Association between hearing loss and vestibular disorders : a review of the interference of hearing in the balance

Dizziness is very prevalent and makes a great impact on people’s life. Because of anatomical and functional similarities of hearing and vestibular systems, it is noted that there is a big relation between hearing loss and vestibular disorders. Depending on the age onset of hearing loss, it can cause even delay on motor development. Objective: To find literature that demonstrates the relation between hearing and balance. Confirming that hearing loss or even intervention to improve quality of hearing can interfere on vestibular system. Methodology: Revision of literature was carried out, preferring recent research only in English. Conclusion: Cochlea and vestibular systems have a close relationship; changes in one of them can cause big damage in the other. So, a complete evaluation of vestibular system is recommended before ear surgeries. Video Head Impulse Test is a new procedure able to evaluate high frequency movements of the head. It was an additional exam of vestibular status and came to help detect problems that were not diagnosed before. Efforts must be directed in order to protect the balance

Hearing preservation in cochlear implant surgery

In the past, it was thought that hearing loss patients with residual low-frequency hearing would not be good candidates for cochlear implantation since insertion was expected to induce inner ear trauma. Recent advances in electrode design and surgical techniques have made the preservation of residual low-frequency hearing achievable and desirable. The importance of preserving residual low-frequency hearing cannot be underestimated in light of the added benefit of hearing in noisy atmospheres and in music quality. The concept of electrical and acoustic stimulation involves electrically stimulating the nonfunctional, high-frequency region of the cochlea with a cochlear implant and applying a hearing aid in the low-frequency range. The principle of preserving low-frequency hearing by a “soft surgery” cochlear implantation could also be useful to the population of children who might profit from regenerative hair cell therapy in the future. Main aspects of low-frequency hearing preservation surgery are discussed in this review: its brief history, electrode design, principles and advantages of electric-acoustic stimulation, surgical technique, and further implications of this new treatment possibility for hearing impaired patients

Hair cell alteration prevalence rates in students of a school in Distrito Federal

Os jovens estão cada vez mais expostos à música alta, que pode prejudicar a audição. O teste das Emissões Otoacústicas, por ser mais sensível à exposição ao ruído, permite detectar precocemente alterações cocleares. OBJETIVO: Investigar a prevalência de lesão das células ciliadas externas por meio do teste de emissões otoacústicas em uma amostra de estudantes. MATERIAL E MÉTODO: Foram realizados os testes de emissões otoacústicas por estímulo transiente e por produto de distorção em 134 indivíduos. Os exames foram analisados de acordo com o critério "passa/falha". Tipo de estudo: Estudo seccional descritivo de prevalência. RESULTADOS: Dos 134 participantes, 80,6% apresentaram emissões otoacústicas transiente alteradas, sendo a maioria do gênero masculino; 97,8% apresentaram emissões otoacústicas produto de distorção alterada e 79,9% apresentaram alteração tanto em transiente quanto em produto de distorção, sendo a maioria do gênero masculino e, ainda, 94,0% relataram fazer uso de fones de ouvido; e 82,8% declararam frequentar lugar com música amplificada. CONCLUSÃO: A alta prevalência de testes alterados pode indicar precocemente uma disfunção coclear e, pelo alto número de participantes que relatou exposição à música alta, há a suspeita de que esse hábito pode estar provocando as alterações cocleares. ______________________________________________________________________________________________________________ ABSTRACTExposure to loud music is increasing among young people, and so could be the number of hearing impairment cases in this population. Otoacoustic emission tests are sensitive in capturing the effects of exposure to noise, and allow the detection of early cochlear disorders. OBJECTIVE: This study aims to look into the prevalence rates of injuries to outer hair cells in a population of students through otoacoustic emission testing. MATERIALS AND METHOD: One-hundred and thirty-four subjects were submitted to transient evoked and distortion product otoacoustic emission tests. Subjects were assessed on a "pass/fail" scale. This is a cross-sectional descriptive study on prevalence rates. RESULTS: More than four fifths (80.6%) of the 134 subjects had altered transient otoacoustic emissions, most of whom were males; 97.8% had altered distortion product otoacoustic emissions and 79.9% had altered test results in both transient evoked and distortion product OAEs; most were males; 94.0% reported they used earphones; and 82.8% stated they frequented places where loud music was played. CONCLUSION: The high prevalence rates of altered test results seem to indicate the presence of early cochlear disorders in the studied subjects. A significant number of subjects reported exposure to loud music, a habit that may be conducive to the onset of cochlear disorders

