Abstract Objectives: To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0–18 years. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: (1) treatment of sensorineural hearing loss: individual hearing aids, bilateral cochlear implants, cochlear implants in young children, unilateral hearing loss, and auditory neuropathy spectrum disorder; and (2) treatment of conductive/mixed hearing loss: external/middle ear malformations, ventilation tube insertion, and tympanoplasty in children. Conclusions: In children with hearing loss, in addition to speech therapy, Hearing AIDS (HAs) or implantable systems may be indicated. Even in children with profound hearing loss, both the use of HAs and behavioral assessments while using the device are important.

Abstract Objectives: To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0 to 18 years. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The evaluation and diagnosis of hearing loss: universal newborn hearing screening, laboratory testing, congenital infections (especially cytomegalovirus), genetic testing and main syndromes, radiologic imaging studies, vestibular assessment of children with hearing loss, auditory neuropathy spectrum disorder, autism spectrum disorder, and noise-induced hearing loss. Conclusions: Every child with suspected hearing loss has the right to diagnosis and appropriate treatment if necessary. This task force considers 5 essential rights: (1) Otolaryngologist consultation; (2) Speech assessment and therapy; (3) Diagnostic tests; (4) Treatment; (5) Ophthalmologist consultation.

Abstract Introduction Understanding all the benefits of bimodality with self-assessment questionnaires on the effect of hearing on quality of life is still necessary. Objective To present whether bimodality still offers hearing benefits to the population who uses acoustic stimulation associated with electrical stimulation. Methods The present study included 13 participants aged between 16 and 80 years old who were users of cochlear implants from Cochlear Corporation and hearing aids. All patients underwent the Hearing in Noise Test, and their visual analog scale score was obtained. Four-tone means were collected, and the participants answered the Speech, Spatial and Hearing Qualities questionnaire. Results Bimodal users had an average sentence recognition rate of 76.0% in silence and 67.6% in fixed noise, and the signal-to-noise ratio in adaptive noise was +2.89dB. In addition, a lower level of difficulty was observed in the test using the visual analog scale. The domain with the highest average was auditory qualities (6.50), followed by spatial hearing (6.26) and hearing for speech (5.81). Individuals with an average between 50 and 70 dB of hearing level showed better sentence recognition in silence and noise. Conclusion Bimodal stimulation showed benefits for users with different degrees of hearing loss; however, individuals who presented greater hearing residue had better performance in speech recognition with noise and in silence in addition to a good perception of hearing quality.

Resumo Introdução: A timpanoplastia é um procedimento cirúrgico que visa reconstruir os mecanismos de transmissão do som na orelha média. Objetivo: Analisar, do ponto de vista audiológico, pacientes com otite média crônica submetidos à timpanoplastia tipo 3 com columela maior, com prótese de reconstituição ossicular total de titânio, ou com columela de estribo com enxerto de cartilagem. Métodos: Estudo prospectivo analítico, feito no ambulatório de otorrinolaringologia de um hospital terciário, por meio da avaliação de 26 pacientes com otite média crônica submetidos à timpanoplastia com diferentes materiais para reabilitação auditiva, como próteses de titânio ou autoenxertos de cartilagem. Resultados: Não houve associação estatisticamente significante entre os fatores de grupo (reconstrução com cartilagem ou titânio) e variáveis pré-operatórias. Não houve associação estatisticamente significante entre as características pós-operatórias dos pacientes e o tipo de reconstrução; nem melhoria subjetiva (melhoria auditiva) ou perfuração residual foram associadas a um tipo de material. O fator via foi o único que demonstrou diferença estatisticamente significante, uma vez que a condução por via aérea apresentou maior melhoria do que a condução por via óssea, reduziu o gap aéreo-ósseo. Conclusão: Não houve diferença estatística entre os dois grupos em relação à melhoria audiométrica. Houve melhoria auditiva em ambos os grupos. Mais estudos com seguimento mais longo devem ser feitos para uma melhor avaliação da evolução.

