ROBERTO MIQUELINO DE OLIVEIRA BECK
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
3 resultados
Resultados de Busca
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- Evaluation of residual hearing in cochlear implants candidates using auditory steady-state response(2015) RAMOS, Henrique Faria; GRASEL, Signe Schuster; BECK, Roberto Miquelino de Oliveira; TAKAHASHI-RAMOS, Marystella Tomoe; RAMOS, Bernardo Faria; ALMEIDA, Edigar Resende de; BENTO, Ricardo Ferreira; NETO, Rubens de BritoConclusion: The correlations between behavioral and auditory steady-state response (ASSR) thresholds were significant at 500, 1000, 2000, and 4000 Hz. ASSR presented high sensitivity and specificity in the detection of residual hearing in cochlear implant candidates when compared with warble-tone audiometry. Objectives: To assess residual hearing in cochlear implant candidates by comparing the electrophysiological thresholds obtained in dichotic single-frequency ASSR with behavioral thresholds at 500, 1000, 2000, and 4000 Hz. Methods: This was a comparative study between ASSR and warble-tone audiometry thresholds in 40 cochlear implant candidates (80 ears) before cochlear implantation with bilateral severe-to-profound sensorineural hearing loss. Results: Thresholds were obtained in 62.5% of all frequencies evaluated in warble-tone audiometry and in 63.1% in the ASSR. ASSR sensitivity was 96% and specificity was 91.6%. Mean differences between behavioral and ASSR thresholds did not reach significance at any frequencies. Strong correlations between behavioral and ASSR thresholds were observed in 500, 1000, and 2000 Hz and moderate in 4000 Hz, with correlation coefficients varying from 0.65 to 0.81. On 90% of occasions, ASSR thresholds were acquired within 10 dB of behavioral thresholds.
- 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.
- Are auditory steady-state responses a good tool prior to pediatric cochlear implantation?(2015) BECK, Roberto Miquelino de Oliveira; GRASEL, Signe Schuster; RAMOS, Henrique Faria; ALMEIDA, Edigar Rezende de; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; BRITO, Rubens deIntroduction: ASSR allow frequency-specific evaluation in intensities up to 120 dB HL and detection of residual hearing in patients with severe-to-profound hearing loss. Aim: to compare ASSR thresholds and behavioral test results in children with suspected severe-to-profound hearing loss. Methods: Cross sectional study to compare ASSR and behavioral responses (VRA or audiometry) in 63 pediatric cochlear implant candidates (126 ears) aged between 6 and 72 months. We included children with normal otomicroscopy, absent responses to click-ABR and otoaccoustic emissions. We excluded children with inner ear malformations, auditory neuropathy spectrum disorder or who did not complete VRA or achieve EEG noise < 30 nV during the ASSR test. Air-conduction ASSR stimuli were continuous sinusoidal tones presented at 0.5, 1, 2 and 4 kHz starting at 110 dB HL Behavioral thresholds were acquired with warble tones presented at 0.5, 1, 2 and 4 kHz in each ear through insert or head phones at maximum presentation level of 120 dB HL Results: Behavioral thresholds were obtained in 36.7% (185/504) of all frequencies in all subjects, 9% in intensities >110 dB HL. Among 504 ASSR measurements, 53 thresholds were obtained (10.5%). Overall 89.5% of the tested frequencies did not show any response at 110 dB HL Most responses were at 500 Hz. Mean differences between behavioral and ASSR thresholds varied from 0.09 to 8.94 dB. Twenty-seven comparisons of behavioral and ASSR thresholds were obtained: 12 at 0.5 kHz, 9 at 1 kHz, Sat 2 kHz and 1 at 4 kHz. Absent responses were observed in both tests in 38.1% at 0.5 kHz, 52.4% at 1 kHz, 74.6% at 2 kHz and 81.0% at 4 kHz. Specificity was > 90% at 1,2 and 4 kHz. In ears with no behavioral response at 120 dB HL all ASSR thresholds were in the profound hearing loss range, 90% of them were >110 dB HL Conclusion: Among 63 pediatric CI candidates, absent responses to high-intensity ASSR was the major finding (specificity > 90%) predicting behavioral thresholds in the profound hearing loss range. These findings can be helpful to confirm the decision for cochlear implantation.