ANA CRISTINA HIROMI HOSHINO
Índice h a partir de 2011
5
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
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- Evolução audiométrica em usuários de implante coclear multicanal(2013) HOSHINO, Ana Cristina Hiromi; CRUZ, Dorilan Rodriguez da; GOFFI-GOMEZ, Maria Valéria Schmidt; BEFI-LOPES, Débora Maria; MATAS, Carla Gentile; FORTUNATO-TAVARES, Talita M.; TSUJI, Robinson KojiPURPOSE: to evaluate how long after activation one can achieve the desired auditory thresholds in individuals multichannel cochlear implant users from different age groups. METHOD: a retrospective cross-sectional from a database, approved by CEP / FMUSP, under number 779/06. Individuals implanted between January 2005 and September 2008, whose files had preoperative audiometric data and 3, 6 and 12 months after CI were included. Seventy-two patients fulfilled the criteria, and they were divided in two groups according to age: group I (17 year old) and GII (18-66 year old). Analysis of variance (ANOVA) of one factor in order to verify the interaction between the mean threshold and time after CI were used. RESULTS: we observed that 15 of the GI have reached around 30dBNA thresholds at 3 months after implant. The same happened to 26 patients of GII. We found significant interaction between time (F (3.140) = 91.973, p = 0.00) and the average hearing thresholds. Post-hoc analysis in the GI group were statistically significant differences for comparisons between HA and 3 months after implantation (p = 0.00) and between 3 and 12 months (p = 0.28). For GII only for comparison between HA and 3 months (p = 0.00). CONCLUSION: a significant hearing change may be observed beginning from three months after IC, but this result is not found in all implanted subjects.
- Predicting emotion perception abilities for cochlear implant users(2023) PAQUETTE, S.; DEROCHE, M. L. D.; V, M. Goffi-Gomez; HOSHINO, A. C. H.; LEHMANN, A.Objective In daily life, failure to perceive emotional expressions can result in maladjusted behaviour. For cochlear implant users, perceiving emotional cues in sounds remains challenging, and the factors explaining the variability in patients' sensitivity to emotions are currently poorly understood. Understanding how these factors relate to auditory proficiency is a major challenge of cochlear implant research and is critical in addressing patients' limitations. Design To fill this gap, we evaluated different auditory perception aspects in implant users (pitch discrimination, music processing and speech intelligibility) and correlated them to their performance in an emotion recognition task. Study sample Eighty-four adults (18-76 years old) participated in our investigation; 42 cochlear implant users and 42 controls. Cochlear implant users performed worse than their controls on all tasks, and emotion perception abilities were correlated to their age and their clinical outcome as measured in the speech intelligibility task. Results As previously observed, emotion perception abilities declined with age (here by about 2-3% in a decade). Interestingly, even when emotional stimuli were musical, CI users' skills relied more on processes underlying speech intelligibility. Conclusions These results suggest that speech processing remains a clinical priority even when one is interested in affective skills.
- Molecular and genetic characterization of a large Brazilian cohort presenting hearing loss(2022) BATISSOCO, Ana Carla; PEDROSO-CAMPOS, Vinicius; PARDONO, Eliete; SAMPAIO-SILVA, Juliana; SONODA, Cindy Yukimi; VIEIRA-SILVA, Gleiciele Alice; LONGATI, Estefany Uchoa da Silva de Oliveira; MARIANO, Diego; HOSHINO, Ana Cristina Hiromi; TSUJI, Robinson Koji; JESUS-SANTOS, Rafaela; ABATH-NETO, Osorio; BENTO, Ricardo Ferreira; OITICICA, Jeanne; LEZIROVITZ, KarinaHearing loss is one of the most common sensory defects, affecting 5.5% of the worldwide population and significantly impacting health and social life. It is mainly attributed to genetic causes, but their relative contribution reflects the geographical region's socio-economic development. Extreme genetic heterogeneity with hundreds of deafness genes involved poses challenges for molecular diagnosis. Here we report the investigation of 542 hearing-impaired subjects from all Brazilian regions to search for genetic causes. Biallelic GJB2/GJB6 causative variants were identified in 12.9% (the lowest frequency was found in the Northern region, 7.7%), 0.4% carried GJB2 dominant variants, and 0.6% had the m.1555A > G variant (one aminoglycoside-related). In addition, other genetic screenings, employed in selected probands according to clinical presentation and presumptive inheritance patterns, identified causative variants in 2.4%. Ear malformations and auditory neuropathy were diagnosed in 10.8% and 3.5% of probands, respectively. In 3.8% of prelingual/perilingual cases, Waardenburg syndrome was clinically diagnosed, and in 71.4%, these diagnoses were confirmed with pathogenic variants revealed; seven out of them were novel, including one CNV. All these genetic screening strategies revealed causative variants in 16.2% of the cases. Based on causative variants in the molecular diagnosis and genealogy analyses, a probable genetic etiology was found in similar to 50% of the cases. The present study highlights the relevance of GJB2/GJB6 as a cause of hearing loss in all Brazilian regions and the importance of screening unselected samples for estimating frequencies. Moreover, when a comprehensive screening is not available, molecular diagnosis can be enhanced by selecting probands for specific screenings.