Abstract Introduction: Tympanoplasty is a surgical procedure designed to reconstruct the mechanisms of sound transmission in the middle ear. Objective: Analyze, from an audiological point of view, patients with chronic otitis media undergoing type 3 tympanoplasty major columella with total ossicular replacement titanium prosthesis or with cartilage graft stapes columella. Methods: This is a prospective analytical study, carried out at the otorhinolaryngology outpatient clinic in a tertiary care hospital, through the evaluation of 26 patients with chronic otitis media who underwent tympanoplasty using different materials for auditory rehabilitation such as titanium prostheses or cartilage autografts. Results: There was no statistically significant association between the group factors (cartilage or titanium reconstruction) and preoperative variables. There was no statistically significant association between the postoperative characteristics of the patients and the type of reconstruction. Neither subjective improvement (hearing improvement) nor residual perforation were associated with a type of material. The via factor was the only one that showed a statistically significant difference once air-conduction pathway improved more than bone-conduction pathway, decreasing the air-bone gap. Conclusion: There was no statistical difference between the two groups in relation to the audiometric improvement. There was hearing improvement in both groups. More studies must be done with a longer follow-up to better evaluate the outcome.

Resumo Introdução: A reabilitação vestibular se consolida como um recurso fundamental para o controle de sintomas vestibulares e sua feitura no meio aquático é considerada segura para as atividades físicas dos idosos, atua simultaneamente nas desordens musculoesqueléticas e na melhoria do equilíbrio. Objetivo: Avaliar os efeitos de um protocolo de fisioterapia aquática em indivíduos com alterações vestibulares periféricas. Método: Estudo de caso intervencional com amostra intencional pareada de quatro sujeitos, selecionados por conveniência, diagnosticados com vestibulopatias periféricas. Os sujeitos foram submetidos a 12 sessões de fisioterapia aquática para reabilitação vestibular. Foram avaliados quanto à tontura em três momentos: inicial, após seis sessões e ao término dos atendimentos. Os testes aplicados foram: o apoio unipodal para mensurar o equilíbrio estático, a prova dos passos de Fukuda que estima o equilíbrio dinâmico e o protocolo dizziness handicap inventory com o objetivo de verificar o quanto a tontura influencia na vida cotidiana. Resultados: Ao analisar o equilíbrio estático, inicialmente os indivíduos se encontravam nas dimensões adaptativas e anormais e ao término do protocolo todos atingiram a normalidade. Em relação ao equilíbrio dinâmico, os indivíduos inicialmente apresentavam grande comprometimento no desvio angular principalmente para o lado da patologia (75% à esquerda e 25% à direita), conseguiram uma melhoria no fim do estudo. Todavia, não conseguiu atingir a significância estatística. O dizziness handicap inventory obteve diferença estatisticamente significante em sua totalidade (p = 0,0414), onde aborda os fatores físicos, funcionais e emocionais. Conclusão: O protocolo de fisioterapia aquática voltado para reabilitação vestibular de pacientes com comprometimento periférico foi avaliado de forma positiva pelos participantes, considerando-se a melhoria no quadro de tontura (estática e dinâmica) e do seu impacto nas atividades cotidianas.

Abstract Introduction: Vestibular rehabilitation is a fundamental resource for vestibular symptom control. Its performance in the aquatic environment is considered safe for the physical activities of the elderly, because they act simultaneously on musculoskeletal disorders and balance improvement. Objective: To evaluate the effects of an aquatic physiotherapy protocol in individuals with peripheral vestibular alterations. Methods: This was an interventional case study with a paired intentional sample of four subjects, who were selected for convenience. The subjects, all of them diagnosed with peripheral vestibulopathy, were submitted to twelve sessions of aquatic physiotherapy for vestibular rehabilitation, being evaluated for dizziness in three moments: initial, after six sessions and at the end of the sessions. The tests applied were: unipodal support to measure static balance, the Fukuda stepping test, which estimates the dynamic balance and the dizziness handicap inventory protocol, aimed at verifying how dizziness influences daily life. Results: When analyzing the static balance, initially the individuals were in the adaptive and abnormal dimensions, and all reached normality at the end of the protocol. Regarding the dynamic balance, the individuals initially showed marked impairment in the angular deviation, mainly to the side of pathology (75% to the left and 25% to the right), achieving improvement at the end of the study. However, it failed to reach statistical significance. The dizziness handicap inventory showed a statistically significant difference in its totality (p = 0.0414), which addresses the physical, functional and emotional factors. Conclusion: In conclusion, the aquatic physiotherapy protocol for vestibular rehabilitation of patients with peripheral impairment was positively assessed by the participants, considering the improvement in dizziness (static and dynamic) and its impact on daily activities.

