Avaliação auditiva objetiva através de potenciais evocados

Seixas, Ricardo Ranieri; Fasolo, Maria Izabel; Moreira, Roberto Normandia

doi:10.1590/S0004-282X1993000400002

Resumos

Analisaram-se 1300 exames de Potencial Evocado Auditivo. Classificaram-se os pacientes segundo faixa de idade, apresentação clínica, relato de fatores de risco que levam a deficiência auditiva e limiar auditivo determinado pelo exame. Distribuíram-se os resultados em 5 faixas de limiar auditivo: audição normal (até 25 dBHL); perda auditiva moderada (25-50 dBHL); perda acentuada (50-70 dBHL); perda severa (70-90 dRHL); e sem resposta ao estímulo auditivo. Estudaram-se os fatores de risco relativos a gestação, parto e período neonatal, história familiar de deficiência auditiva, malformações do aparelho auditivo, anomalias crânio-faciais, síndromes associadas a deficiência auditiva, certas modalidades de doenças infecciosas e uso de determinadas drogas. Investigaram-se também os itens Retardo do Desenvolvimento Neuropsicomotor, Paralisia Cerebral e os casos sem antecedentes conhecidos. Entre as conclusões destacam-se: 82,8% dos pacientes eram portadores de alguma forma de deficiência auditiva; o encaminhamento é tardio, evidenciado pelo fato de 54,1% dos pacientes situarem-se entre 1 e 3 anos de idade; 54,0% da totalidade dos casos apresentavam-se sem linguagem; o fator de risco «Rubéola Congênita» possui a elevada incidência de 14,8%, e este percentual distribuído nas faixas de limiar auditivo revelou um crescimento exponencial, demonstrando inequívoca e acentuada correlação da moléstia com deficiência auditiva.

potencial evocado auditivo (PEA); audiometria objetiva; audiometria de tronco cerebral; deficiência auditiva

We have analyzed 1300 Auditory Brain-Stem Response Audiometry exams. The patients were distributed according to criteria related to age, clinical presentation, hearing impairment risk-factors and hearing thresholds. The results were divided into five groups of hearing thresholds: normal hearing (threshold response obtained up to 25 dBHL); mild hearing loss (25-50 dBHL); moderate hearing loss (50-70 dBHL); severe hearing loss (70-90 dBHL); and without response to acoustic stimuli. We have studied the risk-factors related to gestation, delivery and neonatal period, family history of hearing loss, hearing apparatus malformations, craniofacial anomalies, certain modalities of infectious diseases, hearing impairment associated syndromes, and the use of some kind of drugs. Cerebral palsy, neuropsychomotor development retardation and cases without known antecedents were also studied. The main results of our study show: 82.8% incidence of hearing impairment; the late performance of examinations to evidence a definite hearing loss as 54.1% of the examined patients were at ages ranging from one to three years old; 54.0% of total cases have not presented any language development; the risk-factor «Congênita! Rubeola* has the expressive incidence of 14.8% and the. distribution of this value into hearing threshold ranges has shown an exponential increase which demonstrates a close correlation between that disease and hearing impairment.

evoked potentials; brain-stem evoked response audiometry (BERA); hearing impairment

Ricardo Ranieri Seixas^I; Maria Izabel Fasolo^II; Roberto Normandia Moreira^III

^IMédico, Neurofisiologista Clínico

^IIMédica, Mestranda era Engenharia Biomédica - CEFET-PR

^IIIEngenheiro Eletrônico, Mestrando em Engenharia Biomédica - CEFET-PR

RESUMO

Analisaram-se 1300 exames de Potencial Evocado Auditivo. Classificaram-se os pacientes segundo faixa de idade, apresentação clínica, relato de fatores de risco que levam a deficiência auditiva e limiar auditivo determinado pelo exame. Distribuíram-se os resultados em 5 faixas de limiar auditivo: audição normal (até 25 dBHL); perda auditiva moderada (25-50 dBHL); perda acentuada (50-70 dBHL); perda severa (70-90 dRHL); e sem resposta ao estímulo auditivo. Estudaram-se os fatores de risco relativos a gestação, parto e período neonatal, história familiar de deficiência auditiva, malformações do aparelho auditivo, anomalias crânio-faciais, síndromes associadas a deficiência auditiva, certas modalidades de doenças infecciosas e uso de determinadas drogas. Investigaram-se também os itens Retardo do Desenvolvimento Neuropsicomotor, Paralisia Cerebral e os casos sem antecedentes conhecidos. Entre as conclusões destacam-se: 82,8% dos pacientes eram portadores de alguma forma de deficiência auditiva; o encaminhamento é tardio, evidenciado pelo fato de 54,1% dos pacientes situarem-se entre 1 e 3 anos de idade; 54,0% da totalidade dos casos apresentavam-se sem linguagem; o fator de risco «Rubéola Congênita» possui a elevada incidência de 14,8%, e este percentual distribuído nas faixas de limiar auditivo revelou um crescimento exponencial, demonstrando inequívoca e acentuada correlação da moléstia com deficiência auditiva.

