Introdução: Sabe-se que muitas pessoas sofrem de hipertensão arterial sistêmica (HAS) e indivíduos cada vez mais jovens estão apresentando este quadro. A HAS pode causar várias complicações na saúde geral do indivíduo, em virtude do comprometimento da circulação sanguínea, o que pode afetar até mesmo o sistema auditivo. Porém, os estudos encontrados na literatura, até o momento, são bastante controversos quanto à influência ou não da HAS no sistema auditivo periférico. Objetivos: Verificar se existe influência da hipertensão arterial no sistema auditivo periférico, por meio dos achados na audiometria de altas frequências, nas emissões otoacústicas transientes e produto de distorção, comparando grupos de indivíduos normoouvintes pela audiometria convencional, com e sem HAS; e identificar se alguma das variáveis referentes às avaliações realizadas pode ser utilizada para discriminar os indivíduos nos grupos com ou sem HAS. Método: Participaram deste estudo 40 sujeitos de 30 a 50 anos, divididos em grupos com e sem hipertensão arterial. Todos os indivíduos foram submetidos à meatoscopia, imitanciometria, audiometria tonal nas frequências de 250 Hz a 16000 Hz, logoaudiometria, emissões otoacústicas evocadas transientes e emissões otoacústicas produto de distorção. Resultados: Não foi observada diferença estatisticamente significante entre os grupos com e sem HAS na audiometria convencional e em altas frequências. Para as emissões otoacústicas evocados por estímulo transiente, houve tendência à diferença estatisticamente significante, com as respostas do grupo com HAS piores que do grupo sem HAS. Já as emissões otoacústicas produto de distorção, nas frequências de 1501, 2002 e 3003 Hz, apresentaram diferenças estatisticamente significantes, sendo que o grupo com HAS apresentou amplitudes menores. A análise discriminante mostrou que as variáveis das emissões otoacústicas produto de distorção foram as que melhor discriminaram os indivíduos com e sem HAS. Conclusão: Nossos achados sugerem presença de disfunção coclear em indivíduos com hipertensão arterial, uma vez que as respostas das emissões otoacústicas foram piores no grupo com HAS / Introduction: It is widely known that many people have systemic arterial hypertension (SAH) and, currently, the number of young people with such disease is increasing. SAH may cause a wide range of complications in the general health of an individual due to the involvement of blood circulation, which may affect the hearing system. Nevertheless, the reports found in the scientific field are still controversial regarding the influence of SAH on the peripheral auditory system. Purpose: To verify if there is any influence of SAH on the peripheral auditory system, through data from high frequency audiometry, transient-evoked otoacustic emissions and distortion-product otoacoustic emissions and compare such results to groups of typical hearing individuals, with and without SAH, who underwent the pure-tone audiometry test; and also investigate if any variable regarding the hearing assessment may be used to differentiate individuals with and without SAH. Methods: This study counted on 40 individuals aged between 30 and 50 years old, divided into groups with and without SAH. All individuals underwent the following procedures: otoscopy, imitanciometry, pure-tone audiometry in frequencies from 250Hz to 16000 Hz, logoaudiometry, transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions. Results: There was found no significant statistically difference between the groups with and without SAH neither in pure-tone nor high-frequency audiometry. Regarding transient-evoked otoacustic emissions there was a tendency to a significant statistically difference once the SAH group showed lower results. Concerning distortion-product otoacustic emissions there was found significant statistically difference in the following frequencies: 1501, 2002 e 2003 Hz in which the SAH group showed lower results. Discriminant analysis pointed that variables of distortion-product otoacustic emissions best distinguished individuals with and without SAH. Conclusion: Data from this study suggest cochlear dysfunction in individuals with SAH since their results in otoacoustic emissions were lower than in the group with SAH

