Auditory Brainstem Evoked Response: response patterns of full-term and premature infants

Auditory Brainstem Response (ABR) is important for the early diagnosis of hearing impairment in infants. AIM: To compare ABR responses in full-term and premature infants; gender and ear were taken into account. METHODS: A cross-sectional prospective cohort study was carried out. We evaluated 36 full-term and 30 premature infants that had passed the Transient Otoacoustic Emissions test, had type A tympanometric curves, and had no risk factor for hearing loss besides prematurity. The evaluations were done from the time of hospital discharge to the third month of life, and consisted of a clinical history, acoustic immittance testing and ABR evaluation. RESULTS: The comparison of absolute and interpeak wave I, III and V latencies in right and left ears revealed a statistically significant difference at the interpeak I-III. There was no significant gender differences in the comparison of results. Significant difference in wave I, III and V absolute latencies at 80 dB and in wave V at 60 db and 20 db were observed in a comparison of absolute and interpeak latencies between full-term and premature infants. An inverse correlation was found between age and absolute latencies. CONCLUSIONS: The maturity of the auditory system influences ABR responses in infants. To avoid misinterpretation of results, gestational age must be taken into account in the analysis of ABR in pediatric population.O Potencial Evocado Auditivo de Tronco Encefálico (PEATE) é um teste de grande importância na detecção precoce de alterações auditivas em crianças. OBJETIVOS: Analisar as respostas de neonatos e lactentes termos e prematuros para o PEATE, considerando gênero e orelha. MATERIAL E MÉTODOS: Estudo de coorte transversal e prospectivo. Foram avaliados 36 lactentes termos e 30 prematuros sem indicadores de risco para perda auditiva além da prematuridade,que permaneceram no alojamento conjunto, passaram nas Emissões Otoacústicas Transientes e apresentaram curva timpanométrica tipo A. As avaliações ocorreram entre a alta hospitalar e o terceiro mês de vida, sendo constituídas por anamnese, medidas de imitância acústica e pelo PEATE. RESULTADOS: Na comparação das latências absolutas e interpicos das ondas I, III e V quanto às orelhas direita e esquerda observou-se diferença estatisticamente significante para o interpico I-III. Quanto ao gênero masculino e feminino, não houve diferença significante. Na comparação entre prematuros e termos observou-se diferença significante para as latências absolutas das ondas I, III e V em 80 dB e da onda V em 60 e 20 dB. Verificou-se correlação inversa entre idade gestacional e latências absolutas. CONCLUSÃO: A maturação do sistema auditivo influencia as respostas do PEATE de lactentes. Para evitar a interpretação equivocada dos resultados deve-se considerar a idade gestacional na análise do PEATE nessa população.72973

Otitis Media, Behavioral and Electrophysiological Tests, and Auditory Rehabilitation

For speech and language to develop, an intact and active auditory system is of fundamental importance. The central auditory nervous system (CANS) can be hampered by several occurrences, including otitis media (OM) originating from inflammation in the middle ear and which is often associated with the accumulation of infected (or sometimes noninfected) fluid. OM can have a diffuse effect on cognitive and linguistic abilities, affecting both speech and phoneme perception through a failure to discriminate, store, and reproduce the acoustic contrasts necessary for comprehension. It is especially common in the first years of school. In addition, OM can generate internal noise from the presence of middle ear fluid near the cochlea, which can lead to changes in speech perception, distortion in acoustic images, and a reduction in the speed and accuracy of decoding speech. Evaluating the effectiveness of the CANS is recommended in cases where there have been repeated episodes of OM. Very useful information can be gained from behavioral and electrophysiological tests. The tests allow functional diagnoses to be made and can also reveal clinical and subclinical changes. In this way, they allow information to be collected, which can help in making a prognosis and planning intervention strategies

