Letícia Petersen Schmidt Rosito

Background: Among the complications caused directly or indirectly by the Human Immunodeficiency Virus (HIV) are alterations in the auditory system. Children who are HIV-exposed but uninfected (HEU) appear to have a higher risk of hearing loss (HL) compared to their unexposed peers, but a lower risk than those infected with HIV. However, the literature remains inconclusive regarding this association. This study aims to evaluate the hearing function of HEU infants during the first months of life and to correlate these findings with maternal, gestational, and neonatal variables. Methods: This prospective cohort study included all HIV-exposed infants born in a quaternary hospital in southern Brazil between 2021 and 2023. Maternal, gestational, and neonatal data were collected, as well as the results of neonatal auditory screening. At approximately 6 months of age, otolaryngological and audiological assessments were performed, including wideband tympanometry and electrophysiological evaluation using Auditory Brainstem Response with frequency-specific stimuli. The prevalence of hearing loss refers to the number of infants affected. Results: Thirty-eight infants, with a mean age of 8 months (±3.3), completed the study. Of these, 1 (2.6%) presented with bilateral sensorineural HL, and 13 (34.2%) presented with conductive HL, with 6 cases being unilateral and 7 bilateral. No associations were found between hearing loss and maternal, gestational, or neonatal variables, except for maternal CD4 count, where higher CD4 cell counts were associated with an increased risk of conductive HL. Conclusion: The findings provide relevant data on auditory alterations in HEU infants, demonstrating a high prevalence of conductive HL. These results highlight the importance of monitoring the hearing of these children during the first years of life.

Purpose To evaluate the presence of hearing loss in the first months of life in infants treated for congenital syphilis at birth. Methods Prospective study including all neonates born in a University public hospital in South Brazil, who needed treatment for congenital syphilis after birth in the Neonatal Unit, between 2021 and 2022. Otorhinolaryngologic and audiologic evaluations were performed at a mean age of 3.3 months, concomitantly with the first post-discharge appointment in the congenital syphilis outpatient clinic, through frequency-specific auditory brainstem response. Results Sixty-five patients were included in the study. All subjects underwent Neonatal Hearing Screening before being discharged from the hospital, consisting of transient evoked otoacoustic emission and automated auditory brainstem response tests. Sixty-one patients (93.8%) passed both screening tests and four (6.2%) failed both tests. Concerning the 4 newborns who failed, 2 returned for retesting and had normal results, 1 patient did not show up for retesting, and 1 patient failed both retests. Follow-up was concluded by 23 infants (35.4% of the initial sample) who underwent Frequency-Specific Auditory Brainstem Response testing. The other patients did not attend to the appointments. Regarding the 23 patients that concluded the follow-up, no interaural response asymmetries suggestive of retrocochlear involvement were observed. Additionally, no changes were found in the absolute latencies of waves I, III, and V, or in the interpeak intervals I–III, III–V, and I–V. The Frequency-Specific Auditory Brainstem Response evaluation did not present any abnormalities in the electrophysiological thresholds at the tested frequencies. Conclusion No signs of hearing loss were found in patients treated for congenital syphilis during neonatal period, either in the Neonatal Hearing Screening or in the Frequency-Specific Auditory Brainstem Response during follow-up.

Background: Among the complications caused directly or indirectly by the Human Im-munodeficiency Virus (HIV), auditory system alterations stand out. The HIV exposed un-infected (HEU) children seem to have a higher risk of hearing loss (HL) when compared to their unexposed peers, but a lower risk when compared to those infected with HIV. How-ever, the literature is still not entirely clear on this association. This study aim to evaluate hearing function of HEU infants during the first months of life and correlate these findings with maternal, gestational, and neonatal variables. Methods: A prospective cohort study, including all infants HIV exposed, born in a quaternary hospital in southern Brazil from 2021 to 2023. Maternal, gestational, and neonatal data were collected, as well as neonatal auditory screening results. Around 6 months of age, otolaryngological and audiological assessments were conducted, including wideband tympanometry and electrophysiologi-cal evaluation using the Auditory Brainstem Response with frequency-specific stimulus. Results: Thirty-eight infants, mean age of 8 months (± 3.3), completed the study. Of these, 1 (2.6%) presented bilateral sensorineural HL, and 13 (34.2%) presented conductive HL, 6 cases unilateral and 7 bilateral. No associations were found between hearing loss and maternal, gestational, and neonatal variables, except for maternal CD4 count, where higher CD4 cell counts were associated with a higher risk of conductive HL.

