桥小脑角占位性病变的临床听力学表现

本文总结了经CT或MRI证实以及部分经手术证实的101例桥小脑角占位性病变的纯音测听，听性脑干反应（ABR），耳蜗电图（ECochG）以及前庭功能的表现。结果显示：ABR多表现为Ⅰ～Ⅴ间或延长（＞45ms），仅Ⅰ波存在或ABR各波均消失。未见波Ⅴ幅度小于波Ⅰ。当肿物较大时，可见时测ABR异常。极重度聋患者（35．5％），仍可引出异常ABR波形，故仍不可忽视ABR检查；听力轻度下降，甚至正常考ABR仍有改变。AP出现率随肿物增大而降低，－SP／AP比值≥0．4，可能是继发性伤及耳蜗所致。5例ABR表现正常者仍有半规管功能低下。提示前庭功能检查对桥小脑均占位性病变的诊断具有一定参考意义，临床应将ECochG和前庭功能检测列为诊断桥小脑角占位性病变的参考指标。     

Overview of Audiology in Brazil: State of the Art: La Audiologia en Brasil: Estado del Arte

The aim of this paper is to provide an overview of the field of clinical and rehabilitative audiology for children and adults in Brazil, while simultaneously offering some data and results from several different research studies within the country. The theme will address seven main topics: (1) the status of services and assistance for the hearing impaired; (2) the results of five different institutional research studies showing the main causes of hearing impairment in children in the city of Sao Paulo; (3) a review of subjective and objective methods for early diagnosis and audiological habilitation of children, including parent counseling, hearing aids, and cochlear implants; (4) a discussion of hearing conservation in different settings; (5) a brief consideration of audio-logical rehabilitation for hearing-impaired elderly adults in the country; (6) the main results of the First and Second Brazilian National Campaigns of Deafness Prevention; and (7) conclusions.

Sumario

El objetivo de este trabajo ha sido mostrar una revisión en el campo de la Audiología clínica y reha-bilitativa para niños y adultos en Brasil, mostrando simultáneamente información y resultados de varios estudios de investigación realizado en el país. Se revisáran siete tópicos principales: 1) el estado de los servicios y la asistencia a las personas con trastornos auditivos; 2) los resultados de cinco diferentes estudios institucionales de investigación, mostrando las principales causas de sordera en niños de la ciudad de San Pablo; 3) una revisión de métodos objetivos y subjetivos para el diagnóstico temprano y la habilitación audiológica en niños, incluyendo asesoría a los padres, audífonos e implantes cocleares; 4) una discusión sobre programas de conservación auditiva en diferentes lugares; 5) una breve consideración sobre rehabilitacion audiológica para ancianos hipoacúsicos en el país; 6) los resultados de la Primera y Segunda Campaña Nacional Brasileña de Prevención de la Sordera; y 7) conclusiones.     

Non-Electric Aids to Hearing: A Short History

The historical development of non-electric aids to hearing is traced and a classification of the different types presented. Comparative measures of their different acoustical characteristics will be shown, indicating their relative value in various types of hearing losses. Attitudes towards such devices and principles involved in their selection in the 19th Century are discussed.     

以症状为主线的教学模式在耳鼻咽喉头颈外科规范化培训教学中的应用

耳鼻咽喉头颈外科住院医师规范化培训教学对临床思维的要求日益提高,传统以理论授课为主的教学模式难以使学生对耳鼻咽喉头颈外科形成系统的临床思维,本文探讨了“以症状为主线,充分培养临床思维”的教学模式在耳鼻咽喉头颈外科基地住院医师规范化培训培养中的应用及心得体会.     