Speech-Evoked Brainstem Response

The auditory brainstem response (ABR) is a clinical tool to assess the neural functionality of the auditory brainstem. The use of verbal stimuli in ABR protocols has provided important information of how the speech stimuli are processed by the brainstem structure. The perception of speech sounds seems to begin in the brainstem, which has an important role in the reading process and the phonological acquisition speech ABR assessment allows the identification of fine-grained auditory processing deficits, which do not appear in click evoked ABR responses. The syllable /da/ is commonly used by speech ABR assessment due to it being considered a universal syllable and allows it to be applied in different countries with good clinical assertiveness. The speech ABR is a objective, fast procedure that can be applied to very young subjects. It be utilized in different languages and can provide differential diagnoses of diseases with similar symptoms, as an effective biomarker of auditory processing disorders present in various diseases, such as dyslexia, specific language impairment, hearing loss, auditory processing disorders, otitis media, and scholastic difficulties. Speech ABR protocols can assist in the detection, treatment, and monitoring of various types of hearing impairments

(Central) Auditory Processing: the impact of otitis media

OBJECTIVE: To analyze auditory processing test results in children suffering from otitis media in their first five years of age, considering their age. Furthermore, to classify central auditory processing test findings regarding the hearing skills evaluated. METHODS: A total of 109 students between 8 and 12 years old were divided into three groups. The control group consisted of 40 students from public school without a history of otitis media. Experimental group I consisted of 39 students from public schools and experimental group II consisted of 30 students from private schools; students in both groups suffered from secretory otitis media in their first five years of age and underwent surgery for placement of bilateral ventilation tubes. The individuals underwent complete audiological evaluation and assessment by Auditory Processing tests. RESULTS: The left ear showed significantly worse performance when compared to the right ear in the dichotic digits test and pitch pattern sequence test. The students from the experimental groups showed worse performance when compared to the control group in the dichotic digits test and gaps-in-noise. Children from experimental group I had significantly lower results on the dichotic digits and gaps-in-noise tests compared with experimental group II. The hearing skills that were altered were temporal resolution and figure-ground perception. CONCLUSION: Children who suffered from secretory otitis media in their first five years and who underwent surgery for placement of bilateral ventilation tubes showed worse performance in auditory abilities, and children from public schools had worse results on auditory processing tests compared with students from private schools

Vestibular rehabilitation in a university hospital

A Reabilitação Vestibular visa melhorar o equilíbrio global, a qualidade de vida e orientação espacial dos pacientes com tontura. OBJETIVOS: Traçar o perfil dos pacientes atendidos no Ambulatório de Reabilitação Vestibular do Setor de Otoneurologia de um hospital universitário e verificar os resultados obtidos no período de novembro/2000 a dezembro/2004. MATERIAL E MÉTODO: Levantamento de dados contidos nas fichas dos 93 pacientes submetidos à Reabilitação Vestibular no período. FORMA DE ESTUDO: Clínico retrospectivo. RESULTADOS: A média etária dos pacientes foi de 52,82 anos, 56 do sexo feminino e 37 do sexo masculino. O número médio de atendimentos foi 4,3, sendo maior para os pacientes com distúrbios otoneurológicos centrais (média de 5,9). Dentre os pacientes que concluíram o tratamento proposto, 37 (60,7%) obtiveram melhora significativa, 14 (22,9%) tiveram melhora parcial e 10 (16,4%) não referiram benefícios significativos. Os pacientes que mais se beneficiaram com a Reabilitação Vestibular tinham distúrbios otoneurológicos periféricos. CONCLUSÃO: A maior parte dos pacientes era do sexo feminino, com idade média de 52,8 anos. Cinqüenta e um pacientes (83,6%) tiveram benefício com a terapia confirmando a eficácia do tratamento.The aim of vestibular rehabilitation is to improve total balance, quality of life and spatial orientation of patients with dizziness. AIMS: To determine the characteristics of the patients who underwent the Vestibular Rehabilitation program of the Neurotology Ward of a University Hospital, and to verify the results obtained between November/2000 and December/2004. MATERIALS AND METHODS: analysis of 93 files from patients under Vestibular Rehabilitation during the studied period. STUDY DESIGN: Retrospective clinical. RESULTS: the mean age of patients was 52.82 years, 56 females and 37 males. The average number of therapy sessions was 4.3, higher for patients with central neurotological disorders (average of 5.9). Among the patients who concluded the treatment, 37 (60.7%) had significant improvement, 14 (22.9%) presented partial improvement and 10 (16.4%) did not report significant benefits. Patients with peripheral neurotological disorders were the ones who most benefited from Vestibular Rehabilitation. CONCLUSION: Most of the patients were female, with a mean age of 52.8 years. Fifty one patients (83.6%) benefited from the therapy, confirming treatment efficacy

