RENATA MOTA MAMEDE CARVALLO

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Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina

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  • article 11 Citação(ões) na Scopus
    Evaluation of peripheral auditory pathways and brainstem in obstructive sleep apnea
    (2018) MATSUMURA, Erika; MATAS, Carla Gentile; MAGLIARO, Fernanda Cristina Leite; PEDRENO, Raquel Meirelles; LORENZI-FILHO, Geraldo; SANCHES, Seisse Gabriela Gandolfi; CARVALLO, Renata Mota Mamede
    Introduction: Obstructive sleep apnea causes changes in normal sleep architecture, fragmenting it chronically with intermittent hypoxia, leading to serious health consequences in the long term. It is believed that the occurrence of respiratory events during sleep, such as apnea and hypopnea, can impair the transmission of nerve impulses along the auditory pathway that are highly dependent on the supply of oxygen. However, this association is not well established in the literature. Objective: To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea. Methods: The sample consisted of 38 adult males, mean age of 35.8 (+/- 7.2), divided into four groups matched for age and Body Mass Index. The groups were classified based on polysomnography in: control (n = 10}. mild obstructive sleep apnea (n = 11) moderate obstructive sleep apnea (n=8) and severe obstructive sleep apnea (n = 9}. All study subjects denied a history of risk for hearing loss and underwent audiometry, tympanometry, acoustic reflex and Brainstem Auditory Evoked Response. Statistical analyses were performed using three-factor ANOVA, 2 factor ANOVA, chi-square test, and Fisher's exact test. The significance level for all tests was 5%. Results: There was no difference between the groups for hearing thresholds, tympanometry and evaluated Brainstem Auditory Evoked Response parameters. An association was observed between the presence of obstructive sleep apnea and changes in absolute latency of wave V (p = 0.03). There was an association between moderate obstructive sleep apnea and change of the latency of wave V (p = 0.01). Conclusion: The presence of obstructive sleep apnea is associated with changes in nerve conduction of acoustic stimuli in the auditory pathway in the brainstem. The increase in obstructive sleep apnea severity does not promote worsening of responses assessed by audiometry, tympanometry and Brainstem Auditory Evoked Response. (C) 2016 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
  • article 9 Citação(ões) na Scopus
    Efferent inhibition of otoacoustic emissions in preterm neonates
    (2015) CARVALLO, Renata Mota Mamede; SANCHES, Seisse Gabriela Gandolfi; IBIDI, Silvia Maria; SOARES, Jordana Costa; DURANTE, Alessandra Spada
    Introduction: Abnormalities in auditory function of newborns may occur not only because of preterm birth, but also from the use of medications and from diseases related to prematurity. Objective: To analyze the inhibitory effect from stimulation of the olivocochlear efferent system on transient evoked otoacoustic emissions in preterm neonates, comparing these data with those from full-term neonates. Methods: This was a prospective, cross-sectional, contemporary cohort study with 125 neonates, pooled into two groups: full-term (72 full-term neonates, 36 females and 36 males, born at 37-41 weeks of gestational age); and preterm (53 neonates, 28 males and 25 females, born at <= 36 weeks of gestational age, evaluated at the corrected gestational age of 37-41 weeks). Otoacoustic emissions were recorded using linear and nonlinear click-evoked stimuli, with and without contralateral stimulation. Results: The inhibitory effect of the efferent pathway in otoacoustic emissions was different (p = 0.012) between groups, and a mean reduction of 1.48 dB SPL in full-term births and of 1.02 dB SPL in preterm births was observed for the non-linear click-evoked stimulus. Conclusion: The results suggest a reduced inhibitory effect of the olivocochlear efferent system on otoacoustic emissions in preterm neonates.
