ABSTRACT Purpose To analyze the impact of social distancing, due to the COVID-19 pandemic, on the perception and nuisance with chronic tinnitus and the relationship of the findings with anxiety and depression. Methods The sample was composed by convenience, including subjects aged 21 to 78 years. The evaluation was conducted in two periods: pre-distancing (late 2019) and during distancing (2020). The second evaluation was conducted online via Google Forms, consisting of the following procedures: Semistructured questionnaire, Tinnitus Handicap Inventory (THI), Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI). Results In the comparison of the results of the procedures performed pre-social distancing and during social-distancing, a statistically significant difference was evidenced for the THI and the BAI, but not for the BDI. In the correlation of the perception of chronic tinnitus with anxiety, a statistically significant difference was observed, positive and strong, but not significant with depression. Conclusion Social distancing, due to the COVID-19 pandemic, worsened the perception of and annoyance with chronic tinnitus and was correlated with an increase in anxiety symptoms.

RESUMO Objetivo analisar o impacto do distanciamento social devido à pandemia de COVID-19, sob a percepção e o incômodo com o zumbido crônico e a relação dos achados com a ansiedade e a depressão. Métodos a amostra foi composta por conveniência, incluindo sujeitos com idades de 21 a 78 anos. A avaliação foi realizada em dois períodos: pré-distanciamento (final de 2019) e durante o distanciamento (2020). A segunda avaliação foi realizada de forma online, via Google Forms, consistindo nos seguintes procedimentos: questionário semiestruturado, Tinnitus Handicap Inventory (THI), Inventário de Ansiedade de Beck (BAI) e Inventário de Depressão de Beck (BDI). Resultados nas comparações dos procedimentos entre os períodos pré e pós-distanciamento social, foi evidenciada diferença estatisticamente significativa para o THI e o BAI, mas não para o BDI. Na correlação da percepção do zumbido crônico com a ansiedade, foi observada diferença estatisticamente significativa, positiva e forte, mas não significativa com a depressão. Conclusão o distanciamento social devido à pandemia de COVID-19 piorou a percepção e o incômodo com o zumbido crônico, estando correlacionado com aumento nos sintomas de ansiedade.

RESUMO Objetivo Investigar os efeitos da suplementação antioxidante com extrato de açaí no incômodo com o zumbido crônico e a relação com os níveis de ansiedade e metabolismo oxidativo, não excluindo a sobreposição de enfermidades. Método Ensaio clínico, randomizado, controlado por placebo. Participaram 30 indivíduos, com média de 50,5 anos, 14 do sexo masculino e 16 do feminino, com limiares auditivos normais ou perda auditiva sensorioneural até grau leve bilateralmente, divididos em dois grupos: Grupo Placebo (sem ativo) e Grupo Açaí (100mg de extrato de açaí). Aplicaram-se os seguintes procedimentos antes e após três meses dos tratamentos: Tinnitus Handicap Inventory (THI), Inventário de Ansiedade de Beck (BAI) e amostras de sangue para avaliação de biomarcadores de estresse oxidativo (Peroxidação Lipídica e Carbonilação de proteínas). Resultados Houve redução do incômodo do zumbido para o grupo açaí, verificado por meio do THI (p=0,006). Diferenças significativas foram constatadas na pontuação dos sintomas comuns para os quadros de ansiedade no grupo placebo (p=0,016) porém, o mesmo não foi observado para os biomarcadores de metabolismo oxidativo, apesar de haver uma diminuição dos valores pós-tratamento para os grupos. Conclusão A suplementação antioxidante oral, com extrato de açaí, manifestou efeitos favoráveis no zumbido, reduzindo o desconforto com o sintoma, independente da etiologia de base, podendo ser considerada uma modalidade de tratamento. Entretanto, o efeito dessa suplementação nos sintomas de ansiedade e em biomarcadores de estresse oxidativo precisa de maior investigação.

ABSTRACT Purpose To investigate the effects of antioxidant supplementation with açaí extract on the discomfort with chronic tinnitus and the relationship with the levels of anxiety and oxidative metabolism, not excluding the overlap of diseases. Methods Randomized, placebo-controlled clinical trial. 30 individuals participated, with an average of 50.5 years, 14 males and 16 females, with normal hearing thresholds or sensorineural hearing loss up to mild degree, divided into two groups: Placebo Group (without active) and, Açaí Group (100mg of açaí extract). The following procedures were applied before and after three months of treatments: Tinnitus Handicap Inventory (THI), Beck's Anxiety Inventory (BAI) and blood samples for evaluation of oxidative stress biomarkers (Lipid Peroxidation and Protein Carbonylation). Results There was a reduction in the discomfort of tinnitus for the açaí group verified through THI (p = 0.006). Significant differences were found in the score of common symptoms for anxiety disorders in the placebo group (p = 0.016), however, the same was not observed for oxidative metabolism biomarkers, although there was a decrease in post-treatment values for all groups. Conclusion Oral antioxidant supplementation, with açaí extract, showed favorable effects on tinnitus, reducing discomfort with the symptom, regardless of the underlying etiology, and can be considered a treatment modality. However, the effect of this supplementation on anxiety symptoms and oxidative stress biomarkers needs further investigation.

