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Background: Several health institutions developed strategies to improve health content on Wikimedia platforms given their unparalleled reach. The objective of this study was to compare an online volunteer-based Wikimedia outreach campaign with university course Wikipedia assignments (both focused on improving hearing health content in Wikimedia's public digital knowledge archives), in terms of the reach of the contributions and the extent of the participants' input. A secondary objective was to examine the feasibility and the implementation of the different strategies., Methods: The research team partnered for the (1) coordination of improvements in hearing and healthcare content through educational programs using Wikimedia platforms, (2) participation in the global campaign Wiki4WorldHearingDay2023 and (3) evaluation of the proposed strategies. Metrics used in the comparison of the two strategies included the number of articles edited, number of views of the edited articles (as reach) and the extent of edits, captured as the number of words. The feasibility evaluation included assessing recruitment success and the implementation of the proposed plan among faculty, students from various university programs, and volunteers representing different constituencies., Results: The effort increased the availability of quality plain language information on hearing conditions and hearing care. Both strategies demonstrated to be feasible by their success in recruiting participants who contributed to the effort and by measurable outputs as edits. The contribution of content to Wikimedia platforms as part of education activities provided a more robust result. Wiki4WorldHearingDay2023 145 participants (78 from educational programs) contributed 167,000 words, 258 + references and 140 images to 322 Wikipedia articles (283 existing and 39 new ones), which were viewed 16.5 million times. Contributions occurred in six languages. Edits in Portuguese, mainly by those involved in educational programs, led the number of articles (226 or 70.2%) that were expanded or created during the 5-month tracking period., Conclusions: The elements that contributed to the success of the studied strategies include an impact topic, coordination with educational programs, international multidisciplinary collaborations, the dissemination of the initiative in several platforms, connection with a robust local Wikimedia affiliate, and the use of a technical infrastructure that provides metrics and coordination mechanisms., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Purpose: To analyze the performance of auditory speech perception (PF) after cochlear implant (CI) replacement surgery and associations with age, times of use of the first CI, deprivation, recovery and use of the second device., Methods: The retrospective study analyzed the medical records of 68 participants reimplanted from 1990 to 2016, and evaluated with PF performance tests, considering as a reference, the greater auditory capacity identified during the use of the first CI. Also analyzed were: Etiology of hearing loss; the reasons for the reimplantation; device brands; age range; sex; affected ear; age at first implant; time of use of the first CI, deprivation, recovery and use of the second device. The analyzes followed with the Chi-Square and Spearman, Mann-Whitney and Kruskal-Wallis tests (CI=95%; p≤0.05; Software SPSS®.v22)., Results: Most were children with hearing loss due to idiopathic causes and meningitis. Abrupt stoppage of operation was the most common cause for device replacement. Most cases recovered and maintained or continued to progress in PF after reimplantation. Adults have the worst recovery capacity when compared to children and adolescents. The PF capacity showed a significant association (p≤0.05) with: age at first implant; time of use of the first and second CI., Conclusion: Periodic programming and replacement of the device when indicated are fundamental for the maintenance of auditory functions. Being young and having longer use of implants represent advantages for the development of speech perception skills.

Purpose: To verify the influence of verbal intellectual-cognitive skills on speech perception in noise, in elderly with sensorineural hearing loss, considering education, age, and degree of hearing loss., Methods: 36 elderly between 60 and 89 years old with bilateral sensorineural hearing loss participated in the study. After psychological assessment using the Wechsler Intelligence Scale for Adults (WAIS-III), they were grouped into (GI) 24 elderly without cognitive alteration and (GII) 12 elderly with risk of cognitive alteration. They underwent otorhinolaryngological assessment, audiological interview, pure tone audiometry, and assessment of speech perception in noise using the Hearing in Noise Test (HINT-Brazil). The Mann-Whitney U statistical test compared the results between the groups, and the Spearman correlation verified the variable's age, degree of hearing loss, and level of education., Results: There was no difference between the groups in the ability to perceive speech in noise, except in the noise on the left condition, in which GII showed better performance in HINT-Brazil. The degree of hearing loss and level of education influenced the perception of speech in noise. The level of education was correlated with the WAIS-III results., Conclusion: The decline in verbal intellectual-cognitive skills did not affect speech perception of noise in the elderly with hearing loss. The degree of hearing loss and level of education influenced the performance of the elderly in the speech perception test in noise. Performance in verbal cognitive skills varied according to the level of education.

