Transient Otoacoustic Emissions Research Articles

Effect of Bioabsorbable Poly (dl-Lactide ε-Caprolactone) on Healing of Experimentally Injured Acute Traumatic Middle Ear Mucosa Damage.

Postoperative adhesion is an important complication after middle-ear surgeries. Although many materials have been tried to prevent this complication, the use of Poly (dl-lactide ε-caprolactone) as an anti-adhesive material after middle-ear surgery has not yet been reported. The aim of this study was to evaluate the anti-adhesive effect of poly (dl-lactide ε-caprolactone) on the ears of rats with middle-ear mucosa damage. In our study, 14 Wistar albino rats and 28 ears in total were used. The rats were randomly divided into 4 groups. Middle ear mucosa damage was performed in all groups with a transcanal approach under otomicroscopy in sterile conditions. The effects of poly (dl-lactide ε-caprolactone), silicone sheet, and absorbable gelatin sponge were compared histologically with the secondary healing group. In addition, hearing evaluation was performed before the procedure and on the 28th postoperative day. No significant difference was observed in transient otoacoustic emission and distortion product otoacoustic emissions tests performed before and after the surgical procedure when the groups were compared. While adhesion was observed in the tympanic membrane in the absorbable gelatin sponge group, no adhesion was observed in the other groups. In the absorbable gelatin sponge group, increased fibroblastic activity, inflammation, and neovascularization were observed in the middle-ear mucosa. No significant difference was observed in silicone sheet, poly (dl-lactide ε-caprolactone), and control groups in terms of fibroblastic activity, inflammation, and neovascularization. It can be concluded that absorbable poly (dl-lactide ε-caprolactone) is nonototoxic and biocompatible with the rat's middle ear cavity by short-term evaluation.

Inhibitory effect of contralateral noise on transient otoacoustic emissions in infants with congenital syphilis

ObjectivesAnalyze the inhibitory effect of contralateral noise on transient otoacoustic emissions in infants with congenital syphilis (CS). MethodsCross-sectional study, approved by the Research Ethics Committee n° 3.360.991. Infants with treated CS at birth and infants without risk indicators for hearing impairment were selected. Both groups had the waves I, III and V presence at 80 dB nHL with click BAEP and the presence of response in the nonlinear TEOAEs at 80 dB NPS bilaterally. For suppression, TEOAE were analyzed without the contralateral noise, with the linear stimulus at 60 dB SPL. The neonates who presented a response in three frequencies per ear performed the second TEOAE collection with the contralateral white noise at an intensity of 60 dB SPL. Inferential analysis were performed using the Mann-Whitney and Wilcoxon test, adopting a significance level p < 0.05. ResultsThe sample consisted of 30 subjects divided into two groups, the Study Group (SG), consisting of 16 infants, and the Control Group (CG), consisting of 14 infants with no risk indicators for hearing loss. No differences were observed between the groups and the inhibition values, in the SG 30.8% presented inhibition and 25% for the CG in the right ear, in the left ear it was 46.7% in the SG and 38.5% in the CG. The SG demonstrated greater inhibition in the RE for the frequency bands from 1.5 to 4 KHz. ConclusionsThe analyses adopted in this study point out that the inhibitory effect of contralateral noise on TEOAEs in infants with CS does not differ from infants without risk indicators for hearing loss.

Audiological findings of family farmers exposed to pesticides.

To analyze the possible differences among the hearing of farmers and their families when compared to the population not exposed to pesticides. Cross-sectional study with 70 smallholder family farmers (research group), with the mean age of 39.7 years, of both sexes and a mean of 23.7 years of exposure to pesticides. We included a control group with 71 participants of both sexes with the mean age of 39.5 years, not exposed to either noise or chemical substances, to compare the results. In stage 1, both groups were submitted to conventional and high-frequency audiometry, and acoustic immittance. In stage 2, only people with normal hearing were submitted to the evoked otoacoustic emissions and suppression effect on transient otoacoustic emissions. Significant differences were observed between the groups in the conventional pure-tone and in the high-frequency audiometry, as well as in the acoustic reflex. The most affected frequencies in the conventional pure-tone audiometry ranged from 3 to 6 kHz and, in the high-frequency audiometry, from 9000 to 11200 Hz. As for the transient otoacoustic emissions, the worse suppression effect results were found in the research group. There were differences among the hearing of family farmers and the control group. The conventional auditory thresholds are related to the group, age and sex. Farming is associated with impairments in the basal region of the cochlea, absence of acoustic reflex, reduced signal-to-noise ratio of the transient otoacoustic emissions, and dysfunction in the olivocochlear efferents of the auditory system.

