ANA CLAUDIA MARTINHO DE CARVALHO

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LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina

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  • article 13 Citação(ões) na Scopus
    Cortical maturation in children with cochlear implants: Correlation between electrophysio-logical and behavioral measurement
    (2017) SILVA, Liliane Aparecida Fagundes; COUTO, Maria Ines Vieira; MAGLIARO, Fernanda C. L.; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile
    Central auditory pathway maturation in children depends on auditory sensory stimulation. The objective of the present study was to monitor the cortical maturation of children with cochlear implants using electrophysiological and auditory skills measurements. The study was longitudinal and consisted of 30 subjects, 15 (8 girls and 7 boys) of whom had a cochlear implant, with a mean age at activation time of 36.4 months (minimum, 17 months; maximum, 66 months), and 15 of whom were normal-hearing children who were matched based on gender and chronological age. The auditory and speech skills of the children with cochlear implants were evaluated using GASP, IT-MAIS and MUSS measures. Both groups underwent electrophysiological evaluation using long-latency auditory evoked potentials. Each child was evaluated at three and nine months after cochlear implant activation, with the same time interval adopted for the hearing children. The results showed improvements in auditory and speech skills as measured by IT-MAIS and MUSS. Similarly, the long-latency auditory evoked potential evaluation revealed a decrease in P1 component latency; however, the latency remained significantly longer than that of the hearing children, even after nine months of cochlear implant use. It was observed that a shorter P1 latency corresponded to more evident development of auditory skills. Regarding auditory behavior, it was observed that children who could master the auditory skill of discrimination showed better results in other evaluations, both behavioral and electrophysiological, than those who had mastered only the speech-detection skill. Therefore, cochlear implant auditory stimulation facilitated auditory pathway maturation, which decreased the latency of the P1 component and advanced the development of auditory and speech skills. The analysis of the long-latency auditory evoked potentials revealed that the P1 component was an important biomarker of auditory development during the rehabilitation process.
  • bookPart
    Desenvolvimento da audição, da linguagem, da atividade motora oral e da alimentação e seus principais distúrbios
    (2018) ANDRADE, Cláudia Regina Furquim de; MOLINI-AVEJONAS, Daniela Regina; CARVALHO, Ana Claudia Martinho de; BEFI-LOPES, Débora Maria
  • article 20 Citação(ões) na Scopus
    Quality of life evaluation in children with cochlear implants
    (2015) ALMEIDA, Renata Paula de; MATAS, Carla Gentile; COUTO, Maria Inês Vieira; CARVALHO, Ana Claudia Martinho de
    PURPOSE: To evaluate the quality of life of children with cochlear implants from the perspective of their parents. METHODS: A clinical and cross-sectional study was conducted with 15 parents of children using cochlear implants of both genders aged between 2 and 12 years old. Parents of these children answered the questionnaire ""Children with Cochlear Implants: Parental Perspective"" (CCIPP). Data related to auditory category and time of cochlear implants use were collected from medical records of the children. The percentages of responses on the CCIPP domains were tabulated and descriptively and inferentially analyzed. RESULTS: The cochlear implants had a positive effect on the quality of life of children in the self-reliance (58.9%) and social relationships (56.7%) domains. No correlation was observed between the time of cochlear implants activation (months) and any of the CCIPP domains. However, children with 24 months or less of cochlear implant use presented higher percentages on the communication domain than those with more than 24 months of cochlear implants use. A negative correlation was observed between the auditory category and the effects of the implant domain. CONCLUSION: From the perspective of parents, the use of cochlear implants improves the quality of life of their children; the shorter the time of cochlear implants use, the higher the improvement in quality of life; and the more developed the auditory skills, the lower the percentage of quality of life improvement with the cochlear implants.
