Abstract Introduction Facial nerve stimulation (FNS) is a complication in cochlear implant (CI) when the electrical current escapes from the cochlea to the nearby facial nerve. Different management to reduce its effects are available, although changes might result in a less-than-ideal fitting for the CI user, eventually reducing speech perception. Objective To verify the etiologies that cause FNS, to identify strategies in managing FNS, and to evaluate speech recognition in patients who present FNS. Methods Retrospective study approved by the Ethical Board of the Institution. From the files of a CI group, patients who were identified with FNS either during surgery or at any time postoperatively were selected. Data collection included: CI manufacturer, electrode array type, age at implantation, etiology of hearing loss, FNS identification date, number of electrodes that generated FNS, FNS management actions, and speech recognition in quiet and in noise. Results Data were collected from 7 children and 25 adults. Etiologies that cause FNS were cochlear malformation, head trauma, meningitis, and otosclerosis; the main actions included decrease in the stimulation levels followed by the deactivation of electrodes. Average speech recognition in quiet before FNS was 86% and 80% after in patients who were able to accomplish the test. However, there was great variability, ranging from 0% in quiet to 90% of speech recognition in noise. Conclusion Etiologies that cause FNS are related to cochlear morphology alterations. Facial nerve stimulation can be solved using speech processor programming parameters; however, it is not possible to predict outcomes, since results depend on other variables. (FNS (CI available lessthanideal less than ideal user perception Institution group selected manufacturer type implantation loss date noise 2 adults malformation trauma meningitis otosclerosis 86 80 test However variability 0 90 alterations parameters however outcomes variables 8 9

ABSTRACT Purpose This study aimed to evaluate the contribution of assistive listening technology with wireless connectivity in cochlear implant (CI) users in reverberating and noise situations. Methods Prospective cross-sectional study approved by the Institutional Ethics Committee (CAAE 8 3031418.4.0000.0068). Adolescents and adults CI users with pre- or post-lingual deafness were selected. For bilateral users, each ear was assessed separately. Speech recognition was assessed using recorded lists of disyllabic words presented at 65 dBA at 0° azimuth with and without the Wireless Mini Microphone 2 (Cochlear™) connected to the Nucleus®6 speech processor. Room reverberation was measured as 550 ms. To assess the contribution of the assistive listening device (ALD) in a reverberating environment, speech recognition was assessed in quiet. To assess the contribution of the ALD in reverberation and noise, speech recognition was presented at 0° azimuth along with the noise coming from 8 loudspeakers symmetrically arranged 2 meters away from the center with multi-talker babble noise using signal to noise ratio of +10dB. To avoid learning bias or fatigue, the order of the tests was randomized. Comparison of means was analyzed by t test for paired samples, adopting significance level of p <0.005. Results Seventeen patients with a mean age of 40 years were invited and agreed to participate, with 2 bilateral participants, totaling 19 ears assessed. There was a significant positive contribution from the Mini Mic2 in reverberation, and noise+reverberation (p <0.001). Conclusion ALD was able to improve speech recognition of CI users in both reverberation and noisy situations. (CI situations crosssectional cross sectional CAAE 3031418.4.0000.0068. 3031418400000068 3031418.4.0000.0068 . 3031418 4 0000 0068 3031418.4.0000.0068) pre postlingual post lingual selected separately 6 0 Cochlear™ Cochlear (Cochlear™ Nucleus6 Nucleus Nucleus® processor 55 ms (ALD environment quiet multitalker multi talker 10dB dB +10dB fatigue randomized samples 0005 005 <0.005 participate participants 1 Mic noisereverberation <0.001. 0001 <0.001 001 <0.001) 303141840000006 3031418.4.0000.006 303141 000 006 (Cochlear 5 00 <0.00 30314184000000 3031418.4.0000.00 30314 <0.0 3031418400000 3031418.4.0000.0 3031 <0. 303141840000 3031418.4.0000. 303 <0 30314184000 3031418.4.0000 30 < 3031418400 3031418.4.000 3 303141840 3031418.4.00 30314184 3031418.4.0 3031418.4. 3031418.4 3031418.

