ALESSANDRA GIANNELLA SAMELLI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
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- Influence of obstructive sleep apnea on auditory event-related potentials(2022) PEDRENO, Raquel Meirelles; MATSUMURA, Erika; SILVA, Liliane Aparecida Fagundes; SAMELLI, Alessandra Giannella; MAGLIARO, Fernanda Cristina Leite; SANCHES, Seisse Gabriela Gandolfi; LOBO, Ivone Ferreira Neves; LORENZI-FILHO, Geraldo; CARVALLO, Renata Mota Mamede; MATAS, Carla GentilePurpose To evaluate the influence of obstructive sleep apnea (OSA) on the P300 response of auditory event-related potentials (ERPs) and to correlate the electrophysiological findings with OSA severity. Methods Patients with no OSA and mild, moderate, and severe OSA according to polysomnography (PSG) with normal hearing and no comorbidities were studied. Individuals with a body mass index (BMI) >= 40 kg/m(2), hypertension, diabetes, dyslipidemia, the use of chronic medications, and a risk of hearing loss were excluded. All patients underwent full PSG and auditory ERP measurement using the oddball paradigm with tone burst and speech stimuli. For P300 analysis (latencies and amplitudes), normal multiple linear regression models were adjusted with the groups (No OSA, Mild OSA, Moderate OSA, Severe OSA), age, BMI, and Epworth score as explanatory variables. Results We studied 54 individuals (47 males) aged 35 +/- 8 years with a BMI of 28.4 +/- 4.3 kg/m(2). Patients were divided according to the apnea-hypopnea index (AHI) derived from PSG into no OSA (n = 14), mild (n = 16), moderate (n = 12), and severe OSA (n = 12) groups. Patients with severe OSA presented prolonged P300 latencies with tone burst stimuli compared to patients with no OSA and those with mild and moderate OSA. Conclusion Severe OSA is associated with impairment of the P300 response of auditory ERPs, suggesting a decrease in the processing speed of acoustic information that may be mediated by the level of somnolence.
- Effects of Noise and Chemical Exposure on Peripheral and Central Auditory Pathways in Normal-hearing Workers(2022) TRABANCO, Julio C. S.; MORITA, Bruno; MATAS, Carla Gentile; PAIVA, Karina Mary de; MOREIRA, Renata R.; SANCHES, Seisse G. G.; SAMELLI, Alessandra G.Objectives: To assess the effects of noise and chemical exposure on peripheral and central auditory pathways in normal-hearing workers exposed to chemicals or high noise levels and compare the groups with each other and with workers not exposed to either of these agents. Methods: A total of 54 normal-hearing workers were divided into three groups (chemical, noise, control) and submitted to the following assessments: conventional and extended high-frequency pure-tone audiometry; transient and distortion-product otoacoustic emissions, the inhibitory effect of the efferent auditory pathway; and Staggered Spondaic Word (SSW) and Pitch Pattern Sequence (PPS) test. Results: There were no significant differences between the groups in extended high-frequency hearing thresholds. Significantly lower amplitudes were observed in the noise group for otoacoustic emissions. There were significantly more absences of the inhibitory effect of the efferent system in the noise group. There was no difference between the groups in the SSW test, while in PPS, the noise group performed worse than the control group. Conclusion: These findings suggest that noise exposure produced deleterious effects on the workers' peripheral and central auditory systems, despite their normal hearing thresholds. The chemical group did not have significantly different results from those of the control group. It is important that individuals exposed to noise or chemicals have their auditory pathways monitored with complementary assessments.
- Teleaudiometry as a screening method in school children(2015) BOTASSO, Maine; SANCHES, Seisse Gabriela Gandolfi; BENTO, Ricardo Ferreira; SAMELLI, Alessandra GiannellaOBJECTIVE: To compare the efficacy and feasibility of teleaudiometry with that of sweep audiometry in elementary school children, using pure-tone audiometry as the gold standard. METHODS: A total of 243 students with a mean age of 8.3 years participated in the study. Of these, 118 were boys, and 125 were girls. The following procedures were performed: teleaudiometry screening with software that evaluates hearing at frequencies of 1,000, 2000 and 4000 Hz at 25 dBHL; sweep audiometry screening in an acoustic booth (20 dBHL at the same frequencies); pure-tone audiometry thresholds in an acoustic booth (frequencies of 500, 1000, 2000 and 4000 Hz); and acoustic immittance measurements. RESULTS: The diagnostic capacities of the teleaudiometry/sweep audiometry screening methods were as follows: sensitivity ϝ 58%/65%; specificity ϝ 86%/99%; positive predictive value ϝ 51%/91%; negative predictive value ϝ 89%/92%; and accuracy ϝ 81%/92%. Teleaudiometry and sweep audiometry showed moderate agreement. Furthermore, the use of these methods in series with immittance testing improved the specificity, whereas parallel testing improved the sensitivity. CONCLUSION: Teleaudiometry was found to be reliable and feasible for screening hearing in school children. Moreover, teleaudiometry is the preferred method for remote areas where specialized personnel and specific equipment are not available, and its use may reduce the costs of hearing screening programs.