Prevalence of hearing loss and health vulnerability in children aged 25 to 36 months: an analysis of spatial distribution.

To analyze the association between hearing loss and health vulnerability in children aged 25 to 36 months. Analytical observational cross-sectional study conducted through child hearing screening in nine day-care centers. The screening consisted of anamnesis, otoscopy, tympanometry, transient otoacoustic emissions, and pure tone audiometry. For each exam performed, the 'pass' and 'fail' criteria were established. The children's residential addresses were georeferenced and a choropleth map of the spatial distribution was built, considering the Health Vulnerability Index (HVI). The analysis of the association between the HVI and the variables sex, auditory assessment, and region area of the household was performed using Pearson's Chi-square and Fisher's Exact tests. Ninety-five children of both sexes were evaluated, of which 44.7% presented alterations in at least one of the exams performed, being referred for otorhinolaryngological evaluation and subsequent auditory assessment. Of the observed changes, 36.9% occurred in the tympanometry and 7.8% in the transient otoacoustic emissions. Among children referred for reassessment, 9.7% were diagnosed with conductive hearing loss, 13.6% results within normal limits and 21.4% did not attend for assessment. Of the children who presented the final diagnosis of conductive hearing loss (9.7%), 1.9% were classified as low-risk HVI and 6.8% as medium-risk HVI. There was statistical significance between HVI and the child's place of residence. The association between hearing loss and HIV was not statistically significant; however, it was possible to observe that 77.7% of the children with hearing loss resided in sectors with medium- risk HIV.

Achados audiológicos de agricultores familiares paranaenses expostos a agrotóxicos

ABSTRACT Purpose To analyze the possible differences among the hearing of farmers and their families when compared to the population not exposed to pesticides. Methods Cross-sectional study with 70 smallholder family farmers (research group), with the mean age of 39.7 years, of both sexes and a mean of 23.7 years of exposure to pesticides. We included a control group with 71 participants of both sexes with the mean age of 39.5 years, not exposed to either noise or chemical substances, to compare the results. In stage 1, both groups were submitted to conventional and high-frequency audiometry, and acoustic immittance. In stage 2, only people with normal hearing were submitted to the evoked otoacoustic emissions and suppression effect on transient otoacoustic emissions. Results Significant differences were observed between the groups in the conventional pure-tone and in the high-frequency audiometry, as well as in the acoustic reflex. The most affected frequencies in the conventional pure-tone audiometry ranged from 3 to 6 kHz and, in the high-frequency audiometry, from 9000 to 11200 Hz. As for the transient otoacoustic emissions, the worse suppression effect results were found in the research group. Conclusion There were differences among the hearing of family farmers and the control group. The conventional auditory thresholds are related to the group, age and sex. Farming is associated with impairments in the basal region of the cochlea, absence of acoustic reflex, reduced signal-to-noise ratio of the transient otoacoustic emissions, and dysfunction in the olivocochlear efferents of the auditory system.

Comparing Auditory Brain Stem Responses and Transient Otoacoustic Emissions in Premature Infants with Auditory Developmental Delay: Evidence of Temporary Auditory Neuropathy.

Premature birth causes some permanent or temporary abnormalities in the hearing system of the newborn. Inadequate development of the central auditory nervous system and balance, as well as the delay in the formation of the nerve myelin, can be the cause of many hearing disorders, including permanent or temporary auditory neuropathy spectrum disorder (ANSD). The present study aims to identify and understand developmental delay disorder in the hearing system of infants and investigate the possibility of temporary auditory neuropathy in infants. In this comparative analytical study, twenty premature infants were randomly selected for hearing tests using auditory brainstem response and transient otoacoustic emissions at the time of discharge and three months after the first evaluation. The different components of these tests were analyzed and compared before and after developing the auditory system. The OAEs test showed a signal-to-noise ratio above six dB with appropriate amplitudes in all infants. The grand average waveform of the ABR showed a significant difference between the amplitudes of waves III and V before and after maturation in both ears (p<0.05). In addition, the absolute latency of waves, specifically III and V, showed a significant difference between the two assessment times (0.05). The present study confirmed the occurrence of temporary ANSD or delayed maturation in premature infants following the lack of complete growth and myelination of auditory nerve fibers. There is a need to determine the hearing status of premature infants by frequent examinations and prevent any unnecessary prescription of amplifications.

