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
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- 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.
- Is the spread of excitation width correlated to the speech recognition in cochlear implant users?(2021) SILVA, Juliana Coutinho da; GOFFI-GOMEZ, Maria Valeria Schmidt; MAGALHAES, Ana Tereza; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraPurpose To assess whether there is an interference of the spread of excitation (SOE) on speech recognition. Methods Retrospective cross-sectional study, approved by the institution's ethics committee (CAAE03409212.8.0000.0068). Adult patients with intraoperative neural response telemetry (NRT) performed on electrodes 6, 11 and 16 implanted with Cochlear Ltd (Sydney, Australia) devices were selected. Patients with partial array insertion, pre-lingual hearing loss, deafness etiology due to and CI experience less than 12 months were excluded. SOE was recorded at 10 current units above the NRT threshold (tNRT) and its width in millimeters was collected at point 0.75 of the function. Speech recognition test was 25-recorded monosyllables list, presented at 65 dBHL at 0 degrees azimuth in a sound treated booth. The analysis was divided into groups by electrode array type, regarding the tNRT, SOE width, SOE's peak amplitude and electrode peak. Results A 126 SOE measurements of the 3 tested electrodes were obtained from 43 patients. Patients with straight array had significantly wider SOE, greater peak amplitude at electrode 6 and higher tNRTs. In the perimodiolar array, there was a negative correlation between SOE and monosyllables recognition at electrodes 6 and 11, and in the combined average of the three electrodes, with a significant difference in electrode 11. Sixty-six percent of the SOE measurements had their peak shifted to adjacent electrodes. Conclusion It was observed, in perimodiolar array, the greater the dispersion of electrical current, the worse the speech recognition, especially in the medial electrode.
- Do the minimum and maximum comfortable stimulation levels influence the cortical potential latencies or the speech recognition in adult cochlear implant users?(2021) MARTINS, Kelly Vasconcelos Chaves; GOFFI-GOMEZ, Maria Valeria Schmidt; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraIntroduction: Cochlear implants (CI) programming is based on both the measurement of the minimum levels required to stimulate the auditory nerve and the maximum levels to generate loud, yet comfortable loudness. Seeking for guidance in the adequacy of this programming, the cortical auditory evoked potentials (CAEP) have been gaining space as an important tool in the evaluation of CI users, providing information on the central auditory system. Objective: To evaluate the influence of mishandling of electrical stimulation levels on speech processor programming on hearing thresholds, speech recognition and cortical auditory evoked potential in adult CI users. Material and methods: This is a prospective cross-sectional study, with a sample of adult unilateral CI users of both sexes, aged at least 18 years, post-lingual deafness, with minimum experience of 12 months of device use. Selected subjects should have average free field hearing thresholds with cochlear implant equal to or better than 34 dBHL and monosyllable recognition different from 0%. Individuals who could not collaborate with the procedures or who had no CAEP recordings were excluded. Participants were routinely programmed, and the map was named MO (optimized original map). Then three experimentally wrong maps were made: optimized original map with 10 current units below the maximum comfort level (C), named MC-(map minus C); optimized original map with minus 10 current units at minimum threshold level (T), named MT-(map minus T) and optimized original map with 10 current units above minimum level (T), named MT + (map plus T). In all programs, participants underwent free-field auditory thresholds from 250Hz to 60 0 0Hz, recorded sentences and monosyllabic recognition tests presented at 65dB SPL in quiet and in noise, and free field CAEP evaluation. All tests were performed in an acoustically treated booth, in a randomized order of map presentation. Data were compared by Wilcoxon test. Results: Thirty individuals were selected and signed an informed consent form. The MC-map provided worsening of all free field thresholds, quiet and noise speech recognition, and P1 wave latency delay with significant difference from the results with the MO map. The MT-map worsened the hearing thresholds and statistically significantly reduced the P2 wave latency; MT + map improved free field thresholds except 60 0 0Hz, worsening speech recognition, without statistical significance. Conclusions: The results suggest that maximum levels below the optimal thresholds lead to worse cochlear implant performance in both hearing thresholds and speech recognition tests in quiet and noise, increasing CAEP component P1 latency. On the other hand, the manipulation of minimum threshold levels showed alteration in audibility without significant impact on speech recognition.