Long-latency auditory evoked potentials with verbal and nonverbal stimuli

IntroductionLong-latency auditory evoked potentials represent the cortical activity related to attention, memory, and auditory discrimination skills. Acoustic signal processing occurs differently between verbal and nonverbal stimuli, influencing the latency and amplitude patterns.ObjectiveTo describe the latencies of the cortical potentials P1, N1, P2, N2, and P3, as well as P3 amplitude, with different speech stimuli and tone bursts, and to classify them in the presence and absence of these data.MethodsA total of 30 subjects with normal hearing were assessed, aged 18–32 years old, matched by gender. Nonverbal stimuli were used (tone burst; 1000 Hz – frequent and 4000 Hz – rare); and verbal (/ba/ – frequent; /ga/, /da/, and /di/ – rare).ResultsConsidering the component N2 for tone burst, the lowest latency found was 217.45 ms for the BA/DI stimulus; the highest latency found was 256.5 ms. For the P3 component, the shortest latency with tone burst stimuli was 298.7 with BA/GA stimuli, the highest, was 340 ms. For the P3 amplitude, there was no statistically significant difference among the different stimuli. For latencies of components P1, N1, P2, N2, P3, there were no statistical differences among them, regardless of the stimuli used.ConclusionThere was a difference in the latency of potentials N2 and P3 among the stimuli employed but no difference was observed for the P3 amplitude.     

全国听力语言康复系统听力学教育现状与思考

近年来,我国听力语言康复事业取得长足发展的同时仍面临诸多挑战,听力学专业人才匮乏是其中最重要的问题之一。作为全国听力语言康复专业技术资源中心,中国聋儿康复研究中心通过学历教育、认证教育、继续教育等多种形式开展全国听力语言康复专业人才的培养工作,取得了显著成效。但我国听力语言康复系统的听力学教育仍面临着供需矛盾突出、专业人才欠缺、系统培训能力弱、从业人员管理配套政策不完善等问题。需要从推进教育-从业一体化建设、分层次培养专业人员、完善课程设计、培养听力学学科骨干等方面努力。     

Audiology patient fall statistics and risk factors compared to non-audiology patients

Objective: To compare fall statistics (e.g. incidence, prevalence), fall risks, and characteristics of patients who seek hearing healthcare from an audiologist to individuals who have not sought such services. Design: Case-control study. Study sample: Two groups of community-dwelling older adult patients: 25 audiology patients aged 60 years or older (M age: 69.2 years, SD: 4.5, range: 61–77) and a control group (gender- and age-matched ±2 years) of 25 non-audiology patients (M age: 69.6, SD: 4.7, range: 60–77). Results: Annual incidence of falls (most recent 12 months) was higher in audiology patients (68.0%) than non-audiology patients (28.0%; p?= .005). Audiology patients reported a higher incidence of multiple recent falls (p?=.025) and more chronic health conditions (p?= .028) than non-audiology patients. Conclusions: Significantly more audiology patients fall on an annual basis than non-audiology patients, suggesting that falls are a pervasive issue in general hearing clinics. Further action on the part of healthcare professionals providing audiologic services may be necessary to identify individuals at risk for falling.     

Progressive hearing loss after single exposure to acute acoustic trauma

Summary Progressive hearing loss after single episodes of acute acoustic trauma (Knalltrauma) has been reported in only a few cases. Many authors dispute such a progressive evolution. Since this question is of obvious importance in cases evolving into lawsuits, its occurrence also arouses scientific interest. The present study reports 58 bilateral and 17 unilateral cases of acute acoustic trauma showing progression of more than 20 dB at least at one frequency. The mean follow-up time was more than 20 years. The incidence was estimated as less than 1% of cases involving acute acoustic trauma. The evolution of the progressive hearing loss did not show a specific pattern; in the unilateral group, there were no statistically significant differences between the progression in both ears. The findings clearly indicate that late progression of hearing loss due to single episodes of acute acoustic trauma does not exist unless the affected ear is exposed to additional damage not related to the initial trauma.     

Method for the deconvolution of auditory steady-state responses

The potential evoked by a ‘train’ of N equally spaced auditory clicks, with an inter-click period shorter than the duration of the response to an isolated click, is said to be a steady-state response (SSR). Extracting the individual responses evoked by the clicks of the train during steady state can be key to understanding of the neurophysiological mechanisms underlying SSR generation. In the literature, this task has been dealt with only under the (unwarranted) assumption that the response of the system does not vary during the presentation of the clicks, i.e. no neurophysiological adaptation is present. In this work, a new, non-parametric algorithm is proposed that, relaxing the time-invariance hypothesis, allows the extraction from the SSR of the N waveforms individually evoked by the N clicks of the train. The performance of the approach is evaluated on simulated SSRs and on real data recorded from the temporal cortex of awake rats. Results show that the method is able to detect and assess possible adaptation of the neurophysiological system in the generation of SSRs.