Resumo Introdução: Nos casos de transtornos do espectro autista com perda auditiva severa a profunda, o implante coclear é uma opção terapêutica. Objetivo: Identificar evidências na literatura científica de que o implante coclear traz benefí- cios para pessoas com transtorno do espectro autista com perda auditiva associada. Método: Revisão sistemática da literatura com base nos critérios recomendados pela lista de verificação do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A estratégia População, Intervenção, Comparação, Desfechos e Desenho do Estudo (PICOS) foi usada para definir os critérios de elegibilidade. Os estudos que atenderam aos critérios de inclusão dessa segunda etapa foram incluídos em uma síntese qualitativa. Cada tipo de estudo foi analisado de acordo com a avaliação de risco de viés do Joanna Briggs Institute através da lista de verificação crítica para estudos de coorte, estudos de prevalência e critérios críticos e relatos de casos. Resultados: Foram encontrados 484 artigos em oito bases de dados e 100 na literatura cinzenta que mencionavam a relação entre o implante coclear em pacientes com transtorno do espectro autista e deficiência auditiva. Doze artigos foram lidos na íntegra e 7 foram selecionados para análise qualitativa nesta revisão sistemática. Todos os sete artigos foram analisados de acordo com o checklist de avaliação crítica. Quatro artigos apresentaram baixo risco de viés e três artigos, risco moderado de viés. Neste estudo, foram incluídos 66 pacientes com transtorno do espectro autista e deficiência auditiva que receberam implante coclear. Conclusão: Esta revisão sistemática indica que o implante coclear pode trazer benefícios para indivíduos com transtorno do espectro autista e surdez associada.

Abstract Introduction: In cases of autism spectrum disorders with severe to profound hearing loss, cochlear implant is a therapeutic option. Objective: To identify evidence in the scientific literature that the cochlear implant brings benefits to people with autism spectrum disorders with associated hearing loss. Methods: Systematic review of the literature based on the criteria recommended by PRISMA. The population, intervention, comparison, outcomes, study design, PICOS strategy, was used to define the eligibility criteria. The studies that met the inclusion criteria for this second stage were included in a qualitative synthesis. Each type of study was analyzed according to the Joanna Briggs Institute’s risk of bias assessment through the critical checklist for cohort studies, prevalence studies and critical criteria and case reports. Results: Four hundred and eighty-four articles were found in eight databases and 100 in the gray literature, mentioning the relationship between cochlear implants in patients with autism spectrum disorder and hearing loss. Twelve articles were read in full and 7 were selected for qualitative analysis in this systematic review. All seven articles were analyzed on the critical evaluation checklist. Four articles had a low risk of bias and three articles had a moderate risk of bias. In this study, were included 66 patients with autism spectrum disorder and hearing loss who received cochlear implant. Conclusion: This systematic review indicates that a cochlear implant can bring benefits to autism spectrum disorder patients with associated deafness.

Resumo Introdução Zumbido é um sintoma frequente em pacientes com implante coclear, comumente relatado como persistente e incapacitante em candidatos ao procedimento. Entretanto, o zumbido raramente é considerado na avaliação pré-operatória de pacientes elegíveis para o implante coclear. Muitos estudos têm demonstrado que o implante coclear leva a uma mudança significativa na percepção do zumbido. Objetivo Identificar evidências na literatura científica que indiquem que o implante coclear em pacientes com zumbido pode melhorar a percepção. Método Foram encontrados 140 artigos em nove bases de dados e 20 artigos da literatura cinzenta mencionaram a relação entre o implante coclear e a percepção do zumbido em pacientes elegíveis para o procedimento. A estratégia PICOS (população, intervenção, comparação e desfecho) foi usada para definir os critérios de elegibilidade. Os estudos que atenderam aos critérios de inclusão para esta segunda etapa foram incluídos em uma síntese qualitativa e cada tipo de estudo foi analisado com a critical appraisal checklist for quasi-experimental studies e a critical appraisal checklist for randomized clinical trials do Joanna Briggs Institute. Resultados Foram lidos os textos completos de 11 artigos e selecionados 6 estudos para a metanálise. O tamanho total da amostra dos artigos avaliados foi de 136 pacientes com zumbido, elegíveis para o implante coclear. Conclusões Em conjunto, esses achados apoiam a viabilidade do implante coclear para reduzir a percepção do zumbido, proporcionam uma nova perspectiva no tratamento do zumbido em pacientes com deficiência auditiva candidatos a esse procedimento.

