MARIA VALERIA SCHMIDT GOFFI GOMEZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
36 resultados
Resultados de Busca
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- P3 Cognitive Potential in Cochlear Implant Users(2018) GRASEL, Signe; GRETERS, Mario; GOFFI-GOMEZ, Maria Valeria Schimidt; BITTAR, Roseli; WEBER, Raimar; OITICICA, Jeanne; BENTO, Ricardo FerreiraIntroduction The P3 cognitive evoked potential is recorded when a subject correctly identifies, evaluates and processes two different auditory stimuli. Objective to evaluate the latency and amplitude of the P3 evoked potential in 26 cochlear implant users with post-lingual deafness with good or poor speech recognition scores as compared with normal hearing subjects matched for age and educational level. Methods In this prospective cohort study, auditory cortical responses were recorded from 26 post-lingual deaf adult cochlear implant users (19 with good and 7 with poor speech recognition scores) and 26 control subjects. Results There was a significant difference in the P3 latency between cochlear implant users with poor speech recognition scores (G-) and their control group (CG) (p = 0.04), and between G-and cochlear implant users with good speech discrimination (G+) (p = 0.01). We found no significant difference in the P3 latency between the CG and G+. In this study, all G-patients had deafness due to meningitis, which suggests that higher auditory function was impaired too. Conclusion Post-lingual deaf adult cochlear implant users in the G-group had prolonged P3 latencies as compared with the CG and the cochlear implant users in the G+ group. The amplitudes were similar between patients and controls. All G-subjects were deaf due to meningitis. These findings suggest that meningitis may have deleterious effects not only on the peripheral auditory system but on the central auditory processing as well.
- Speech Perception Performance of Double Array Multichannel Cochlear Implant Users With Standard and Duplicated Maps in Each of the Arrays(2013) BENTO, Ricardo Ferreira; GOFFI-GOMEZ, Maria Valeria Schmidt; TSUJI, Robinson Koji; FONSECA, Anna Carolina de Oliveira; IKARI, Liliane Satomi; BRITO NETO, Rubens Vuono deObjective: The present investigation evaluated the speech perception performance of patients with ossified cochlea implanted with the 24M Double Array cochlear implant, using standard and duplicated maps in each of the arrays. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: Sixteen subjects received a Double Array cochlear implant. Among these, 9 fulfilled the following inclusion criteria: bilateral severe-to- profound postlingual deafness; bilateral obliterated cochlea, as shown by a computed tomographic scan; and a minimum age of 14 years to ensure reliable responses in the behavioral tests with the 3 tested maps. Intervention: Rehabilitative. Main Outcome Measures: The speech perception performance with the 2 arrays was compared with that with a basal array duplicated map and an apical array duplicated map. Three maps were fitted: the default map with both arrays activated, a double channel map using only the electrodes of the basal array, and a double channel map programmed only with the electrodes of the apical array. The test battery was composed of a vowel test, a 4-choice word test, and sentence recognition in quiet. Results: Statistical significance was reached in comparison the all tests in all programming conditions. Speech recognition in the standard map with both electrode arrays activated showed the highest scores. Conclusion: Performance with the 2 split electrode arrays was superior to those with the single arrays, regardless of the duplication of channels.
- Microangiopathy of the inner ear, deafness, and cochlear implantation in a patient with Susac syndrome(2011) BITTENCOURT, Aline Gomes; SANTOS, Andrea Felice Dos; GOFFI-GOMEZ, Maria Valeria Schmidt; KUTSCHER, Kellen; TSUJI, Robinson Koji; BRITO, Rubens De; BENTO, Ricardo FerreiraConclusion: The cochlear implant was beneficial as an attempt to restore hearing and improve communication abilities in this patient with profound sensorineural hearing loss secondary to Susac syndrome. Objective: To report the audiological outcomes of cochlear implantation (CI) in a young woman with Susac syndrome after a 6-month follow-up period. Susac syndrome is a rare disorder. It is clinically characterized by a typical triad of sensorineural deafness, encephalopathy, and visual defect, due to microangiopathy involving the brain, inner ear, and retina. Methods: This was a retrospective review of a case at a tertiary referral center. After diagnosis, the patient was evaluated by a multidisciplinary team and received a cochlear implant in her right ear. Results: The patient achieved 100% open-set sentence recognition in noise conditions and 92% monosyllable and 68% medial consonant recognition in quiet conditions after 6 months of implant use. She reported the use of the telephone 3 months after activation.