- Use of remote control in the intraoperative telemetry of cochlear implant: multicentric study(2019) TANAMATI, Liege Franzini; GOFFI-GOMEZ, Maria Valeria Schmidt; MUNIZ, Lilian Ferreira; SAMUEL, Paola Angelica; WIEMES, Gislaine Richter Minhoto; LIMA, Daniele Penna; CURI, Silvia Badur; ONUKI, Lucia Cristina; QUEIROZ, Carla Fortunato; CAPISTRANO, Ana Karla Bigois; MORET, Adriane Lima Mortari; KIMURA, Marcia Yuri Tsumura; OYANGUREN, Valeria; MAUCH, HerbertIntroduction: The conventional evaluation of neural telemetry and impedance requires the use of the computer coupled to an interface, with software that provides visualization of the stimulus and response. Recently, a remote control (CR220 (R)) was launched in the market, that allows the performance of intraoperative tests with minimal instrumentation. Objective: To evaluate the agreement of the impedance values and neural telemetry thresholds, and the time of performance in the conventional procedure and by the remote control. Methods: Multicentric prospective cross-sectional study. Intraoperative evaluations of cochlear implants compatible with the use of CR220 (R) were included. The tests were carried out in the 22 electrodes to compare the time of performance in the two situations. The agreement of the neural telemetry threshold values obtained from five electrodes was analyzed, and the agreement of impedance was evaluated by the number of electrodes with altered values in each procedure. Results: There were no significant difference between the impedance values. There was a moderate to strong correlation between the electrically-evoked compound action potential thresholds. The mean time to perform the procedures using the CR220 was significantly lower than that with the conventional procedure. Conclusion: The use of the CR220 provided successful records for impedance telemetry and automatic neural response telemetry. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Voice Analysis of Postlingually Deaf Adults Pre- and Postcochlear Implantation(2011) UBRIG, Maysa Tiberio; GOFFI-GOMEZ, Maria Valeria S.; WEBER, Raimar; MENEZES, Marcia H. Moreira; NEMR, Nair Katia; TSUJI, Domingos Hiroshi; TSUJI, Robinson KojiObjectives. To ascertain whether cochlear implantation (Cl), without specific vocal rehabilitation, is associated with changes in perceptual and acoustic vocal parameters in adults with severe to profound postlingual deafness. Hypothesis. Merely restoring auditory feedback could allow the individual to make necessary adjustments in vocal pattern. Study Design. Prospective and longitudinal. Methods. The experimental group composed of 40 postlingually deaf adults (20 males and 20 females) with no previous laryngeal or voice disorders. Participants' voices were recorded before CI and 6-9 months after Cl. To check for chance modifications between two evaluations, a control group of 12 postlingually deaf adults, six male and six female, without CI was also evaluated. All sessions composed of the recording of read sentences from Consensus Auditory-Perceptual Evaluation of Voice and sustained vowel /a/. Auditory and acoustic analyses were then conducted. Results. We found a statistically significant reduction in overall severity, strain, loudness, and instability in auditory analysis. In vocal acoustic analysis, we found statistically significant reduction fundamental frequency (F0) values (in male participants) and F0 variability (in both genders). The control group showed no statistically significant changes in most vocal parameters assessed, apart from pitch and F0 (in female participants only). On comparing the interval of variation of results between the experimental and control groups, we found no statistically significant difference in vocal parameters between Cl recipients and nonrecipients, with the exception of F0 variability in male participants. Conclusions. The patients in our sample showed changes in overall severity, strain, loudness, and instability values, and reductions in F0 and its variability. On comparing the variation of results between the groups, we were able to prove in our study that implant recipients postlingually deaf adults (experimental group), without specific vocal rehabilitation, differed from nonrecipients (control group) in loudness and F0 variability sustained vowel /a/ in male participants.