  • article 16 Citação(ões) na Scopus
    Medial olivocochlear function in children with poor speech-in-noise performance and language disorder
    (2017) ROCHA-MUNIZ, Caroline Nunes; CARVALLO, Renata Mota Mamede; SCHOCHAT, Eliane
    Objectives: Contralateral masking of transient-evoked otoacoustic emissions is a phenomenon that suggests an inhibitory effect of the olivocochlear efferent auditory pathway. Many studies have been inconclusive in demonstrating a clear connection between this system and a behavioral speech-in-noise listening skill. The purpose of this study was to investigate the activation of a medial olivocochlear (MOC) efferent in children with poor speech-in-noise (PSIN) performance and children with language impairment and PSIN (SLI + PSIN). Methods: Transient evoked otoacoustic emissions (TEOAEs) with and without contralateral white noise were tested in 52 children (between 6 and 12 years). These children were arranged in three groups: typical development (TD) (n = 25), PSIN (n = 14) and SLI + PSI (n = 13). Results: PSIN and SLI + PSI groups presented reduced otoacoustic emission suppression in comparison with the TD group. Conclusion: Our finding suggests differences in MOC function among children with typical development and children with poor SIN and language problems.
  • article 1 Citação(ões) na Scopus
    Middle ear muscle reflex measurement in neonates: Comparison between 1000 Hz and 226 Hz probe tones
    (2015) LYRA-SILVA, Kilza Arruda de; SANCHES, Seisse Gabriela Gandolfi; NEVES-LOBO, Ivone Ferreira; IBIDI, Silvia Maria; CARVALLO, Renata Mota Mamede
    Introduction: Middle ear muscle reflex (MEMR) evaluation assists in diagnosing hearing problems because normal responses depend on preconditions of a healthy auditory system. Studies in neonates recording the acoustic reflex with 226 Hz probes have described high rates of absence. Other studies using a high frequency probe have found higher rates of presence in normal neonates. However, few studies have compared results between low and high frequency probes in the same newborns. Objective: To comparatively assess the ipsilateral acoustic reflex recorded by 226 Hz and 1000 Hz probes in newborns. Method: A total of 77 newborns, with the presence of transient otoacoustic emissions, underwent tympanometry, wideband acoustic immittance, and ipsilateral reflex investigations with 226 Hz and 1000 Hz tone probes. Results: The acoustic reflex was activated at a much lower intensity with all activating stimuli using the 1000 Hz probe compared with the values of the 226 Hz probe. There was a higher incidence of ipsilateral acoustic reflexes recorded by the 1000 Hz tone probe compared to the 226 Hz tone probe. There was no correlation between the acoustic reflex thresholds and otoacoustic emissions. Conclusion: In newborns, the acoustic reflex measurements obtained with the 1000 Hz probe showed advantages over the 226 Hz probe.
  • article 4 Citação(ões) na Scopus
    Reflectância de banda larga em recém-nascidos com presença de emissões otoacústicas evocadas por transiente
    (2013) SILVA, Kilza Arruda de Lyra e; UROSAS, Juliana Granja; SANCHES, Seisse Gabriela Gandolfi; CARVALLO, Renata Mota Mamede
    PURPOSE: To characterize the normal values of acoustic energy reflectance obtained with pure-tone stimulation in neonates prior to hospital discharge. METHODS: Seventy-seven infants (37 girls and 40 boys) were evaluated by measuring acoustic reflectance using pure-tone stimuli, transient-evoked otoacoustic emissions, and tympanometric probe frequencies of 226 Hz and 1 kHz. RESULTS: At low frequencies (258-750 Hz), greater energy reflectance was observed, while at medium frequencies (1-3 kHz), greater energy absorption was observed. There was no difference between ears or between genders. CONCLUSION: Normal energy reflectance values were obtained for the studied population. The data indicate a reflectance curve with a distinct configuration for the studied age.