Palavras-chave: potencial evocado auditivo (PEA), audiometria objetiva, audiometria de tronco cerebral, deficiência auditiva.

SUMMARY

We have analyzed 1300 Auditory Brain-Stem Response Audiometry exams. The patients were distributed according to criteria related to age, clinical presentation, hearing impairment risk-factors and hearing thresholds. The results were divided into five groups of hearing thresholds: normal hearing (threshold response obtained up to 25 dBHL); mild hearing loss (25-50 dBHL); moderate hearing loss (50-70 dBHL); severe hearing loss (70-90 dBHL); and without response to acoustic stimuli. We have studied the risk-factors related to gestation, delivery and neonatal period, family history of hearing loss, hearing apparatus malformations, craniofacial anomalies, certain modalities of infectious diseases, hearing impairment associated syndromes, and the use of some kind of drugs. Cerebral palsy, neuropsychomotor development retardation and cases without known antecedents were also studied. The main results of our study show: 82.8% incidence of hearing impairment; the late performance of examinations to evidence a definite hearing loss as 54.1% of the examined patients were at ages ranging from one to three years old; 54.0% of total cases have not presented any language development; the risk-factor «Congênita! Rubeola* has the expressive incidence of 14.8% and the. distribution of this value into hearing threshold ranges has shown an exponential increase which demonstrates a close correlation between that disease and hearing impairment.

Key words: evoked potentials, brain-stem evoked response audiometry (BERA), hearing impairment.

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Aceite: 6-abril-1993.

Dr. Ricardo Ranieri Seixas Rua Padre Anchieta 155 - 80410-030 Curitiba PR - Brasil.

Trabalho realizado no Serviço Integral de Neurofisiologia Clínica, Curitiba

1. Adelman C, Levi H, Linder N, Sohmer H. Neonatal auditory brain-stem response threshold and latency: 1 hour to 5 months. Electroenceph Clin Neurophysiol 1990, 77:77-80.
2. American Academy of Pediatrics. Joint Committee on Infant Hearing Position Statement 1982. Pediatrics 1982, 70:496-497.
3. Barden TP, Peltzman P. Newborn brain stem auditory evoked responses and perinatal clinical events. Am J Obstetr Gynecol 1980, 136:912-919.
4. Bess FH, Peek BF, Chapman JJ. Further observations on noise levels in infant incubators. Pediatrics 1979, 63:100-106.
5. Chiappa KH. Evoked potentials in clinical medicine. Ed 2. New York: Raven Press, 1990.
6. Douek E, Dodson HC, Banister LH et al. Effects of incubator noise on the cochlea of the newborn. Lancet 1976, 2:1110.
7. Duara S, Suter MS, Bessard KK, Gutberlet RL. Neonatal screening with auditory brainstem responses: results of follow-up audiometry and risk factor evaluation. J Pediatr 1986, 108:276.
8. Emerson RG, Brooks EB, Parker SW, Chiappa KH. Effects of click polarity on brainstem auditory evoked potentials in normal subjects and patients: unexpected sensitivity of wave V. Ann NY Acad Sci 1982, 388:710-721.
9. Epstein CM. The use of brain stem auditory evoked potentials in the evaluation of the central nervous system. Neurologic Clinics 1988, 6:771-790.
10. Feinmesser M, Tell L, Levi H. Follow-up of 40,000 ifants screened for hearing defect. Audiology 1982, 21:197.
11. Goldie W. The brainstem auditory evoked potentials in infants and children. J Clin Neurophysiol 1992, 9:394-407.
12. Goodwin S. Preventive care for children: immunization in England and Wales. Pediatrics 1990, 86(Suppl):1056-1060.
13. Hinman A. Immunizations in the United States. Pediatrics 1990, 86(Suppl) :1064-1066.
14. Lary S, Briassoulis G, Vries L, Dubowitz L, Dubowitz V. Hearing threshold in preterm and term infants by auditory brainstem response. J Pediatr 1986, 107:593-599.
15. Legat A, Arezzo J, Vaughan H Jr. The anatomic and physiologic bases of brainstem auditory evoked potentials. Neurologic Clinics 1988, 4:681-704.
16. Picton T, Durieux-Smith A. Auditory evoked potentials in the assessment of hearing. Neurologic Clinics 1988, 4:791-808.
17. Schulman-Galambos C, Galambos R. Brain stem evoked response audiometry in newborn hearing screening. Arch Otolaryngol 1979, 105:86-90.
18. Schwartz DM, Morris MD, Spydell JD, Brink CT, Grim MA, Schwartz JA. Influence of click polarity on the brain-stem auditory evoked response (BAER) revisited. Electroenceph Clin Neurophysiol 1988, 77:445-457.
19. Shannon D, Felix J, Krumhoz A, Goldstein P, Harris K. Hearing screening of high-risk newborns with brainstem auditory evoked potentials: a follow-up study. Pediatrics 1984, 73:22-26.
20. Starr A, Amlie RN, Martin WH, Sanders S. Development of auditory function in newborn infants revealed by auditory brain-stem potentials. Pediatrics 1977, 60:831-839.
21. Stein LK, Kraus N, Ozdamar O et al. Hearing loss in an institutionalized mentally retarded population: identification by auditory brainstem response. Arch Otolaryngol Head Neck Surg 1987, 113:32-35.
22. Suzuki J, Kodera K, Kaga K. Auditory evoked brainstem response assessment in otolaryngology. Ann NY Acad Sci 1982, 388:487-500.
23. Verbrugge H. The national immunization program of the Netherlands. Pediatrics 1990, 86(Suppl): 1060-1063.
24. Verbrugge H. Children with special needs in the Netherlands: impaired hearing, adolescent pregnancy, and myelomeningocele. Pediatrics 1990, 86 (Suppl): 1117-1119.