Wideband Tympanometry

The wideband tympanometry (WBT) assesses the middle ear function with a transient wideband stimulus in order to capture the middle ear behavior at a wide range of frequencies. Data in the literature suggest that the WBT has more sensibility to detect middle ear disorders than the traditional tympanometry. In this context, pathologies, which might be more easily identified/monitored by WBT, include otosclerosis, flaccid eardrums, ossicular chain discontinuity with semicircular canal dehiscence, and negative middle ear pressure with middle ear effusion. The chapter presents information on classical tympanometry, the multifrequency tympanometry equivalent coded as WBT, clarification of terms used in WBT measurements, and a short overview of clinical applications in infants and adults

Temporal Auditory Processing And Phonological Awareness In Children With Benign Epilepsy With Centrotemporal Spikes.

The aim of this research was to analyze temporal auditory processing and phonological awareness in school-age children with benign childhood epilepsy with centrotemporal spikes (BECTS). Patient group (GI) consisted of 13 children diagnosed with BECTS. Control group (GII) consisted of 17 healthy children. After neurological and peripheral audiological assessment, children underwent a behavioral auditory evaluation and phonological awareness assessment. The procedures applied were: Gaps-in-Noise test (GIN), Duration Pattern test, and Phonological Awareness test (PCF). Results were compared between the groups and a correlation analysis was performed between temporal tasks and phonological awareness performance. GII performed significantly better than the children with BECTS (GI) in both GIN and Duration Pattern test (P < 0.001). GI performed significantly worse in all of the 4 categories of phonological awareness assessed: syllabic (P = 0.001), phonemic (P = 0.006), rhyme (P = 0.015) and alliteration (P = 0.010). Statistical analysis showed a significant positive correlation between the phonological awareness assessment and Duration Pattern test (P < 0.001). From the analysis of the results, it was concluded that children with BECTS may have difficulties in temporal resolution, temporal ordering, and phonological awareness skills. A correlation was observed between auditory temporal processing and phonological awareness in the suited sample.201525634

Newborn Hearing Screening And Early Diagnostic In The Nicu.

The aim was to describe the outcome of neonatal hearing screening (NHS) and audiological diagnosis in neonates in the NICU. The sample was divided into Group I: neonates who underwent NHS in one step and Group II: neonates who underwent a test and retest NHS. NHS procedure was automated auditory brainstem response. NHS was performed in 82.1% of surviving neonates. For GI, referral rate was 18.6% and false-positive was 62.2% (normal hearing in the diagnostic stage). In GII, with retest, referral rate dropped to 4.1% and false-positive to 12.5%. Sensorineural hearing loss was found in 13.2% of infants and conductive in 26.4% of cases. There was one case of auditory neuropathy spectrum (1.9%). Dropout rate in whole process was 21.7% for GI and 24.03% for GII. We concluded that it was not possible to perform universal NHS in the studied sample or, in many cases, to apply it within the first month of life. Retest reduced failure and false-positive rate and did not increase evasion, indicating that it is a recommendable step in NHS programs in the NICU. The incidence of hearing loss was 2.9%, considering sensorineural hearing loss (0.91%), conductive (1.83%) and auditory neuropathy spectrum (0.19%).201484530

Efficacy of a spot-on formulation containing moxidectin 2.5%/imidacloprid 10% for the treatment of Cercopithifilaria spp. and Onchocerca lupi microfilariae in naturally infected dogs from Portugal