Prevalência de perda auditiva e vulnerabilidade a saúde em crianças de 25 a 36 meses: uma análise da distribuição espacial

ABSTRACT Purpose To analyze the association between hearing loss and health vulnerability in children aged 25 to 36 months. Methods Analytical observational cross-sectional study conducted through child hearing screening in nine day-care centers. The screening consisted of anamnesis, otoscopy, tympanometry, transient otoacoustic emissions, and pure tone audiometry. For each exam performed, the 'pass' and 'fail' criteria were established. The children's residential addresses were georeferenced and a choropleth map of the spatial distribution was built, considering the Health Vulnerability Index (HVI). The analysis of the association between the HVI and the variables sex, auditory assessment, and region area of the household was performed using Pearson's Chi-square and Fisher's Exact tests. Results Ninety-five children of both sexes were evaluated, of which 44.7% presented alterations in at least one of the exams performed, being referred for otorhinolaryngological evaluation and subsequent auditory assessment. Of the observed changes, 36.9% occurred in the tympanometry and 7.8% in the transient otoacoustic emissions. Among children referred for reassessment, 9.7% were diagnosed with conductive hearing loss, 13.6% results within normal limits and 21.4% did not attend for assessment. Of the children who presented the final diagnosis of conductive hearing loss (9.7%), 1.9% were classified as low-risk HVI and 6.8% as medium-risk HVI. There was statistical significance between HVI and the child's place of residence. Conclusion The association between hearing loss and HIV was not statistically significant; however, it was possible to observe that 77.7% of the children with hearing loss resided in sectors with medium- risk HIV

Auditory Outcomes in Adolescents with Prenatal Alcohol Exposure

The aim of the study was to investigate three aspects of auditory function (auditory acuity, cochlear dysfunction, and auditory processing) in adolescents with fetal alcohol exposure without phenotypic changes. Fifty-one adolescents with and without intrauterine exposure to alcohol were selected from a cohort study. The summons, evaluation, and analysis of the results were carried out blindly regarding the respective exposure to alcohol. The auditory tests were pure-tone audiometry, transient otoacoustic emissions, and behavioral assessment of auditory processing (speech-in-noise, dichotic digits, and gap-in-noise). After testing, 45 adolescents were included in the evaluation and were divided into exposed (n = 22) and non-exposed (n = 23) groups. Hearing loss was identified in one subject in the exposed group (4.5%). In the absence of hearing loss, there were no significant differences in tonal thresholds or in the magnitudes of the sensory (cochlear) responses between groups (p > 0.05). There was also no difference between the two groups regarding performance on the processing tests (speech-in-noise p = 0.71, dichotic p = 0.94, and gap-in-noise p = 0.33). However, the exposed group had more cases of hearing disorders (hearing loss plus auditory processing disorders) than the non-exposed group (22.7% vs. 4.3%).

Transient otoacoustic emissions with contralateral suppression findings in COVID-19 patients

ObjectiveThe virus called SARS-CoV-2, which is known as the first epidemic of the twenty-first century, is known to affect the central and peripheral nervous system. In the literature, complaints of sudden hearing loss, tinnitus, and vertigo have been reported in the patients.The aim of this study is to objectively reveal the effect of the coronavirus disease 2019 on the efferent auditory system.MethodsTwenty-three participants, who had the coronavirus disease 2019, were included in the study group, while 20 healthy participants were included in the control group. The test of transient otoacoustic emissions with contralateral suppression was applied to individuals who had normal audiological and immitansmetric evaluations findings.ResultsIn audiological evaluation, a significant difference was observed between the groups in the 125–500 Hz low frequency range and 4 kHz–12.5 kHz high frequency range. In the test of TEOAE and TEOAE with contralateral suppression, a significant difference was observed between the groups at 4 kHz.ConclusionThe effect of the coronavirus disease 2019 on the peripheral hearing system has been shown. Its effect on the efferent hearing system in the high frequency region has been revealed.