- Tablet-based tele-audiometry: Automated hearing screening for schoolchildren(2020) SAMELLI, Alessandra G.; RABELO, Camila M.; SANCHES, Seisse G. Gandolfi; MARTINHO, Ana C.; MATAS, Carla G.Introduction To assess the performance of a tablet-based tele-audiometry method for automated hearing screening of schoolchildren through a comparison of the results of various hearing screening approaches. Methods A total of 244 children were evaluated. Tablet-based screening results were compared with gold-standard pure-tone audiometry. Acoustic immittance measurements were also conducted. To pass the tablet-based screening, the children were required to respond to at least two out of three sounds for all the frequencies in each ear. Several hearing screening methods were analysed: exclusively tablet-based (with and without 500 Hz checked) and combined tests (series and parallel). The sensitivity, specificity, positive and negative predictive values and accuracy were calculated. Results A total of 9.43% of children presented with mild to moderate conductive hearing loss (unilateral or bilateral). Diagnostic values varied among the different hearing screening approaches that were evaluated: sensitivities ranged from 60 to 95%, specificities ranged from 44 to 91%, positive predictive values ranged from 15 to 44%, negative predictive values ranged from 95 to 99%, accuracy values ranged from 49 to 88%, and area under curve values ranged from 0.690 to 0.883. Regarding diagnostic values, the highest results were found for the tablet-based screening method and for the series approach. Discussion Compared with the results obtained by conventional audiometry and considering the diagnostic values of the different hearing screening approaches, the highest diagnostic values were generally obtained using the automated hearing screening method (including 500 Hz). Thus, this application, which was developed for the tablet computer, was shown to be a valuable hearing screening tool for use with schoolchildren. Therefore, we suggest that this hearing screening protocol has the potential to improve asynchronous tele-audiology service delivery.
- The audiological profile of adults with and without hypertension(2016) SOARES, Mariana Aparecida; SANCHES, Seisse Gabriela Gandolfi; MATAS, Carla Gentile; SAMELLI, Alessandra GiannellaOBJECTIVE: To determine whether there is any influence of systemic arterial hypertension on the peripheral auditory system. METHODS: This was a cross-sectional study that investigated 40 individuals between 30 and 50 years old, who were divided into groups with and without systemic arterial hypertension, using data from high-frequency audiometry, transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions. The results were compared with those from groups of normal-hearing individuals, with and without systemic arterial hypertension, who underwent the pure-tone audiometry test. All individuals also underwent the following procedures: otoscopy, acoustic immittance measures, pure-tone audiometry at frequencies from 250 to 16000 Hz, transient-evoked otoacoustic emissions test and distortion-product otoacoustic emissions test. RESULTS: No statistically significant difference was observed between the groups with and without systemic arterial hypertension in either conventional or high-frequency audiometry. Regarding transient-evoked otoacoustic emissions, there was a trend toward statistical significance whereby the systemic arterial hypertension group showed lower results. Regarding distortion-product otoacoustic emissions, the systemic arterial hypertension group showed significantly lower results at the following frequencies: 1501, 2002, and 3003 Hz. A discriminant analysis indicated that the distortion-product otoacoustic emissions variables best distinguished individuals with and without systemic arterial hypertension. CONCLUSION: Data from this study suggest cochlear dysfunction in individuals with systemic arterial hypertension because their otoacoustic emission results were lower than those in the systemic arterial hypertension group.
- Tablet-Based Hearing Screening(2017) SAMELLI, Alessandra G.; RABELO, Camila M.; SANCHES, Seisse G. G.; AQUINO, Camila P.; GONZAGA, DeniseIntroduction: Hearing loss (HL) affects people worldwide, many of whom are children. Especially in developing countries, epidemiological data on the prevalence of HL are insufficient to implement effective health promotion programs. In this preliminary study with young adults, we describe and validate a tablet-based hearing screening test developed for interactive remote hearing screening and compare the performance of an audiometry screening tablet application with conventional audiometry. In addition, the sensitivity, specificity, and predictive values of the tablet-based method and the concordance between the two methods were analyzed. Methods: Thirty volunteers participated in a double-blind study assessing two auditory threshold screening methods: tablet-based hearing screening and sweep audiometry. For both methods, a correct response to a minimum of two tones out of three emitted at 20 dBHL for the frequencies of 1, 2, and 4 kHz and 30 dBHL for 0.5 kHz in both ears, was considered a negative screening result (normal hearing), whereas hearing impairment was considered a positive screening result. Results: According to both methods, 26 participants had normal hearing and four had HL. The Kappa coefficient indicated perfect concordance between methods. The tablet-based hearing screening method had a sensitivity of 100% (confidence interval [CI]: 30.5-100.0), a specificity of 100% (CI: 87.1-100.0), a positive predictive value of 100% (CI: 30.5-100.0), and a negative predictive value of 100% (CI: 87.1-100.0). Conclusions: The tablet-based hearing screening test was shown to be a reliable and an accurate method for hearing screening that can be used effectively in places with Internet access and where local audiologists are not available.
- Comparison of screening methods for conductive hearing loss identification in children: low-cost proposal(2012) SAMELLI, A. G.; RABELO, C. M.; PEREIRA, M. B.; PORTELA, M. N.; SANCHES, S. G. G.; NEVES-LOBO, I. F.Objective To evaluate the effectiveness of two screening methods (imitanciometry screening and questionnaire) to identify children at risk for conductive hearing loss, comparing this data with complete audiologic evaluation. Methods Of 507 children aged between three and six, 111 completed all procedures. The observational methods used were: imitanciometry screening, a questionnaire to identify risk factors for hearing loss and complete audiologic evaluation. Results obtained in the first two instruments were compared with results from complete audiologic evaluation (gold standard). From these comparisons, sensitivity and specificity, accuracy, positive and negative predictive values, and odds ratio were determined for the two screening methods and for the combination of both methods. Results The two methods applied in series (questionnaire and after imitanciometry screening) showed a greater odds ratio and better correlation between sensitivity and proportion of false-positives (ROC curve). Conclusion Combining the two tests in series improved screening accuracy. This combination was the best tool for identifying children at risk for conductive hearing loss.