INTRODUCTION: Health impacts caused by the use of pesticides are large. Studies have demonstrated the effect of pesticides associated with other harmful agents, however, if assumes that, in isolation, the pesticides can also be harmful to hearing. As the high-frequency Audiometry (AAF) is a procedure used in the clinical diagnosis of hearing loss caused by chemical agents, was studied the possibility of the contribution of this resource in the detection of hearing loss caused by pesticides. OBJECTIVE: Evaluate hearing health of rural workers with and without exposure to pesticides. MATERIAL AND METHODS: Cross-sectional study that has met the criteria of research ethics, and had no conflict of interest, was held in 87 workers, aged 18 to 59 years, with formal, informal working and/or on family farming. Were evaluated 87 workers not exposed to pesticides (Group 1) and 49 that had exposure to these products (Group 2), whose have done anamnesis, ear canal inspection, distortion product otoacoustic emissions (DPOAE), pure tone audiometry at 0.5K, 1K, 2K, 3K, 4K, 6K and 8KHz, being normal, high frequency audiometry at 9K, 10K, 11,2K, 12,5K, 14K, 16K, 18K and 20KHz. RESULTS: The workers were distributed in 41% of the males and 59% female; 54% worked in agriculture (p < 0.0001), the mixture of pesticides was reported by 77% of the examined, the glyphosate based product was the most used (73%) and 24% did not know inform the name of the pesticide used, the use of personal protective equipment has not been identified, the average age of onset was 11 years (SD = 3.89), the glyphosate-based product was the most used (73%) and 24% did not know inform the name of the pesticide used. The use of personal protective equipment has not been identified, the average age of onset was 11 years (SD = 3.89) and 23% of the subjects (p = 0.013) reported dizziness before, during or after the application of pesticides. Workers exposed to pesticides (G2) showed higher averages in the AAF thresholds than those who were not exposed (G1) with significance between 9,000 and 20,000 Hz in both ears (p < 0.0001), regardless of the age group. The results of DPOAE and other symptoms were not significant. CONCLUSION: Workers exposed to pesticides showed worse results in the AAF, when compared with those without exposure. The AAF can be considered a sensitive instrument to detect auditory changes in workers exposed to pesticides. / INTRODUÇÃO: Os impactos à saúde ocasionados pelo uso de agrotóxicos são amplos. Estudos tem demonstrado o efeito dos agrotóxicos associados a outros agentes otoagressores, entretanto, se pressupõe que, isoladamente, os agrotóxicos também podem ser prejudiciais à audição. Como a Audiometria de Altas frequências (AAF) é um procedimento utilizado no diagnóstico clínico da perda auditiva ocasionada por agentes químicos, se estuda a possibilidade da contribuição deste recurso na detecção das perdas auditivas ocasionadas por agrotóxicos. OBJETIVO: avaliar a saúde auditiva dos trabalhadores rurais com e sem exposição a agrotóxicos. MATERIAL E MÉTODO: Estudo transversal que atendeu os critérios de ética em pesquisa, e, não apresentou conflito de interesses. Foi realizado em 87 trabalhadores rurais, na faixa etária de 18 a 59 anos, com vínculo de trabalho formal, informal e/ou que atuavam na agricultura familiar. Foram avaliados 38 sujeitos não expostos a agrotóxicos (G1) e 49 com exposição a estes produtos (G2), que realizaram anamnese, meatoscopia, emissões otoacústicas evocadas por produto de distorção (EOAPD), audiometria tonal liminar nas frequências convencionais de 500 a 8.000 Hz, e, em se apresentando normal, foi realizada a AAF em 9.000, 10.000, 11.200, 12.500, 14.000, 16.000, 18.000 e 20.000 Hz. RESULTADOS: A amostra foi distribuída em 41% trabalhadores do sexo masculino e 59% do sexo feminino; 54% atuavam na agricultura familiar (p<0,0001), a mistura de agrotóxicos foi relatada por 77% dos examinados, o produto à base de glifosato foi o mais utilizado (73%) e 24% não souberam informar o nome do agrotóxico utilizado. O uso de Equipamento de Proteção Individual não foi identificado, a média de idade de início de trabalho foi 11 anos (DP=3,89) e 23% dos sujeitos (p=0,013) relataram tonturas antes, durante ou após a aplicação de agrotóxicos. Os trabalhadores expostos a agrotóxicos (G2) apresentaram maiores médias em limiares da AAF que aqueles que não foram expostos (G1), com significância entre 9.000 e 20.000 Hz em ambas as orelhas (p<0,0001), independente da faixa etária. Os resultados das EOAPD e demais sintomas não foram significativos. CONCLUSÃO: Os trabalhadores expostos a agrotóxicos apresentaram piores resultados na AAF, quando comparados com aqueles sem exposição. A AAF pode ser considerada um instrumento sensível para detectar alterações auditivas em trabalhadores expostos a agrotóxicos.