- 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 KojiPurpose: 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.
- Outcomes of Late Implantation in Usher Syndrome Patients(2017) HOSHINO, Ana Cristina H.; ECHEGOYEN, Agustina; GOFFI-GOMEZ, Maria Valéria Schmidt; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraAbstract Introduction Usher syndrome (US) is an autosomal recessive disorder characterized by hearing loss and progressive visual impairment. Some deaf Usher syndrome patients learn to communicate using sign language. During adolescence, as they start losing vision, they are usually referred to cochlear implantation as a salvage for their new condition. Is a late implantation beneficial to these children? Objective The objective of this study is to describe the outcomes of US patients who received cochlear implants at a later age. Methods This is a retrospective study of ten patients diagnosed with US1. We collected pure-tone thresholds and speech perception tests from pre and one-year post implant. Results Average age at implantation was 18.9 years (5-49). Aided average thresholds were 103 dB HL and 35 dB HL pre and one-year post implant, respectively. Speech perception was only possible to bemeasured in four patients preoperatively, who scored 13.3; 26.67; 46% vowels and 56% 4-choice. All patients except one had some kind of communication. Two were bilingual. After one year of using the device, seven patients were able to perform the speech tests (from four-choice to close set sentences) and three patients abandoned the use of the implant. Conclusion We observed that detection of sounds can be achieved with late implantation, but speech recognition is only possible in patients with previous hearing stimulation, since it depends on the development of hearing skills and the maturation of the auditory pathways.
- Avaliação do Naída CI Q70 e estratégia UltraZoom para o reconhecimento de fala em situações reverberantes e com ruído competitivo(2020) SAMUEL, Paola Angelica; GOFFI-GOMEZ, Maria Valéria Schmidt; HOSHINO, Ana Cristina; AGRAWAL, Smita; RODRIGUEZ, Carina; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraAbstract Purpose 1) To measure speech understanding in noise with the Naída Q70 in the omnidirectional microphone mode (T-Mic) and adaptive directional microphone mode (UltraZoom) in reverberating acoustics and noisy conditions. 2) To measure improvement in speech understanding with use of the Advanced Bionics (AB) Naída Q70 sound processor for existing Harmony users. Methods Seven adult unilateral cochlear implant (CI) recipients, who were experienced users of the Harmony sound processor, participated in the study. Sentence recognition was evaluated in quiet in a reverberating room, with Harmony and Naída CI Q70 processors. Effectiveness of Naída CI Q70’s UltraZoom directional microphone was evaluated in noise. Target stimuli were recorded Portuguese sentences presented from 0° azimuth. Twenty-talker babble was presented at +5dB SNR from ±90° azimuth. In addition to sentence recognition, the participants also rated the clarity of sound and difficulty of listening in the various test conditions. In order to evaluate the outcomes under more realistic acoustic conditions, tests were conducted in a non-sound treated reverberant room (RT60 of 553 ms and noise floor of 42.7 dBA (Leq). Results The average sentence recognition in quiet in the reverberant non-sound treated room was 38.5% with the Harmony and 66.5% with Naída CI Q70. The average sentence recognition score in noise was 40.5% with Naída CI Q70 without UltraZoom and 64.5% with UltraZoom. For subjective ratings of sound clarity and listening ease in noise no difference were identified between the test conditions. Conclusion For experienced users of the Harmony sound processor, speech understanding in quiet in a reverberating room was significantly improved with the Naída CI Q70. The use of an adaptive directional microphone technology (UltraZoom) enhanced speech perception in noise.
