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.
- 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.
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 MamedeThis 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.- 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 GentilePURPOSE: 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.
- Avaliação auditiva periférica em crianças com síndrome de Down(2014) CARRICO, Barbara; SAMELLI, Alessandra Giannella; MATAS, Carla Gentile; MAGLIARO, Fernanda Cristina Leite; CARVALLO, Renata Mota Mamede; LIMONGI, Suelly Cecília Olivan; NEVES-LOBO, Ivone FerreiraPurpose This study sought to characterize the peripheral auditory system of individuals with Down syndrome (DS) using conventional and high-frequency audiometry. Methods We performed a cross-sectional and observational study. Fifteen individuals with DS, who were of both genders and between 7 and 15 years of age, participated in this study. The following procedures were performed: otoscopy, tympanometry with ipsilateral and contralateral acoustic reflex, pure-tone audiometry, vocal audiometry and high-frequency audiometry. Results There was a predominance of mild conductive hearing loss in one or both ears. The mean hearing thresholds for conventional audiometry were below 20 dB HL and between 20 and 40 dB HL for high-frequency audiometry. The Pearson correlation coefficient indicated a moderate positive correlation between the 9-14 kHz thresholds and age. Conclusion Overall, no significant differences were observed when comparing the right and left ears of individuals with DS, in regards to pure-tone audiometry, immittance testing and speech audiometry. Most children showed middle ear abnormalities and conductive hearing loss. Moreover, high-frequency audiometry suggested the onset of impaired cochlear function, which may be associated with frequent otitis media episodes and/or early cochlear degeneration.
- Severe obstructive sleep apnea is associated with cochlear function impairment(2018) MATSUMURA, Erika; MATAS, Carla G.; SANCHES, Seisse G. G.; MAGLIARO, Fernanda C. L.; PEDRENO, Raquel M.; GENTA, Pedro R.; LORENZI-FILHO, Geraldo; CARVALLO, Renata M. M.The purpose of this study is to investigate the association between obstructive sleep apnea (OSA) with middle ear acoustic transference and cochlear function. Male individuals with and without mild, moderate, and severe OSA according to standard criteria of full polysomnography and no co-morbidities were studied. Subjects with BMI 40 kg/m(2), present or past treatment for OSA, with heart failure, diabetes, hypertension, dyslipidemia, stroke, use of chronic medications, and previous history of risk for hearing loss were excluded. All subjects were submitted to full polysomnography, evaluation of wideband acoustic immittance by energy of absorbance (EA), and distortion product otoacoustic emissions (DPOAE). We studied 38 subjects (age 35.8 +/- 7.2 years, BMI 28.8 +/- 3.8 kg/m(2)) divided into no OSA (n = 10, age 33.6 +/- 6.4 years, BMI 26.9 +/- 4.1 kg/m(2)), mild (n = 11, age 32.8 +/- 2.9 years, BMI 28.5 +/- 3.5 kg/m(2)), moderate (n = 8, age 34.1 +/- 6.8 years, BMI 29.6 +/- 3.3 kg/m(2)), and severe OSA (n = 9, age 41.2 +/- 9.2 years, BMI 30.5 +/- 3.8 kg/m(2)). EA was similar between groups. In contrast, patients with severe OSA presented significantly lower DPOAE amplitudes when compared to the control, mild, and moderate OSA groups (p ae 0.03, for all comparisons). Acoustic transference function of middle ear is similar in adults with and without OSA. Severe OSA is independently associated with cochlear function impairment in patients with no significant co-morbidities.
- Electrophysiological study of hearing in full-term small-for-gestational-age newborns(2012) ANGRISANI, Rosanna Mariangela Giaffredo; AZEVEDO, Marisa Frasson De; CARVALLO, Renata Mota Mamede; DINIZ, Edna Maria de Albuquerque; MATAS, Carla GentilePURPOSE: To describe the Brainstem Auditory Evoked Potential (BAEP) results of full-term small-for-gestational-age newborns, comparing them to the results of full-term appropriate-for-gestational-age newborns, in order to verify whether the small-for-gestational-age condition is a risk indicator for retrocochlear hearing impairment. METHODS: This multicentric prospective cross-sectional study assessed 86 full-term newborns - 47 small- (Study Group) and 39 appropriate-for-gestational-age (Control Group - of both genders, with ages between 2 and 12 days. Newborns with presence of transient evoked otoacoustic emissions and type A tympanometry were included in the study. Quantitative analysis was based on the mean and standard deviation of the absolute latencies of waves I, III and V and interpeak intervals I-III, III-V and I-V, for each group. For qualitative analysis, the BAEP results were classified as normal or altered by analyzing these data considering the age range of the newborn at the time of testing. RESULTS: In the Study Group, nine of the 18 (38%) subjects with altered BAEP results had the condition of small-for-gestational-age as the only risk factor for hearing impairments. In the Control Group, seven (18%) had altered results. Female subjects from the Study Group tended to present more central alterations. In the Control Group, the male group tended to have more alterations. CONCLUSION: Full-term children born small or appropriate for gestational age might present transitory or permanent central hearing impairments, regardless of the presence of risk indicators.
- Audiological and electrophysiological assessment of professional pop/rock musicians(2012) SAMELLI, Alessandra G.; MATAS, Carla G.; CARVALLO, Renata M. M.; GOMES, Raquel F.; BEIJA, Carolina S. de; MAGLIARO, Fernanda C. L.; RABELO, Camila M.In the present study, we evaluated peripheral and central auditory pathways in professional musicians (with and without hearing loss) compared to non-musicians. The goal was to verify if music exposure could affect auditory pathways as a whole. This is a prospective study that compared the results obtained between three groups (musicians with and without hearing loss and non-musicians). Thirty-two male individuals participated and they were assessed by: Immittance measurements, pure-tone air conduction thresholds at all frequencies from 0.25 to 20 kHz, Transient Evoked Otoacoustic Emissions, Auditory Brainstem Response (ABR), and Cognitive Potential. The musicians showed worse hearing thresholds in both conventional and high frequency audiometry when compared to the non-musicians; the mean amplitude of Transient Evoked Otoacoustic Emissions was smaller in the musicians group, but the mean latencies of Auditory Brainstem Response and Cognitive Potential were diminished in the musicians when compared to the non-musicians. Our findings suggest that the population of musicians is at risk for developing music-induced hearing loss. However, the electrophysiological evaluation showed that latency waves of ABR and P300 were diminished in musicians, which may suggest that the auditory training to which these musicians are exposed acts as a facilitator of the acoustic signal transmission to the cortex.