RESUMO Objetivo Avaliar a contribuição da tecnologia de escuta assistida em usuários de implante coclear (IC) em situações de reverberação e ruído. Métodos Estudo transversal prospectivo aprovado pelo Comitê de Ética Institucional (CAAE 8 3031418.4.0000.0068). Foram selecionados adolescentes e adultos usuários de IC com surdez pré ou pós-lingual. Para usuários bilaterais, cada orelha foi avaliada separadamente. O reconhecimento de fala foi avaliado por meio de listas gravadas de palavras dissílabas apresentadas a 65 dBA a 0° azimute com e sem o Mini Microfone2 (Cochlear™) conectado ao processador de fala Nucleus®6. A reverberação da sala foi medida como 550 ms. Para avaliar a contribuição do dispositivo de escuta assistida (DEA) em ambiente reverberante, o reconhecimento de fala foi avaliado no silêncio. Para avaliar a contribuição do DEA em reverberação e ruído, o reconhecimento de fala foi apresentado a 0° azimute com o ruído proveniente de 8 alto-falantes dispostos simetricamente a 2 metros de distância do centro com ruído de múltiplos falantes usando relação sinal-ruído de +10dB. Para evitar viés de aprendizado ou fadiga, a ordem dos testes foi randomizada. A comparação das médias foi analisada pelo teste t para amostras pareadas, adotando-se nível de significância de p<0,005. Resultados Dezessete pacientes com idade média de 40 anos foram convidados e concordaram em participar, sendo 2 participantes bilaterais, totalizando 19 orelhas. Houve contribuição positiva significante do Mini Mic2 na reverberação e ruído+reverberação (p<0,001). Conclusão DEA foi capaz de melhorar o reconhecimento de fala de usuários de IC tanto em situações de reverberação quanto ruidosas. (IC CAAE 3031418.4.0000.0068. 3031418400000068 3031418.4.0000.0068 . 3031418 4 0000 0068 3031418.4.0000.0068) póslingual. póslingual pós lingual. lingual pós-lingual bilaterais separadamente 6 0 Microfone Cochlear™ Cochlear (Cochlear™ Nucleus6 Nucleus Nucleus®6 55 ms (DEA reverberante silêncio altofalantes alto sinalruído sinal 10dB dB +10dB fadiga randomizada pareadas adotandose adotando se p0005 p 005 p<0,005 participar 1 orelhas Mic ruídoreverberação p<0,001. p0001 p<0,001 001 (p<0,001) ruidosas 303141840000006 3031418.4.0000.006 303141 000 006 (Cochlear Nucleus® 5 p000 00 p<0,00 (p<0,001 30314184000000 3031418.4.0000.00 30314 p00 p<0,0 (p<0,00 3031418400000 3031418.4.0000.0 3031 p0 p<0, (p<0,0 303141840000 3031418.4.0000. 303 p<0 (p<0, 30314184000 3031418.4.0000 30 p< (p<0 3031418400 3031418.4.000 3 (p< 303141840 3031418.4.00 (p 30314184 3031418.4.0 3031418.4. 3031418.4 3031418.

RESUMO Objetivo identificar se as diferenças no desenvolvimento da aquisição das habilidades auditivas iniciais em crianças após o implante coclear, unilateral ou bilateral, podem ser evidenciadas durante o primeiro ano de uso. Métodos estudo longitudinal retrospectivo de levantamento de prontuários. Foram incluídas crianças que receberam o implante coclear antes dos 4 anos de idade, separadas em dois grupos. O primeiro, composto por crianças implantadas unilateralmente e o segundo, por crianças implantadas bilateral e simultaneamente. Foram coletados os dados referentes à escala IT-MAIS (Infant-Toddler Meaningful Auditory Integration Scale) antes da cirurgia e três meses, seis meses e um ano após a cirurgia. Esses resultados foram comparados com os marcadores clínicos já existentes. Além disso, as famílias foram classificadas segundo a Escala de Avaliação de Envolvimento Familiar. Resultados foram avaliados os resultados de 29 crianças com implante coclear bilateral e 30 crianças com implante coclear unilateral. A pontuação obtida no IT-MAIS dos dois grupos foi semelhante aos marcadores clínicos. Quanto à Escala de Avaliação de Envolvimento Familiar, houve diferença, mostrando que as famílias do grupo dos bilaterais estavam mais envolvidas. Conclusão no primeiro ano de uso do implante coclear, o desenvolvimento da aquisição das habilidades auditivas iniciais das crianças implantadas bilateralmente não diferiu do desenvolvimento de crianças implantadas unilateralmente, sugerindo que as habilidades auditivas iniciais são passíveis de desenvolvimento com entrada auditiva unilateral.

ABSTRACT Purpose To identify the development of initial auditory skills in children with unilateral and bilateral cochlear implant during the first year of use. Methods Retrospective longitudinal study of medical records of children who received cochlear implant under the age of four, separated into two groups. The first, composed of children implanted unilaterally and the second, by children implanted and simultaneously. Data on the IT-MAIS scale (Infant-Toddler Meaningful Auditory Integration Scale) were collected before surgery and three months, six months and one year after surgery. These results were compared with the existing Clinical Markers. In addition, the family’s classification was noted, according to the Family Involvement Assessment Scale. Results The data of 29 children with bilateral cochlear implant and 30 children with unilateral cochlear implant were evaluated. The IT-MAIS score of the two groups was similar to the Clinical Markers. Regarding the Family Involvement Assessment Scale, there was a difference, showing that families in the bilateral group were more involved. Conclusion In the first year of use of the cochlear implant, the development of children implanted bilaterally did not differ from the development of children implanted unilaterally, suggesting that initial auditory skills are likely to develop with unilateral auditory input.