- Benefit of Cochlear Implantation in Children with Multiple-handicaps: Parent's Perspective(2018) NASRALLA, Heloisa Romeiro; MONTEFUSCO, Adilson Marcos; HOSHINO, Ana Cristina H.; SAMUEL, Paola Angelica; MAGALHAES, Ana Tereza de Matos; GOFFI-GOMEZ, Maria Valeria Schmidt; TSUJI, Robinson Koji; BENTO, Ricardo FerreiraIntroduction The cochlear implants centers in the world are studying the cochlear implantation in children with multiple handicaps. Objective To develop a questionnaire to analyze the subjective benefits of the cochlear implantation in multiple handicapped children according to their parent's perspective. Methods A questionnaire was applied to 14 families of multiple handicapped children, aging from 2-12 years old and having from 11 months to 11 years of implant use. Results The social-emotional abilities were improved because of many factors, such as: auditory exposure, which happened in 84% of the children; recognition of their own names, which increased in 56%; and development of eye contact, in 28% of the subjects. Other benefits appeared to be: music appreciation and more attention and adherence to other therapies and school activities. Besides, some children became interested in objects, playing with other children, and more adapted to daily routines. Thirty-five percent of the children acquired oral language, mainly the bilaterally implanted, while 14% of them were engaged in sign language. Although all of the children showed a significant improvement in communication, the emotional issues of some families and the severity of the handicaps negatively impacted the outcomes. In spite of the families' acknowledgement of some benefits, the diagnosis of autism spectrum disorder caused frustration, requiring a readjustment of the expectations. Conclusion The questionnaire turned out to be an adequate tool to reveal the social-emotional benefits of cochlear implantation. Although oral language was not the major outcome in these cases, the cochlear implant benefits involved the whole family. All of the families recommended the implant to other children in a similar situation.
- Vocabulário expressivo em crianças usuárias de implante coclear(2017) COLALTO, Claudia Aparecida; GOFFI-GOMEZ, Maria Valéria Schmidt; MAGALHÃES, Ana Tereza de Matos; SAMUEL, Paola Angélica; HOSHINO, Ana Cristina Hiromi; PORTO, Bruna Lins; TSUJI, Robinson KojiABSTRACT Objective: to verify whether children with cochlear implants (CI) acquire vocabulary at the same pace as normally hearing children, and which factors influence their acquisition. Methods: the vocabulary test of the ABFW was performed on 20 children who had been using the cochlear implant for at least three years. Historical information, such as age at time of implant, hearing age (i.e., at time of implant use), and family participation in the rehabilitation process, was gathered from patients’ files. Correlation statistical analysis was then performed. Results: it was observed that children with CI may acquire vocabulary similar to that of hearing children, depending on many aspects. The age at time of implantation and hearing age did not significantly correlate to the vocabulary results. The factor that demonstrated statistical significance was family participation, which showed a positive correlation: the more the family was involved in the rehabilitation process, the better the children’s results on the vocabulary test. Conclusion: it was, thus, possible to conclude that children with CI develop their vocabulary in a similar manner as hearing children, depending on factors that transcend the child’s age at time of implantation and hearing age. Family participation, in the rehabilitation process, was shown to be of critical importance in the child’s vocabulary development.
- 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.
- Mercury Exposure in a Riverside Amazon Population, Brazil: A Study of the Ototoxicity of Methylmercury(2015) HOSHINO, Ana; PACHECO-FERREIRA, Heloisa; SANCHES, Seisse Gabriela G.; CARVALLO, Renata; CARDOSO, Nathália; PEREZ, Maurício; CÂMARA, Volney de MagalhãesIntroduction Mercury poisoning causes hearing loss in humans and animals. Acute and long-term exposures produce irreversible peripheral and central auditory system damage, and mercury in its various forms of presentation in the environment is ototoxic. Objective We investigated the otoacoustic emissions responses in a riverside population exposed to environmental mercury by analyzing the inhibitory effect of the medial olivocochlear system (MOCS) on transient otoacoustic emissions (TEOAE). Methods The purpose of the research was to evaluate the entire community independently of variables of sex and age. All of the participants were born and lived in a riverside community. After otolaryngologic evaluation, participants were received tympanometry, evaluation of contralateral acoustic reflexes, pure tone audiometry, and recording of TEOAEs with nonlinear click stimulation. Hair samples were collect to measure mercury levels. Results There was no significant correlation between the inhibitory effect of the MOCS, age, and the level of mercury in the hair. Conclusions The pathophysiological effects of chronic exposure may be subtle and nonspecific and can have a long period of latency; therefore, it will be important to monitor the effects of mercury exposure in the central auditory system of the Amazon population over time. Longitudinal studies should be performed to determine whether the inhibitory effect of the MOCS on otoacoustic emissions can be an evaluation method and diagnostic tool in populations exposed to mercury.