Evaluation of Medial Olivocochlear Neural Efferent Pathway in Tinnitus Perception in Normal-hearing Individuals.

The objective of this study is to investigate a possible role of the Medial Olivocochlear (MOC) efferent neural pathway and neural connections responsible for tinnitus generation in silence/sensory deprivation. By placing normal hearing participants in a sound booth for 10 minutes, silence/sensory deprivation was created. This offered assessment of MOC neural pathway in normal hearing participants in silence. Hyperactivity of MOC neural pathway was assessed by its more suppressive effect on Transient Otoacoustic Emissions (TEOAEs) in silence. The required auditory measurements were recorded in the sound booth using recommended diagnostic protocols to ensure the effect of 'only silence' on auditory structures. TEOAE were recorded from the right ear and suppression was measured by placing noise in the left ear. Fifty-eight normal hearing male individuals between age 18-35 years were recruited as participants in this study. Approximately, forty-one percent of the participants perceived some type of tinnitus during/after 10 minutes of silence. No statistically significant difference was found in the total TEOAE amplitude and TEOAE suppression amplitude before and after ten minutes of silence. Post silence total TEOAE suppression between tinnitus perceiving and non-perceiving tinnitus participants were not statistically significantly different. These results suggest that the medial olivocochlear efferent pathway or lower brain stem area does not appear to play a role in the emergence of temporary tinnitus in silence however indicate the involvement of higher central auditory nervous system structures in perception of the tinnitus which support the well-accepted notion that tinnitus is the central auditory processing phenomenon.

Zumbido crônico: análise das contribuições clínicas de diferentes avaliações audiológicas

ABSTRACT Purpose To investigate whether there are differences in peripheral and central audiological findings between individuals with normal hearing thresholds with and without chronic tinnitus, and thereby understand which hearing tests are most important in this population. Methods The sample was composed of convenience, including individuals from 18 to 59 years old, divided into two groups: Group 1 (G1) composed of subjects without complaints of chronic tinnitus, and Group 2 (G2) composed of individuals with chronic tinnitus. The evaluation consisted of the following procedures: Anamnesis, High-frequency audiometry (HFA), Transient Otoacoustic emissions (TOAEs), Auditory Brainstem Response (ABR)-click, Frequency Following Response (FFR), and Long Latency Auditory Evoked Potential (LLAEP)-speak. Results G2 showed increased values for HFA, with significant differences. For both groups, TOAEs showed a predominance of responses. In ABR there were no statistically significant differences. In FFR, G1 obtained a greater amplitude of wave V and there was a greater absence in LLAEP of P1, N2, and P300 in G2. Conclusion The HFA, the analysis of the wave V/I ratio in ABR, the FFR, and the LLAEP identified alterations in individuals with chronic tinnitus, demonstrating that such procedures are promising in the evaluation of this population.

Investigation of cochlear microphonics recorded with different stimulus types.

Electrocochleography (ECochG), one of the first defined tests under auditory evoked potentials, is a total electrical response of inner and outer hair cells inside the cochlea and auditory nerve record technique to the presence of an acoustic stimulus. These records can be used in Meniere disease and auditory neuropathy spectrum disorder diagnosis, intraoperative monitoring. In addition, the presence of cochlear microphonics plays a crucial role in auditory neuropathy spectrum disorder diagnosis. In our study, healthy individuals were tested with extratimpanic electrocochleography record method via Click and LS CE-Chirp stimulus, and the results were compared to the age, sex, and noise sensitivity categories. This study had executed at Başkent University, Faculty of Health Sciences Audiology laboratory. The study group consisted of 42 volunteers between 18 and 40 years old. To understand the suitability of volunteers, pure tone audiometry, tympanometry, and transient otoacoustic emission tests were performed. Individuals with no hearing loss were tested with 100 dBnHL intensity level via click and LS CE-Chirp stimulus. The obtained values were statistically evaluated in the SPSS 23.0 program in accordance with the data distribution. An independent sample t-test was used for data showing normal distribution, and Mann-Whitney U test was used for data not showing normal distribution. The level (p < 0.05) was considered statistically significant for all analyses performed. Cochlear microphonic amplitudes recorded with click and LS CE-Chirp stimuli were higher in males than in females (p = 0.051 and p = 0.001, respectively). When the age groups were evaluated, no difference was observed in the CM amplitudes obtained with both click and LS CE-Chirp stimuli. There was no correlation between age and CM amplitudes. Additionally, it was determined that the CM amplitudes recorded with the click stimulus in individuals with noise sensitivity were higher than those without noise sensitivity (p = 0.051). It is thought that the ECochG amplitudes of different gender, different age, and different noise sensitivity, which are the results of our study, can be used in the diagnosis of diseases such as auditory neuropathy spectrum disorder.