RESUMO Objetivo O objetivo deste estudo foi avaliar o efeito do sistema CROS em fenômenos como efeito sombra da cabeça em usuários de implante coclear unilateral. Método Estudo transversal prospectivo, aprovado pelo conselho de ética sob protocolo 2.128.869. Onze adultos com surdez de instalação pós-lingual usuários de IC Advanced Bionics unilateral foram selecionados. O reconhecimento de fala foi avaliado com palavras gravadas apresentadas a 65dBA a 0o azimute e a (90o no lado contralateral ao IC), com ruído a 55dBA, usando somente o IC e IC+sistema CROS. Os resultados foram analisados usando teste t pareado com alfa de 0,05. Resultados Os escores médios de reconhecimento de fala foram significativamente melhores com IC + CROS em relação à condição apenas IC (p <0,05, p <0,005 e p <0,005 respectivamente). Na apresentação à frente não foram encontradas diferenças significantes. Conclusão Os usuários de IC unilateral sem resíduo útil para uso de prótese auditiva ou impossibilitados de submeter-se à cirurgia bilateral podem se beneficiar do dispositivo CROS para o reconhecimento de fala, sobretudo quando a fala for apresentada ao lado contralateral ao IC.

ABSTRACT Purpose The aim of this study was to evaluate the contribution of the CROS system on the head shadow effect in unilateral implant users. Methods Prospective cross-sectional study, approved by the ethics committee under protocol 2.128.869. Eleven adults with post-lingual deafness users of unilateral Advanced Bionics CI were selected. Speech recognition was evaluated with recorded words presented at 65dBA at 0o azimuth and at 90o on the side contralateral to the CI, with noise at 55dBA, using CI alone and CI + CROS system. The results were analyzed using paired t-test with a 0.05 alpha. Results The mean speech recognition scores were significantly better with CI + CROS in relation to the condition of CI alone (p <0.05, p <0.005 and p <0.005 respectively). In the presentation at 0o azimuth, no significant differences were found. Conclusion Users of unilateral CI without useful residual hearing for the use of hearing aids or unable to undergo bilateral surgery can benefit from the CROS device for speech recognition, especially when the speech is presented on the side contralateral to the CI.

Abstract Introduction The use of cochlear implants and hearing aids (bimodal) has been growing with the expansion of the indication for them, and it is important to ensure protocols so that there is a balance of the loudness regarding the two devices. Objective To evaluate if the limited complex sounds present in the frequency bands of the current devices enable the balance of the loudness in adult users of bimodal stimulation, and to analyze if speech recognition improves after balancing. Methods A prospective cross-sectional study with convenience sampling. The sample was composed of 25 adults who had used either a cochlear implant for at least 6 months or a contralateral hearing aid, with a mean age of 46 years. The balancing of the loudness was performed in an acoustic room with the computer's sound box (0° azimuth at 70 dB SPL). The instrumental sounds were filtered through eight different frequency bands. The patients used both hearing devices and were asked if the sound was perceived to be louder in one of the ears or centrally. The speech test was evaluated with sentence silence (65 dB SPL) and/or noise signal ratio of 0 dB/+ 10 dB in free field at 0° azimuth, before and after balancing. Results: Out of the 25 patients, 5 failed to achieve balance at every tested frequency, and 3 achieved balance at almost every frequency, except 8 kHz. There was a significant difference between the speech recognition test only in silence before and after balancing. Conclusion: Most patients achieved sound equalization at all evaluated frequencies under the complex-sound protocol. Additionally, most patients experienced improved speech recognition after balancing.

RESUMO Objetivo identificar a contribuição do microfone omnidirecional (T-Mic) e microfone direcional adaptativo (UltraZoom) do processador de som Naída CIQ70 para o reconhecimento da fala no ruído e em ambiente reverberante. Identificar a contribuição do processador de som Naída CIQ70 para usuários do processador Harmony. Métodos participaram do estudo sete adultos com implante coclear unilateral, usuários do processador de som Harmony. O reconhecimento de sentenças foi avaliado em silêncio, em sala reverberante (RT60 de 553 ms) e ruído de 42,7 dBA (Leq), com os processadores Harmony e Naída CIQ70. A contribuição do microfone direcional UltraZoom foi avaliada no ruído. As sentenças gravadas foram apresentadas a 0° azimute. O ruído (babble noise) foi apresentado a + 5 dB SNR, a 90° azimute. Os participantes avaliaram subjetivamente a clareza do som e a dificuldade de escutar nas várias condições do teste. Resultados a média do reconhecimento de sentenças no silêncio com reverberação foi de 38,5% com o Harmony e 66,5% com o Naída CIQ70. A pontuação média de reconhecimento de sentenças no ruído foi de 40,5% com o Naída CIQ70, sem UltraZoom, e de 64,5% com UltraZoom. Nas classificações subjetivas de clareza do som e facilidade de escuta no ruído, nenhuma diferença foi identificada entre as condições de teste. Conclusão para usuários experientes do processador de som Harmony, a compreensão da fala em silêncio em uma sala reverbente foi significativamente melhor com o Naída CIQ70. O uso de uma tecnologia de microfone direcional adaptativa (UltraZoom) contribuiu para o reconhecimento de fala no ruído.