Os potenciais evocados auditivos de tronco encefálico (PEATE) são um instrumento clínico muito útil na avaliação da maturação das vias auditivas em crianças nascidas pré-termo. Objetivos: Observar a maturação da via auditiva pela análise PEATE em crianças nascidas prétermo em três idades (4, 12 e 20 meses de idade). Casuística e Método: Coorte, individual, observacional, comparativo e contemporâneo. O fator em estudo foi crianças nascidas pré-termo e o desfecho à observação da maturação da via auditiva neste grupo, pela análise PEATE, em três avaliações (aos 4, 12 e 20 meses de idade), precedido de avaliação otorrinolaringológica e audiológica com objetivo de garantir que não apresentavam alteração auditiva. Resultados: Ingressaram 73 crianças pré-termo. Não foi encontrada diferença estatística (P>0,05) na comparação dos resultados entre os gêneros, bem como interaural. Houve diferença estatiticamente significante entre idade gestacional, as latências absolutas e intervalos interpicos nas três avaliações realizadas, ocorrendo uma diminuição das latências com o aumento da idade. Verificamos que a maturação da onda I foi mais rápida, e a maturação da onda V foi mais lenta. Podemos perceber que a maturação da via auditiva até o tronco encefálico segue o sentido caudorostral, sendo a da via periférica mais precoce, e a da rostral, mais tardia. Conclusão: Com base nos achados deste estudo, recomendamos que a aplicação do procedimento de avaliação audiológica através do PEATE em crianças nascidas pré-termo, pelo menos até os 20 meses de idade, seja realizado levando-se em conta a idade gestacional a fim de se obter análises fidedignas. / Brainstem Auditory Evoked Potential (BAEP) is a very useful clinical instrument in the evaluation of the auditory pathways maturation in preterm children. Objective: To observe the maturation of the auditory pathway with the use of the BAEP analysis in preterm children at three different ages (four, 12 and 20 months). Casuistry and Method: Group, individual, observational, comparative and contemporary. Preterm children and the outcome to observation of the auditory pathway maturation by the BAEP analysis in three evaluations (at 4, 12 and 20 months of age) were studied. The procedures were preceded by otolaryngological and auditory evaluation with the objective to guarantee the non presence of auditory alteration. Results: Seventy-three preterm children participated in the study. Statistically significant difference was not found (P> 0,05) in the comparison between genders and between ears. There was a statistically significant difference among gestational ages, absolute latencies and interpic intervals in the three evaluations conducted, occurring a reduction of latencies with age increase. We verified that maturation of wave I was faster and the maturation of wave V was slower. We could perceive that the maturation of the auditory pathway up to the brainstem follows the caudorostral direction, being the peripheral pathway more precocious and the rostral pathway more delayed. Conclusion: Based on the findings of this study, we recommend the application of the audiological evaluation procedure using BAEP in preterm children, at least until 20 months of age, by taking into account the gestational age in order to obtain reliable analyses.

