Objetivo analisar as falhas técnicas em próteses auditivas de um grupo de usuários do Programa de Saúde Auditiva de uma Universidade em Curitiba. Métodos analisou-se o relatório técnico de 104 próteses de usuários que compareceram ao serviço para a consulta de acompanhamento. Resultados o relatório apontou para defeitos em: 21% receptor; 15% caixa; 12% suspensão; 9% microfone; 2% amplificador. Com relação à causa provável do defeito: 58% desgaste em função do tempo de uso; 25% umidade; 23% mau uso. Quanto ao valor dos consertos: mínimo de R$44,00 para revisão e limpeza (36%) e máximo de R$900,00 para substituição de peças (9,6%); 21% da amostra teve o orçamento realizado entre R$100,00 e R$500,00; 37% dos aparelhos foram substituídos. Conclusão Os defeitos detectados deveram-se a problemas de manuseio entre os usuários recentes, e desgaste entre os usuários mais antigos.

Purpose to analyze the technical problems in hearing aids for a user group Program Hearing Health at a university in Curitiba. Methods we analyzed the technical report of 104 implants users who attended the service for follow-up visit. Results the report pointed to defects: 21% receiver, 15% cash, 12% suspension; microphone 9%, 2% amplifier. With regard to the probable cause of the defect: 58% wear a function of time of use, 25% humidity, 23% misuse. As the value of repairs: minimum of R$ 44.00 for review and cleaning (36%) and maximum of R$ 900.00 for replacement parts (9.6%), 21% of the sample was held between the budget R$ 100, 00 and R$ 500.00, 37% of the devices were replaced. Conclusion the defects were due to handling problems among recent users, and burnout among older users.

Introduction  Fishing, one of the oldest productive activities, is an important sector of the national and world economy. Aim  To evaluate the vestibular behavior in a population of fishermen. Methods  In a retrospective and cross-sectional study, 13 fishermen (mean 45.0), between 33 and 62 years of age, were submitted to anamnesis, otorhinolaryngological evaluation, and vestibular exam through the vector electronystagmography. Results  The most evident otoneurologic symptoms were hearing loss (76.9%), tinnitus (61.7%), dizziness (46.1%), and headache (46.1%). The most evident clinical symptoms were fatigue (46.1%), depression (23.0%), anxiety (15.3%), insomnia (7.7%), and agitation during sleep (7.7%). There were alterations in the vestibular exam in 5 fishermen (38.5%) discovered in the caloric test. There was a prevalence of alteration in the peripheral vestibular system. There was a major frequency of the peripheral vestibular irritative syndrome. Conclusion  The otoneurologic complaints were frequent in the population studied to verify the importance of allowing labyrinth exams and the need for adopting preventive measures relating to noise exposure as well as carbon monoxide exposure, because they can cause and/or enhance various manifestations of labyrinthine vestibular impairment that can affect the quality of life of these workers.

Introduction  Over the years the immune system suffers many morphologic and functional alterations, which result in a peak of function in puberty and a gradual decrease in the elderly. Aim  Treat patients 55 years or older with allergic rhinitis with immunotherapy and then analyze the response to allergens. Materials and Methods  From June 2009 to July 2010, 104 charts of patients 55 years or older with allergic complaints were evaluated. The patients were selected by anamnesis, physical examination, and otorhinolaryngologic exam. The patients had cutaneous test for mites before and after 1 year of sublingual specific immunotherapy. The cutaneous response was classified as negative (absent), light, moderate, or severe. Results  Before vaccination, 42 (40.4%) patients were classified as having a severe form of allergy and 62 (59.6%) as having a moderate allergy. After the specific therapy, 40 (38.4%) patients were classified as negative (absent), 37 (35.6%) as light, 19 (18.3%) as moderate, and 8 (7.7%) as severe responses. Conclusion  Immunotherapy, a desensitization technique, is indicated in cases which patients cannot avoid the exposure to allergens and in situations where pharmacologic therapy is not ideal. Specific immunotherapy to treat the allergic rhinitis in elderly patients was efficient and had no collateral effects, and in addition to the clinical benefit, improvement in the cutaneous test could also be observed.