P021 Does Obstructive Sleep Apnea (OSA) lead to impairment within the cochlea?

Abstract Introduction The cessation of breathing with OSA is linked to the continuous decrease in oxygen saturation throughout the night which could impact the inner ear as it is sensitive to hypoxic changes. Inner ear hair cells response from the cochlea is measured through Transient Otoacoustic Emission (TEOAEs). This study aimed to evaluate TEOAEs in suspected OSA patients and its correlation with oxygen saturation. Methods TEOAEs were measured before sleep and in the morning in suspected OSA patients and healthy participants. The following frequencies were measured: 1000Hz, 1500Hz, 2000Hz, 3000Hz and 4000Hz. Polysomnography with oxygen saturation was completed overnight. Preliminary analysis was completed on 11 no OSA, 22 mild OSA, 13 moderate OSA and 27 severe OSA patients. Results One-way ANOVA with Tukey post-hoc analysis revealed a difference between severe vs mild with average TEOAE only (p = 0.04). A moderate correlation was found between average TEOAE and minimum O2 saturation, rs (72) = 0.444, p&amp;lt; 0.0001) through Spearman’s rank-order correlation. As middle ear function can impact TEOAE results, regression analysis revealed an association between a decrease in TEOAE and lowered minimum O2 saturation (F (1,63) = 8.951, p = 0.004, partial n2 = 0.124) when middle ear pressure was controlled. Discussion Oxygen desaturation with OSA is associated with a decrease in inner ear hair cells response, which was independent from middle ear function. Despite this association, a difference in TEOAE was only found between severe vs mild, which could be due to the current sample size of the preliminary data.

Neuropatía Auditiva Infantil

La combinación de las otoemisiones acústicas transitorias (OEAT) y los potenciales evocados auditivos del tronco cerebral (PEATC) nos permite identificar a un grupo de pacientes con neuropatía auditiva (NA), cuyas implicaciones clínicas y terapéuticas constituyen un reto en nuestra práctica otológica. La población pediátrica estudiada por nosotros, no ha manifestado una alteración en el examen neurológico o en la resonancia nuclear magnética cerebral o de los oídos internos. Las OEAT y los timpanogramas tipo A,se registraron en el 100% de los casos. Los reflejos estapediales y los PEATC estaban ausentes en todos los pacientes. En la audiometría tonal o conductual, el grado de hipoacusia neurosensorial osciló entre leve a moderada, siendo bilateral en todos los casos. Los niños que colaboraron en las pruebas verbales, demostraron una desproporcionada disminución de la comprensión de la palabra que no correspondió a sus audiogramas tonales. Los hallazgos previos sugieren que la lesión es neurosensorial, con normofuncionalidad de las células ciliadas externas cocleares (OEAT presentes). No se puede precisar si la lesión está localizada en las células ciliadas internas, en el octavo par o en ambos. Las etiologías más probables que han justificado la NA han sido: hiperbilirrubinemia, anoxia perinatal, prematuridad o idiopáticas. El resultado de la rehabilitación del lenguaje con los audífonos demuestra una efectividad limitada. Todos los pacientes están siendo tratados por un terapeuta en el leguaje. El éxito de esta terapia depende de la precocidad en su instauración.