INTRODUCTION: Health impacts caused by the use of pesticides are large. Studies have demonstrated the effect of pesticides associated with other harmful agents, however, if assumes that, in isolation, the pesticides can also be harmful to hearing. As the high-frequency Audiometry (AAF) is a procedure used in the clinical diagnosis of hearing loss caused by chemical agents, was studied the possibility of the contribution of this resource in the detection of hearing loss caused by pesticides. OBJECTIVE: Evaluate hearing health of rural workers with and without exposure to pesticides. MATERIAL AND METHODS: Cross-sectional study that has met the criteria of research ethics, and had no conflict of interest, was held in 87 workers, aged 18 to 59 years, with formal, informal working and/or on family farming. Were evaluated 87 workers not exposed to pesticides (Group 1) and 49 that had exposure to these products (Group 2), whose have done anamnesis, ear canal inspection, distortion product otoacoustic emissions (DPOAE), pure tone audiometry at 0.5K, 1K, 2K, 3K, 4K, 6K and 8KHz, being normal, high frequency audiometry at 9K, 10K, 11,2K, 12,5K, 14K, 16K, 18K and 20KHz. RESULTS: The workers were distributed in 41% of the males and 59% female; 54% worked in agriculture (p < 0.0001), the mixture of pesticides was reported by 77% of the examined, the glyphosate based product was the most used (73%) and 24% did not know inform the name of the pesticide used, the use of personal protective equipment has not been identified, the average age of onset was 11 years (SD = 3.89), the glyphosate-based product was the most used (73%) and 24% did not know inform the name of the pesticide used. The use of personal protective equipment has not been identified, the average age of onset was 11 years (SD = 3.89) and 23% of the subjects (p = 0.013) reported dizziness before, during or after the application of pesticides. Workers exposed to pesticides (G2) showed higher averages in the AAF thresholds than those who were not exposed (G1) with significance between 9,000 and 20,000 Hz in both ears (p < 0.0001), regardless of the age group. The results of DPOAE and other symptoms were not significant. CONCLUSION: Workers exposed to pesticides showed worse results in the AAF, when compared with those without exposure. The AAF can be considered a sensitive instrument to detect auditory changes in workers exposed to pesticides. / INTRODUÇÃO: Os impactos à saúde ocasionados pelo uso de agrotóxicos são amplos. Estudos tem demonstrado o efeito dos agrotóxicos associados a outros agentes otoagressores, entretanto, se pressupõe que, isoladamente, os agrotóxicos também podem ser prejudiciais à audição. Como a Audiometria de Altas frequências (AAF) é um procedimento utilizado no diagnóstico clínico da perda auditiva ocasionada por agentes químicos, se estuda a possibilidade da contribuição deste recurso na detecção das perdas auditivas ocasionadas por agrotóxicos. OBJETIVO: avaliar a saúde auditiva dos trabalhadores rurais com e sem exposição a agrotóxicos. MATERIAL E MÉTODO: Estudo transversal que atendeu os critérios de ética em pesquisa, e, não apresentou conflito de interesses. Foi realizado em 87 trabalhadores rurais, na faixa etária de 18 a 59 anos, com vínculo de trabalho formal, informal e/ou que atuavam na agricultura familiar. Foram avaliados 38 sujeitos não expostos a agrotóxicos (G1) e 49 com exposição a estes produtos (G2), que realizaram anamnese, meatoscopia, emissões otoacústicas evocadas por produto de distorção (EOAPD), audiometria tonal liminar nas frequências convencionais de 500 a 8.000 Hz, e, em se apresentando normal, foi realizada a AAF em 9.000, 10.000, 11.200, 12.500, 14.000, 16.000, 18.000 e 20.000 Hz. RESULTADOS: A amostra foi distribuída em 41% trabalhadores do sexo masculino e 59% do sexo feminino; 54% atuavam na agricultura familiar (p<0,0001), a mistura de agrotóxicos foi relatada por 77% dos examinados, o produto à base de glifosato foi o mais utilizado (73%) e 24% não souberam informar o nome do agrotóxico utilizado. O uso de Equipamento de Proteção Individual não foi identificado, a média de idade de início de trabalho foi 11 anos (DP=3,89) e 23% dos sujeitos (p=0,013) relataram tonturas antes, durante ou após a aplicação de agrotóxicos. Os trabalhadores expostos a agrotóxicos (G2) apresentaram maiores médias em limiares da AAF que aqueles que não foram expostos (G1), com significância entre 9.000 e 20.000 Hz em ambas as orelhas (p<0,0001), independente da faixa etária. Os resultados das EOAPD e demais sintomas não foram significativos. CONCLUSÃO: Os trabalhadores expostos a agrotóxicos apresentaram piores resultados na AAF, quando comparados com aqueles sem exposição. A AAF pode ser considerada um instrumento sensível para detectar alterações auditivas em trabalhadores expostos a agrotóxicos.