Objectives: (1) To calculate the sensitivity and specificity of tympanometry with a 226 Hz probe to identify middle ear condition in children; (2) To propose the intersection range of static compliance and tympanometric peak pressure values obtained in ears with and without middle ear effusion., Methods: 224 children's ears without middle ear alteration, with a mean age of 1 year and 4 months (GI), and 56 children's ears with middle ear effusion (GII), with a mean age of two years, were analyzed. For analysis, the static compliance and tympanometric peak pressure values obtained in the tympanometry with a 226 Hz probe were considered., Results: In the group with no alteration, the Mann Whitney Test showed no significant difference between the sexes for the static compliance (p = 0.085) and tympanometric peak pressure (p = 0.782). No difference was seen, either, for compliance (p = 0.079) and pressure (p = 0.678) values, according to age. When applying the optimal criterion of the ROC curve, the cutoff value obtained was ≤0.26 ml for static compliance (sensitivity= 83.9 %; specificity= 86.6 %) and ≤-56 daPa for peak pressure (sensitivity= 82.1 %; specificity= 84.8 %). When comparing the values obtained for the two groups, it is noted that the data overlap, that is, they create an inconclusive intersection range between the normal middle ear and the altered one., Conclusion: The tympanometry cut-off with greater sensitivity and specificity was, respectively, 83.9 and 86.6 % for static compliance and 82.1 and 84.8 % for tympanometric peak pressure. The ranges from 0.16 to 0.43 ml for static compliance and from -109 to 25 daPa for tympanometric peak pressure do not allow defining the presence or absence of alteration in the middle ear, in children aged 6 to 36 months., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Purpose: To analyze the effects of auditory stimulation on heart rate variability (HRV) indices in healthy individuals with normal hearing and with hearing loss, regardless of type and/or grade, by means of a systematic review., Research Strategies: This is a systematic review with a meta-analysis that addresses the following question: in healthy individuals with normal hearing and/or with hearing loss, what are the effects of auditory stimulation on HRV indices in comparison to silence? We consulted the Cochrane Library, Embase, LILACS, PubMed, Web of Science, and Scopus databases and the gray literature (Google Scholar, OpenGrey, and ProQuest)., Selection Criteria: There were no restrictions as to period or language of publication., Data Analysis: We identified 451 records, an additional 261 in the gray literature, and five studies in a search through the references, resulting in a total of 717 records, with 171 duplicate records. After screening the titles and abstracts of 546 studies, we excluded 490 and considered 56 studies in full to assess their eligibility., Results: Nine of these studies were included in the systematic review, eight of which were suitable for the meta-analysis., Conclusion: It is suggested that auditory stimulation may influence the RMSSD, pNN50, SDNN, RRTri and SD2 indices of HRV in healthy adults with normal hearing.

Purpose: To analyze hyperbilirubinemia as an indicator for the definition of risk protocol in newborn hearing screening (NHS) and in auditory monitoring in full-term and preterm neonates., Methods: This is an observational, cross-sectional and retrospective study. A total of 554 children born in a public maternity hospital were included and divided into two groups: (G1) with 373 full-terms neonates; (G2) with 181 preterm neonates. Data were collected from the participant's medical records to obtain information regarding the result of the NHS, performed by recording the automated auditory brainstem response (AABR), birth conditions, clinical characteristics, interventions performed, and results of the first test of total bilirubin (TB) and indirect bilirubin (IB) as well as the peak of TB and IB. A descriptive statistical analysis of the results was performed, and the level of significance adopted was 5%., Results: On the NHS test, quotes of retest referral rates were smaller in G1 when compared to G2. There was no significant difference between the groups regarding type of delivery, gender, presence of Rh and ABO incompatibility, G6PD enzyme deficiency, and performance of phototherapy. TB and IB levels at the first exam and at peak time did not differ between neonates with "pass" and "fail" results on the NHS test in both groups., Conclusion: Bilirubin levels in the neonatal period below the recommended values for indication of exchange transfusion are not directly related to the "fail" result on the NHS tests in term and preterm neonates.