The potential use of melatonin for preventing cisplatin ototoxicity : an insight for a clinical approach

Cisplatin, one of the most effective and potent anticancer drugs, is used in the treatment of a wide variety of both pediatric and adult malignancies. However, the chemotherapeutic use of cisplatin is limited by its serious side effects, such as nephrotoxicity and ototoxicity. Ototoxicity produced by cisplatin is usually persistent, depending on the age of the patient, the cumulative number of doses, the number of chemotherapy cycles, the history of noise exposure, and deteriorating renal function. The mechanism of the ototoxicity caused by cisplatin is based on the generation of reactive oxygen species, which interfere with the antioxidant protection of the organ of Corti. Thus, protecting the cochlea with antioxidants ameliorates ototoxicity from cisplatin. In this context, melatonin appears as a therapeutic option for preventing the ototoxic effects of cisplatin, since the research in the last decade has proven its ability to be both a direct free radical scavenger and indirect antioxidant. In this sense, some of the evidence suggesting that melatonin is efficient for combating cisplatin-induced ototoxicity is summarized and discussed in this paper

A perda auditiva no idoso e suas interferências na linguagem e na vida psicossocial

A presbiacusia pode ser um fator de limitação do idoso, contribuindo para o desenvolvimento de alguns distúrbios de ordem emocional e favorecendo o isolamento devido à dificuldade de comunicação com o meio social em que vive. Objetivo: analisar, por meio de revisão da literatura científica, a associação entre perda auditiva e baixa autoestima no idoso. Método: foi realizada uma revisão de literatura a cerca de trabalhos científicos que abordassem a perda auditiva em idosos, com seleção das publicações julgadas relevantes. Conclusão: existe associação entre a perda auditiva e a baixa autoestima em idosos e quanto maior o grau da perda auditiva mais evidente podem ser os sintomas

Emissões otoacústicas evocadas por produto de distorção em trabalhadores normo-ouvintes expostos ao ruído ocupacional

Introdução: O teste das Emissões Otoacústicas tem tido destaque pela possibilidade de detectar precocemente alterações cocleares advindas da exposição ao ruído, não identificadas pela audiometria tonal. Objetivo: Avaliar as emissões otoacústicas evocadas por produto de distorção em trabalhadores normo-ouvintes expostos ao ruído ocupacional. Método: Trata-se de um estudo transversal, realizado em indústrias metalúrgicas do Distrito Federal, nas quais avaliou-se, por meio das Emissões Otoacústicas por Produto de Distorção trabalhadores de ambos os sexos, com idades entre 18 e 35 anos, limiares de audibilidade igual ou inferior a 25 dBNA, sem alterações auditivas. Resultados: Foram encontradas alterações significantes nas emissões otoacústicas em ambas as orelhas. Na amplitude e na relação sinal/ruído observou-se que quanto mais alta é a frequência menores são as médias encontradas nas emissões otoacústicas. A frequência com piores registros é a de 6 KHz. Conclusão: As emissões otoacústicas evocadas por produto de distorção em trabalhadores normo-ouvintes revelam alterações cocleares capazes de detectar precocemente o surgimento da lesão nas células ciliadas externas

Knowledge of cochlear implants in Federal District Audiologists, Speech-Language Pathologists, and Otolaryngologists