A neuropatia/dessincronia auditiva é caracterizada pelo funcionamento coclear normal, evidenciado pela presença das emissões otoacústicas e/ou do microfonismo coclear associado à ausência dos potenciais evocados auditivos de tronco encefálico. Este estudo teve por objetivo avaliar a função coclear e neural em indivíduos com o diagnóstico de neuropatia/dessincronia auditiva através da eletrococleografia extratimpânica. Dezoito crianças foram estudadas, sendo divididas em dois grupos: grupo controle (n = 7) formado por crianças, com idade média de 7 anos, com sistema auditivo periférico normal e grupo estudo (n = 11) formado por crianças com idade média de 3 anos, com emissões otoacústicas presentes, reflexos acústicos e potencial evocado auditivo de tronco encefálico ausentes. A eletrococleografia extratimpânica foi aplicada em ambos os grupos, utilizando para registrar os potenciais elétricos um eletrodo de conduto auditivo externo, modelo TIPtrode. O estímulo utilizado para pesquisa do microfonismo coclear foi o tone burst de 2000Hz e, para a pesquisa dos potenciais de ação e de somação foi utilizado o click. Ambos os estímulos foram aplicados nas polaridades rarefação e condensação. Vinte e seis orelhas foram analisadas, sendo 10 orelhas do grupo controle e 16 orelhas do grupo estudo. Os resultados de ambos os grupos foram analisados em relação à amplitude, início, término e duração do microfonismo coclear e à ocorrência do potencial de ação e do potencial de somação. Após análise estatística dos resultados, observou-se que os dois grupos, quando comparados entre si, apresentaram resultados semelhantes em relação à amplitude do microfonismo coclear. O microfonismo coclear no grupo estudo teve início atrasado quando comparado ao grupo controle, mas sem diferença estatisticamente significante.Houve diferenças estatísticas p<0,001) em relação aos parâmetros de término e duração do microfonismo coclear. O grupo estudo apresentou tempo de término e de duração maiores que o grupo controle. O potencial de ação e o de somação foram ausentes em 100% do grupo estudo (n= 16 orelhas). Observou-se que o funcionamento do microfonismo coclear e dos potenciais de ação e de somação das crianças com neuropatia/dessincronia auditiva estava alterado quando comparado ao grupo controle. / The auditory neuropathy/auditory dys-synchrony is characterized by the normal cochlear functioning due to the presence of the otoacoustic emissions and/or of the cochlear microphonic associated to the absence of the auditory brainstem response. This study had as an objective to evaluate the cochlear and neural functions in individuals with the diagnosis of auditory neuropathy/auditory dys-synchrony through the extratympanic electrocochleography. Eighteen children were studied, having been divided into two groups: the control group (n = 7) formed by children averaging 7 years of age with normal peripheral auditory system and the study group (n = 11) formed by children averaging 3 years with present otoacoustic emissions, absent of the acoustic reflexes and the auditory brainstem response. The extratympanic electrocochleography was applied in both groups, using in order to register electrical potentials, an electrode of external ear canal, TIPtrode model. The stimulus used for research of cochlear microphonic was the tone burst of 2000Hz and the click was used for the research of action potentials and of the summation. Both stimuli were applied in the rarefaction and condensation polarities. Twenty-six ears were analyzed, being 10 from the control group and 16 from the study group. The results of both groups were analyzed in relation to the amplitude, beginning, ending and duration of the cochlear microphonic and to the occurrence of the action potentials and of the potential of summation. After statistical analysis of the results, it was observed that both groups, when compared among each other presented similar results in relation to the amplitude of the cochlear microphonic. The cochlear microphonic in the study group had a late beginning when compared to the control group, but with no significant statistical difference. There were statistical differences (p<0,001) in relation to the ending and duration parameters of the cochlear microphonic. The study group presented time of ending and duration higher than the control group. The action potentials and the summation were absent in 100% of the study group (n = 16 ears). It was observed that the cochlear microphonic functioning and the action potentials and the summation of the children with auditory neuropathy/auditory dyssynchrony were altered when compared to the control group.