RESUMO Objetivo Investigar se há diferenças nos achados audiológicos periféricos e centrais entre indivíduos com limiares auditivos normais com e sem zumbido crônico e, com isso, entender quais exames auditivos são importantes nessa população. Métodos A amostra foi composta por conveniência, incluindo indivíduos de 18 a 59 anos, divididos em dois grupos: grupo 1 (G1), formado por sujeitos sem queixa de zumbido crônico e grupo 2 (G2), por indivíduos com zumbido crônico. A avaliação consistiu nos seguintes procedimentos: anamnese, audiometria de altas frequências (AAF), emissões otoacústicas transientes (EOAT), potencial evocado auditivo de tronco encefálico (PEATE)-clique, frequency following response (FFR) e o potencial evocado auditivo de longa latência (PEALL)-fala. Resultados O G2 apresentou valores aumentados para a AFF, com diferenças significativas. Para ambos os grupos, a EOAT mostrou predominância de presença de respostas. No PEATE, não houve diferenças estatisticamente significativas. No FFR, o G1 obteve maior amplitude de onda V e houve maior ocorrência de ausências no PEALL dos potenciais P1, N2 e P300, no G2. Conclusão A AAF, a análise da relação da onda V/I do PEATE, o FFR e o PEALL identificaram alterações nos indivíduos com zumbido crônico, demonstrando que tais procedimentos são promissores na avaliação dessa população.

ABSTRACT Purpose To investigate whether there are differences in peripheral and central audiological findings between individuals with normal hearing thresholds with and without chronic tinnitus, and thereby understand which hearing tests are most important in this population. Methods The sample was composed of convenience, including individuals from 18 to 59 years old, divided into two groups: Group 1 (G1) composed of subjects without complaints of chronic tinnitus, and Group 2 (G2) composed of individuals with chronic tinnitus. The evaluation consisted of the following procedures: Anamnesis, High-frequency audiometry (HFA), Transient Otoacoustic emissions (TOAEs), Auditory Brainstem Response (ABR)-click, Frequency Following Response (FFR), and Long Latency Auditory Evoked Potential (LLAEP)-speak. Results G2 showed increased values for HFA, with significant differences. For both groups, TOAEs showed a predominance of responses. In ABR there were no statistically significant differences. In FFR, G1 obtained a greater amplitude of wave V and there was a greater absence in LLAEP of P1, N2, and P300 in G2. Conclusion The HFA, the analysis of the wave V/I ratio in ABR, the FFR, and the LLAEP identified alterations in individuals with chronic tinnitus, demonstrating that such procedures are promising in the evaluation of this population.

Abstract Introduction The use of the speech-evoked auditory brainstem response (ABR) shows how the brainstem operates up to the subcortex in a more complexmanner than when the click-evoked ABR is used. Objective To study the applicability of the speech-evoked ABR in adults with hearing loss. Methods The sample was composed of a study group of 11 subjects, with ages ranging between 18 and 59 years, and auditory thresholds within normal standards, with loss of up to 65 dB at high frequencies or up to moderately severe symmetric sensorineural hearing loss. The sample underwent a basic audiological assessment, as well as speech-evoked ABR and click-evoked ABR, in which waves I, III and V, and V, A, C, D, E, F were respectively marked. The electrophysiological assessments were performed using the SmartEP device (Intelligent Hearing Systems, Miami, FL, US). Results For the speech-evoked ABR, the reference values were used in the identification and analysis of the study group. Those values found for the study group were: V = 8.56; A = 10.97; C = 21.33; D = 29.51; E = 37.93; F = 46.96; and O = 55.97. In the comparison between groups, the study group presented an increase in latency only in wave C. Conclusion The speech-evoked ABR can be performed in subjects with up to moderately severe hearing loss, and the test proved to be appropriate, because, unlike the click-evoked ABR, the former does not suffer influence of peripheral hearing loss.

RESUMO Objetivo: comparar os níveis mínimos de resposta por via aérea e via óssea entre a Audiometria de Reforço Visual e o Potencial Evocado Auditivo de Estado Estável nas crianças de seis a 12 meses, com e sem comprometimento condutivo. Métodos: foram avaliadas 60 crianças de seis a doze meses, sendo 30 com e 30 sem comprometimento condutivo. Foram excluídas crianças com má formação no meato acústico externo, com alteração neurológica e/ou síndrome genética, além de portadores de perda auditiva neurossensorial ou mista. As crianças foram submetidas à Audiometria de Reforço Visual e Potencial Evocado Auditivo de Estado Estável por via aérea e via óssea no mesmo dia. Os resultados das duas avaliações foram comparados e correlacionados entre si. Resultados: na comparação por via aérea para o grupo sem comprometimento de orelha média os níveis mínimos de resposta para 500 e 1000Hz foram menores (melhores limiares) para o Potencial Evocado Auditivo de Estado Estável em ambas as orelhas e por via óssea foram muito similares em todas as frequências. Para as crianças com comprometimento condutivo, as respostas por via aérea foram melhores para todas as frequências avaliadas quando obtidas por meio do Potencial Evocado Auditivo de Estado Estável. Por via óssea foram muito similares para ambos os grupos. Conclusão: foi possível comparar os achados para os níveis mínimos de resposta por via aérea e via óssea entre a Audiometria de Reforço Visual e o Potencial Evocado Auditivo de Estado Estável, sendo que a comparação para a via óssea em ambos os grupos, traz uma equivalência nos valores, sendo estes muito similares. Ainda, para a via aérea, no grupo controle, houve valores aproximados entre as respostas de algumas frequências, enquanto que no grupo com comprometimento condutivo os valores do Potencial Evocado Auditivo de Estado Estável foram melhores que as respostas comportamentais em todas as frequências pesquisadas.