Purpose: To characterize hearing thresholds at frequencies of 500, 1000, 2000 and 4000 Hz in children undergoing reimplantation with a follow-up of at least 10 years., Methods: Retrospective review of medical records of children who underwent reimplantation surgery for at least 10 years. The auditory thresholds obtained in free-field pure tone audiometry with the cochlear implant were evaluated at frequencies of 500, 1000, 2000 and 4000 Hz at four different times: 1 (before failure), 2 (activation), 3 (five years after reimplantation) and 4 (ten years after reimplantation, regardless of the time of use of the 2nd CI) in patients with a follow-up of at least 10 years., Results: Evaluating patients who underwent reimplantation, it was observed that the thresholds of 500, 1000, 2000, 4000 Hz were similar in the long term to those obtained in patients who were implanted only once, thus not presenting damage in the detection of sounds., Conclusion: Reimplantation had no long-term effect on the hearing thresholds obtained in children who underwent this surgery due to internal component failure.

Purpose: Longitudinally verify the influence of auditory tonal thresholds obtained with transcutaneous and percutaneous bone-anchored hearing aids on speech perception in individuals with external and/or middle ear malformation and chronic otitis media., Methods: Observational, retrospective, longitudinal follow-up study of 30 unilateral users of the transcutaneous and percutaneous Baha® system for the collection of secondary data on pure tone thresholds obtained through free field audiometry and sentence recognition threshold in silence and noise in conditions: without the prosthesis; at the time of activation; in the first month of use (post 1); and in the third month (post 2)., Results: There was a significant difference between pure tone thresholds obtained at frequencies of 3 and 4kHz with better results for the percutaneous technique at all evaluation moments. For both systems, better performance was observed in sentence recognition in silence and in noise, with a significant difference in activation (p<0.001), but it remained stable during the other evaluation moments. The percutaneous system showed better benefit in recognizing sentences in noise only on activation (p=0.036), when compared to the transcutaneous system., Conclusion: The percutaneous system provided better audibility for high frequencies; however, such audibility did not influence sentence recognition in the silent situation for both systems. For the noise situation, better responses were observed in the percutaneous system, however, the difference was not maintained over time.

Purpose: To evaluate the usability and satisfaction of users with the interface of the 'Agente Escuta' application, in addition to identifying problems and possibilities for improvement., Methods: Descriptive exploratory translational study, characterized by a usability test with a quantitative and qualitative approach, subdivided into three stages: (I) prior evaluation of usability by 10 judges, including students, primary care professionals, professors and researchers in Information Technology and Speech Therapy; (II) evaluation of the application by the target audience, that is, community health agents from six municipalities in Rio Grande do Norte; (III) evaluation of the satisfaction of the agents who used the application in their work routine. The System Usability Scale and the Net Promoter Score were used, in addition to a qualitative evaluation of the opinions., Results: Usability was rated as excellent by judges, regardless of category. In the evaluation by community health agents, usability was considered good and there was no effect of the city of origin. It was found that the perception of the judges and the target audience were different, with a lower score for the participants in the second stage. However, most would give positive publicity to the product. The heuristic with the highest score was ease of memorization and participants in the third stage were interested in continuing to use the tool in practice, even after the end of the study., Conclusion: The Agente Escuta prototype showed good usability and satisfaction and aspects that could be improved in future solutions were identified.