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-07-15T14:14:47Z No. of bitstreams: 1 jacquelinedeassispinto.pdf: 1415006 bytes, checksum: 5007465a343c99ebcadca2bdb8d70d84 (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-07-19T15:56:03Z (GMT) No. of bitstreams: 1 jacquelinedeassispinto.pdf: 1415006 bytes, checksum: 5007465a343c99ebcadca2bdb8d70d84 (MD5) / Made available in DSpace on 2016-07-19T15:56:03Z (GMT). No. of bitstreams: 1 jacquelinedeassispinto.pdf: 1415006 bytes, checksum: 5007465a343c99ebcadca2bdb8d70d84 (MD5) Previous issue date: 2011-03-28 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / OBJETIVOS: Estimar a presença de perda auditiva típica para ototoxicidade por uso disfuncional de alcoólicos — nomeadamente o uso freqüente de altas doses, por longo tempo — controladas por exposição a ruído ocupacional e idade; comparar os grupos de estudo a variáveis relativas a dados sociodemográficas; uso de alcoólicos, tabaco, outras substâncias psicoativas e saúde auditiva. MÉTODOS: Estudo de corte transversal, com homens em idade entre 30 até 50 anos, com histórico negativo de exposição a ruído ocupacional; exame otorrinolaringológico normal, incluídos em dois grupos: indivíduos com uso prévio disfuncional de alcoólicos e indivíduos que nunca fizeram uso disfuncional de alcoólicos. Submetidos a questionário para coleta de dados, exame otorrinolaringológico e avaliação audiológica básica. RESULTADOS: ocorreram diferenças significativas entre os dois grupos estudados para as variáveis: nível de escolaridade (p=0,007); remuneração (p=0,039) e presença de perdas auditivas típicas para ototoxicidade (p=0,002). 87,5% das perdas auditivas no grupo de alcoolistas foram perdas típicas para ototoxicidade, enquanto esta prevalência foi de apenas 25,0% dentre os indivíduos que nunca fizeram uso disfuncional de alcoólicos. As variáveis que apresentaram diferença significativa em relação a presença de perda auditiva típica para ototoxicidade foram: uso-na-vida de drogas (p=0,017), uso-na-vida de tabaco (p=0,000), relato de dificuldade para ouvir (p=0,00), presença de zumbido (p=0,004) e freqüência a cultos religiosos (p=0,034). No processo de regressão logística, o modelo final de regressão indicou que o uso prévio disfuncional de alcoólicos aumentou o risco em 990% e o uso-de-tabaco na vida aumentou o risco em 702%. CONCLUSÕES: os resultados reforçam a evidência de que o uso disfuncional de alcoólicos seja capaz de desencadear quadros de perda auditiva típica para Ototoxicidade. / OBJECTIVES: To estimate the presence of hearing loss for ototoxicity by typical dysfunctional use of alcohol - including the frequent use of high doses for a long time - controlled by occupational noise exposure and age, to compare the study groups with variables related to sociodemographic data, use of alcohol, tobacco and other psychoactive substances and hearing health. METHODS: Cross-sectional study, men aged between 30 to 50 years, with a negative history of exposure to occupational noise; normal ENT examination, included in two groups: patients with previous use of alcoholics and dysfunctional individuals who had never used dysfunctional alcoholics. Submitted the questionnaire for data collection, otolaryngologic and audiometric. RESULTS: significant differences between the two groups for the variables: education level (p=0,007), pay (p=0,039) and presence of hearing loss typical for ototoxicity (p=0,002). 87,5% of hearing losses in the group of alcoholics were typical loss for ototoxicity, while this rate was only 25,0% among individuals who had never used dysfunctional alcoholics. The variables that showed significant difference in the presence of typical hearing loss for ototoxicity were use-in-life drugs (p=0,017), use-on-life tobacco (p=0,000), reported hearing difficulty (p=0,00), tinnitus (p=0,004) and attendance at religious services (p=0,034). In the process of logistic regression, the final regression model indicated that prior use of dysfunctional alcohol increased the risk by 990% and use-of-life in tobacco increased the risk by 702%. CONCLUSIONS: The results support the evidence that the use of dysfunctional alcoholics are able to unleash the typical hearing loss ototoxicity.

