Cochlear implant hearing rehabilitation in elderly patients

Objectives: This study aimed to evaluate the benefits of cochlear implant in adults with more than 65 years of age at time of surgery compared with those obtained by adults implanted at younger ages. The author also intended to evaluate the impact of cochlear implantation in the quality of life of older patients. Results: Outcomes of verbal discrimination performance in elderly cochlear implant users were generally lower than those obtained by the remaining adult population, with a statistical difference in 7 of 11 tests used in the study. The results obtained at the questionnaires answered by the elderly group revealed a significant reduction of hearing handicap after cochlear implantation. Conclusions: Age alone should not be a contraindication for hearing rehabilitation by cochlear implant. Despite producing a lower performance compared to that achieved by younger patients, cochlear implant in the elderly provides a significant improvement in quality of life.info:eu-repo/semantics/publishedVersio

Testes de avaliação do processamento auditivo central : SSW em português europeu

Mestrado em Ciências da Fala e da AudiçãoA possibilidade de avaliação do sistema auditivo central é uma melhoria na prática clínica em Audiologia. Com o nosso trabalho disponibilizamos para a língua portuguesa europeia, a ferramenta mais utilizada na Audiologia internacional, julgando, assim, contribuir para uma melhor avaliação dos indivíduos com alterações do processamento auditivo central. O nosso trabalho foi dividido em diversas etapas: revisão da anatomo-fisiololgia e da literatura existente e posterior criação do teste SSW versão Português Europeu. Para a criação do teste foi criada a lista de estímulos em Português Europeu, avaliada a sua adaptação a crianças, gravada e criado o teste para avaliar a população normoouvinte. A avaliação foi efectuada a 89 indivíduos dos 12 aos 59 anos, 45 do género feminino e 44 do género masculino, dos quais 10 são canhotos. Também foram avaliadas 5 crianças com 6 anos e 7 crianças com 9 anos. Como principal resultado salientamos a obtenção do SSW para o Português Europeu, com as mesmas características do teste original de Katz, não tendo o nosso trabalho revelado diferenças estatísticas no desempenho no teste relacionadas com género, região territorial de origem e predominância motora (dextro/canhoto). Contudo, foi encontrada diferença estatística no desempenho no teste quando se avaliou a formação académica dos indivíduos do grupo 3 (idades de 12 a 59 anos) em que os indivíduos sem frequência universitária revelaram pior desempenho. ABSTRACT: The possibility of evaluating the Central auditory system it’s an improvement in the Audiology practice. With our work we provide for the European Portuguese Language the most used tool in international audiology in this evaluation, thinking that our contribution will be of importance in evaluating subject’s whit exchanges in the central auditory processing, ether children or adults. The Work was split in several stages: summary of anatomy and physiology, existing literature on the theme and posterior creation of a version of the SSW test for European Portuguese. For the creation of the test, a list was produced in European Portuguese, the adaptation for children was evaluated, the list was recorded and a test was created to be evaluate on the normal hearing population. The evaluation was carry out on a total of 89 subjects from 12 to 59 years old, 44 males and 45 females, 79 subjects were right handed and ten subjects were left handed. Also some children were evaluated, 5 children with the age of 6 years and 7 children of 9 years old. The most important result is the production of the SSW test for the European Portuguese Language whit the same characteristics of the original test from KATZ, our work shows no statistical differences regarding the gender and right or left handed, however it was found a statistic difference on in the subject’s test performance whit academic background on the group 3 (12 to 59 years old). Subject’s whit academic background performed better than subject’s without academic background

Auditory processing disorder test battery in European Portuguese: development and normative data for pediatric population

There is an increasing need for state-of-the-art Central Auditory Processing assessment for Portuguese native speakers, applicable as early as possible. As a contribution to answering this need, this paper presents a new battery for Central Auditory Processing assessment for European Portuguese applicable to children aged 5 and above, named BAPA-PE, providing information regarding test selection and development. The battery consists of six behavioral tests: Staggered Spondaic Words (SSW) for European Portuguese, Filtered Speech, Speech in Noise, Detection Interval in Noise, Duration, and Frequency Pattern. The normative data for children aged 5 to 12 are also reported. A sample was obtained of 217 subjects without ear pathology and with typical development. Each age group was composed of at least 30 children. All children were evaluated using pure tone audiometry, speech audiometry, impedance, and otoacoustic emissions. Normative scores are reported for each of the six auditory processing tests. The assessment is applicable to young children (aged 5 and 6). The statistical analyses showed significant effects in scores of Age for all tests and of Ear for several tests. The main result from the work presented, the Auditory Processing Assessment Battery—European Portuguese (BAPA-PE), is available for clinical use with normative data. This battery is a new tool for behaviorism assessment of European Portuguese speakers with suspected central auditory pathology and for monitoring the results of auditory training.info:eu-repo/semantics/publishedVersio