Objective: To evaluate the effectiveness of an online continuing education course on infant hearing health for primary care professionals., Design: A prospective longitudinal study with interrupted time series pre-test/post-test design. The effectiveness of the online course was assessed by comparing pre- vs. post-training performance and analysing responses to evaluations of the quality of the course., Study Sample: The sample comprised individuals enrolled between September 2018 and August 2019 in a Ministry of Health course, "Actions in primary care for the early identification of hearing impairment" offered on the AVASUS platform., Results: Of the 2908 individuals registered, 1842 (63.3%) completed the course. Their ages ranged from 18 to 77 years, and 67.4% of them were females. Students and doctors were overrepresented among the enrollees. All Brazilian states were included in the sample. Comparisons of pre- and post-training performances showed a significant improvement in knowledge, and 99.3% of the participants provided positive comments regarding the quality of the course., Conclusions: The course is an effective distance learning tool on infant hearing health for primary care professionals. The online course circumvents the limitations posed by geographical barriers and also facilitates decentralisation.

Objectives: To analyze the feasibility of using wideband absorbance to verify the patency of pressure equalizing tubes (PETs) in clinical practice and to present the response pattern of this measure for ears with patent PET., Methods: This observational case-control type study evaluated 48 ears of 30 children with severe or profound hearing loss, aged 10-44 months, of both sexes. The subjects were subdivided into two groups: 24 ears with Sheppard type PET (experimental group - EG) and 24 ears with normal middle ear (control group - CG), paired with the EG, according to age, sex, and ear evaluated. To obtain the wideband absorbance, a Middle-Ear Power Analyzer, version 5.0 (Mimosa Acoustics), was used, and absorbance values for pure tone and chirp stimuli were analyzed., Results: There was no influence of ear (right or left) on the measurements obtained. The EG showed higher absorbance values at low frequencies. Although the two stimuli made it possible to identify the difference in acoustic transfer function between the groups studied, compared to pure tone, the chirp stimulus allowed identification of differences in a higher number of frequencies., Conclusions: Ears with a patent PET present an acoustic transfer pattern that differs from that obtained for normal middle ears, with a higher absorbance at low frequencies. Both pure tone and chirp stimuli can be used to identify such differences, nevertheless, the use of chirp stimulus is recommended, since it allows differentiation over a wider frequency range., Competing Interests: Conflicts of interest There are no conflicts of interest, financial, or otherwise., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Introduction: Benefits of bilateral cochlear implants (CI) may be compromised by delays to implantation of either ear. This study aimed to evaluate the effects of sequential bilateral CI use in children who received their first CI at young ages, using a clinical set-up., Methods: One-channel cortical auditory evoked potentials and speech perception in quiet and noise were evoked at repeated times (0, 3, 6, 12 months of bilateral CI use) by unilateral and bilateral stimulation in 28 children with early-onset deafness. These children were unilaterally implanted before 3.69 years of age (mean ± SD of 1.98 ± 0.73 years) and received a second CI after 5.13 ± 2.37 years of unilateral CI use. Comparisons between unilaterally evoked responses were used to measure asymmetric function between the ears and comparisons between bilateral responses and each unilateral response were used to measure the bilateral benefit., Results: Chronic bilateral CI promoted changes in cortical auditory responses and speech perception performance; however, large asymmetries were present between the two unilateral responses despite ongoing bilateral CI use. Persistent cortical differences between the two sides at 1 year of bilateral stimulation were predicted by increasing age at the first surgery and inter-implant delay. Larger asymmetries in speech perception occurred with longer inter-implant delays. Bilateral responses were more similar to the unilateral responses from the first rather than the second CI., Conclusion: These findings are consistent with the development of the aural preference syndrome and reinforce the importance of providing bilateral CIs simultaneously or sequentially with very short delays., (© 2022 S. Karger AG, Basel.)

