizado com os médicos que todos, 100%, referiram ter conhecimento da saúde auditiva do bebê, 69% recomendaram o teste da orelhinha, 82% referiram que até os primeiros três meses seria o período ideal para o diagnóstico auditivo e apenas 37% souberam referir quais os exames necessários a serem realizados. Entre os enfermeiros, 78% demonstraram ter conhecimento sobre a detecção precoce da perda auditiva e 67% referiram orientar os pais sobre o teste da orelhinha. Sobre a importância da detecção precoce da deficiência auditiva, 22% não responderam ou não acharam relevante. No questionário realizado com as mães, 81% relataram não terem recebido orientações a respeito das doenças que alteram o desenvolvimento auditivo, 72% não tinham conhecimento a respeito da detecção precoce da deficiência auditiva. CONCLUSÃO: mostrou-se evidente neste estudo um conhecimento reduzido com relação a detecção precoce da perda auditiva e da triagem auditiva neonatal por parte das pessoas envolvidas nesta pesquisa.PURPOSE: to investigate the knowledge and valorization of early detection of hearing loss by health professionals involved in the period before and after gestation and to check the mothers' knowledge on the importance of neonatal auditory screening. METHODS: the research instrument consisted of three questionnaires with closed and specific questions for the involved professionals, including pediatricians, gynecologists, obstetricians and nurses, in addition to the mothers of newborns from a maternity ward in the city of Maringá, Paraná, during the period between January to February 2005. RESULTS: it was observed in the questionnaire completed with the doctors that 100% described having knowledge of the baby's auditory health, 69% recommended otoacoustic emissions (OAE) 82% related that within the first three months it would be the ideal period for an auditory diagnosis and just 37% knew which were the exams to be performed. Among the nurses, 78% demonstrated having knowledge on early detection of hearing loss and 67% related having trained the parents to perform the (OAE). With regard to the importance of early detection of hearing loss, 22% did not answer or did not find it important. In the questionnaire completed with the mothers, 81% described not having received counseling regarding the diseases that alter auditory development, 72% did not have any knowledge regarding early detection of hearing loss. CONCLUSION: a reduced knowledge was found to be evident in this study, with regard to the early detection of hearing loss and neonatal auditory screening, by the people involved in this research.

OBJETIVO: verificar a efetividade dos exercícios de reabilitação vestibular (RV) por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI) - adaptação brasileira. MÉTODOS: avaliaram-se oito pacientes (três do sexo feminino e cinco do sexo masculino), na faixa etária de 48 a 71 anos, encaminhados da Associação Paranaense de Parkinson para o Laboratório de Otoneurologia da Universidade Tuiuti do Paraná. Os pacientes foram divididos em dois grupos e submetidos aos seguintes procedimentos: anamnese, avaliação otorrinolaringológica, avaliação vestibular por meio da vectoeletronistagmografia (VENG) e aplicação do questionário DHI - adaptação brasileira pré e pós RV utilizando-se os protocolos de Cawthorne e Cooksey (grupo A) e Herdman (grupo B). RESULTADOS: a) conforme as queixas otoneurológicas referidas na anamnese, observou-se a prevalência da tontura (100,0%), tremor (100,0%) e desvio de marcha (75,0&); b) no exame vestibular, todos os pacientes (100,0%) apresentaram alteração, sendo a maior freqüência das síndromes vestibulares periféricas deficitárias (62,5%); c) houve melhora significativa dos aspectos funcional (p = 0,020470) e emocional (p = 0,013631) após a realização dos exercícios de RV utilizando-se o protocolo de Cawthorne e Cooksey e do aspecto emocional (p=0,007316) utilizando-se o protocolo de Herdman. CONCLUSÃO: comparando-se os dois protocolos utilizados, verificou-se uma melhora significativa dos pacientes do grupo A, submetidos ao protocolo de Cawthorne e Cooksey (p=0.0231).PURPOSE: to check the effectiveness of vestibular rehabilitation exercises (RV) by means of an evaluation of a pre and post application of the Dizziness Handicap Inventory (DHI) questionnaire (Brazilian version). METHODS: eight patients were evaluated (three female and five male), in the age group varying from 48 to 71, referred from the Paraná Association of Parkinson to the Otoneurological Laboratory of Tuiuti University of Paraná. The patients were divided in two groups and submitted to the following procedures: anamnesis, otorhinolaryngological evaluation, vestibular evaluation through vectoelectronystagmography (VENG) and an application of DHI questionnaire (Brazilian version) before and after RV, using Cawthorne and Cooksey (group A) and Herdman (group B) protocols. RESULTS: a) regarding the otoneurological complaints referred to in the anamnesis, the prevalence of dizziness (100.0%), trembling (100.0%) and deviation during walking (75.0%) were observed; b) In the vestibular exam, all patients (100.0%) presented alterations, with the largest incidence being the deficient peripheral vestibular syndromes (62.5%); c) There was significant improvement of the functional (p = 0,020470) and emotional (p = 0,013631) aspects after accomplishing the RV exercises using the Cawthorne and Cooksey protocol and of the emotional aspect (p=0,007316) using Herdman protocol. CONCLUSION: comparing the two protocols used, a significant improvement of group A patients, submitted to the protocol of Cawthorne and Cooksey (p=0.0231), was confirmed.