ABSTRACT Purpose: to compare the findings of minimum levels of answers through air and bone conductions between the Visual Reinforcement Audiometry and the Steady-State Auditory Evoked Potential in infants from six to twelve months, with and without conductive disorder. Methods: sixty children aged six to twelve months were evaluated, 30 presenting conductive disorder, and 30 not presenting it. Children with malformation in the external auditory meatus with neurological alteration and / or genetic syndrome were excluded, as well as patients with sensorineural or mixed hearing loss. The infants were subjected to Visual Reinforcement Audiometry and Steady-State Auditory Evoked Potential evaluation through air and bone conduction on the same day. The results of both assessments were compared and correlated. Results: in the comparison through air conduction, for the group without conductive disorder of the medium ear, the minimum levels of response for 500 and 1000Hz were lower (better thresholds) for Steady-State Auditory Evoked Potential in both ears, and through bone conduction were very similar in all frequencies. Concerning the infants that present conductive disorder, the responses through air conduction were better in all frequencies evaluated when obtained via Steady-State Auditory Evoked Potential test. Through bone conduction, the results were very similar for both groups. Conclusion: it was possible to compare the findings to the minimum levels of response through air and bone conductions between the Visual Reinforcement Audiometry and the Steady-State Auditory Evoked Potential, being that the comparison for bone conduction in both groups presents an equivalence in the results, being very similar. In addition, for the air conduction, in the control group, there was proximity of responses of some frequencies, while the values for the Steady-State Auditory Evoked Potential test were better than the behavioral responses in the conductive disorder group.

Abstract Introduction The auditory system consists of sensory structures and central connections. The evaluation of the auditory pathway at a central level can be performed through behavioral and electrophysiological tests, because they are complementary to each other and provide important information about comprehension. Objective To correlate the findings of speech brainstem-evoked response audiometry with the behavioral tests Random Gap Detection Test and Masking Level Difference in adults with hearing loss. Methods All patients were submitted to a basic audiological evaluation, to the aforementioned behavioral tests, and to an electrophysiological assessment, by means of click-evoked and speech-evoked brainstem response audiometry. Results There were no statistically significant values among the electrophysiological test and the behavioral tests. However, there was a significant correlation between the V and A waves, as well as the D and F waves, of the speech-evoked brainstem response audiometry peaks. Such correlations are positive, indicating that the increase of a variable implies an increase in another and vice versa. Conclusion It was possible to correlate the findings of the speech-evoked brainstem response audiometry with those of the behavioral tests Random Gap Detection and Masking Level Difference. However, there was no statistically significant correlation between them. This shows that the electrophysiological evaluation does not depend uniquely on the behavioral skills of temporal resolution and selective attention.

RESUMO Objetivo Estabelecer valores de referência para a latência do potencial cognitivo P300 com estímulos tone burst. Métodos Participaram do estudo 28 indivíduos entre 18 e 59 anos. O registro do P300 foi realizado no equipamento Masbe da marca Contronic. Os eletrodos foram fixados nas posições Fpz (eletrodo terra), Cz (eletrodo ativo), M1 e M2 (eletrodos referência). A intensidade foi de 80 dB NA. A frequência do estímulo frequente foi de 1.000Hz e a do estímulo raro de 2.000Hz. Os estímulos foram apresentados na forma binaural. Resultados A média de idade dos indivíduos foi de 35 anos. A média de latência para P300 de 305ms. Conclusão Usando o protocolo descrito, o valor máximo de latência aceitáveis para P300 foram de 362,5ms (305 + 2DP 28,75) na faixa etária do adulto de 18 a 59 anos.

ABSTRACT Objective To establish reference intervals for cognitive potential P300 latency using tone burst stimuli. Methods This study involved 28 participants aged between 18 and 59 years. P300 recordings were performed using a two-channel device (Masbe, Contronic). Electrode placement was as follows: Fpz (ground electrode), Cz (active electrode), M1 and M2 (reference electrodes). Intensity corresponded to 80 dB HL and frequent and rare stimulus frequencies to 1,000Hz and 2,000Hz, respectively. Stimuli were delivered binaurally. Results Mean age of participants was 35 years. Average P300 latency was 305ms. Conclusion Maximum acceptable P300 latency values of 362.5ms (305 + 2SD 28.75) were determined for adults aged 18 to 59 years using the protocol described.