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Introdução: Os potenciais evocados auditivos corticais com estímulo acústico podem auxiliar a verificar o benefício do implante coclear a nível cortical. Porém, o benefício com este dispositivo só será atingido se houver estimulação cortical suficiente fornecida pelos impulsos elétricos dos eletrodos intracocleares. Sendo assim, é necessário compreender a resposta cortical com estímulo elétrico e se esta tem similaridade com o resultado do mesmo exame com estímulo acústico. Com isso, espera-se compreender como o sistema auditivo nervoso central reage aos impulsos elétricos dos níveis de estimulação programados no implante coclear para cada individuo, e assim verificar se o procedimento é útil para predizer a efetividade da programação do dispositivo. Objetivo: Identificar se o registro do complexo de ondas P1-N1-P2-N2 será registrado com estímulo acústico e elétrico e suas similaridades em relação aos seus valores de latência e amplitude, assim como correlacionar tais achados com o tempo de surdez, tempo de uso do implante coclear, porcentagem de acertos nos testes de reconhecimento de fala e nível máximo de conforto da corrente elétrica no programa em uso. Metodologia: Estudo prospectivo de corte transversal aprovado pelo comitê de ética da instituição, CAE número 93350218.9.0000.0068. Foram selecionados adultos diagnosticados com surdez pós lingual e usuários de implante coclear da marca Cochlear© há 6 meses ou mais, sem alterações neurológicas e/ou cognitivas declaradas, com inserção total dos eletrodos. O potencial evocado auditivo cortical foi registrado com quatro eletrodos de contato em Fz, Cz, A1 e A2, pelo equipamento Intelligent HearingSystem IHS. Para o estímulo acústico utilizouse o tone burst em 2 k e 4 kHz e estímulo de fala /ba/, apresentados a 70 dBNA a 0º azimuth, em campo livre. O estímulo elétrico foi eliciado através do processador de fala, usando-se o software Custom Sound EP (Cochlear© Limited 2016), nos eletrodos 6 e 11 na corrente elétrica correspondente ao nível máximo de conforto (nível C) do programa em uso. As latências e amplitudes dos registros do complexo P1N1P2N2 foram analisados por dois profissionais experientes. Os dados foram analisados pelos testes t pareado e de Pearson no software SPSS versão 21 (SPSS 21.0 for Windows). Resultados: O nível de concordância entre os dois profissionais foi de 95%, o que resultou na amostra final de 19 indivíduos. Foram observadas diferenças significantes nos valores de latência e amplitude do complexo de ondas quando comparados os estímulos acústico e elétrico. Foram identificadas correlações positivas significantes entre os valores de latência e amplitude do PEAC com o tempo de uso do dispositivo e com a porcentagem de acertos no reconhecimento de fala, sugerindo que quanto maior o tempo de uso e melhor o reconhecimento de fala, menor a latência. Conclusão: O potencial evocado auditivo cortical com estímulo elétrico, nos eletrodos 6 e 11, avaliado no nível de corrente elétrica de máximo conforto do mapa em uso, foi capaz de gerar respostas corticais, demonstrando ser um instrumento útil para verificar a estimulação cortical com implante coclear. O maior tempo de uso do dispositivo demonstrou gerar respostas mais rápidas e efetivas Introduction: Cortical auditory evoked potentials with acoustic stimulus can help to verify the benefit of cochlear implants in the auditory cortex. However, the benefit with this device will only be achieved if there is sufficient cortical stimulation provided by electrical impulses from the intracochlear electrodes. Therefore, it is necessary to understand the cortical response to electrical stimulation and whether this is similar to the result of the same exam with acoustic stimulation. It is expected to understand how the central auditory nervous system reacts to the electrical impulses on the stimulation levels programmed in the cochlear implant for each individual and verify if the procedure is useful to predict the effectiveness of the device programming. Objective: To identify whether the recording of the wave complex P1-N1-P2-N2 will be recorded with acoustic and electrical stimuli and their similarities in relation to the presence of waves and their latency and amplitude values, as well as to correlate such findings with the time of deafness, time of cochlear implant use, percentage of correct answers in the speech recognition tests and maximum comfort level in the program in use. Methods: Prospective cross sectional study approved by the institution\'s ethics committee, CAE number 93350218.9.0000.0068. Adults diagnosed with postlingual deafness and Cochlear devices users for at least 6 months, without declared neurological and/or cognitive alterations, with complete electrode insertion were selected. The cortical auditory evoked potential was performed with five contact electrodes in Fz, Cz, A1 and A2, recorded by the Intelligent Hearing System IHS equipment. For