Background: Contralateral noise masking is an important aspect of auditory brainstem response (ABR) measurements., Purpose: The primary aim of this study is to determine how contralateral white noise (WN) masking influences the amplitude and the latency of V wave generated during ABR measurements, using tone burst (TB), in adult ears with normal hearing (NH). The secondary aim of this study is to ascertain the need of contralateral masking in ABR measurements with the TB stimuli using a 3A insertion earphone, and to propose the applicability of WN masking in unilateral sensorineural hearing loss (USNHL)., Research Design: It is a cross-sectional observational and descriptive study., Study Sample: Experiment 1: Thirty individuals, without any otologic, psychological, or neurological dysfunction, were selected. Experiment 2: Fifteen individuals with previous audiological diagnoses of severe and profound USNHL were considered., Intervention: The study involves ABR TB at specific frequencies of 0.5, 1, 2, and 4 kHz., Data Collection and Analysis: Experiment 1: The evaluation was performed at the fixed intensity of 80 dB nHL (decibel normalized hearing level) on the tested ear, followed by the application of simultaneous masking to the nontested ear, intensity ranged from 0 to 80 dB. Experiment 2: ABR threshold measurements were first performed on the ear with hearing loss (HL) at the frequencies of 1, 2, and 4 kHz. The results were subsequently confirmed using contralateral masking., Results: Experiment 1: At any given frequency, there were no statistically significant differences in the amplitude and latency of V wave with increase in the intensities of WN masking. Experiment 2: Cross-hearing was observed at least once in all frequencies analyzed through the occurrence of V wave., Conclusion: In conclusion, the contralateral WN masking at the maximum intensity of 80 dB does not affect the amplitude and latency of V wave of the ABR TB at 1, 2, and 4 kHz. Contralateral masking for the ABR TB presented using 3A insertion earphones is necessary at 1, 2, and 4 kHz in individuals with severe or profound degrees of USNHL and at intensities of 15, 20, and 10 dB above the ABR threshold of the nontested ear., Competing Interests: None declared., (American Academy of Audiology. This article is published by Thieme.)

Objective: To verify the effectiveness of a nursing training program in the area of children's hearing health using interactive tele-education., Methods: Interrupted time series with non-random control group pre-test/ post-test. A cohort of 41 nurses, with no previous formal training in hearing health. A "Children's Hearing Health" Cybertutor was employed. The effectiveness of the nursing training was verified by comparing pre- versus post-training performance and by analyzing responses to an evaluation questionnaire., Results: Following training, the performance was significantly better in all domains assessed and in the total score. The evaluation questionnaire demonstrated that the Cybertutor was well accepted and the performance revealed in the pre-training phase demonstrated the need for children´s hearing health training., Conclusion: The effectiveness of the nursing training program in the area of Children's Hearing Health using interactive tele-education could be proven, since there was an improvement in performance in all domains evaluated.

Purpose: To describe unilateral and bilateral asymmetric sensorineural hearing loss in children and its etiological, audiological and demographic characteristics., Methods: Retrospective cross-sectional study developed in the Seção de Implante Coclear of Hospital de Reabilitação de Anomalias Craniofaciais, through the analysis of medical records., Results: Data from 1152 patients were analyzed: 424 (37%) adolescents, adults or elderly, and 728 (63%) children, of whom 691 (95%) had bilateral symmetrical hearing loss, and 37 (5%) had unilateral hearing loss (n=10) or bilateral asymmetric (n=27) sensorineural hearing loss. The mean age at diagnosis of unilateral sensorineural hearing loss was 33.58±21.69 months, and for asymmetric bilateral it was 33.12±21.69 months, with a prevalence of 1.4% and 3.7%, respectively. The highest risk indicator for hearing loss for both groups was the family history of permanent deafness, which began in childhood. The majority of the relatives of children with unilateral sensorineural hearing loss presented the highest low socioeconomic classification (50%), while children with bilateral asymmetric sensorineural hearing loss were also be subdivided into upper (37%) and lower (37%)., Conclusion: We observed a greater occurrence of asymmetric bilateral sensorineural hearing loss compared to unilateral hearing loss, as well as the hereditary risk indicator, with a predominance of the deep ear and female preponderance in both groups. Although neonatal hearing screening provides early identification of unilateral sensorineural hearing loss, the age at the audiological diagnosis is still above the recommended level. In addition, the majority of the children's family members presented a low level of income.