  • article 10 Citação(ões) na Scopus
    Sequential bilateral cochlear implant: results in children and adolescents
    (2019) ALMEIDA, Gabriela Felix Lazarini; MARTINS, Marcella Ferrari; COSTA, Lucas Bevilacqua Alves da; COSTA, Orozimbo Alves da; CARVALHO, Ana Claudia Martinho de
    Introduction: The use of the bilateral cochlear implants can promote the symmetrical development of the central auditory pathways, thus benefiting the development of auditory abilities and improving sound localization and the ability of auditory speech perception in situations of competitive noise. Objective: To evaluate the ability of speech perception in children and adolescents using sequential bilateral cochlear implants, considering the association of these variables: age at surgery, time of device use and interval between surgeries. Methods: A total of 14 individuals between 10 and 16 years of age, who demonstrated surgical indication for the use of sequential bilateral cochlear implants as intervention in the auditory habilitation process, were assessed. The speech perception ability was assessed through sentence lists constructed in the Portuguese language, presented in two situations: in silence, with fixed intensity of 60 dB SPL, and in competitive noise, with a signal-to-noise ratio of +15 dB. The evaluation was performed under the following conditions: unilateral with the first activated cochlear implant, unilateral with the second activated cochlear implant and bilateral with both devices activated. Results: The results of the speech perception tests showed better performance in both silence and in noise for the bilateral cochlear implant condition when compared to the 1st cochlear implant and the 2nd cochlear implant alone. A worse result of speech perception was found using the 2nd cochlear implant atone. No statistically significant correlation was found between age at the surgical procedure, interval between surgeries and the time of use of the 2nd cochlear implant, and the auditory speech perception performance for all assessed conditions. The use of a hearing aid prior to the 2nd cochlear implant resulted in benefits for auditory speech perception with the 2nd cochlear implant, both in silence and in noise. Conclusion: The bilateral cochlear implant provided better speech perception in silence and in noise situations when compared to the unilateral cochlear implant, regardless of the interval between surgeries, age at the surgical procedure and the time of use of the 2nd cochlear implant. Speech perception with the 1st cochlear implant was significantly better than with the 2nd cochlear implant, both in silence and in noise. The use of the hearing aid prior to the 2nd cochlear implant influenced speech perception performance with the 2nd cochlear implant, both in silence and in noise. (C) 2018 Associacao Brasileira de Otorrinotaringologia e Cirurgia Cervico-Facial.
  • article 0 Citação(ões) na Scopus
    Can the use of the CROS system provide head shadow effect contribution to unilateral Cochlear Implant Users?
    (2022) HOSHINO, Ana Cristina Hiromi; GOFFI-GOMEZ, Maria Valeria Schmidt; SIERRA, Paola Angelica Samuel; AGRAWAL, Smita; RODRIGUEZ, Carina; CARVALHO, Ana Claudia Martinho de; TSUJI, Robinson Koji
    Purpose: The aim of this study was to evaluate the contribution of the CROS system on the head shadow effect in unilateral implant users. Methods: Prospective cross-sectional study, approved by the ethics committee under protocol 2.128.869. Eleven adults with post-lingual deafness users of unilateral Advanced Bionics CI were selected. Speech recognition was evaluated with recorded words presented at 65dBA at 0o azimuth and at 90o on the side contralateral to the CI, with noise at 55dBA, using CI alone and CI + CROS system. The results were analyzed using paired t-test with a 0.05 alpha. Results: The mean speech recognition scores were significantly better with CI + CROS in relation to the condition of CI alone (p <0.05, p <0.005 and p <0.005 respectively). In the presentation at 0o azimuth, no significant differences were found. Conclusion: Users of unilateral CI without useful residual hearing for the use of hearing aids or unable to undergo bilateral surgery can benefit from the CROS device for speech recognition, especially when the speech is presented on the side contralateral to the CI.
  • article
    Central Auditory Nervous System Stimulation through the Cochlear Implant Use and Its Behavioral Impacts: A Longitudinal Study of Case Series
    (2021) CAVALCANTI, Marina Isabel; SILVA, Liliane Aparecida Fagundes; GOMEZ, Maria Valeria Schmidt Goffi; KOJI, Tsuji Robinson; BENTO, Ricardo Ferreira; CARVALHO, Ana Claudia Martinho de; GENTILE, Matas Carla
    The purpose of this study was to investigate, over a period of five years, the cortical maturation of the central auditory pathways and its impacts on the auditory and oral language development of children with effective use and without effective use of a Cochlear Implant (CI). A case series study was conducted with seven children who were CI users and seven children with normal hearing, with age- and gender-matched to CI users. The assessment was performed by long-latency auditory evoked potentials and auditory and oral language behavioral protocols. The results pronounced P1 latency decrease in all CI users in the first nine months. Over five years, five children with effective CI use presented decrease or stabilization of P1 latency and a gradual development of auditory and oral language skills, although, for most of the children, the electrophysiological and behavior results remained poor than their hearing peers' results. Two children who stopped the effective use of CI after the first year of activation had worsened auditory and oral language behavioral skills and presented increased P1 latency. A negative correlation was observed between behavioral measures and the P1 latency, the P1 component being considered an important clinical resource capable of measuring the cortical maturation and the behavioral evolution.