Prenatal Exposure to Tobacco and Alcohol Alters Development of the Neonatal Auditory System

Prenatal exposures to alcohol (PAE) and tobacco (PTE) are known to produce adverse neonatal and childhood outcomes including damage to the developing auditory system. Knowledge of the timing, extent, and combinations of these exposures on effects on the developing system is limited. As part of the physiological measurements from the Safe Passage Study, Auditory Brainstem Responses (ABRs) and Transient Otoacoustic Emissions (TEOAEs) were acquired on infants at birth and one-month of age. Research sites were in South Africa and the Northern Plains of the U.S. Prenatal information on alcohol and tobacco exposure was gathered prospectively on mother/infant dyads. Cluster analysis was used to characterize three levels of PAE and three levels of PTE. Repeated-measures ANOVAs were conducted for newborn and one-month-old infants for ABR peak latencies and amplitudes and TEOAE levels and signal-to-noise ratios. Analyses controlled for hours of life at test, gestational age at birth, sex, site, and other exposure. Significant main effects of PTE included reduced newborn ABR latencies from both ears. PTE also resulted in a significant reduction of ABR peak amplitudes elicited in infants at 1-month of age. PAE led to a reduction of TEOAE amplitude for 1-month-old infants but only in the left ear. Results indicate that PAE and PTE lead to early disruption of peripheral, brainstem, and cortical development and neuronal pathways of the auditory system, including the olivocochlear pathway.

Audiologic Characteristics of Hearing and Tinnitus in Occupational Noise-Induced Hearing Loss.

Background: To analyze the characteristics of patients with noise-induced hearing loss (NIHL) by comparing audiologic test findings between groups with and without tinnitus.Methods:This study involved patients with noise-induced hearing loss (NIHL) who presented to the otolaryngology clinic between January 2016 and April 2019. Tests including 3 pure-tone audiometry (PTA) tests at intervals greater than 1 week, and auditory brainstem response (ABR) were evaluated and patients were screened for tinnitus. The tinnitus patients had otoacoustic emission. Comparison was done between the tinnitus group and the group without tinnitus. Results: Of the 730 subjects with NIHL, 389 had tinnitus. PTA showed significantly higher thresholds at 2 kHz to 8 kHz in the tinnitus group. Although ABR tests tended to show more prolonged I, III, and V latency in the tinnitus group, the differences were not statistically significant. Distortion product otoacoustic emissions (DPOAE) showed more abnormalities at 3 kHz, and 4 kHz than at 1 kHz and 2 kHz. Transient otoacoustic emission (TEOAE) showed abnormal findings in both ears.Conclusion:In NIHL, hearing loss was more severe in patients with, than without tinnitus. DPOAE showed more abnormalities at 3 kHz, 4 kHz, and 6 kHz than at 1 kHz and 2 kHz, and TEOAE was abnormal at all frequencies.

Audiovestibular Dysfunction in Patients with Fibromyalgia Syndrome.

Objectives: Fibromyalgia syndrome is a disorder of widespread pain with unknown etiology. These patients frequently suffer from otologic complaints. This study aims to analyze the audiovestibular functions in patients with fibromyalgia syndrome.Methods: The study included 33 fibromyalgia patients and 33 healthy volunteers. All the study subjects underwent audiological assessment, multifrequency tympanometry, transient otoacoustic emission, and ocular and cervical vestibular-evoked myogenic potentials tests.Results: Pure-tone hearing thresholds of right and left ears were found to be decreased in fibromyalgia patients compared to controls (P < 0.05). Middle ear resonance frequency values were significantly decreased in patients with fibromyalgia syndrome compared to controls (P < .05). The values for signal-to-noise ratios were higher in controls than in the FMS patients. The difference was significant for 1000, 2000, and 4000 Hz (P > .005). Cervical vestibular-evoked myogenic potential waves were obtained in all controls, but could not be obtained in 5 right ears and 4 left ears of the fibromyalgia patients (P < .05). Also, ocular vestibular-evoked myogenic potentials were obtained in all controls, but could not be obtained in 7 right ears and 10 left ears of the patients with fibromyalgia syndrome (P < .05).Conclusion: Our findings support the presence of audiovestibular dysfunction in patients with fibromyalgia. Further research that focuses on the pathogenesis of these dysfunctions is required.

