Audiometria de alta freqüência em adultos jovens e mais velhos quando a audiometria convencional é normal

Auditory perceptual discomfort and low-hearing tolerance in the first episode psychosis

Awareness of perceptual and sensory changes that might occur in visual, auditory, proprioception, and other senses, in the early stages towards the First Episode Psychosis (FEP), and their subsequent sensorial evolution as the disturb progresses deeper into an acute episode, might be a key element for interrupting the process. In the present study, we investigated hearing discomfort/tolerance to 16 given sound streams. Sixteen people diagnosed with FEP, participated in the experiment. Sixteen frequency sweeps varying in modulation envelopes (sawtooth, sine), order (ascending, descending), duration (4s, 8s), and range (50–8000 Hz, 2–8 kHz) were presented randomly, but always in the same sequence, to FEP and healthy controls (HC). The level of discomfort was estimated by the participant by making a mark across a continuous line whose extremes read “nothing bad” (left) and “too bad” (right). Results showed that ascending sine pure frequency sweeps (p < 0.01) and descending sine pure frequencies sweeps (p < 0.01) caused the maximum discomfort in FEP. Other variables also showed differences between FEP and HC, and FEP were always more intolerant to such pure frequency sweeps than HC. We conclude that this might be useful for very early assessment of people at risk, people with FEP, and people with schizophrenia.

High-Frequency Audiometry in Women with and without Exposure to Workplace Noise

For this study, high-frequency audiometry was used to compare the hearing thresholds, with respect to age, among women exposed to noise in their working environment, as well as those not exposed to such noise. The cohort comprised 243 women (average age 36.2 years), of which 88 women were employed in a noisy (L_Aeq,8h 85-105 dB) workplace, while 155 women did not experience noise. Age categories were determined according to the World Health Organization (Geneva, Switzerland). Hearing thresholds were measured at frequencies of 0.125-16 kHz. Higher hearing thresholds were found in the youngest age groups (18-29 and 30-44 years) among those exposed to noise, as compared to those who were not. The difference in hearing thresholds between the exposed and unexposed groups increased with age, as well as with the frequencies. The highest difference in hearing thresholds for these age categories was measured at 11.25 kHz. The oldest age group (45-63 years) exposed to noise showed lower hearing thresholds than the unexposed group at all frequencies from 4 kHz to 16 kHz. High-frequency audiometry can be used for the early detection of increased hearing thresholds at high frequencies. High-frequency audiometry could be included in preventive programs, especially for younger people exposed to noise, in order to enable earlier detection of noise-induced hearing loss.

[High frequency hearing among rural workers exposed to pesticides]

Pesticides may cause a number of health problems and are considered oto-agressive agents. The objective of this study was to investigate the high frequency hearing characteristics of workers both with and without exposure to pesticides, that presented normal conventional audiometry. It involved a cross-sectional study with 87 workers, of both genders, between 19 and 59 years, with formal or informal jobs and some of whom worked with family agriculture, either using pesticides or not, who had taken High-Frequency Audiometry tests. The use of glyphosate was reported by 73% of workers and several pesticide mixtures occurred in 78% of them. There were no cases of proper use of personal protective equipment recommended for the activity. The workers exposed to pesticides had worse results in High-Frequency Audiometry tests in comparison with those who had no contact with pesticides (p < 0.0001). High-Frequency Audiometry has proved to be a useful and effective tool in the early detection of hearing loss caused by pesticides.

High-frequency auditory thresholds in normal hearing adults

PURPOSE

Evaluate high-frequency auditory thresholds, seeking to compare responses between the ears, to verify the correlation between hearing level and aging and analyze frequency responses in normal hearing adults.

METHODS

This is a prospective, quantitative, transversal study conducted with a convenience sample. Study participants were 60 individuals aged 18 to 58 years (mean=25.82) with auditory thresholds within normality standards (250-8000 Hz) and normal results in acoustic immittance measurements. High-frequency pure-tone hearing thresholds were determined using an Interacoustics AS10HF audiometer with electrodynamic high-fidelity KOSS R/80 headphones, with thresholds expressed in dBNPS.

RESULTS

Hearing thresholds showed an increase for the right ear with statistical significance at the 10, 11 and 14 kHz frequencies and a tendency to significance at 13 kHz. As of the 14 kHz frequency, a progressive increase directly proportional to the frequency was observed bilaterally, with the thresholds increasing proportionally to age advancement for all frequencies.

CONCLUSION

High-frequency auditory thresholds progressively increase proportionally to frequency and age advancement in normal hearing individuals, with higher values ​​for the right ear.

Distortion-product otoacoustic emissions at ultra-high frequencies in parents of individuals with autosomal recessive hearing loss

Purpose: To evaluate the cochlear function of parents of individuals with autosomal recessive gene Gap Junction Protein Beta-2 hearing loss by ultra-high frequencies distortion-product otoacoustic emissions (DPOAEs), compared with responses of a control group matched for age and gender. Methods: We studied 56 subjects aged from 20 to 58 years, divided into two groups. The study group comprised 28 parents of hearing-impaired patients due to autosomal recessive inheritance, 14 females aged 20.0-55.0 years (mean 32.8 years) and 14 males aged 20.0-58.0 years (mean 35.2 years). Control group was composed of normal hearing individuals, 14 males and 14 females age-matched to the study group. The subjects underwent tests for audiometry, tympanometry, and DPOAE in the frequency range of 9.000-16.000 Hz. Results: We found 64.3% of normal results of DPOAE in the study group compared to 91.1% in the control. There were significant differences between groups in the ears and DPOAE responses, and the mean level of response was in 10 dBNPS in study group and 14 dBNPS in the control. The Pearson's correlation between age and DPOAE in ultra-high frequencies showed no statistical significance. Conclusion: DPOAE at ultra-high frequencies were able to identify individuals from both groups, suggesting that heterozygous individuals for the Gap Junction Protein Beta-2 gene mutation may have damage to the cochlear function before clinical manifestation in audiometry.