Introduction: The cochlear implant is an effective device for children with severe and/or profound prelingual hearing loss, since it provides considerable improvement in oral language acquisition through the auditory pathway. The use of a cochlear implant contributes to the development of auditory perception, favoring the acquisition of the linguistic processes related to communication skills, which might have a positive effect on other areas of development., Objective: The aim of this study was to verify the performance of children using cochlear implants for expressive and receptive oral language., Methods: This was a prospective cross-sectional study that used the following tests: Child language test in the phonology, vocabulary, fluency and pragmatics areas, and the Peabody picture vocabulary test. Thirty children participated in this study, of both genders, aged between 36 and 72 months, with severe and/or profound bilateral sensorineural hearing loss, without other impairments and users of unilateral cochlear implant with full electrode insertion for a minimum of 12 months., Results: The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language. Even though when compared to the normative language acquisition process, the results showed that these children had patterns of linguistic skills that are below their chronological age; the results indicate that these children are developing expressive and receptive oral language skills, and this is the outcome that should be taken into account in this study., Conclusion: The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories., (Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

Purpose: To verify the influence of the age of implantation in the development of closed-set auditory recognition and auditory comprehension abilities in children using unilateral cochlear implants (CI), comparing distinct groups and determining clinical markers., Methods: Participants were 180 children operated and activated until 36 months of age and who used a CI for at least 60 months. Abilities of auditory recognition in closed-set and auditory comprehension were analyzed through the GASP Tests 5 and 6. The influence of age of implantation was investigated with three groups of children: implanted before 18 months (G1), between 19 and 24 months (G2) and between 25 and 36 months of age (G3)., Results: There was no statistically significant difference when comparing the three groups. Children progressively developed auditory abilities, presenting auditory recognition ability together at approximately 41±4 months of CI use and auditory comprehension at 53±4 months., Conclusion: There was no correlation between hearing performance and age of implantation for children implanted before 36 months of age. For the abilities of auditory recognition and comprehension, the clinical marker was 41±4 and 53±4 months of auditory age, respectively. Therefore, it is expected that, around 60 months of CI use, children implanted during the sensitive period can understand speech without the aid of orofacial reading, reaching the most complex hearing abilities.

Purpose: The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR)., Method: We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator., Results: In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz., Conclusions: Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

Introduction: The literature has reported the association between lead and auditory effects, based on clinical and experimental studies. However, there is no consensus regarding the effects of lead in the auditory system, or its correlation with the concentration of the metal in the blood., Objective: To investigate the maturation state of the auditory system, specifically the auditory nerve and brainstem, in rats exposed to lead acetate and supplemented with ferrous sulfate., Methods: 30 weanling male rats (Rattus norvegicus, Wistar) were distributed into six groups of five animals each and exposed to one of two concentrations of lead acetate (100 or 400mg/L) and supplemented with ferrous sulfate (20mg/kg). The maturation state of the auditory nerve and brainstem was analyzed using Brainstem Auditory Evoked Potential before and after lead exposure. The concentration of lead in blood and brainstem was analyzed using Inductively Coupled Plasma-Mass Spectrometry., Results: We verified that the concentration of Pb in blood and in brainstem presented a high correlation (r=0.951; p<0.0001). Both concentrations of lead acetate affected the maturation state of the auditory system, being the maturation slower in the regions corresponding to portion of the auditory nerve (wave I) and cochlear nuclei (wave II). The ferrous sulfate supplementation reduced significantly the concentration of lead in blood and brainstem for the group exposed to the lowest concentration of lead (100mg/L), but not for the group exposed to the higher concentration (400mg/L)., Conclusion: This study indicate that the lead acetate can have deleterious effects on the maturation of the auditory nerve and brainstem (cochlear nucleus region), as detected by the Brainstem Auditory Evoked Potentials, and the ferrous sulphate can partially amend this effect., (Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. All rights reserved.)