- Important Factors in the Cognitive Development of Children with Hearing Impairment: Case Studies of Candidates for Cochlear Implants(2014) NASRALLA, Heloisa Romeiro; GOMEZ, Maria Valéria Schimidt Goffi; MAGALHAES, Ana Tereza; BENTO, Ricardo FerreiraIntroduction The factors that affect the development of children with and without hearing disabilities are similar, provided their innate communication abilities are taken into account. Parents need to mourn the loss of the expected normally hearing child, and it is important that parents create bonds of affection with their child. Objective To conduct a postevaluation of the development and cognition of 20 candidates for cochlear implants between 1 and 13 years of age and to observe important factors in their development. Methods The following instruments were used in accordance with their individual merits: interviews with parents; the Vineland Social Maturity Scale; the Columbia Maturity Scale; free drawings; Bender and Pre-Bender testing; and pedagogical tests. Results The results are described. Conclusion Parental acceptance of a child's deafness proved to be the starting point for the child's verbal or gestural communication development, as well as for cognitive, motor, and emotional development. If the association between deafness and fine motor skills (with or without multiple disabilities) undermines the development of a child's speech, it does not greatly affect communication when the child interacts with his or her peers and receives maternal stimulation. Overprotection and poor sociability make children less independent, impairs their development, and causes low self-esteem. Further observational studies are warranted to determine how cochlear implants contribute to patient recovery.
- Hearing preservation using topical dexamethasone alone and associated with hyaluronic acid in cochlear implantation(2015) RAMOS, Bernardo Faria; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; GOFFI-GOMEZ, Maria Valeria Schmidt; RAMOS, Henrique Faria; SAMUEL, Paola Angelica; BRITO, RubensConclusion: Topical dexamethasone associated with hyaluronic acid in cochlear implant surgery demonstrated a statistically significant difference in the preservation of low-frequency thresholds when compared with topical dexamethasone alone and a control group. Topical dexamethasone alone was not superior in hearing preservation when compared to the control group. Objective: To compare the effects of topical dexamethasone alone and associated with hyaluronic acid intraoperatively in hearing preservation in cochlear implantation. Methods: Eighteen severely to profoundly hearing-impaired adult patients with measurable hearing were divided into three groups preoperatively: cochlear implantation as a control group (group 1), cochlear implantation using topical dexamethasone intraoperatively (group 2), and cochlear implantation using topical dexamethasone associated with hyaluronic acid intraoperatively (group 3). Preimplant and postimplant low-frequency pure-tone averages (PTAs) were calculated from unaided audiograms at 125, 250, and 500 Hz. Results: The mean changes in the low-frequency PTA comparing postoperative against preoperative thresholds were 28.03 +/- 6.77 dB in group 1, 30 +/- 14.53 dB in group 2, and 7.23 +/- 6.12 dB in group 3. There was statistical difference when comparing group 3 with groups 1 and 2 using one-way ANOVA (p = 0.002) followed by Scheffe post hoc test.
- Is There Any Correlation between Spread of Excitation Width and the Refractory Properties of the Auditory Nerve in Cochlear Implant Users?(2021) SILVA, Juliana Coutinho da; GOFFI-GOMEZ, Maria Valeria Schmidt; TSUJI, Robinson Koji; BENTO, Ricardo; BRITO NETO, RubensBackground: The spread of excitation (SOE) and auditory nerve recovery function (REC) are objective measures recorded by neural response telemetry and may interfere in cochlear implant (CI) stimulation. Objective: To analyze and correlate SOE with the refractory periods in subjects with pre- and postlingual deafness implanted with different electrode arrays. Methods: This was a retrospective study of 323 ears separated by perimodiolar or straight arrays and by pre- or postlingually deaf recipients. Measures were collected intraoperatively on electrode 11. The SOE width was measured in millimeters at the 0.75 point of the curve, and the relative (tau) and absolute (t0) refractory periods were measured in microseconds. Results: There was a statistical correlation between the SOE and the t0 in the patients with postlingual deafness implanted with the perimodiolar array. The SOE width was statistically different between the straight and perimodiolar arrays and between the pre- and postlingual groups in the perimodiolar array. Tau was statistically different between the pre- and postlingual groups with the straight array and the t0, between the pre- and postlingual groups with the perimodiolar array. Neural response threshold and amplitude of the neural response were not statistically different among groups. Conclusion: There was a correlation between SOE width and t0 only in patients with acquired deafness. The findings suggest that different factors influence SOE and REC, considering SOE is different according to the electrode array and REC being different according the onset of deafness.