Overview of Newborn Hearing Screening by transient otoacoustic emissions in Aswan, Egypt: A Hospital-Based preliminary Study

Objectives: One of the most significant risk groups for hearing loss is neonates who spend time in the neonatal intensive care unit (NICU). This study aimed to estimate the prevalence of hearing loss in all neonates admitted to our hospital NICU and evaluate their risk factors. It is a prospective cross-sectional study conducted on all neonates admitted to our hospital in one year. Patients and methods: All Neonates were subjected to history, clinical, Otoscopic examination, and Oto-acoustic emissions test. Neonates with congenital ear anomalies or ear problems that interfere with the screening test were excluded. Results: 90.6% of cases passed the test, and 9.4% had a Refer result in the initial screening. A repeated test for the referral cases showed 6.7% passed and 2.7% had hearing affection (2% bilateral and 0.7 % unilateral). Conclusions: The prevalence of hearing loss was 2.7%, 2 % had bilateral hearing affection, and 0.7 % had unilateral hearing affection. There was a significant correlation between exposures to certain risk factors among the affected neonates; all cases remained more than 5 days in NICU with history of exposure to ototoxic drugs, especially gentamycin, furosemide, vancomycin, and amikacin.

Auditory and Language Development Assessment of Newborns Aged One to Four Years Exposed to Gestational Zika Virus Infection: A Case Series

The known neurotropism of the Zika virus (ZikV) suggests that auditory organs and their neural pathways may be affected by prenatal Zika infections. Among the possible manifestations are audiological and language disorders, but so far, the data in the literature are inconclusive. Objective: To describe early and late hearing disorders in children with Congenital Zika Virus Infection (CZVI) and evaluate the language development of this population between 14 and 47 months of age and its possible correlation with the alterations found in auditory exams. Methods: Longitudinal, prospective, observational study of newborns born in Juiz de Fora and its macroregion with confirmed diagnosis of ZikV infection during pregnancy. Participants were examined from one to four years of age for hearing using the transient otoacoustic emissions (TOAE) test, immittance testing and brainstem auditory evoked potential (BAEP), and language using the Bayley Scales of Infant Development—Third Edition (Bayley III). Results: 15 participants were included; eight (53.33%) presented alterations in at least one of the hearing tests, one had an early loss (6%) of sensorineural origin, and seven (46.67%) had a poor language performance. In the three (20%) participants whose audiological exams were altered, there was language impairment, and two (13.33%) participants had extensive malformations in the central nervous system (CNS), presented language delay, and hearing exams were within normality. Conclusion: Infants and preschoolers with CZVI may present early neurosensory loss and late hearing loss with fluctuating character. Even if there were no significant association between the audiological exams results and the Bayley III performance, in the present sample, language development was below expectations for the age in the participants who had alterations in the three audiological exams, when there is early hearing loss or extensive lesions to the CNS. The results reinforce the importance of audiological examinations, especially the BAEP morphological and auditory threshold, in monitoring cases of CZVI until at least three years of age.

Medial olivary complex reflex in term newborns with hyperbilirubinemia

ObjectiveThis study aimed to compare the integrity of the efferent auditory pathways of newborns that had high hyperbilirubinemia levels and required treatment due to these and healthy newborns. MethodsTerm-born (37 weeks or later) infants that were brought to the Newborn Polyclinic of the Başkent University Hospital were included in the study. The study included a total of 84 infants including healthy newborns (n = 42) and those that had jaundice and were receiving phototherapy (n = 42). After conducting a general otorhinolaryngology examination on all newborns included in the study, Transient Otoacoustic Emission (TEOAE) test was carried out in the absence and presence of contralateral noise. The obtained contralateral suppression values were compared between the two groups. ResultsIn the TEOAE test, the responses obtained at 1 kHz in the newborns receiving phototherapy were found to be lower. The difference between the groups was significant (p = 0.038). The rates of suppression presence at 2 kHz, 2.8 kHz and total OAE were found significantly higher (p < 0.05) in the group not receiving phototherapy. Among the phototherapy-receiving infants, the hyperbilirubinemia levels of the infants in whom suppression was obtained in the contralateral suppression test did not show a statistically significant difference in comparison to those in whom suppression was not obtained (p > 0.05). ConclusionBased on the obtained data, hyperbilirubinemia may have a disruptive effect on the efferent auditory system in newborns. Consequently, we are of the opinion that, in addition to hearing screening in risky newborn infants, a MOC suppression test would be useful.