OBJETIVO: avaliar o comportamento vestibular em pacientes com disfunção temporomandibular. MÉTODOS: avaliaram-se 27 pacientes do sexo feminino, na faixa etária de 30 a 53 anos, encaminhadas do Centro de Diagnóstico e Tratamento da Articulação Temporomandibular para o Laboratório de Otoneurologia da Universidade Tuiuti do Paraná. Realizaram-se os seguintes procedimentos: anamnese, inspeção otológica e avaliação vestibular por meio da vectoeletronistagmografia. RESULTADOS: as queixas mais freqüentes foram: dificuldade ou dor ao movimento do pescoço (77,7%), dor irradiada para ombro/braço (77,7%), zumbido e formigamento de extremidade superior (77,7%), tontura e dor de cabeça (66,6%), ansiedade (55,5%), sensação de cabeça oca (51,8%), agitação durante o sono (51,8%) e depressão (51,8%). O exame vestibular esteve alterado em 20 pacientes (74,0%) na prova calórica. Houve freqüência de alteração no sistema vestibular periférico. Houve predomínio das síndromes vestibulares periféricas deficitárias. CONCLUSÃO: ressalta-se a importância de se estudar a relação do sistema vestibular com a disfunção temporomandibular uma vez que observamos, na presente pesquisa, um número elevado de alteração no exame labiríntico.PURPOSE: to evaluate the vestibular functioning in patients with temporomandibular joint dysfunction. METHODS: 27 female patients were evaluated, with age varying from 30 to 53-year-old, referred from the Centre of Diagnosis and Treatment of Temporomandibular Joint Dysfunction to the Otoneurological Laboratory of Tuiuti University of Paraná. The following exams were carried out: anamnesis, otoscopy and vestibular evaluations through vectoelectronystagmography. RESULTS: the most frequent complaints were: difficulty or pain with movement of the neck (77.7%), pain irradiated to the shoulder/arm (77.7%), tinnitus and paresthesia of superior extremities (77.7%) in each one, dizziness and headaches (66,6%), anxiety (55.5%), empty head sensations, agitation during sleep and depression (51.8%) in each one. The vestibular exam showed alterations in 20 patients (74.0%) in the caloric test. There was a prevalence of alterations in the peripheral vestibular system. There was a prevalence of deficient peripheral vestibular syndrome. CONCLUSION: the importance of studying the relationship between the vestibular system and temporomandibular joint dysfunction is emphasized, since a high number of alterations in the labyrinthic exam have been noted in this research.

OBJETIVO: avaliar o nível de ruído nas salas de aula de primeira série do ensino fundamental, bem como verificar sua interferência durante as atividades de leitura e ditado. MÉTODOS: realizou-se a medição dos níveis de ruído segundo padrões ANSI em sete salas de aula de cinco escolas da rede municipal de ensino da cidade de Urussanga/SC durante as atividades de leitura e ditado. Posteriormente aplicou-se um questionário aos alunos e professores abordando a interferência do ruído nas atividades realizadas. Participaram da pesquisa 109 crianças sendo, 59 do gênero masculino e 50 do gênero feminino. RESULTADOS: os níveis de ruído presentes nas salas de aulas, variou de 59,5 a 71,3 dB(A). Quanto à percepção dos alunos e professores sobre o ruído, 94,5% dos alunos e 100% dos professores perceberam outras fontes sonoras durante as atividades, mas, apenas 52,39% dos alunos e 42,8% dos professores afirmaram interferência do ruído na aplicação das atividades. CONCLUSÃO: observou-se que o nível de ruído mesmo estando acima do proposto pelas normas nacionais, não interferiu no resultado do ditado. Por outro lado, os professores, principalmente das salas mais ruidosas, necessitaram elevar a voz durante a aplicação da atividade, queixando-se posteriormente de cansaço vocal.PURPOSE: to evaluate noise level in the classrooms of first grade children as well as, to verify its interference during reading and dictation activities. METHODS: measuring noise levels according to ANSI standards was performed in seven classrooms of five schools of the municipal network of teaching in the city of Urussanga, Santa Catarina during reading and dictation activities. Afterwards, a questionnaire was introduced to the students and teachers dealing with the interference of noise in the accomplished activities. 109 children participated in the survey and 59 were males and 50 females. RESULTS: noise levels present in the classrooms varied from 59.5 to 71.3 dB(A). Regarding the students' and teachers' perception of the noise, 94.5% of the students and 100% of the teachers noted other sound sources during the activities but just 52.39% of the students and 42.8% of the teachers affirmed an interference from the noise during the practice of the activities. CONCLUSION: it was observed that the noise level, despite being above proposed limits according to national standards, did not interfere in the results of the dictation. On the other hand, the teachers, mainly in the noisiest rooms, needed to raise their voices during the practice of their activities, complaining afterwards about vocal fatigue.