Evaluation of temporal resolution and performance with degraded acoustic signal in patients with cochlear implant: preliminary study

Desde o início da actividade de implantação coclear no Serviço de ORL do Centro Hospitalar de Coimbra em 1985, foram efectuadas 630 cirurgias, 374 das quais em crianças e 256 em adultos. A falta de informação sobre o desempenho dos indi- víduos implantados em testes de avaliação do processamento auditivo central, que nos permita compreender melhor a va- riabilidade dos resultados obtidos e também verificar se exis- tem diferenças de performance nestes testes entre adultos e crianças implantadas, motivou os autores a iniciar a aplicação dos testes de resolução temporal e de desempenho com si- nais acústicos degradados em dois grupos de pacientes im- plantados (19 implantados em idade adulta e 28 implantados quando crianças). Para o efeito, efectuaram a aplicação dos testes de detecção de intervalo no ruído, fala filtrada e fala no ruído. Após a comparação estatística dos dois grupos es- tudados foi já possível, apesar do carácter preliminar do es- tudo e do tamanho da amostra, encontrar diferença estatisticamente significativa entre os grupos no teste de fala filtrada, com desempenho superior nos adultos

Processamento auditivo central em pessoas idosas: resultados preliminares

A presbiacúsia acarreta dificuldades na interpretação do sinal sonoro com uma influência acrescida na perceção do discurso na presença de ruído. Pretende-se estudar as habilidades do processamento auditivo central na discriminação da fala no ruído, em pessoas idosas.info:eu-repo/semantics/publishedVersio

A European perspective on auditory processing disorder-current knowledge and future research focus

Current notions of \u201chearing impairment,\u201d as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other more sophisticated audiometric tests such as speech audiometry in noise or complex non-speech sound perception. This disorder, defined as \u201cAuditory Processing Disorder\u201d (APD) or \u201cCentral Auditory Processing Disorder\u201d is classified in the current tenth version of the International Classification of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order to further clarify the nature of APD and thus assist in optimumdiagnosis and evidence-based management. This European consensus presents the main symptoms, conditions, and specific medical history elements that should lead to auditory processing evaluation. Consensus on definition of the disorder, optimum diagnostic pathway, and appropriate management are highlighted alongside a perspective on future research focus

Consensus Statement on Bone Conduction Devices and Active Middle Ear Implants in Conductive and Mixed Hearing Loss

Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-conduction devices and middle-ear implants have advantages but also limitations concerning complexity/invasiveness of the surgery, medical complications, and effectiveness. To counsel the patient, the clinician should have a good overview of the options with regard to safety and reliability as well as unequivocal technical performance data. The present consensus document is the outcome of an extensive iterative process including ENT specialists, audiologists, health-policy scientists, and representatives/technicians of the main companies in this field. This document should provide a first framework for procedures and technical characterization to enhance effective communication between these stakeholders, improving health care

Both “illness and temptation of the enemy”: melancholy, the medieval patient and the writings of King Duarte of Portugal (r. 1433–38)

Recent historians have rehabilitated King Duarte of Portugal, previously maligned and neglected, as an astute ruler and philosopher. There is still a tendency, however, to view Duarte as a depressive or a hypochondriac, due to his own description of his melancholy in his advice book, the Loyal Counselor. This paper reassesses Duarte's writings, drawing on key approaches in the history of medicine, such as narrative medicine and the history of the patient. It is important to take Duarte's views on his condition seriously, placing them in the medical and theological contexts of his time and avoiding modern retrospective diagnosis. Duarte's writings can be used to explore the impact of plague, doubt and death on the life of a well-educated and conscientious late-medieval ruler