Background: Onchocerca lupi and Cercopithifilaria spp. are vector-borne filarioids of dogs, which harbour skin microfilariae (mfs), the former being of zoonotic concern. Proper treatment studies using compounds with microfilaricidal activity have not been performed. Therefore, this study aimed to assess the efficacy of a commercially available spot-on formulation containing moxidectin 2.5%/imidacloprid 10% for the treatment of O. lupi or Cercopithifilaria spp. skin-dwelling mfs in naturally infected dogs. Methods: Privately owned dogs (n = 393) from southern Portugal were sampled via skin biopsies to identify and count mfs in 20&nbsp;µl of skin sediment. A total of 22 mfs-positive dogs were allocated to treatment group (n = 11; G1) or left untreated as a control (n = 11; G2). As a pilot investigation to test the treatment efficacy, five dogs assigned to G1 were treated four times at monthly intervals with moxidectin 2.5%/imidacloprid 10% spot-on formulation on SDs 0, 28 (± 2), 56 (± 2), and 84 (± 2). Based on the negative results for both O. lupi and/or Cercopithifilaria spp. mfs of dogs in the pilot study from SD28 onwards, the remaining six dogs in G1 were treated at SD0 and assessed only at SD28. Results: Of the 393 animals sampled, 78 (19.8%) scored positive for skin-dwelling mfs. At the pilot investigation, a mean number of 19.6 mfs for O. lupi was recorded among five infected dogs whereas no mfs were detected at SD28. At SD0, the mean number of Cercopithifilaria spp. larvae was 12.6 for G1 and 8.7 for G2. The mean number of mfs for G2 was 20.09. Conclusions: Results herein obtained suggest that a single treatment with moxidectin 2.5%/imidacloprid 10% spot-on formulation is efficacious against skin-dwelling mfs in dogs. The microfilaricidal effect of moxidectin could also be useful in reducing the risk of O. lupi infection for humans.[Figure not available: see fulltext.

Efficacy of a spot-on formulation containing moxidectin 2.5%/imidacloprid 10% for the treatment of Cercopithifilaria spp. and Onchocerca lupi microfilariae in naturally infected dogs from Portugal

Funding Information: The authors are grateful to Giada Annoscia and Riccardo Paolo Lia (Department of Veterinary Medicine, University of Bari, Italy) for their support during molecular identification and morphometric determination of the parasites. Funding Information: This study has been partially funded by Elanco Animal Health, Monheim, Germany. Publisher Copyright: © 2021, The Author(s).BACKGROUND: Onchocerca lupi and Cercopithifilaria spp. are vector-borne filarioids of dogs, which harbour skin microfilariae (mfs), the former being of zoonotic concern. Proper treatment studies using compounds with microfilaricidal activity have not been performed. Therefore, this study aimed to assess the efficacy of a commercially available spot-on formulation containing moxidectin 2.5%/imidacloprid 10% for the treatment of O. lupi or Cercopithifilaria spp. skin-dwelling mfs in naturally infected dogs. METHODS: Privately owned dogs (n = 393) from southern Portugal were sampled via skin biopsies to identify and count mfs in 20 µl of skin sediment. A total of 22 mfs-positive dogs were allocated to treatment group (n = 11; G1) or left untreated as a control (n = 11; G2). As a pilot investigation to test the treatment efficacy, five dogs assigned to G1 were treated four times at monthly intervals with moxidectin 2.5%/imidacloprid 10% spot-on formulation on SDs 0, 28 (± 2), 56 (± 2), and 84 (± 2). Based on the negative results for both O. lupi and/or Cercopithifilaria spp. mfs of dogs in the pilot study from SD28 onwards, the remaining six dogs in G1 were treated at SD0 and assessed only at SD28. RESULTS: Of the 393 animals sampled, 78 (19.8%) scored positive for skin-dwelling mfs. At the pilot investigation, a mean number of 19.6 mfs for O. lupi was recorded among five infected dogs whereas no mfs were detected at SD28. At SD0, the mean number of Cercopithifilaria spp. larvae was 12.6 for G1 and 8.7 for G2. The mean number of mfs for G2 was 20.09. CONCLUSIONS: Results herein obtained suggest that a single treatment with moxidectin 2.5%/imidacloprid 10% spot-on formulation is efficacious against skin-dwelling mfs in dogs. The microfilaricidal effect of moxidectin could also be useful in reducing the risk of O. lupi infection for humans.publishersversionpublishe