Durante Alessandra Spada, Wieselberg Margarita Bernal, Roque Nayara, Carvalho Sheila, Pucci Beatriz, Gudayol Nicolly, de Almeida Kátia
Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2017 Mar-Apr;83(2):147-154. doi: 10.1016/j.bjorl.2016.02.016. Epub 2016 Apr 29.
The use of hearing aids by individuals with hearing loss brings a better quality of life. Access to and benefit from these devices may be compromised in patients who present difficulties or limitations in traditional behavioral audiological evaluation, such as newborns and small children, individuals with auditory neuropathy spectrum, autism, and intellectual deficits, and in adults and the elderly with dementia. These populations (or individuals) are unable to undergo a behavioral assessment, and generate a growing demand for objective methods to assess hearing. Cortical auditory evoked potentials have been used for decades to estimate hearing thresholds. Current technological advances have lead to the development of equipment that allows their clinical use, with features that enable greater accuracy, sensitivity, and specificity, and the possibility of automated detection, analysis, and recording of cortical responses.
To determine and correlate behavioral auditory thresholds with cortical auditory thresholds obtained from an automated response analysis technique.
The study included 52 adults, divided into two groups: 21 adults with moderate to severe hearing loss (study group); and 31 adults with normal hearing (control group). An automated system of detection, analysis, and recording of cortical responses (HEARLab) was used to record the behavioral and cortical thresholds. The subjects remained awake in an acoustically treated environment. Altogether, 150 tone bursts at 500, 1000, 2000, and 4000Hz were presented through insert earphones in descending-ascending intensity. The lowest level at which the subject detected the sound stimulus was defined as the behavioral (hearing) threshold (BT). The lowest level at which a cortical response was observed was defined as the cortical electrophysiological threshold. These two responses were correlated using linear regression.
The cortical electrophysiological threshold was, on average, 7.8dB higher than the behavioral for the group with hearing loss and, on average, 14.5dB higher for the group without hearing loss for all studied frequencies.
The cortical electrophysiological thresholds obtained with the use of an automated response detection system were highly correlated with behavioral thresholds in the group of individuals with hearing loss.
听力损失患者使用助听器可带来更高的生活质量。对于那些在传统行为听力学评估中存在困难或限制的患者，如新生儿和幼儿、患有听觉神经病谱系障碍、自闭症和智力缺陷的个体，以及患有痴呆症的成年人和老年人，获取这些设备并从中受益可能会受到影响。这些人群（或个体）无法进行行为评估，因此对客观听力评估方法的需求日益增长。皮层听觉诱发电位已被使用数十年以估计听力阈值。当前的技术进步促使了设备的发展，这些设备允许其临床应用，具有更高的准确性、敏感性和特异性，以及自动检测、分析和记录皮层反应的可能性。
确定行为听觉阈值与通过自动反应分析技术获得的皮层听觉阈值之间的相关性。
该研究纳入了52名成年人，分为两组：21名中度至重度听力损失的成年人（研究组）；以及31名听力正常的成年人（对照组）。使用皮层反应自动检测、分析和记录系统（HEARLab）记录行为和皮层阈值。受试者在经过声学处理的环境中保持清醒。通过插入式耳机以降-升强度呈现150个500、1000、2000和4000Hz的短纯音。受试者检测到声音刺激的最低水平被定义为行为（听力）阈值（BT）。观察到皮层反应的最低水平被定义为皮层电生理阈值。使用线性回归对这两种反应进行相关性分析。
对于所有研究频率，听力损失组的皮层电生理阈值平均比行为阈值高7.8dB，无听力损失组平均高14.5dB。
使用自动反应检测系统获得的皮层电生理阈值与听力损失个体组的行为阈值高度相关。