Diabetes mellitus (DM) é uma doença crônica causada pela não produção e uso inadequado de insulina. Enfermidade crônico-degenerativa. Complicações crônicas do DM, no sistema auditivo, podem causar atrofia do gânglio espiral, degeneração da bainha de mielina do VIII par craniano, diminuição de fibras nervosas na lâmina espiral ou espessamento das paredes capilares da estria vascular e das pequenas artérias. OBJETIVO: Verificar os limiares auditivos em indivíduos portadores de DM tipo 1. MATERIAL E MÉTODOS: Estudo clínico envolvendo 60 indivíduos, divididos em Grupo Estudo (GE) e Grupo Controle (GC), indivíduos diabéticos e não diabéticos. Realizada anamnese, exame físico, otorrinolaringológico e exame audiométrico. RESULTADOS:Quanto aos limiares de audibilidade, no GE, houve diferença estatisticamente significante nas frequências 250, 500, 10.000, 11.200, 12.500, 14.000 e 16.000 Hz em ambas as orelhas e médias das orelhas. Na comparação dos GE e GC, houve diferença estatisticamente significativa com maior probabilidade de ocorrência de hipoacusia em alguma frequência independente da orelha testada no GE. CONCLUSÕES: Houve diferenças estatisticamente significativas nos achados audiológicos no GE quando comparado com GC, justificando avaliação audiológica completa em pacientes diabéticos tipo 1, incluindo audiometria de altas frequências.

Diabetes mellitus (DM) is a chronic degenerative disease that impairs normal insulin production and use. DM chronic auditory complications may include spiral ganglion atrophy, degeneration of the vestibulocochlear nerve myelin sheath, reduction of the number of spiral lamina nerve fibers, and thickening of the capillary walls of the stria vascularis and small arteries. OBJECTIVE: This paper aims to verify the hearing thresholds of individuals with type 1 DM. MATERIALS AND METHODS: Sixty patients were enrolled in this trial and divided into case and control groups featuring diabetic and non-diabetic subjects respectively. All individuals were interviewed and underwent physical examination, ENT examination, and audiometric tests. RESULTS: Statistically significant difference was observed in hearing thresholds of case group subjects at 250, 500, 10,000, 11,200, 12,500, 14,000 and 16,000 Hz for both ears and ear average. Case group subjects had higher likelihood of having hypacusis at any frequency regardless of ear than controls. CONCLUSION: Statistically significant differences were seen in the audiological findings of case group subjects when compared to controls. Thorough audiological examination including high frequency audiometry is required for subjects with diabetes mellitus type 1.

TEMA: a polimiosite é uma enfermidade sistêmica idiopática caracterizada por um processo inflamatório não supurativo que acomete a musculatura esquelética e manifesta-se clinicamente por fraqueza muscular proximal e simétrica. Possui incidência variável, cerca de um caso para cada 100 mil habitantes, havendo predominância no sexo feminino. PROCEDIMENTOS: avaliou-se no Setor de Otoneurologia de uma Instituição, um paciente com diagnóstico de polimiosite, com 60 anos, do sexo feminino, que referiu dificuldade para escutar no ouvido direito, zumbido, ansiedade, insônia, dificuldade nos movimentos do pescoço e dor irradiada para ombros e braços. Foram realizados os seguintes procedimentos: anamnese, inspeção otológica, avaliação audiológica e vestibular. RESULTADOS: a) na avaliação audiológica apresentou, perda auditiva neurossensorial de grau moderado na orelha direita e limiares auditivos dentro dos padrões de normalidade na orelha esquerda; b) na imitanciometria apresentou, curva timpanométrica do tipo "A" e presença dos reflexos estapedianos bilateralmente; c) no exame vestibular observou-se, nistagmo semi-espontâneo do tipo múltiplo e ausência do efeito inibidor da fixação ocular. CONCLUSÃO: observou-se alteração nos exames realizados, principalmente, no exame labiríntico que demonstrou a importância de sua realização e a sensibilidade na captação de alteração que sugeriu envolvimento do sistema nervoso central contribuindo dessa forma, para uma intervenção e acompanhamento terapêutico mais rápido e eficaz.