RESUMO Objetivo: Analisar características perinatais de crianças com transtorno do espectro autista (TEA). Métodos: Revisão retrospectiva dos prontuários medicos de 75 crianças com TEA, entre janeiro de 2008 e janeiro de 2015. Os critérios de inclusão foram o diagnóstico de TEA baseado no DSM-5 e o termo de consentimento assinado pelo responsável legal. O critério de exclusão foi ausência de todos os dados no prontuário médico. As variáveis analisadas foram: idade materna, prematuridade (idade gestacional menor que 37 semanas), baixo peso ao nascer (

OBJETIVO: Investigar o comportamento auditivo de pacientes com insuficiência renal crônica submetidos ao transplante renal. MÉTODOS: Foram avaliados 30 pacientes, 10 do gênero feminino e 20 do gênero masculino, na faixa etária de 13 a 26 anos (média de idade 16,97 anos). Os sujeitos foram submetidos a anamnese, avaliação otorrinolaringológica, avaliação audiológica convencional e de altas frequências, medidas de imitância acústica e avaliação do processamento auditivo central. Para os resultados da audiometria de altas frequências foi utilizado um grupo controle. RESULTADOS: Os sujeitos não apresentaram queixas auditivas na anamnese. Os resultados da audiometria convencional demonstraram predomínio da normalidade; na audiometria de altas frequências, os pacientes apresentaram resultados piores do que os sujeitos do grupo controle. Na imitanciometria houve predomínio de curva tipo A bilateral. Na avaliação do processamento auditivo central, 14 sujeitos (46,67%) apresentaram resultados alterados no Staggered Spondaic Word Test (SSW). Houve diferença significativa entre a variável idade e o resultado da audiometria tonal limiar: quanto maior a idade, menor a sensibilidade auditiva nos limiares de 250 Hz a 8 kHz. Houve relação entre o tipo de doador (cadáver ou vivo) e o resultado do teste SSW: os índices de resultados alterados foram maiores quando o doador era cadáver, em comparação com casos de doador vivo. CONCLUSÃO: Houve alterações na avaliação audiológica convencional e de altas frequências e no processamento auditivo central de sujeitos com insuficiência renal crônica submetidos ao transplante renal, sugerindo a necessidade de orientação à equipe envolvida quanto aos cuidados, prevenção e identificação precoce de acometimentos audiológicos.

JUSTIFICATIVA E OBJETIVOS: A amplitude de movimento do pescoço pode ser reduzida pela presença de disfunções vertebrais e miofasciais, as quais podem ser tratadas pela manipulação osteopática por meio da técnica articulatória rítmica cervical. O objetivo deste estudo foi verificar se a manipulação osteopática, através da técnica articulatória rítmica gera aumento da amplitude de rotação cervical mensurada por fleximetria. MÉTODOS: A casuística foi constituída de 58 indivíduos de ambos os gêneros, com idade média de 36±6,5 anos, com cervicalgia mecânica crônica, que foram submetidos de maneira randomizada à fleximetria controle da rotação cervical, à manipulação osteopática, por meio da técnica articulatória rítmica, ao repouso de 5 minutos e à fleximetria estudo da rotação cervical. RESULTADOS: A comparação entre as médias das fleximetrias de rotação cervical através do teste t de Student para dados pareados, ao nível de significância de 0,05 (5%), mostrou que houve aumento significativo da rotação cervical em todos os casos (p