Avaliação auditiva objetiva através de potenciais evocados

Hearing impairment evaluation using brain-stem evoked response audiometry

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Nov 1993

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adelman C, Levi H, Linder N, Sohmer H. Neonatal auditory brain-stem response threshold and latency: 1 hour to 5 months. Electroenceph Clin Neurophysiol 1990, 77:77-80.

[2] 2. American Academy of Pediatrics. Joint Committee on Infant Hearing Position Statement 1982. Pediatrics 1982, 70:496-497.

[3] 3. Barden TP, Peltzman P. Newborn brain stem auditory evoked responses and perinatal clinical events. Am J Obstetr Gynecol 1980, 136:912-919.

[4] 4. Bess FH, Peek BF, Chapman JJ. Further observations on noise levels in infant incubators. Pediatrics 1979, 63:100-106.

[5] 5. Chiappa KH. Evoked potentials in clinical medicine. Ed 2. New York: Raven Press, 1990.

[6] 6. Douek E, Dodson HC, Banister LH et al. Effects of incubator noise on the cochlea of the newborn. Lancet 1976, 2:1110.

[7] 7. Duara S, Suter MS, Bessard KK, Gutberlet RL. Neonatal screening with auditory brainstem responses: results of follow-up audiometry and risk factor evaluation. J Pediatr 1986, 108:276.

[8] 8. Emerson RG, Brooks EB, Parker SW, Chiappa KH. Effects of click polarity on brainstem auditory evoked potentials in normal subjects and patients: unexpected sensitivity of wave V. Ann NY Acad Sci 1982, 388:710-721.

[9] 9. Epstein CM. The use of brain stem auditory evoked potentials in the evaluation of the central nervous system. Neurologic Clinics 1988, 6:771-790.

[10] 10. Feinmesser M, Tell L, Levi H. Follow-up of 40,000 ifants screened for hearing defect. Audiology 1982, 21:197.

[11] 11. Goldie W. The brainstem auditory evoked potentials in infants and children. J Clin Neurophysiol 1992, 9:394-407.

[12] 12. Goodwin S. Preventive care for children: immunization in England and Wales. Pediatrics 1990, 86(Suppl):1056-1060.

[13] 13. Hinman A. Immunizations in the United States. Pediatrics 1990, 86(Suppl) :1064-1066.

[14] 14. Lary S, Briassoulis G, Vries L, Dubowitz L, Dubowitz V. Hearing threshold in preterm and term infants by auditory brainstem response. J Pediatr 1986, 107:593-599.

[15] 15. Legat A, Arezzo J, Vaughan H Jr. The anatomic and physiologic bases of brainstem auditory evoked potentials. Neurologic Clinics 1988, 4:681-704.

[16] 16. Picton T, Durieux-Smith A. Auditory evoked potentials in the assessment of hearing. Neurologic Clinics 1988, 4:791-808.

[17] 17. Schulman-Galambos C, Galambos R. Brain stem evoked response audiometry in newborn hearing screening. Arch Otolaryngol 1979, 105:86-90.

[18] 18. Schwartz DM, Morris MD, Spydell JD, Brink CT, Grim MA, Schwartz JA. Influence of click polarity on the brain-stem auditory evoked response (BAER) revisited. Electroenceph Clin Neurophysiol 1988, 77:445-457.

[19] 19. Shannon D, Felix J, Krumhoz A, Goldstein P, Harris K. Hearing screening of high-risk newborns with brainstem auditory evoked potentials: a follow-up study. Pediatrics 1984, 73:22-26.

[20] 20. Starr A, Amlie RN, Martin WH, Sanders S. Development of auditory function in newborn infants revealed by auditory brain-stem potentials. Pediatrics 1977, 60:831-839.

[21] 21. Stein LK, Kraus N, Ozdamar O et al. Hearing loss in an institutionalized mentally retarded population: identification by auditory brainstem response. Arch Otolaryngol Head Neck Surg 1987, 113:32-35.

[22] 22. Suzuki J, Kodera K, Kaga K. Auditory evoked brainstem response assessment in otolaryngology. Ann NY Acad Sci 1982, 388:487-500.

[23] 23. Verbrugge H. The national immunization program of the Netherlands. Pediatrics 1990, 86(Suppl): 1060-1063.

[24] 24. Verbrugge H. Children with special needs in the Netherlands: impaired hearing, adolescent pregnancy, and myelomeningocele. Pediatrics 1990, 86 (Suppl): 1117-1119.