Abstract Introduction Tinnitus is a frequent symptom in cochlear implant patients, often reported as persistent and disabling in implant candidates. Tinnitus is rarely considered in the preoperative evaluation of patients who are eligible for cochlear implantation. Many studies have shown that a cochlear implant leads to a significant change in the perception of tinnitus. Objective To identify evidence in the scientific literature indicating that cochlear implant in eligible patients with tinnitus can improve tinnitus perception. Methods One hundred forty articles were found from nine databases, and 20 articles from the gray literature mentioned the relationship between cochlear implant and tinnitus perception in patients eligible for cochlear implant. The PICOS (population, intervention, comparison, and outcome) strategy, was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies and the Joanna Briggs Institute critical appraisal checklist for randomized clinical trials. Results The full texts of 11 articles were read, and 6 studies were selected for the meta-analysis. The total sample size in the evaluated articles was 136 patients with tinnitus who were eligible for cochlear implantation. Conclusions Taken together, these findings support the feasibility of cochlear implantation to reduce the perception of tinnitus, thus providing a new perspective in the treatment of tinnitus in patients with hearing loss who are candidates for cochlear implantation.

Resumo Introdução: A voz de indivíduos com deficiência auditiva tem sido amplamente descrita e pode estar comprometida em todos os níveis do sistema fonatório. Objetivo: Desenvolver e validar uma ferramenta para avaliar a voz dessa população. Método: A ferramenta foi submetida às etapas de validação sugeridas pelo Scientific Advisory Committee of the Medical Outcomes Trust. A amostra do estudo foi composta por 78 indivíduos brasileiros com implantes cocleares (grupo experimental) e 78 indivíduos com audição normal (grupo controle) divididos em grupos por faixa etária – crianças de 3 a 5 anos; crianças de 6 a 10 anos e adultos de 18 a 46 anos. Os participantes do estudo realizaram uma gravação de voz da vogal /a/ sustentada, fala encadeada e conversa espontânea, que foi avaliada por três especialistas em voz com o instrumento proposto. Este instrumento consistem em escalas visuais analógicas dos aspectos suprassegmentares da voz, coordenação pneumofonoarticulatória, ressoância, fonação, parâmetro adicional e impressão geral da qualidade vocal. Resultados: A avaliação por um comitê de especialistas e um teste-piloto estabeleceram a validade de conteúdo. Medidas de confiabilidade mostraram excelente reprodutibilidade teste-reteste para a maioria dos parâmetros. A análise com a curva ROC mostrou que a avaliação perceptivo-auditiva com a vogal sustentada não diferenciou significantemente os indivíduos com implante coclear daqueles com audição normal e o parâmetro “velocidade de fala” não diferenciou os grupos. Para a fala encadeada e conversa espontânea, a maioria dos parâmetros diferenciou o grupo experimental do grupo controle, com uma área sob a curva ≥ 0,7. Os valores de corte com máxima especificidade e sensibilidade foram 30,5 para desvio discreto, 49,0 para desvio moderado e 69,5 para desvio intenso. Conclusões: O protocolo de avaliação de voz do deficiente auditivo é uma ferramenta confiável e útil para avaliar as particularidades da voz de indivíduos com deficiência auditiva e implante coclear e pode ser utilizada em pesquisas e contextos clínicos para padronizar a avaliação e facilitar a troca de informações entre os serviços.

Abstract Introduction: The voice of individuals with hearing impairment has been widely described, and can be compromised in all levels of the phonatory system. Objective: To develop and validate an instrument for evaluating the voice of this population. Methods: The instrument underwent the validation steps suggested by the Scientific Advisory Committee of the Medical Outcomes Trust. The study sample consisted of seventy-eight Brazilian people with cochlear implants (experimental group) and 78 individuals with normal hearing (control group), divided in groups by age range — children from 3 to 5 years; children from 6 to 10 years and adults from 18 to 46 years. The study sample participated in a voice recording of the sustained vowel /a/, connected speech and spontaneous conversation, in which three voice specialists rated using the proposed instrument. It consists of visual-analog scales of suprasegmental aspects, respiratory-phonatory coordination, resonance, phonation, additional parameters and general vocal perception. Results: Evaluation by an expert committee and a pilot test established content validity. Reliability measures showed excellent test-retest reproducibility for the majority of the parameters. Analysis with the ROC curve showed that perceptual evaluation with the sustained vowel did not strongly differentiate individuals with cochlear implants from those with normal hearing, and the parameter “speech rate” did not differentiate the groups at all. For the connected speech and spontaneous conversation, the majority of the parameters differentiated the experimental group from the control group with an area under the curve ≥0.7. The cutoff values with maximum specificity and sensitivity were 30.5 for mild, 49.0 for moderate and 69.5 for intense deviation. Conclusions: The protocol for the evaluation of voice in subjects with hearing impairment, PEV-SHI, is a reliable and useful tool for assessing the particularities of the voice of individuals with hearing impairment treated with cochlear implants and can be used in research and clinical settings to standardize evaluation and facilitate information exchange among services.