Introduction The World Health Organization (WHO) estimates that ∼ 32 million children worldwide are affected by hearing loss (HL). Cochlear implant is the first-line treatment for severe to profound sensorineural HL. It is considered one of the most successful prostheses developed to date. Objective To evaluate the oral language development of pediatric patients with prelingual deafness implanted in a reference hospital for the treatment of HL in southern Brazil. Methods We conducted a retrospective cohort study with a review of medical records of patients undergoing cochlear implant surgery between January 2009 and December 2018. Language development was assessed by reviewing consultations with speech therapy professionals from the cochlear implant group. Results A total of 152 children were included in the study. The mean age at cochlear implant surgery was of 41 months (standard deviation [SD]: ± 15). The patients were divided into six groups considering the type of language most used in their daily lives. We found that 36% of children use oral language as their primary form of communication. In a subanalysis, we observed that patients with developed or developing oral language had undergone cochlear implant surgery earlier than patients using Brazilian Sign Language (Língua Brasileira de Sinais, LIBRAS, in Portuguese) or those without developed language. Conclusion The cochlear implant is a state-of-the-art technology that enables the re-establishment of the sense of hearing and the development of oral language. However, language development is a complex process known to present a critical period to properly occur. We still see many patients receiving late diagnosis and treatment, which implies a delay and, often, the impossibility of developing oral communication. Level of Evidence Level 3 (cohort study).

RESUMO Objetivo: verificar o gênero, a idade, a localização do zumbido, a presença ou ausência de perda auditiva e seu grau, assim como as medidas psicoacústicas (pitch, loudness, nível mínimo de mascaramento e inibição residual) de pacientes com zumbido crônico e as suas relações. Métodos: o estudo incluiu sujeitos de ambos os gêneros, com idades entre 25 e 85 anos, com queixa de zumbido crônico e que realizassem acompanhamento em ambulatório especializado do Hospital de Clínicas de Porto Alegre. Foram submetidos a anamnese, avaliação audiológica básica, pesquisa de pitch, loudness, inibição residual (IR) e nível mínimo de mascaramento (NMM). Foram utilizados os seguintes testes estatísticos: Teste Qui-Quadrado, Teste Exato de Fisher, Teste U de Wilcoxon - Mann-Whitney, Teste Kruskal Wallis e Coeficiente de Correlação de Spearman. O nível de significância utilizado foi de 5% (p≤0,05). Resultados: houve associação entre a variável tipo de zumbido e presença ou ausência de perda auditiva (PA), grau de PA, NMM e loudness, assim como, entre idade e presença ou ausência de PA e seu grau. A loudness e o NMM apresentaram fraca correlação diretamente proporcional, ao passo que as correlações entre pitch e loudness, pitch e NMM e IR versus NMM apresentaram-se fracas e inversamente proporcionais. Conclusão: houve heterogeneidade entre as características do zumbido e dos indivíduos acometidos. Conclui-se, de acordo com os resultados expostos, que existe influência de algumas variáveis entre si, da mesma maneira que ocorre entre as medidas psicoacústicas.

Purpose: to verify the sex, age, tinnitus location, presence or absence of hearing loss, its degree, and the psychoacoustic measurements (pitch, loudness, minimum masking level [MML], and residual inhibition [RI]) of patients with chronic tinnitus and their relationships. Methods: the study included subjects of both sexes, aged 25 to 85 years, with complaints of chronic tinnitus, followed up at the health service where the research was conducted. They were submitted to medical history survey, basic audiological assessment, and pitch, loudness, RI, and MML research. The following statistical tests were used: chi-square test, Fisher’s exact test, Wilcoxon-Mann-Whitney U test, Kruskal-Wallis test, and Spearman’s correlation coefficient. The significance level was set at 5% (p≤0.05). Results: the type of tinnitus was associated with the presence or absence of hearing loss (HL), degree of HL, MML, and loudness; age was associated with the presence or absence of HL and its degree. There was a directly weak proportional correlation between loudness and MML, whereas the correlations between pitch and loudness, pitch and MML, and RI and MML were weak and inversely proportional. Conclusion: both the affected subjects and their tinnitus characteristics were heterogeneous. The results indicate that some variables influence one another, which also happens between psychoacoustic measurements.

OBJETIVO: Avaliar o incômodo provocado pelo zumbido em um grupo de indivíduos acometidos pelo sintoma.MÉTODOS: Estudo de caráter longitudinal, observacional e quantitativo, sendo a amostra composta por pacientes atendidos em um ambulatório especializado em hospital universitário. Os pacientes foram submetidos à avaliação otorrinolaringológica, responderam ao Tinnitus Handicap Inventory (THI) em dois momentos distintos e realizaram avaliação audiológica. Todos os pacientes receberam orientações gerais e o tratamento foi realizado de acordo com as necessidades de cada paciente. Os dados foram analisados utilizando-se o software SPSS e aplicando-se os testes de Wilcoxon, Mann-Whitney, Kruskal-Wallis e correlação de Spearman. O nível de significância adotado foi p<0,05.RESULTADOS: A amostra foi composta por 185 pacientes, sendo 114 do sexo feminino. A idade variou de 23 a 82 anos. Houve redução significativa do grau de incômodo provocado pelo zumbido ao longo do tempo. Não houve correlação significativa do tempo entre as avaliações, idade, pitch e loudness do zumbido e grau da perda com a melhora do escore total do THI. Não houve associação da melhora do escore total THI com: tipo de perda, lateralidade do zumbido, hipótese diagnóstica e sexo do paciente.CONCLUSÕES: Com o passar do tempo houve melhora no incômodo provocado pelo zumbido na amostra. Hipotetiza-se que a habituação foi um fator determinante para a diminuição do impacto do zumbido.