RESUMO
OBJECTIVES: Research focusing on changes in the clinical practice of audiological diagnosis has become increasingly necessary, particularly in pediatric audiology. The pursuit of accurate and reliable examinations has intensified given the importance of early detection and intervention in cases of childhood hearing loss. Thus, this study aims to investigate the correlation between electrophysiological auditory thresholds, as obtained through frequency-specific auditory brainstem responses with two distinct chirp stimuli (narrow-band CE-Chirp Level Specific and narrow-band iChirp), in children with hearing impairments. In addition, this research set out to correlate these thresholds with behavioral responses while simultaneously comparing the examination durations relative to the type of stimuli and the degree of hearing loss. DESIGN: A cohort of 20 children (aged 6 months to 12 years) with varying degrees of hearing impairment (ranging from mild to profound) were recruited. The participants underwent bilateral measurement of their electrophysiological thresholds via auditory brainstem responses across different frequencies (500, 1000, 2000, and 4000 Hz), and the timeframe for determining these thresholds was carefully recorded. Subsequently, behavioral thresholds were ascertained using pure-tone audiometry or visual reinforcement audiometry based on the child's age. The data collected was subsequently analyzed using Pearson and Spearman correlation coefficients. To compare examination times, the Student t test and the Kruskal-Wallis test were used. RESULTS: There was a pronounced correlation between the thresholds obtained through both narrow-band chirp stimuli. Moreover, a substantial correlation was found between electrophysiological and behavioral thresholds at 1000, 2000, and 4000 Hz, especially when compared with pure-tone audiometry. The mean differences between the electrophysiological and behavioral thresholds were below 6 dB nHL, and the exam duration was relatively consistent across both devices, averaging 47.63 (±19.41) min for the narrow-band CE-Chirp Level Specific and 52.42 (±26) min for the narrow-band iChirp. Notably, variations in exam duration did not relate to varying degrees of hearing loss when using the narrow-band CE-Chirp Level Specific. Nevertheless, the narrow-band iChirp indicated significantly shorter durations in instances of profound degree measurements, demonstrating a statistically significant difference. CONCLUSIONS: The narrow-band CE-Chirp Level Specific and narrow-band iChirp stimuli provided similar estimates of electrophysiological auditory thresholds in children with hearing impairments, giving accurate estimations of behavioral thresholds. The time it took to complete the assessment is comparable between both stimuli. For the narrow-band iChirp, the degree of hearing loss was shown to impact the testing time, and children with profound hearing loss underwent faster exams. Ultimately, this study exhibits significant clinical implications as it reveals that the narrow-band CE-Chirp Level Specific and narrow-band iChirp stimuli could be remarkably promising for clinically exploring electrophysiological thresholds in children with hearing impairments.
Assuntos
Audiometria de Tons Puros , Limiar Auditivo , Potenciais Evocados Auditivos do Tronco Encefálico , Humanos , Criança , Pré-Escolar , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Feminino , Masculino , Limiar Auditivo/fisiologia , Lactente , Perda Auditiva/fisiopatologia , Estudos de Coortes , Perda Auditiva Neurossensorial/fisiopatologia , Estimulação Acústica/métodosRESUMO
BACKGROUND: Agricultural activities and exposure to pesticides increase the risk of hearing loss and might reduce cholinesterase activity. OBJECTIVE: To describe and analyze the correlation between hearing screening and plasma and erythrocyte cholinesterase activity relative to rural workers exposed to pesticides. METHODS: Cross-sectional, quantitative, descriptive and explanatory study conducted with 71 rural workers exposed to pesticides. Data were collected by means of an instrument to characterize exposure to pesticides, hearing screening and blood samples to measure plasma and erythrocyte cholinesterase activity. RESULTS: Each participant used three different pesticides, on average, glyphosate being the most frequently mentioned. About 60.6% of the sample exhibited hearing abnormalities and 32.4% complained of tinnitus. Erythrocyte cholinesterase activity was within the normal range in all the cases; one single participant exhibited reduced plasma cholinesterase activity. There was not significant correlation between the hearing screening and cholinesterase levels. CONCLUSION: Audiological evaluation should be included in the assessment of rural workers. Monitoring workers exposed to pesticides should not be restricted to cholinesterase activity alone, because this method is insufficient to detect actual exposure to pesticides.
INTRODUÇÃO: A atividade agrícola e a exposição a agrotóxicos aumentam o risco de perda auditiva e a possibilidade de redução das colinesterases. OBJETIVOS: Descrever e correlacionar os resultados da triagem auditiva e da dosagem das colinesterases plasmática e eritrocitária de trabalhadores rurais expostos a agrotóxicos. MÉTODO: Pesquisa de natureza quantitativa, com alcance descritivo e explicativo, com delineamento transversal, realizada com 71 trabalhadores rurais expostos a agrotóxicos. A coleta de dados foi realizada de três formas: instrumento de coleta para caracterização do contato aos agrotóxicos; triagem auditiva; e coleta de sangue para dosagem das colinesterases plasmática e eritrocitária. RESULTADOS: Cada trabalhador utilizava "em média" três agrotóxicos diferentes e o mais citado foi o glifosato. Sobre a triagem auditiva, 60,6% possuíam alterações auditivas e 32,4%, zumbido. Na dosagem da colinesterase eritrocitária, todos os trabalhadores rurais apresentaram valores de dosagens de colinesterase dentro da normalidade. Na dosagem da colinesterase plasmática, um participante apresentou valor de dosagem inferior ao normal. Não houve correlação significativa entre a triagem auditiva e o valor das colinesterases. CONCLUSÕES: A avaliação audiológica deve ser incluída no cuidado à saúde dos trabalhadores rurais e o acompanhamento ocupacional de trabalhadores expostos a agrotóxicos não deve ser restrito à dosagem das colinesterases, pois tal medida é insuficiente para diagnosticar exposição real a agrotóxicos.