Abstract Introduction Facial nerve palsy results in both functional disability and psychological morbidity. There are several well-established grading scales to quantify the quality of life of these patients. Objective Translate and validate the Facial Clinimetric Evaluation (FaCE) scale and Synkinesis Assessment Questionnaire (SAQ) to Brazilian Portuguese. Methods This study adopted a forward-backward translation method and performed cross-cultural adaptation. A pilot study was conducted to correct any confusing language and to evaluate content validity. A validation study was then performed. Internal consistency of the Brazilian Portuguese version of the FaCE and SAQ items was evaluated by Cronbach’s alpha coefficient. Construct validity was assessed by Spear- man’s Rank Correlation Coefficient between FaCE and SAQ scores to eFACE, House- Brackmann, Short Form 12 (SF-12) and Facial Disability Index (FDI) (sub)scores. Results A total of 90 patients were included. Cronbach’s alpha for total domain scored 0.881 for FaCE and 0.809 for SAQ. FaCE total score correlation to eFACE total and House- Brackmann showed Spearman’s r value of 0.537 and -0.538, respectively (p < 0.001). SAQ correlation to eFACE synkinesis subdomain was -0.449 (p < 0.001). No correlation was found between SAQ and HB score. FaCE total score correlations were of 0.301 and 0.547 for SF-12 PCS and MCS, respectively (p < 0.001). Correlation between FaCE total and FDI Physical and Social/well-being functions were 0.498 and 0.567 (p < 0.001). Conclusion Brazilian Portuguese FaCE scale and SAQ versions achieved high validity and reliability in the present study. These translated instruments demonstrated good psychometric properties, being proper to use in clinical practice in Brazil and with Brazilian Portuguese speakers.

Abstract Introduction The bone-anchored hearing aid (BAHA) is a bone conduction system that transmits the sound directly to the inner ear by surpassing the skin impedance and the subcutaneous tissue. It is indicated for patients with mixed, conductive and unilateral sensorineural hearing loss who did not benefit from conventional hearing aids (HAs). Although the benefits from BAHA are well demonstrated internationally, this field still lacks studies in Brazil. Objective To assess the auditory rehabilitation process in BAHA users through audiological, speech perception and tinnitus aspects. Methods Individuals with hearing loss were assessed before and after the implantation. The participants were subjected to pure tone audiometry in free field, functional gain audiometry, speech perception tests, tinnitus handicap inventory (THI) in open format, and to the visual analog scale (VAS). Results It was found that the participants benefited from the use of BAHA. The difference in the performance of the participants before and after the BAHA surgery was significant in terms of hearing acuity. There was no statistically significant difference in the speech perception tests. The tinnitus assessment showed that 80% of the participants scored slight tinnitus severity in THI after using a BAHA. Eighty percent of the participants classified their tinnitus as absent tomild in the VAS after the surgery. Conclusion Based on the results of the current study, we can conclude that the participants improved both the auditory perception and the tinnitus handicap.

Resumo Introdução A otosclerose é uma osteodistrofia do osso temporal, caracterizada pela reabsorção e neoformação óssea desordenadas em indivíduos geneticamente predispostos. Clinicamente, a otosclerose é caracterizada por perda auditiva progressiva condutiva e/ou mista e por zumbido. Objetivo Uma revisão das últimas duas décadas de publicações que relatam o grau de melhora do zumbido com a estapedectomia. Método Foram analisados 125 artigos publicados nos últimos 20 anos que mencionavam a relação entre otosclerose e zumbido. A literatura sempre mostrou a melhoria auditiva como principal objetivo e resultado da estapedectomia. No entanto, artigos recentes reforçaram a necessidade de cirurgia para a melhoria do zumbido. O momento ideal para avaliar o zumbido através de diferentes escalas é no sexto mês pós-operatório. A melhoria auditiva média estimada é de 93% e a do zumbido, de 85,52%. Resultados Foram revisados resumos de 12 artigos que preencheram os critérios de pesquisa, foram incluídos no estudo 8 artigos de acordo com os critérios de seleção. Este estudo investiga o grau de melhora do zumbido com a estapedectomia, utilizando diferentes escalas: tinnitus functional index, escala visual analógica, tinnitus functional index e escala visual analógica, escala visual analógica e "questionário sobre o zumbido", método de Newman e o Tinnitus Score Advocated, da Sociedade Audiológica do Japão (Japan Audiological Society). O total das amostras dos artigos avaliados foi de 254 participantes. Conclusão Concluímos que a estapedectomia é bastante eficaz no tratamento do zumbido (melhoria média de 85,52%) e perda auditiva (melhoria média de 93%). Ao decidir sobre a indicação cirúrgica em pacientes com otosclerose, a presença e o nível de zumbido devem ser considerados, assim como o nível de audição.