A perceptual sound field synthesis approach for music is presented. Its signal processing implements critical bands, the precedence effect and integration times of the auditory system by technical means, as well as the radiation characteristics of musical instruments. Furthermore, interaural coherence, masking and auditory scene analysis principles are considered. As a result, the conceptualized sound field synthesis system creates a natural, spatial sound impression for listeners in extended listening area, even with a low number of loudspeakers. A novel technique, the “precedence fade”, as well as the interaural cues provided by the sound field synthesis approach, allow for a precise and robust localization.Simulations and a listening test provide a proof of concept. The method is particularly robust for signals with impulsive attacks and long quasi-stationary phases, as in the case of many instrumental sounds. It is compatible with many loudspeaker setups, such as 5.1 to 22.2, ambisonics systems and loudspeaker arrays for wave front synthesis. The perceptual sound field synthesis approach is an alternative to physically centered wave field synthesis concepts and conventional, perceptually motivated stereophonic sound and benefits from both paradigms.

No description available.

Background: Disabling hearing loss is a global burden. This burden is worsened by the emergence of multi-drug resistant tuberculosis (MDR-TB). Some of the medications used to treat MDR-TB are damaging to the cochlea and auditory nerve (ototoxic) and can lead to permanent hearing loss and/or balance disorders. Ototoxicity monitoring aims to reduce this burden by preventing or minimising the damage caused by ototoxic treatment as it can progress and worsen speech perception difficulties. However, the proposed test battery for ototoxicity monitoring is lengthy and demands active participation which is not ideal for ill patients (such as those on MDR-TB treatment). The Sensitive Range of Ototoxicity (SRO) technique is recommended to shorten the test time. The SRO consists of seven consecutive relatively high frequencies determined from the highest frequency the participant responded to. The SRO technique is time efficient. Although the SRO technique provides the prospect of a shortened test battery, there is still a global lack of audiologists. Automated audiometry is a vital application for testing especially when audiologists are not available to physically do the test. Automated audiometry has been previously validated. Clinically, automated audiometry is objective and allows for standardisation. Even though automated audiometry helps improve access to monitoring more patients, patient preference is an important factor when using automated audiometry to ensure patient-centred care is not compromised. Aims and Objectives: This study aimed to investigate the specificity and sensitivity of the SRO technique with automated audiometry compared to the gold standard (manual audiometry). This comparison was made by firstly, determining the testing time efficiency and the correlation of thresholds obtained with the different test methods and, secondly, testing the diagnostic value of automated audiometry using the SRO technique. The incidence of an ototoxicity-induced hearing loss was described by determining the time interval between starting ototoxic MDR-TB treatment and the onset of a significant threshold shift (STS) according to ASHA's criteria. Lastly, the test method preference of the participants with MDR-TB was described and compared using a short exit survey. Study Design: A prospective repeated-measures study design was used. Participants were chosen based on a risk factor (i.e. exposure to ototoxic medication) for an outcome of interest (i.e. the presence or absence of an STS). With a repeated measures study, multiple tests using different test methods can be compared with the same sample. Participants: Twenty-seven in-patients at Brooklyn Chest Hospital and DP Marais TB Hospital with normal hearing and on MDR-TB medication were included in the study. Their age range was from 19 to 51 years old with an average age of 33 years old. Non-probability convenience sampling was used as it was cost-effective, reduced data collection time and was relatively easy to execute. Data collection materials and procedures: The procedure for data collection included weekly follow-up testing for a maximum of four weeks. The test battery was as follows: an auditory symptom questionnaire, otoscopy examination, and manual and automated audiometry using the SRO technique with a fifteen-minute break in between. Participants were tested with the KUDUwave ™ in a non-sound treated room. The frequency range was determined with the SRO technique. If an STS was obtained, the patient was discharged from the study after completing an exit survey. Statistics: Analysis included descriptive statistics and inferential statistics. A Bonferroni corrected p-value (initially p ≤ 0.05) was used. Manual and automated audiometry thresholds were compared using the Pearson's Correlation Coefficient test. Manual and automated audiometry