  • article 6 Citação(ões) na Scopus
    Influence of obstructive sleep apnea on auditory event-related potentials
    (2022) PEDRENO, Raquel Meirelles; MATSUMURA, Erika; SILVA, Liliane Aparecida Fagundes; SAMELLI, Alessandra Giannella; MAGLIARO, Fernanda Cristina Leite; SANCHES, Seisse Gabriela Gandolfi; LOBO, Ivone Ferreira Neves; LORENZI-FILHO, Geraldo; CARVALLO, Renata Mota Mamede; MATAS, Carla Gentile
    Purpose To evaluate the influence of obstructive sleep apnea (OSA) on the P300 response of auditory event-related potentials (ERPs) and to correlate the electrophysiological findings with OSA severity. Methods Patients with no OSA and mild, moderate, and severe OSA according to polysomnography (PSG) with normal hearing and no comorbidities were studied. Individuals with a body mass index (BMI) >= 40 kg/m(2), hypertension, diabetes, dyslipidemia, the use of chronic medications, and a risk of hearing loss were excluded. All patients underwent full PSG and auditory ERP measurement using the oddball paradigm with tone burst and speech stimuli. For P300 analysis (latencies and amplitudes), normal multiple linear regression models were adjusted with the groups (No OSA, Mild OSA, Moderate OSA, Severe OSA), age, BMI, and Epworth score as explanatory variables. Results We studied 54 individuals (47 males) aged 35 +/- 8 years with a BMI of 28.4 +/- 4.3 kg/m(2). Patients were divided according to the apnea-hypopnea index (AHI) derived from PSG into no OSA (n = 14), mild (n = 16), moderate (n = 12), and severe OSA (n = 12) groups. Patients with severe OSA presented prolonged P300 latencies with tone burst stimuli compared to patients with no OSA and those with mild and moderate OSA. Conclusion Severe OSA is associated with impairment of the P300 response of auditory ERPs, suggesting a decrease in the processing speed of acoustic information that may be mediated by the level of somnolence.
  • article 10 Citação(ões) na Scopus
    The influence of (central) auditory processing disorder on the severity of speech-sound disorders in children
    (2016) VILELA, Nadia; BARROZO, Tatiane Faria; PAGAN-NEVES, Luciana de Oliveira; SANCHES, Seisse Gabriela Gandolfi; WERTZNER, Haydee Fiszbein; CARVALLO, Renata Mota Mamede
    OBJECTIVE: To identify a cutoff value based on the Percentage of Consonants Correct-Revised index that could indicate the likelihood of a child with a speech-sound disorder also having a (central) auditory processing disorder. METHODS: Language, audiological and (central) auditory processing evaluations were administered. The participants were 27 subjects with speech-sound disorders aged 7 to 10 years and 11 months who were divided into two different groups according to their (central) auditory processing evaluation results. RESULTS: When a (central) auditory processing disorder was present in association with a speech disorder, the children tended to have lower scores on phonological assessments. A greater severity of speech disorder was related to a greater probability of the child having a (central) auditory processing disorder. The use of a cutoff value for the Percentage of Consonants Correct-Revised index successfully distinguished between children with and without a (central) auditory processing disorder. CONCLUSIONS : The severity of speech-sound disorder in children was influenced by the presence of (central) auditory processing disorder. The attempt to identify a cutoff value based on a severity index was successful.
  • article 14 Citação(ões) na Scopus
    From otoacoustic emission to late auditory potentials P300: the inhibitory effect
    (2012) SCHOCHAT, Eliane; MATAS, Carla Gentile; SAMELLI, Alessandra Giannella; CARVALLO, Renata Mota Mamede
    This study verifies the effects of contralateral noise on otoacoustic emissions and auditory evoked potentials. Short, middle and late auditory evoked potentials as well as otoacoustic emissions with and without white noise were assessed. Twenty-five subjects, normal-hearing, both genders, aged 18 to 30 years, were tested. In general, latencies of the various auditory potentials were increased at noise conditions, whereas amplitudes were diminished at noise conditions for short, middle and late latency responses combined in the same subject. The amplitude of otoacoustic emission decreased significantly in the condition with contralateral noise in comparison to the condition without noise. Our results indicate that most subjects presented different responses between conditions (with and without noise) in all tests, thereby suggesting that the efferent system was acting at both caudal and rostral portions of the auditory system.
  • article 4 Citação(ões) na Scopus
    Wideband reflectance in Down syndrome
    (2016) SOARES, Jordana Costa; UROSAS, Juliana Granja; CALARGA, Karenina Santos; PICHELLI, Tathiany Silva; LIMONGI, Suelly Cecilia Olivan; SHAHNAZ, Navid; CARVALLO, Renata Mota Mamede
    Objective: Children with Down syndrome (DS) have a high incidence of middle ear disorders and congenital abnormalities of the external, middle and inner ear. Energy reflectance (ER), a wideband acoustic immittance (WAI) measurement parameter, can measure the sound energy reflected or absorbed in the ear canal over a wider range of frequencies more efficiently and faster than conventional single-tone 226 Hz tympanometry. The aim of the present study was to compare the WAI measurements of children with DS with those of typically developing, normal-hearing children according to their tympanometric findings. Methods: Four groups of children with Down syndrome (age range: 2 years and 4 months to 16 years and 3 months; mean age: 8.5 yr) with normal tympanograms (19 ears), flat tympanograms (13 ears), mild negative pressure tympanograms (6 ears between -100 and -199 daPa at the admittance peak) and severe negative pressure tympanograms (4 ears at -200 daPa or lower at the admittance peak) were assessed. All findings were compared with data obtained from 21 ears of a healthy control group (age range: 3 years and 1 month to 13 years and 11 months; mean age: 7.9 yr). The subjects underwent tympanometry with a 226-Hz probe tone frequency and ER measurements along the 200-6,000 Hz range with a chirp stimulus using the Middle-Ear Power Analyzer (MEPA3 - HearID) by Mimosa Acoustics (Champaign, IL), software, version 3.3 [38]. Results: Statistically significant differences were observed in the ER curves for some comparisons between the studied groups. There was also a negative correlation between the static acoustic admittance at the tympanic membrane level and ER measured with a chirp stimulus at 500 and 1,000 Hz. The discriminant analysis technique, which used a chirp stimulus at 1,000 and 1,600 Hz to classify the participants' data based on ER values, achieved a correct classification rate of 59.52% for participants with DS. Conclusion: While groups with abnormal middle ear status, as indicated by tympanometry, showed higher ER values compared to the DS tymp A group and the control group, similar reflectance curves were observed between control group and the DS tymp A group. WAI shows promise as a clinical diagnostic tool in investigating the impact of middle ear disorders in DS group. However, further research is required to investigate this issue in narrower age range group and a larger sample size.
  • article 7 Citação(ões) na Scopus
    Caracterização eletrofisiológica da audição em prematuros nascidos pequenos para a idade gestacional
    (2013) ANGRISANI, Rosanna Mariangela Giaffredo; AZEVEDO, Marisa Frasson de; CARVALLO, Renata Mota Mamede; DINIZ, Edna Maria de Albuquerque; FERRARO, Alexandre Archanjo; GUINSBURG, Ruth; MATAS, Carla Gentile
    PURPOSE: To characterize the Auditory Brainstem Response (ABR) of small for gestational age preterm newborns and to compare the findings to those of appropriate for gestational age premature newborns in order to verify whether the small for gestational age condition is a risk factor for hearing loss. METHODS: This prospective cross-sectional multicenter study evaluated 72 preterm newborns of both genders (35 small and 37 appropriate for gestational age), who were born at 30 to 36 weeks of gestational age and were evaluated before hospital discharge. Only newborns with present transient evoked otoacoustic emissions and tympanometry type A were included. The ABR was performed with click stimuli. The quantitative data analysis was performed using mean and standard deviation measures for each group. For qualitative analysis, the ABR results were classified as normal or altered according to the absolute latencies of waves I, III, V and interpeaks I-III, III-V, I-V. The analysis was carried out considering the age of the newborn at the time of examination. RESULTS: Alterations were evident in 32 newborns (44.44%), being 15 small (43%) and 17 appropriate for gestational age (46%), with no between-groups difference. Of the 15 small for gestational age newborns with altered ABR, six presented as auditory risk only the small for gestational age condition. In the group of adequate for gestational age newborns, there was a higher occurrence of alteration in males. CONCLUSION: There was no difference in responses of auditory evoked potential between small and appropriate for gestational age preterm newborns. Therefore, the condition does not behave as a risk factor for retrocochlear impairment.