Abstract Introduction Otospongiosis is temporal bone osteodystrophy, characterized by disordered bone resorption and neoformation in genetically predisposed individuals. Clinically, otospongiosis is characterized by progressive conductive and/or mixed hearing loss and by tinnitus. Objective A review of the last two decades of publications that report the degree of tinnitus improvement with stapes surgery. Methods 125 articles published in the last 20 years mentioning the relationship between otosclerosis and tinnitus. Literature has always shown that the hearing improvement after stapes surgery was the main result sought and found. However, recent articles has reinforced the need for surgery for the tinnitus improvement. The ideal time to assess tinnitus through different scales is in the sixth month post-operative. The estimated average hearing improvement is 93% and tinnitus is 85.52%. Results Summaries of 12 articles were reviewed which fulfilled the search criteria of the survey, and 8 studies were included in the study according the selection criteria. This studies investigating the degree of tinnitus improvement with stapes surgery, using different scales as: tinnitus functional index, visual analog scale, tinnitus functional index and visual analog scale, visual analog scale and "questionnaire asking about tinnitus", Newman's method and Tinnitus Score Advocated by the Japan Audiological Society. The total of the samples of the evaluated articles was of 254 participants. Conclusion We conclude that stapes surgery is effective for the treatment of tinnitus (average improvement is 85.52%), and hearing loss (average improvement is 93%). When deciding about the surgical indication in patients with otosclerosis, the presence and level tinnitus should be considered as well as the level of hearing.

Resumo Introdução: O maior interesse por tratamentos minimamente invasivos, como os fios de sustentação, com menor risco de complicações, mínimo tempo de afastamento das atividades laborais e eficazes em corrigir a ptose e as rítides características do envelhecimento fez muitos especialistas adotarem essa técnica, porém muitas dúvidas sobre sua segurança e eficácia limitam sua adoção de forma geral. Objetivo: Analisar dados publicados na literatura sobre longevidade dos resultados, sua eficácia, segurança e seu risco de eventos adversos graves associados aos procedimentos com vários tipos de sutura. Método: Revisão de literatura com as palavras-chave thread lift, barbed suture, suture suspension e Aptos. Devido à escassez de literatura, foram também selecionados relatos recentes de rejuvenescimento facial com uso de fios, complementados com trabalhos das referências bibliográficas. Resultado: Os primeiros resultados da suspensão facial com fios com garras permanecem inconclusivos. Os eventos adversos podem ocorrer, embora em sua maioria sejam pequenos, autolimitados e de curta duração. Os dados sobre o efeito máximo da correção, a longevidade dos resultados e as consequências da permanência dos fios em longo prazo não são claros. Conclusão: O interesse pelo lifting com fios está em alta no momento, mas esta revisão sugere que ele não deve ser apresentado como opção a uma ritidoplastia.

Abstract Introduction: The increased interest in minimally-invasive treatments, such as the thread lifting, with lower risk of complications, minimum length of time away from work and effectiveness in correcting ptosis and aging characteristics has led many specialists to adopt this technique, but many doubts about its safety and effectiveness still limit its overall use. Objective: To analyze data published in the literature on the durability of results, their effectiveness, safety, and risk of serious adverse events associated with procedures using several types of threading sutures. Methods: Literature review using the key words "thread lift", "barbed suture", "suture suspension" and "APTOS". Due to the scarcity of literature, recent reports of facial lifting using threads were also selected, complemented with bibliographical references. Result: The first outcomes of facial lifting with barbed sutures remain inconclusive. Adverse events may occur, although they are mostly minor, self-limiting, and short-lived. The data on the maximum effect of the correction, the durability of results, and the consequences of the long-term suture stay are yet to be clarified. Conclusion: Interest in thread lifting is currently high, but this review suggests that it should not yet be adopted as an alternative to rhytidectomy.