the acoustic stimulus, tone burst at 2 k and 4 kHz and speech stimulus /ba/ were used, presented at 70 dBHL at 0º azimuth in free field. The electrical stimulus was elicited through the speech processor using Custom Sound EP software (Cochlear Limited 2016). Electrodes 6 and 11 were selected in the electrical current corresponding to the maximum comfort level (C level) of the program in use. To analyze the results an audiologist with experience in the area of electrophysiology was invited to participate as a judge. Data were analyzed by paired t test and Pearson correlation using SPSS version 21 software (SPSS 21.0 for Windows). Results: The agreement level between the wave judges was 95% leading to a final sample of 19 individuals. Statistically significant differences were observed in the latency and amplitude values of the wave complex when comparing acoustic and electrical stimuli. Correlations between the latency and amplitude values with the time of implant use and with speech recognition results were observed. Conclusion: The cortical auditory evoked potentials with electrical stimulation on electrodes 6 and 11 at the C level of the map in use were able to generate cortical responses, showing to be a useful instrument to verify cortical stimulation with cochlear implant. Longer device use has shown to generate faster and more effective responses

Made available in DSpace on 2021-06-25T12:27:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-11-30 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Introduction Any type of sensory deprivation in childhood resulting from conductive hearing loss may impair the development of peripheral and central auditory pathway structures with negative consequences for binaural processing. Objective To characterize and compare monoaural and binaural auditory responses in neonates and children without and with a history of recurrent otitis. Methods The study included participants from 0 to 8 years and 11 months old, in good general health conditions, of both genders, divided into a control group, with no history of otitis, and a study group, with history of recurrent otitis. Cortical potential with speech stimulus /ba/-/da/ was used as collection procedure. The arithmetic calculation of the 512 points of the wave was performed to obtain the grand average of the waves of the subjects in both groups. The Shapiro-Wilk and mixed repeated measures analysis of covariance (ANCOVA) statistical tests were performed to analyze the group effect, the condition, and the interaction (group versus condition) controlling the effect of the age-sex covariable. Results There was a statistically significant difference between the groups for all latency values; and for the P1, N1, P2, and N2 latencies, the differences between the groups occurred in the three analyzed conditions (right and left ears and binaural), revealing the influence of sensory deprivation. There were no significant differences in relation to wave amplitudes. Conclusion There are differences in the cortical potential with speech stimuli and in the binaural interaction component of children with and without history of recurrent otitis. Univ Sao Paulo, Dept Speech Therapy, Fac Med, Sao Paulo, SP, Brazil Univ Estadual Paulista, Dept Speech Therapy, Marilia, SP, Brazil Univ Sao Paulo, Dept Speech Therapy, Bauru, SP, Brazil Univ Marilia UNIMAR, Dept Biostat, Marilia, SP, Brazil Univ Estadual Paulista, Dept Speech Therapy, Marilia, SP, Brazil

Hearing loss may be related to several factors, including hearing loss resulting from certain genetic syndromes. Kearns-Sayre syndrome is characterized by mutations in mitochondrial DNA (deoxyribonucleic acid), responsible for the production of energy (adenosine triphosphate-ATP), which is extremely important for the development of structures that require it, such as the cochlea. The case was followed up at the hospital since 2000, due to the progressive characteristic of hearing loss found in audiological tests and findings in cases related to the syndrome. The intervention with individual sound amplification devices proved to be of little benefit for good oral communication of one of the patients, who was diagnosed with bilateral profound hearing loss. Thus, after discussions in clinical meetings, the team opted for the indication of the cochlear implant for the patient, according to the current criteria for indication of this surgery, and with which it obtained good results. His twin sister, who presented good results with hearing aids, will continue in audiological follow-up, to verify the evolution of the case and discuss a new approach, if necessary. Patients with suspected or diagnosed Kearns-Sayre syndrome should seek audiological diagnosis, because it is a possible progressive hearing loss, requiring rehabilitation with the use of hearing devices. Maintaining oral communication is extremely important because, in these cases, other functions will be impaired, such as muscle tone and vision.

