ROBINSON KOJI TSUJI
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
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- 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.
- Auditory and language skills in children with auditory brainstem implants(2020) FERNANDES, Nayara Freitas; GOMES, Marcos de Queiroz Teles; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; GOFFI-GOMEZ, Maria Valria SchimdtObjective: The aim of this study is to characterize the development of auditory and language skills in children during the first 3 years of auditory brainstem implant (ABI) use. Method: It is a retrospective longitudinal analysis of auditory and language skills in 12 children and pre-adolescents with pre-lingual deafness following ABI surgery (mean age at surgery: 4 years; age range: 2-11 years). Responses were analyzed aboutInfant Toddler Meaningful Auditory Integration Scale (IT-MAIS), MAIS, and Meaningful Use of Speech Scale (MUSS) at 1, 3, 6, 12, 18, 24, and 36 months after ABI activation. Results: Maximum IT-MAIS/MAIS and MUSS scores after 3 years of ABI use were 45.35% and 35.28%, respectively. Conclusion: Pediatric patients exhibit slow progressive development of auditory and language skills following ABI activation.
- Auditory brainstem implant outcomes and MAP parameters: Report of experiences in adults and children(2012) GOFFI-GOMEZ, Maria Valeria Schmidt; MAGALHAES, Ana Tereza; BRITO NETO, Rubens; TSUJI, Robinson Koji; GOMES, Marcos de Queiroz Telles; BENTO, Ricardo FerreiraThe auditory brainstem implant (ABI) was first developed to help neurofibromatosis type 2 patients. Recently, its use has been recently extended to adults with non-tumor etiologies and children with profound hearing loss who were not candidates for a cochlear implant (Cl). Although the results has been extensively reported, the stimulation parameters involved behind the outcomes have received less attention. Objective: The aim of this study is to describe the audiologic outcomes and the MAP parameters in ABI adults and children at our center. Methods: Retrospective chart review. Five adults and four children were implanted with the ABI24M from September 2005 to June 2009. In the adult patients, four had Neurofibromatosis type 2, and one had postmeningitic deafness with complete ossification of both cochleae. Three of the children had cochlear malformation or dysplasia, and one had complete ossified cochlea due to meningitis. Map parameters as well as the intraoperative electrical auditory brainstem responses were collected. Evaluation was performed with at least six months of device use and included free-field hearing thresholds, speech perception tests in the adult patients and for the children, the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and (ESP) were used to evaluate the development of auditory skills, besides the MUSS to evaluate. Results: The number of active electrodes that did not cause any non-auditory sensation varied from three to nineteen. All of them were programmed with SPEAK strategy, and the pulse widths varied from 100 to 300 mu s. Free-field thresholds with warble tones varied from very soft auditory sensation of 70 dBHL at 250 Hz to a pure tone average of 45 dBHL. Speech perception varied from none to 60% open-set recognition of sentences in silence in the adult population and from no auditory sensation at all to a slight improvement in the IT-MAIS/MAIS scores. Conclusion: We observed that ABI may be a good option for offering some hearing attention to both adults and children. In children, the results might not be enough to ensure oral language development. Programming the speech processor in children demands higher care to the audiologist.