- Retrolabyrinthine approach for cochlear nerve preservation in neurofibromatosis type 2 and simultaneous cochlear implantation(2013) BENTO, Ricardo Ferreira; MONTEIRO, Tatiana Alves; BITTENCOURT, Aline Gomes; GOFFI-GOMEZ, Maria Valeria Schmidt; BRITO, Rubens deINTRODUCTION: Few cases of cochlear implantation (CI) in neurofibromatosis type 2 (NF2) patients had been reported in the literature. The approaches described were translabyrinthine, retrosigmoid or middle cranial fossa. OBJECTIVES: To describe a case of a NF2- deafened-patient who underwent to vestibular schwannoma resection via RLA with cochlear nerve preservation and CI through the round window, at the same surgical time. RESUMED REPORT: A 36-year-old woman with severe bilateral hearing loss due to NF2 was submitted to vestibular schwannoma resection and simultaneous CI. Functional assessment of cochlear nerve was performed by electrical promontory stimulation. Complete tumor removal was accomplishment via RLA with anatomic and functional cochlear and facial nerve preservation. Cochlear electrode array was partially inserted via round window. Sound field hearing threshold improvement was achieved. Mean tonal threshold was 46.2 dB HL. The patient could only detect environmental sounds and human voice but cannot discriminate vowels, words nor do sentences at 2 years of follow-up. CONCLUSION: Cochlear implantation is a feasible auditory restoration option in NF2 when cochlear anatomic and functional nerve preservation is achieved. The RLA is adequate for this purpose and features as an option for hearing preservation in NF2 patients.
- Are Auditory Steady-State Responses Useful to Evaluate Severe-to-Profound Hearing Loss in Children?(2015) GRASEL, Signe Schuster; ALMEIDA, Edigar Rezende de; BECK, Roberto Miquelino de Oliveira; GOFFI-GOMEZ, Maria Valeria Schmidt; RAMOS, Henrique Faria; ROSSI, Amanda Costa; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; BRITO, Rubens deObjective. To evaluate Auditory Steady-State Responses (ASSR) at high intensities in pediatric cochlear implant candidates and to compare the results to behavioral tests responses. Methods. This prospective study evaluated 42 children with suspected severe-to-profound hearing loss, aged from 3 to 72 months. All had absent ABR and OAE responses. ASSR were evoked using binaural single frequency stimuli at 110 dB HL with a 10 dB down-seeking procedure. ASSR and behavioral test results were compared. Results. Forty-two subjects completed both ASSR and behavioral evaluation. Eleven children (26.2%) had bilateral responses. Four (9.5%) showed unilateral responses in at least two frequencies, all confirmed by behavioral results. Overall 61 ASSR responses were obtained, most (37.7%) in 500 Hz. Mean thresholds were between 101.3 and 104.2 dB HL. Among 27 subjects with absent ASSR, fifteen had no behavioral responses. Seven subjects showed behavioral responses with absent ASSR responses. No spurious ASSR responses were observed at 100 or 110 dB HL. Conclusion. ASSR is a valuable tool to detect residual hearing. No false-positive ASSR results were observed among 42 children, but in seven cases with absent ASSR, the test underestimated residual hearing as compared to the behavioral responses.
bookPart Implante Auditivo de Tronco Encefálico(2014) BENTO, Ricardo Ferreira; SANTOS, Andréa Felice dos; GOFFI-GOMEZ, Maria Valéria Schmidt- Longitudinal Analysis of the Absence of Intraoperative Neural Response Telemetry in Children using Cochlear Implants(2014) MOURA, Amanda Christina Gomes de; GOFFI-GOMEZ, Maria Valéria Schmidt; COUTO, Maria Ines Vieira; BRITO, Rubens; TSUJI, Robinson Koji; BEFI-LOPES, Debora Maria; MATAS, Carla Gentile; BENTO, Ricardo FerreiraIntroduction Currently the cochlear implant allows access to sounds in individuals with profound hearing loss. The objective methods used to verify the integrity of the cochlear device and the electrophysiologic response of users have noted these improvements. Objective To establish whether the evoked compound action potential of the auditory nerve can appear after electrical stimulation when it is absent intraoperatively. Methods The clinical records of children implanted with the Nucleus Freedom (Cochlear Ltd., Australia) (CI24RE) cochlear implant between January 2009 and January 2010 with at least 6 months of use were evaluated. The neural response telemetry (NRT) thresholds of electrodes 1, 6, 11, 16, and 22 during surgery and after at least 3 months of implant use were analyzed and correlated with etiology, length of auditory deprivation, and chronological age. These data were compared between a group of children exhibiting responses in all of the tested electrodes and a group of children who had at least one absent response. Results The sample was composed of clinical records of 51 children. From these, 21% (11) showed no NRT in at least one of the tested electrodes. After an average of 4.9 months of stimulation, the number of individuals exhibiting absent responses decreased from 21 to 11% (n = 6). Conclusion It is feasible that absent responses present after a period of electrical stimulation. In our sample, 45% (n = 5) of the patients with intraoperative absence exhibited a positive response after an average of 4.9 months of continued electrical stimulation.