testing time and threshold means were compared using paired sample's t-tests. The diagnostic value of automated audiometry with the SRO technique was assessed with Receiver Operating Characteristics (ROC) Curves. Results: Manual audiometry was statistically more time-efficient compared to automated audiometry by an average of one minute and ten seconds (t (94) = -5.44; p< 0.003). There was a strong positive correlation for both left and right ears between the thresholds' obtained from manual and automated audiometry at 8kHz to 16 kHz (df> 28 = r > 0.70, p< 0.003). Automated audiometry was found to be a fair diagnostic test (area under the curve was 0.75; p= 0.002). Also, the ROC curve revealed that automated audiometry had a sensitivity of 61% and specificity of 90% when compared to manual audiometry (gold standard). Only participants that started data collection within 31 days after starting their MDR-TB treatment were included in the analysis of determining the incidence of an ototoxicity-induced hearing loss (n= 24 ears). This study found that 41.67% of ears (n= 10) had an ototoxicity-induced hearing loss. A box and whisker plot revealed that data was skewed to the right (i.e. more variation in data between the median and the maximum values) and that the median number of days for an ototoxicity-induced hearing loss to appear was 33 days. Secondly, 55.55% of participants (n=15 out of 27) reported auditory symptoms before data collection commencement. Aural fullness was the most reported symptom (n= eight out of 15). Ten out of 15 (66.66%) participants that reported auditory symptoms obtained an ototoxicity-induced hearing loss. Lastly, most participants (i.e. 13 out of 19; 68.42%) that completed the exit survey had no preference between manual or automated audiometry. The common rationale among these participants was “No difference noted.” Conclusion: This research study has revealed that manual audiometry was more time-efficient compared to automated audiometry in patients with MDR-TB. Also, automated audiometry was a fair diagnostic test. It may aid in reducing the disproportionate audiologist to patient ratio, especially in a developing country. However, manual audiometry (with the SRO technique) is more clinically appropriate in patients that are difficult-to-test. Secondly, audiometric settings can be changed to accommodate testing frequencies in 1/6 octaves so that the SRO technique can be clinically adopted. An ototoxicity-induced hearing loss seems to appear 33 days after ototoxic MDR-TB treatment commencement. Aural fullness was a commonly reported symptom among participants with MDRTB. Aural fullness is omnipresent in peripheral auditory pathologies. Therefore, auditory symptoms reported by patients' needs a comprehensive audiological investigation. Lastly, more research is needed on how patients (and clinicians) experience the advances in technology innovation especially in audiology where technology innovation is continuously evolving.

BACKGROUND: The aim of this study was to evaluate distortion product otoacoustic emissions (DPOAEs) and extended high-frequency (EHF) thresholds in a control group and in patients with normal hearing sensitivity in the conventional frequency range and reporting unilateral tinnitus. MATERIAL/METHODS: Seventy patients were enrolled in the study: 47 patients with tinnitus in the left ear (Group 1) and 23 patients with tinnitus in the right ear (Group 2). The control group included 60 otologically normal subjects with no history of pathological tinnitus. Pure-tone thresholds were measured at all standard frequencies from 0.25 to 8 kHz, and at 10, 12.5, 14, and 16 kHz. The DPOAEs were measured in the frequency range from approximately 0.5 to 9 kHz using the primary tones presented at 65/55 dB SPL. RESULTS: The left ears of patients in Group 1 had higher median hearing thresholds than those in the control subjects at all 4 EHFs, and lower mean DPOAE levels than those in the controls for almost all primary frequencies, but significantly lower only in the 2-kHz region. Median hearing thresholds in the right ears of patients in Group 2 were higher than those in the right ears of the control subjects in the EHF range at 12.5, 14, and 16 kHz. The mean DPOAE levels in the right ears were lower in patients from Group 2 than those in the controls for the majority of primary frequencies, but only reached statistical significance in the 8-kHz region. CONCLUSIONS: Hearing thresholds in tinnitus ears with normal hearing sensitivity in the conventional range were higher in the EHF region than those in non-tinnitus control subjects, implying that cochlear damage in the basal region may result in the perception of tinnitus. In general, DPOAE levels in tinnitus ears were lower than those in ears of non-tinnitus subjects, suggesting that subclinical cochlear impairment in limited areas, which can be revealed by DPOAEs but not by conventional audiometry, may exist in tinnitus ears. For patients with tinnitus, DPOAE measures combined with behavioral EHF hearing thresholds may provide additional clinical information about the status of the peripheral hearing.