Objetivo: descrever a auto-avaliação de otorrinolaringologistas e fonoaudiólogos do Distrito Federal acerca do conhecimento em relação ao implante coclear. Métodos: estudo transversal e analítico com coleta de dados obtidos por meio da aplicação de questionários on-line. Participaram do estudo 73 fonoaudiólogos e 33 otorrinolaringologistas que responderam questões acerca do conhecimento do Implante Coclear na cidade de Brasília-Distrito Federal. Resultados: 31% (n=22) dos fonoaudiólogos acreditam ter conhecimento suficiente no que se refere ao procedimento cirúrgico, enquanto que no grupo dos otorrinolaringologistas esse número chegou a 59,4% (n=19), apresentando significância estatística entre os grupos (p<0,01). Ambos os grupos mostraram conhecimento insatisfatório em relação ao tipos de implante, mapeamentos, ativação, acompanhamento, custos, manutenção e o IC inserido no SUS. Conclusão: os profissionais otorrinolaringologistas e fonoaudiólogas pesquisados, atuantes no Distrito Federal, não apresentaram o conhecimento satisfatório acerca do implante coclear na análise geral dos domínios pesquisados.Purpose: to describe the self-assessment of Otolaryngologists, Audiologists, and Speech-Language Pathologists from the Federal District on their knowledge concerning cochlear implants. Methods: cross-sectional and analytical study with data collection obtained by applying online questionnaires.73 Audiologists and Speech-Language Pathologists, and 33 Otolaryngologists participated in the study. They answered questions regarding their knowledge of Cochlear Implants in Brasília - Federal District, Brazil. Results: 31% (n=22) of the Audiologists and Speech-Language Pathologists believe they have sufficient knowledge regarding the surgical procedure, whereas in the group of otolaryngologists, the figure was 59.4% (n = 19). Statistical significance between groups is observed (p <0.01). Both groups showed poor knowledge regarding implant types, mappings, activation, monitoring, and maintenance costs and cochlear implantation performed by the SUS (Brazilian Unified Health System). Conclusion: Otolaryngologists, Audiologists, and Speech-Language Pathologists surveyed, who work in the Federal District, did not show satisfactory knowledge of the cochlear implant in the overall analysis of the areas surveyed

Nasal involvement in obstructive sleep apnea syndrome

Numerous studies have reported an association between nasal obstruction and obstructive sleep apnea syndrome (OSAS), but the precise nature of this relationship remains to be clarified. This paper aimed to summarize data and theories on the role of the nose in the pathophysiology of sleep apnea as well as to discuss the benefits of surgical and medical nasal treatments. A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in OSAS. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex, and the role of nitric oxide (NO). Pharmacological treatment presents some beneficial effects on the frequency of respiratory events and sleep architecture. Nonetheless, objective data assessing snoring and daytime sleepiness are still necessary. Nasal surgery can improve the quality of life and snoring in a select group of patients with mild OSAS and septal deviation but is not an effective treatment for OSA as such. Despite the conflicting results in the literature, it is important that patients who are not perfectly adapted to CPAP are evaluated in detail, in order to identify whether there are obstructive factors that could be surgically corrected

Melatonin prevents age-related hearing loss in the murin experimental model

Objective: The present study aimed to perform a morphological and morphometric analysis of cochlear structures of C57BL/6J mice receiving oral melatonin for a 12-month period. Methods: 32 male C57BL/6J were divided into control and melatonin groups. Control received saline and ethanol solution and melatonin group, 50 L of 10 mg of melatonin/kg/day orally for a 12-month period. After de experiment the animals were sacrificed into a 40% concentration of CO2 chamber, and the blades were morphological and morphometrically analyzed. Results: The melatonin group revealed a higher median density of viable cells (45 ± 10.28 cells/100 m2, 31---73, vs. 32 ± 7.47 cells/100 m2, 25---48). The median area of stria vascularis was 55.0 ± 12.27 cells/100 m2 (38---80) in the control, and 59.0 ± 16.13 cells/100 m2 (40---134) in the melatonin group. The morphometric analysis of the spiral ligament reveals a higher median of total viable neurons in the melatonin (41 ± 7.47 cells/100 m2, 27---60) than in the control group (31 ± 5.68 cells/100 m2, 21---44). Conclusion: Although melatonin is a potent antioxidant, it does not completely neutralize the occurrence of presbycusis; however, it may delay the onset of this condition