BACKGROUND: polymyositis is an idiopathic systematic disease characterized by a non-suppurative inflammatory process which attacks the skeletal musculature and manifests itself clinically by proximal and symmetrical muscular debility. It shows a variable incidence, approximately one in every hundred thousand inhabitants, predominately in females. PROCEDURES: a patient, 60 years, female and diagnosed with polymyositis was evaluated in the Otoneurology Sector of an Institution, referred having hearing difficulties in the right ear, tinnitus, anxiety, insomnia, difficulties in neck movement and shoulders and arms disseminated pain. The following procedures were carried out: anamnesis, otological inspection, audiological evaluation and vestibular exam. RESULTS: a) in the audiological evaluation there was sensorineural hearing loss from moderate degrees in the right ear and normal hearing thresholds in the left ear; b) in the imitanciometry there was a type "A" tympanometric curve and the presence of the stapedial reflexes, bilaterally; c) in the vestibular exam, semi-spontaneous multiple nystagmus and an absence of the inhibiting effect for ocular fixation were observed. CONCLUSION: alterations were observed in the accomplished exams, mainly in the vestibular exam, which demonstrated the importance for being carried out; and the sensitivity in the acquisition of the alteration which suggested an involvement of the central nervous system, contributing, thus, to a faster and more effective intervention and therapeutic accompaniment.

A síndrome de West é um tipo de espasmo infantil caracterizado por encefalopatia epiléptica associado a espasmos em flexão e deficiência mental de instalação no primeiro ano de vida e de etiologia incerta. Acredita-se ser determinada por diferentes fatores etiológicos como infeção intrauterina, esclerose tuberosa, asfixia perinatal ou afecções pós-natais. FORMA DE ESTUDO: Observacional coorte com corte transversal. MATERIAL E MÉTODO: No presente estudo dez pacientes com Síndrome de West foram submetidos ao exame de Potencial Evocado de Tronco Cerebral (BERA) para avaliar o envolvimento do tronco cerebral e das vias auditivas a este nível. RESULTADO: Os achados anormais ao BERA incluem alteração na morfologia das curvas com reprodutibilidade apenas de onda I e II, (caso 7), aumento do intervalo interpico da onda I-V (casos 1, 2 e 9), aumento da proporção de amplitude da onda I/V (caso 8) e alteração do limiar eletrofisiológico (caso 7). Tais achados ao BERA sugerem que a disfunção do sistema nervoso resulte principalmente da hipogênese ou degeneração das células nervosas, em parte como resultado da dismielinização. CONCLUSÃO: Os autores recomendam o uso de estudos eletrofisiológicos para avaliar a disfunção do sistema nervoso central no paciente com suspeita de espasmo infantil.

The West syndrome is a pediatric disease that involves muscular spasm, mental deficiency and epileptic encephalopathy. This disease tends to be noticed in the first year of life and has no etiology known. It is believed to be caused by different etiology factors as uterine infection, tuberous sclerosis, perinatal asphyxia, or post-born diseases. STUDY DESIGN: Observacional cohort with transversal cut. MATERIAL AND METHOD: In this study, ten West Syndrome patients were submitted to Auditory Brainstem Response (ABR) to evaluate the involvement of the hearing system. RESULTS: The abnormal results consisted in morphological alterations (case 7), increase of the interval I-V (cases 1, 2, 9), increase of the amplitude proportion I/V (case 8) and alteration of the thresholds. These findings suggest that the nervous system dysfunction results of the hypogenesis or degeneration of the nervous cells, as a result of the dysmyelination process. CONCLUSION: The authors recommend the use of ABR to evaluate the function of the nervous and hearing systems in patients with West Syndrome.