Objective: To characterize the P(1) component of long latency auditory evoked potentials (LLAEPs) in cochlear implant users with auditory neuropathy spectrum disorder (ANSD) and determine firstly whether they correlate with speech perception performance and secondly whether they correlate with other variables related to cochlear implant use., Methods: This study was conducted at the Center for Audiological Research at the University of São Paulo. The sample included 14 pediatric (4-11 years of age) cochlear implant users with ANSD, of both sexes, with profound prelingual hearing loss. Patients with hypoplasia or agenesis of the auditory nerve were excluded from the study. LLAEPs produced in response to speech stimuli were recorded using a Smart EP USB Jr. system. The subjects' speech perception was evaluated using tests 5 and 6 of the Glendonald Auditory Screening Procedure (GASP)., Results: The P(1) component was detected in 12/14 (85.7%) children with ANSD. Latency of the P(1) component correlated with duration of sensorial hearing deprivation (*p=0.007, r=0.7278), but not with duration of cochlear implant use. An analysis of groups assigned according to GASP performance (k-means clustering) revealed that aspects of prior central auditory system development reflected in the P(1) component are related to behavioral auditory skills., Conclusions: In children with ANSD using cochlear implants, the P(1) component can serve as a marker of central auditory cortical development and a predictor of the implanted child's speech perception performance., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Unlabelled: Processing acoustic clues from the sounds of speech depends on the proper perception of the frequency and duration of stimuli as a sequence of events., Aim: To assess the capacity for temporal organization in users of multichannel CI., Method: 14 normal hearing individuals formed the control group, matching in age and gender other 14 users of multichannel CI, who made up the study group, and they were assessed and compared as to the Frequency Patterns Test (FPT) and Duration Patterns Test (DPT)., Results: CI users had good performance in temporal organization tasks, with mean results of 48.7% in the FPT and 59.6% in the DPT. For the control group, mean performance at the FPT was of 63.4% and in the DPT of 64.6%. We did not see statistically significant difference between the results from the control and study groups., Conclusion: The CI provided favorable performance in the tasks that required temporal organization skill for individuals evaluated in this study.

Background: training of community health agents in hearing health., Aim: to verify the effectiveness of a training program regarding the hearing health of children for Community Health Agents of a Family Health Program., Method: research sample consisted of two groups: Group A, constituted by 31 community health agents, from Bauru, SP, and Group B, constituted by 75 community health agents, from Sorocaba, SP. Training was provided through classes for both groups. For Group A, a text adapted from the material organized by the World Health Organization (2006) was used so that the community health agents could follow the activities in an interactive way. Training focused on the following topics: normal and impaired hearing; types, prevention and causes of hearing loss; procedures to identify and diagnose the hearing impairment and rehabilitation. Pre and post training questionnaires were used to assess the assimilation of the presented content., Results: training demonstrated to be effective, since there was an increase in the overall score when comparing the scores obtained in the pre and post training questionnaires., Conclusion: the results indicate the effectiveness of the training program for community health agents of a Family Health Program with the use of texts and with an interactive approach.

Background: bone conduction auditory brainstem responses (ABR) in normal hearing individuals., Aim: to evaluate the clinical applicability of bone conduction ABR, characterizing normality and determining an assessment protocol., Method: participants of this study were 22 individuals with normal hearing (20dB NA), with ages between 20 and 30 years, 14 female and 8 male. All individuals were assessed using air and bone (vibrator positioned on the forehead and mastoid) conduction ABR. EP25 equipment, Interacoustic; 3A insertion phone; B-71 bone vibrator; click stimulus., Results: it was possible to evaluate the bone conduction ABR in all individuals. The results demonstrate that the electrophysiological threshold obtained when the vibrator was positioned on the forehead (32.69+/-5.63 and 32.5+/-7.07dB nHL) was higher than that obtained when the vibrator was positioned on the mastoid (25.00+/-7.33 and 30.00+/-5.34dB nHL) for both genders respectively. For this reason the vibrator was positioned on the mastoid. The electrophysiological threshold obtained by bone conduction was higher than that obtained by air conduction for both genders and also when all individuals were grouped together. Thus it is necessary to use a correction factor, according to the results, of 10dB nHL. The latency-intensity values of the V wave in the ipsilateral and contralateral recordings differed statistically according to gender, and should be considered separately. The value of 26.81+/-6.99dB nHL was adopted as being the normal threshold for bone conduction ABR., Conclusion: it is possible to evaluate bone conduction ABR in the clinical environment. These results, when considered along with the air conduction ABR, increase the chances of a more precise diagnosis regarding the type of hearing loss.