Changes in click characteristics during ABR recording

SummaryManipulation of auditory stimuli affect the ABR evoked potentials and aid the diagnosis, particularly in auditory neuropathy patients. Some patients with auditory neuropathy lose evoked otoacoustic emissions over time; in these cases, comparing responses to rarefaction and condensation clicks, and decreasing the stimulus rate can show an extended cochlear microphonism or yield an improved electric potential record.AimTo analyze the effect of these click manipulations on the records of potentials of patients with hearing loss as a form of improving the diagnosis.Study designA clinical prospective study.Patients and Method59 patients with hearing loss underwent ABR recording using rarefaction and condensation clicks at a stimulus rate of 27.7/sec, and rarefaction clicks at a stimulus rate of 3.3/sec. The records were compared to the otoacoustic evoked emission.ResultsEight (13.53%) patients showed changes in the recorded ABR potentials as a result of manipulating the characteristics of clicks, such as extended cochlear microphonism or an improved record of electric potentials. Five patients had no otoacoustic evoked emissions.ConclusionManipulation of click stimuli can improve the topographic diagnosis of hearing loss, particularly in the group of auditory neuropathy patients with no otoacoustic evoked emissions, where usually, the diagnosis is only possible through the method described above

Hidrato de cloral para captação dos Potenciais Elétricos Auditivos Chloral Hydrate to Study Auditory Brainstem Response

O Hidrato de cloral é um sedativo usado em procedimentos pediátricos devido à pouca depressão respiratória e cardíaca. OBJETIVO: Avaliar a eficácia da droga para a captação do PEATE e sistematizar o seu emprego. MATERIAL E MÉTODO: Estudo prospectivo transversal com 41 crianças. A dose inicial de HC 10% foi de 50mg/kg com reforço de 6 mg/kg administrado após 30 minutos nos casos onde não houve sedação. A efetividade da droga foi determinada pela indução do sono até 1 hora após a administração da dose inicial. A ocorrência de sono foi correlacionada com as doses (50mg ou 56mg/kg), a idade, o peso e o sexo. RESULTADOS: As 41 crianças que participaram do estudo tomaram 50mg/kg e 23 dormiram em 30 minutos, 2 apresentaram depressão respiratória; 16 crianças tomaram reforço de 6mg/kg e 13 dormiram em mais 30 minutos. A dose total de 56mg/kg apresentou um efeito estatisticamente significante na indução do sono (p<0,05) em comparação com a dose de 50mg/kg. CONCLUSÃO: O HC é uma droga com um bom efeito satisfatório com a dose de 50mg/kg seguida de mais 6mg/kg em até uma hora após a administração. Complicações podem ocorrer, independente da dose usada. ClinicalTrials.gov Identifier: NCT 00949780.<br>Chloral Hydrate (CH) is a sedative and hypnotic drug used in pediatric procedures owing to the low depressive effect it has on the respiratory and cardiac systems. AIM: To assess the efficacy of the drug in performing ABR and to systematize its use. MATERIALS AND METHODS: A prospective cross-sectional study with 41 children without history of heart or lung disease. The initial dose of CH at 10% was 50mg/Kg, with a boost dose of 6mg/Kg administered 30 minutes later in cases in which there was no sedation. Drug effectiveness was established by sleep induction by 1 hour after the administration of the initial dose. Sleep occurrence was correlated with doses (50mg or 56mg/Kg), age, weight and gender. RESULTS: All the 41 children who participated in the study took 50mg/kgof the agent and 23 of them slept within 30 minutes, 2 had respiratory complications, 16 had the 6mg/Kg boost dose and 13 fell asleep after 30 minutes. The 56 mg/kg dose presented a statistically significant effect on sleep induction (p<0.05) when compared to the 50mg/kg dose. CONCLUSION: CH produced a satisfactory effect with 50 mg/Kg dose plus 6mg/kg up to one hour after administration. Complications can occur regardless of the dose used

Ambulatório de foniatria infantil: características clínicas e epidemiológicas

Children with language or learning impairment and normal hearing need phoniatric assessment to analyse various communication and development aspects targeting the differential diagnosis and therapeutic indications.Objective: Characterize clinical and epidemiological features of a pediatric population treated in a phoniatric outpatient clinic.Method: A cross-sectional historical cohort study (retrospective study) was performed involving 68 patients undergoing phoniatric consultation. Outcome measures were age, gender, source of referral for phoniatric consultation, phoniatric diagnosis, mean age at diagnosis, neonatal risks, family history of communication disorders and referrals.Results: 70.58% were male and 29.42% female, mean age 6.85 +/- 2.49 years. 63.23% from external services and 45.59% had no hearing diagnosis. 14 different diagnoses were performed: 50% had Cerebral Palsy, Specific Language Impairment and Pervasive Developmental Disorder. the difference between the average ages was statistically significant (F = 4.369 p = 0.00). 50% had a family history of communication disorders and 51.47% history of neonatal risk. 51.47% were referred for neurological consultation and 79.41% for therapies.Conclusion: the population seen was predominantly male, with more complex language development deviations probably due to multiple etiologies. Many of them had no hearing diagnosis.DERDIC PUCSP, Training Program Phoniatry, São Paulo, BrazilDERDIC PUCSP, Training Program Hearing Electrophysiol, São Paulo, BrazilHSPM SP, São Paulo, BrazilDERDIC PUCSP, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilDERDIC PUCSP, Dept Otorhinolaryngol, São Paulo, BrazilCatholic Univ São Paulo PUCSP, Speech & Hearing Sch, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc