RENATA MOTA MAMEDE CARVALLO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
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- 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 MamedeIntroduction: 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.
- 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 SpadaIntroduction: 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.
- 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 MamedeIntroduction: 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.
- Simetria das medidas timpanométricas e as respostas das emissões otoacústicas transientes em neonatos(2014) SILVA, Liliane Aparecida Fagundes; SILVA, Kilza de Arruda Lyra e; SANCHES, Seisse Gabriela Gandolfi; CARVALLO, Renata Mota Mamede deOBJETIVO: verificar a ocorrência de simetria maior ou igual à 70%, entre as orelhas, comparando os resultados da timpanometria nas frequências de 226 e 1000Hz com as respostas das emissões otoacústicas em neonatos. MÉTODOS: foram avaliados 39 neonatos, em média com 60 horas de vida, sendo 20 do sexo feminino e 19 do sexo masculino. Cada recém-nascido foi submetido à avaliação timpanométrica com as sondas de 226 e 1000 Hz, e avaliação das emissões otoacústicas transientes em ambas as orelhas. Os resultados foram submetidos a testes estatísticos. RESULTADOS: na análise da amostra pode-se observar ocorrência de simetria <70% nas respostas das emissões otoacústicas em 74,4% do total de neonatos. Por outro lado, na timpanometria, houve uma maior ocorrência de simetria ≥ 70%, tanto para sonda de 226 quanto para 1000Hz (76,9% e 84,6%, respectivamente). No que diz respeito ao gênero e orelha, as diferenças encontradas em cada teste não foram significantes, embora tenha sido observada maior amplitude de respostas de emissões otoacústicas na orelha direita. CONCLUSÃO: os resultados sugerem haver simetria no sistema auditivo em sua porção mais periférica, e início de assimetrias a partir da cóclea.
- 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 MamedePURPOSE: 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.
- 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 GentilePurpose 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.
- 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 MamedeOBJECTIVE: 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.
- Development of auditory perception in preschool children(2020) VILELA, Nadia; SANCHES, Seisse Gabriela Gandolfi; CARVALLO, Renata Mota MamedeObjective: The aim of this study was to determine whether the auditory skills presented by five-year-old children can predict their performance in auditory processing (AP) tests at seven years old. Design: Thirty five children were evaluated for AP at two different times. At evaluation 1, the children were between 5 years 2 months and 6 years 1 month of age, and at evaluation 2, they were between 7 years 1 month and 7 years 8 months of age. The interval between the evaluations ranged from 18 to 23 months. After evaluation 2, the 7-year-olds were classified according to their performance on central AP tests. The children were divided into three groups: GI included nine children with at least two AP tests that scored two standard deviations below the mean and the presence of a speech complaint; GII included 18 children with at least two AP tests that scored two standard deviations below the mean and no speech complaints; and GIII included eight children with no more than one test scored two standard deviations below the mean and no speech disorders complaint. The analysis was performed considering each test individually and as a battery of applied tests. From the results obtained, a discriminant analysis was performed to assess the differences in test performance between the groups when the children were 5 years old. Results: The discriminant analysis showed that with the results obtained during evaluation 1, it was possible to predict which group 74.3% of the children would be classified into after evaluation 2. The percentage of correct classifications for each group was 77.8% for GI, 66.7% for GII and 87.5% for GIII. That is, 87.5% of the children who were classified as GIII after evaluation 2 had already demonstrated good auditory performance in the tests applied at 5 years of age. Conclusions: Children who exhibited lower scores on AP tests at 7 years of age had demonstrated poor auditory perception at 5 years of age. This finding is relevant because it offers the possibility of stimulating or training these auditory skills in preschoolers to foster their development.
- Medidas de reflectância acústica na otosclerose: estudo de caso(2014) NETO, Letícia Cortez; CIBIN, Bruna Carla; CARVALLO, Renata Mota Mamede; SANCHES, Seisse Gabriela GandolfiThis research aimed to analyze the reflectance measurements in a patient with otosclerosis. The patient, female, 51 years old; she complained of bilateral hearing loss and had a diagnosis hypothesis of otosclerosis. The following audiological tests were performed in both ears: tympanometry, pure-tone audiometry, and speech audiometry tests and acoustic reflectance measurements. Through acoustic wideband reflectance analysis, it was possible to observe an increase in reflectance, such as is seen in otosclerotic ears, between the frequencies of 500 Hz and 1500 Hz and to differentiate the left and right ear. Acoustic reflectance measurements have the potential to yield results that allow the differentiation between the two ears; thus, the use of the wideband acoustic reflectance is suggested as a part of the otosclerosis diagnostic procedure.
- Processamento temporal de crianças com transtorno fonológico submetidas ao treino auditivo: estudo piloto(2012) VILELA, Nadia; WERTZNER, Haydée Fiszbein; SANCHES, Seisse Gabriela Gandolfi; NEVES-LOBO, Ivone Ferreira; CARVALLO, Renata Mota MamedePURPOSE: This study compared the temporal processing performance of children with phonological disorders submitted to formal and informal auditory training. METHODS: Fifteen subjects with phonological disorder (pure tone thresholds ≤20 dBHL from 0.50 to 4 kHz, and age between 7 years and 10 years and 11 months) were evaluated, divided into three groups: Control Group: five subjects (mean age 9.1 years) without auditory processing disorder, who passed through two evaluations of the auditory processing at intervals of six to eight weeks and without any intervention; Formal Training Group with five subjects (average 8.3 years) with auditory processing disorder submitted to eight sessions of formal training; and Informal Training Group, with five subjects (average 8.1 years) with auditory processing disorder submitted to eight sessions of informal training. RESULTS: After eight sessions the formal training group showed an improvement of 8% and the informal training group of 22.5% in comparison with the pitch pattern sequence test. For the duration pattern sequence test, the average of the formal training group improved by 12.9% and the informal training group by 18.7%. There was no statistical difference between the means obtained by both groups after intervention, neither in the pitch pattern nor in the duration pattern sequence test. CONCLUSION: Although the results did not present significant differences, this pilot study suggests that both formal and informal trainings provide improvement in the temporal processing abilities of children with phonological and auditory processing disorders.