- Contribution of noise reduction pre-processing and microphone directionality strategies in the speech recognition in noise in adult cochlear implant users(2021) GOFFI-GOMEZ, Maria Valeria Schmidt; MUNIZ, Lilian; WIEMES, Gislaine; ONUKI, Lucia Cristina; CALONGA, Luciane; OSTERNE, Francisco Jose; KOS, Maria Isabel; CALDAS, Fernanda Ferreira; CARDOSO, Carolina; CAGNACCI, ByankaPurpose Refinement currently offered in new sound processors may improve noise listening capability reducing constant background noise and enhancing listening in challenging signal-to-noise conditions. This study aimed to identify whether the new version of speech processor preprocessing strategy contributes to speech recognition in background noise compared to the previous generation processor. Methods This was a multicentric prospective cross-sectional study. Post-lingually deaf adult patients, with at least 1 year of device use and speech recognition scores above 60% on HINT sentences in quiet were invited. Speech recognition performance in quiet and in noise with sound processors with previous and recent technologies was assessed under four conditions with speech coming from the front: (a) quiet (b) fixed noise coming from the front, (c) fixed noise coming from the back, and (d) adaptive noise ratios with noise coming from the front. Results Forty-seven cochlear implant users were included. No significant difference was found in quiet condition. Performance with the new processor was statistically better than the previous sound processor in all three noisy conditions (p < 0.05). With fixed noise coming from the back condition, speech recognition was 62.9% with the previous technology and 73.5% on the new one (p < 0.05). The mean speech recognition in noise was also statistically higher, with 5.8 dB and 7.1 dB for the newer and older technologies (p < 0.05), respectively. Conclusion New technology has shown to provide benefits regarding speech recognition in noise. In addition, the new background noise reduction technology, has shown to be effective and improves speech recognition in situations of more intense noise coming from behind.
- Speech Recognition of Cochlear Implant Users Inside a Noisy Helicopter Environment(2019) CALDEIRAA, Juliana Maria Araujo; GOFFI-GOMEZ, Maria Valeria Schmidt; IMAMURA, Rui; BENTO, Ricardo FerreiraIn this study, we tested whether the speech recognition, through radio communications, of cochlear implant (CI) users inside a noisy helicopter cockpit is adequate for safe flight. Method: Speech recognition tests (sentences, numbers and disyllables) through a very-high-frequency radio were administered to 12 CI users in a soundproof booth, inside a helicopter with the engine turned off and turned on. Results: In quiet environments, radio communications were impacted only for disyllable intelligibility, but in noisy situations, all tests were affected. Conclusions: CI subjects did not achieve the auditory levels recommended by the International Civil Aviation Organization. (C) 2019 S. Karger AG, Basel
- Converted and Upgraded Maps Programmed in the Newer Speech Processor for the First Generation of Multichannel Cochlear Implant(2013) MAGALHAES, Ana Tereza de Matos; GOFFI-GOMEZ, M. Valeria Schmidt; HOSHINO, Ana Cristina; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; BRITO, RubensObjective: To identify the technological contributions of the newer version of speech processor to the first generation of multichannel cochlear implant and the satisfaction of users of the new technology. Among the new features available, we focused on the effect of the frequency allocation table, the T-SPL and C-SPL, and the preprocessing gain adjustments (adaptive dynamic range optimization). Study Design: Prospective exploratory study. Setting: Cochlear implant center at hospital. Patients: Cochlear implant users of the Spectra processor with speech recognition in closed set. Seventeen patients were selected between the ages of 15 and 82 and deployed for more than 8 years. Interventions: The technology update of the speech processor for the Nucleus 22. Main Outcome Measures: To determine Freedom's contribution, thresholds and speech perception tests were performed with the last map used with the Spectra and the maps created for Freedom. To identify the effect of the frequency allocation table, both upgraded and converted maps were programmed. One map was programmed with 25dB T-SPL and 65dB C-SPL and the other map with adaptive dynamic range optimization. To assess satisfaction, SADL and APHAB were used. Results: All speech perception tests and all sound field thresholds were statistically better with the new speech processor; 64.7% of patients preferred maintaining the same frequency table that was suggested for the older processor. The sound field threshold was statistically significant at 500, 1,000, 1,500, and 2,000 Hz with 25dB T-SPL/65dB C-SPL. Regarding patient's satisfaction, there was a statistically significant improvement, only in the subscale of speech in noise abilities and phone use. Conclusion: The new technology improved the performance of patients with the first generation of multichannel cochlear implant.