Behavioral hearing thresholds between 0.125 and 20 kHz using depth-compensated ear simulator calibration

OBJECTIVES

The purpose of this study was to obtain behavioral hearing thresholds for frequencies between 0.125 and 20 kHz from a large population between 10 and 65 yr old using a clinically feasible calibration method expected to compensate well for variations in the distance between the eardrum and an insert-type sound source. Previous reports of hearing thresholds in the extended high frequencies (>8 kHz) have either used calibration techniques known to be inaccurate or specialized equipment not suitable for clinical use.

DESIGN

Hearing thresholds were measured from 352 human subjects between 10 and 65 yr old having clinically normal-hearing thresholds (<20 dB HL) up to 4 kHz. An otoacoustic emission probe fitted with custom sound sources was used, and the stimulus levels individually tailored on the basis of an estimate of the insertion depth of the measurement probe. The calibrated stimulus levels were determined on the basis of measurements made at various depths of insertion in a standard ear simulator. Threshold values were obtained for 21 frequencies between 0.125 and 20 kHz using a modified Békésy technique. Forty-six of the subjects returned for a second measurement months later from the initial evaluation.

RESULTS

In agreement with previous reports, hearing thresholds at extended high frequencies were found to be sensitive to age-related changes in auditory function. In contrast with previous reports, no gender differences were found in average hearing thresholds at most evaluated frequencies. Two aging processes, one faster than the other in time scale, seem to influence hearing thresholds in different frequency ranges. The standard deviation (SD) of test-retest threshold difference for all evaluated frequencies was 5 to 10 dB, comparable to that reported in the literature for similar measurement techniques but smaller than that observed for data obtained using the standard clinical procedure.

CONCLUSIONS

The depth-compensated ear simulator-based calibration method and the modified Békésy technique allow reliable measurement of hearing thresholds over the entire frequency range of human hearing. Hearing thresholds at the extended high frequencies are sensitive to aging and reveal subtle differences, which are not evident in the frequency range evaluated regularly (≤8 kHz). Previously reported gender-related differences in hearing thresholds may be related to ear-canal acoustics and the calibration procedure and not because of differences in hearing sensitivity.

Adaptação aberta: avaliação da satisfação dos usuários de um centro de alta complexidade

OBJETIVO: avaliar subjetivamente o grau de satisfação dos usuários de AASI open fit (OTE). MÉTODOS: 11 indivíduos com deficiência auditiva neurossensorial, de grau leve a severo, com configuração descendente, usuários de AASI OTE, foram submetidos ao questionário de auto-avaliação International Outcome Inventory for Hearing Aids (IOI-HA - versão em Português). RESULTADOS: em relação aos sete domínios avaliados, verificou-se que a média referente ao uso foi de 4,45; quanto ao benefício foi de 4,27; em relação à limitação de atividade residual foi de 4,45; quanto à satisfação foi de 4,72; quanto à restrição de participação de atividade residual foi de 4,81; para o domínio impacto nos outros foi de 4,90 e 4,18 para a qualidade de vida. Ressalta-se que a pontuação máxima para cada domínio avaliado era de 5,0 e a mínima 1,0. A média obtida para na pontuação total (soma de todas as questões) foi de 31,81 sendo a máxima 35,0. Na comparação entre os fatores, houve diferença estatística significante do Fator 2 sobre o Fator 1. CONCLUSÃO: com este estudo pode-se atestar o alto grau de satisfação do uso do AASI OTE apresentado pela maioria da amostra coletada, em todos os domínios analisados.

Processamento auditivo e potenciais evocados auditivos de tronco cerebral (BERA)

OBJETIVO: verificar relação existente entre os potenciais auditivos de tronco cerebral e a avaliação comportamental do processamento auditivo. MÉTODOS: foi realizada em um grupo de 60 meninas residentes de Paraíba do Sul na idade de nove a 12 anos com limiares tonais dentro dos padrões de normalidade e timpanometria tipo A com presença dos reflexos acústicos. Os testes utilizados para a avaliação comportamental do processamento auditivo foram: avaliação simplificada do processamento auditivo, teste de fala no ruído, teste de dissílabos alternados e teste dicótico não verbal. Após a avaliação do processamento auditivo, as crianças foram subdivididas em dois grupos, G1 (sem alteração no processamento auditivo) e G2 (com alteração no processamento auditivo) e submetidas aos potenciais auditivos de tronco cerebral. Os parâmetros utilizados na comparação dos dois grupos foram: latência absoluta das ondas I, III e V; latência interpicos das ondas I-III, I-V, III-V; diferença interaural da latência interpico I-V; e diferença interaural da latência da onda V. RESULTADOS: foram encontradas diferenças estatísticas nos parâmetros de latência interpico das ondas I-V na orelha esquerda (p=0,009), diferença interaural da latência interpico de ondas I-V (p=0,020) e diferença da latência interpico de ondas I e V da orelha direita para a esquerda entre os grupos G1 e G2 (p=0,025). CONCLUSÃO: foi possível encontrar relação dos potenciais evocados auditivos de tronco cerebral com a avaliação comportamental do processamento auditivo nos parâmetros de latência interpico entre as ondas I e V da orelha esquerda e diferença interaural da latência interpico I-V na orelha esquerda.