  • article 6 Citação(ões) na Scopus
    Fatores que influenciam na participação dos pais de crianças usuárias de implante coclear na (re)habilitação oral: revisão sistemática
    (2013) COUTO, Maria Inês Vieira; CARVALHO, Ana Claudia Martinho
    PURPOSE: To identify and analyze factors that influence the participation of parents in the rehabilitation process of children with cochlear implants (CI). RESEARCH STRATEGY: Question formulation and articles selection in three databases using the following keywords: cochlear implant (implante coclear) and parents (pais). SELECTION CRITERIA: Complete original articles published in Brazilian Portuguese or English, with direct participation of parents of children with CI. DATA ANALYSIS: Articles were fully read. Data regarding characterization of the centers, research methodology and content were analyzed. RESULTS: Thirteen articles were selected based on the established criteria. The types of studies were cross-sectional and case-control (interview technique). The following influential factors were identified: pre-CI surgery factors (knowledge about CI, quality and quantity of information, specialist's advices, ethical and biomedical aspects, rehabilitation engagement, contact with experienced families, social service support and overall costs); rehabilitation aspects (CI use, oral communication modality, regular school, other disabilities, social and demographic aspects and rehabilitation program's effectiveness); other important influential processes (communication modality, auditory and language development, second oral language learning, as well as parent's behavior and satisfaction). CONCLUSION: The engagement of parents in the rehabilitation process of children with CI depends on several distinct influential factors which audiologists should understand and consider when elaborating a rehabilitation program.
  • article 0 Citação(ões) na Scopus
    Cortical maturation in children with cochlear implants: Correlation between electrophysiological and behavioral measurement (vol 12, e0171177, 2017)
    (2017) SILVA, Liliane Aparecida Fagundes; COUTO, Maria Ines Vieira; MAGLIARO, Fernanda C. L.; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile
  • article 6 Citação(ões) na Scopus
    Long latency auditory evoked potentials in children with cochlear implants: systematic review
    (2013) SILVA, Liliane Aparecida Fagundes; COUTO, Maria Ines Vieira; MATAS, Carla Gentile; CARVALHO, Ana Claudia Martinho de
    The aim of this study was to analyze the findings on Cortical Auditory Evoked Potentials in children with cochlear implant through a systematic literature review. After formulation of research question and search of studies in four data bases with the following descriptors: electrophysiology (eletrofisiologia), cochlear implantation (implante coclear), child (criança), neuronal plasticity (plasticidade neuronal) and audiology (audiologia), were selected articles (original and complete) published between 2002 and 2013 in Brazilian Portuguese or English. A total of 208 studies were found; however, only 13 contemplated the established criteria and were further analyzed; was made data extraction for analysis of methodology and content of the studies. The results described suggest rapid changes in P1 component of Cortical Auditory Evoked Potentials in children with cochlear implants. Although there are few studies on the theme, cochlear implant has been shown to produce effective changes in central auditory path ways especially in children implanted before 3 years and 6 months of age.
  • article 15 Citação(ões) na Scopus
    Maturação dos potenciais evocados auditivos de longa latência em crianças ouvintes: revisão sistemática
    (2017) SILVA, Liliane Aparecida Fagundes; MAGLIARO, Fernanda Cristina Leite; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile
    ABSTRACT Purpose To analyze how Auditory Long Latency Evoked Potentials (LLAEP) change according to age in children population through a systematic literature review. Research strategies After formulation of the research question, a bibliographic survey was done in five data bases with the following descriptors: Electrophysiology (Eletrofisiologia), Auditory Evoked Potentials (Potenciais Evocados Auditivos), Child (Criança), Neuronal Plasticity (Plasticidade Neuronal) and Audiology (Audiologia). Selection criteria Level 1 evidence articles, published between 1995 and 2015 in Brazilian Portuguese or English language. Data analysis Aspects related to emergence, morphology and latency of P1, N1, P2 and N2 components were analyzed. Results A total of 388 studies were found; however, only 21 studies contemplated the established criteria. P1 component is characterized as the most frequent component in young children, being observed around 100-150 ms, which tends to decrease as chronological age increases. The N2 component was shown to be the second most commonly observed component in children, being observed around 200-250 ms.. The other N1 and P2 components are less frequent and begin to be seen and recorded throughout the maturational process. Conclusion The maturation of LLAEP occurs gradually, and the emergence of P1, N1, P2 and N2 components as well as their latency values are variable in childhood. P1 and N2 components are the most observed and described in pediatric population. The diversity of protocols makes the comparison between studies difficult.