Made available in DSpace on 2018-11-12T17:26:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-08-01. Added 1 bitstream(s) on 2018-11-12T17:34:52Z : No. of bitstreams: 1 S1516-18462018000400442.pdf: 323574 bytes, checksum: 8ced7f7ee3c535c02f7c6feff0967e91 (MD5) RESUMOObjetivo: descrever e comparar os resultados das provas oculares (sacádicos, rastreio, e optocinético) da vectoeletronistagmografia entre os grupos com dislexia, transtorno de aprendizagem e controle.Métodos: participaram deste estudo 28 estudantes do sexo masculino e feminino, com idade entre 8 e 11 anos. Foram divididos em três grupos, sendo Grupo I: Dez escolares com Dislexia, Grupo II: Nove escolares com Transtornos de Aprendizagem e Grupo III: Nove escolares sem dificuldades de aprendizagem. Nesta pesquisa foi realizada avaliação da vectoeletronistagmografia digital: provas oculares (sacádicos, rastreio, e optocinético).Resultados: verificou-se que as provas de movimento sacádico, nistagmo optocinético e rastreio pendular mostraram diferenças sutis entre os três grupos. Na comparação das provas de movimentos sacádicos dos olhos e pesquisa do nistagmo optocinético foi observada que a velocidade do movimento do olho esquerdo que se mostrou mais lento para o Grupo I, e ainda mais lentos para o Grupo II. Foi observado também que os grupos GI e GII foram mais lentos para o rastreio em pêndulo do estímulo luminoso em relação ao grupo controle.Conclusão: de modo geral, foi observada diferença entre os grupos para a medida da vectoeletronistagmografia, que indicam rastreios e reflexo vestibular-ocular mais lentos nas crianças com dislexia e transtornos de aprendizagem. ABSTRACTObjective: to describe and compare the results of ocular (saccadic, screening, and optokinetic) tests of vectoelectronystagmography among the groups with dyslexia, learning disorder and control.Methods: 28 male and female students aged 8 to 11 years participated in this study. They were divided into three groups: Group I, 10 students with dyslexia, Group II, 9 students with learning disorders and Group III, 9 students with no learning disorders. In this research, digital vectoelectronystagmography - ocular test - was performed.Results: saccadic movement, optokinetic nystagmus, and pendular tracking tests were found to show subtle differences among the three groups. Comparing the saccadic eye movements and the optokinetic nystagmus tests, it was observed that the movement in the left eye was slower for Group I, and even slower for Group II. It was also observed that GI and GII were slower for the pendular tracking of luminous stimulus in relation to the control group.Conclusion: in general, there are differences among the groups in the vectoelectronystagmography, which indicated slower tracking and vestibulo-ocular reflex in children with dyslexia and learning disorders. Universidade de São Paulo Faculdade de Medicina UNESP Faculdade de Filosofia e Ciências Universidade Estadual de Campinas UNESP Faculdade de Filosofia e Ciências

RESUMO Introdução Os potenciais evocados auditivos são respostas elétricas que ocorrem nas vias auditivas centrais, resultantes de estimulação acústica. O uso de estímulos de fala para eliciar a resposta desses potenciais possibilita a compreensão de informações sobre codificação e decodificação da fala no sistema nervoso central. Objetivo Comparar o resultado do potencial evocado auditivo de latência longa com dois diferentes estímulos de fala. Métodos Participaram do estudo 30 escolares saudáveis, de ambos os sexos, com idade entre 8 e 12 anos. Para os potenciais evocados auditivos, foram utilizados dois diferentes estímulos de fala para a discriminação auditiva: Teste 1 /ba/ x /da/ e Teste 2 /pa/ x /da/. Os estímulos foram aleatoriamente apresentados, sendo 20% raros e 80% frequentes. Os escolares participaram de uma tarefa auditiva ativa e disseram [da] para identificar os estímulos raros. A normalidade dos dados foi determinada utilizando o teste de Shapiro-Wilk. Para comparar a média com o Teste 1 e Teste 2, foi realizada a estimulação t de Student. Resultados Houve diferença significativa na latência P3 na orelha direita, amplitude P2 na orelha direita e amplitude P3 na orelha esquerda. Ocorreram valores mais longos com estímulo /ba/ x /da/. Conclusão As respostas dos potenciais evocados auditivos de latência longa variam em função do estímulo e do cuidado em sua análise, quando se utilizam estímulos de fala na avaliação. ABSTRACT Introduction Auditory Evoked Potentials are electrical responses that occur in the central auditory pathways, resulting from acoustic stimulation. The use of speech stimuli to elicit the response of these potentials allows to understand information about speech coding and decoding in the central nervous system. Purpose To compare the Long Latency Auditory Evoked Potential of two different speech stimuli. Methods Thirty healthy school children of both genders, aged between 8 and 12 years, participated in the study. For the auditory evoked potentials, different speech stimuli were used for the auditory discrimination: Test 1 /ba/ x /da/ and Test 2 /pa/ x /da/. The stimuli were randomly presented: 20% infrequent and 80% frequent. The school children participated in an active auditory task and said [da] to identify the infrequent stimuli. The normality of the data was determined using the Shapiro-Wilk test. To compare the mean with Test 1 and Test 2, stimulation was performed using Student t test. Results There was a significant difference in P3 latency in the right ear, P2 amplitude in the right ear and P3 amplitude in the left ear. Longer values occurred with stimulus /ba/ x /da/. Conclusion The responses of long latency auditory evoked potentials vary depending on the stimulus and care in the analysis when using speech stimuli in the evaluation.