Vieira Eliara Pinto, Azevedo Marisa Frasson de
Escola Paulista de Medicina, Departamento de Fonoaudiologia, Universidade Federal de São Paulo, Brazil.
Pro Fono. 2007 Apr-Jun;19(2):185-94. doi: 10.1590/s0104-56872007000200007.
Hearing evaluation in children.
To verify the Minimum Response Levels (MRL) through the use of Visual Reinforcement Audiometry (VRA) in the sound field, in 50 normal hearing children and in 25 children with hearing loss, taking into account the following variables: side of sound presentation, gender, age and type of stimulus.
VRA was performed using pure tone frequency modulation (warble) and the Sonar System. The modulated tones were produced by the Pediatric Audiometer, in the frequencies of 500, 1000, 2000 and 4000 Hz and at the intensities of 80, 60, 40 and 20 dBNA. The modulated tones were presented in a decreasing sequence of intensity and by using the stimulus-reply-visual reinforcement conditioning. The assessment procedure and analysis of response were the same when using the stimuli of the Sonar System. However, on this occasion, a sound amplification box was used. Each loudspeaker with the visual reinforcement was positioned approximately at 90 masculine azimuth to the right and the left of the child, and at a distance of approximately 50 cm. Visual reinforcement was an illuminated clown.
No statistically significant difference was found between the MNL and the side of sound presentation. The MRL at 500 Hz and 2000 Hz, when using the Sonar System, were lower for normal hearing males. In this group, there was a decrease in the MRL with the increase in age for both stimuli. When comparing the MRL with two stimuli, there was a statistically significant difference in favor of the Sonar System, but only for the group of normal hearing children below two years of age.
The MRL decrease with age independently of the stimulus and are lower when using the Sonar System. For the group of children with hearing loss no significant difference was found for any of the studied variables.
儿童听力评估。
通过声场中的视觉强化测听法(VRA),对50名听力正常儿童和25名听力损失儿童的最小反应水平(MRL)进行验证,同时考虑以下变量:声音呈现侧、性别、年龄和刺激类型。
使用纯音频率调制(调频)和声纳系统进行VRA。调制音由儿科听力计产生,频率为500、1000、2000和4000赫兹,强度为80、60、40和20 dBNA。调制音以强度递减顺序呈现,并采用刺激-反应-视觉强化条件反射。使用声纳系统的刺激时,评估程序和反应分析相同。然而,此时使用了一个声音放大盒。每个带有视觉强化装置的扬声器分别位于儿童右侧和左侧约90°方位,距离约50厘米。视觉强化物是一个发光的小丑。
未发现MNL与声音呈现侧之间存在统计学显著差异。使用声纳系统时,听力正常男性在500赫兹和2000赫兹处的MRL较低。在该组中,两种刺激下的MRL均随年龄增长而降低。比较两种刺激下的MRL时,仅在两岁以下听力正常儿童组中,声纳系统具有统计学显著优势。
MRL随年龄降低,与刺激无关,且使用声纳系统时更低。对于听力损失儿童组,未发现任何研究变量存在显著差异。