Abstract Purpose 1) To measure speech understanding in noise with the Naída Q70 in the omnidirectional microphone mode (T-Mic) and adaptive directional microphone mode (UltraZoom) in reverberating acoustics and noisy conditions. 2) To measure improvement in speech understanding with use of the Advanced Bionics (AB) Naída Q70 sound processor for existing Harmony users. Methods Seven adult unilateral cochlear implant (CI) recipients, who were experienced users of the Harmony sound processor, participated in the study. Sentence recognition was evaluated in quiet in a reverberating room, with Harmony and Naída CI Q70 processors. Effectiveness of Naída CI Q70’s UltraZoom directional microphone was evaluated in noise. Target stimuli were recorded Portuguese sentences presented from 0° azimuth. Twenty-talker babble was presented at +5dB SNR from ±90° azimuth. In addition to sentence recognition, the participants also rated the clarity of sound and difficulty of listening in the various test conditions. In order to evaluate the outcomes under more realistic acoustic conditions, tests were conducted in a non-sound treated reverberant room (RT60 of 553 ms and noise floor of 42.7 dBA (Leq). Results The average sentence recognition in quiet in the reverberant non-sound treated room was 38.5% with the Harmony and 66.5% with Naída CI Q70. The average sentence recognition score in noise was 40.5% with Naída CI Q70 without UltraZoom and 64.5% with UltraZoom. For subjective ratings of sound clarity and listening ease in noise no difference were identified between the test conditions. Conclusion For experienced users of the Harmony sound processor, speech understanding in quiet in a reverberating room was significantly improved with the Naída CI Q70. The use of an adaptive directional microphone technology (UltraZoom) enhanced speech perception in noise.

Resumo Introdução: A avaliação convencional da telemetria neural e de impedâncias implica o uso do computador acoplado a uma interface, o software fornece o estímulo e a visualização das respostas. Recentemente, foi lançado um controle remoto (CR220®), que possibilita testes intraoperatórios com instrumental mínimo. Objetivo: Avaliar a concordância dos valores das impedâncias e dos limiares da telemetria neural e o tempo de execução no procedimento convencional e pelo controle remoto. Método: Estudo prospectivo transversal multicêntrico. Foram incluídas as avaliações intraoperatórias de implante coclear compatível com o uso do CR220®. Os testes foram realizados nos 22 eletrodos para comparar os tempos de execução nas duas situações. Foi analisada a concordância dos valores do limiar da telemetria neural obtidos em cinco eletrodos e a concordância das impedâncias foi avaliada pelo número de eletrodos com valores alterados em cada procedimento. Resultados: Não houve diferença significante entre as impedâncias. Obteve-se moderada a forte correlação entre os limiares do potencial de ação composto eletricamente evocado. O tempo médio para os procedimentos com o CR220 foi significativamente menor do que com o procedimento convencional. Conclusão: O uso do CR220 proporcionou registros bem-sucedidos para a telemetria de impedância e a telemetria automática de respostas neurais.

Abstract Introduction: The conventional evaluation of neural telemetry and impedance requires the use of the computer coupled to an interface, with software that provides visualization of the stimulus and response. Recently, a remote control (CR220®) was launched in the market, that allows the performance of intraoperative tests with minimal instrumentation. Objective: To evaluate the agreement of the impedance values and neural telemetry thresholds, and the time of performance in the conventional procedure and by the remote control. Methods: Multicentric prospective cross-sectional study. Intraoperative evaluations of cochlear implants compatible with the use of CR220® were included. The tests were carried out in the 22 electrodes to compare the time of performance in the two situations. The agreement of the neural telemetry threshold values obtained from five electrodes was analyzed, and the agreement of impedance was evaluated by the number of electrodes with altered values in each procedure. Results: There were no significant difference between the impedance values. There was a moderate to strong correlation between the electrically-evoked compound action potential thresholds. The mean time to perform the procedures using the CR220 was significantly lower than that with the conventional procedure. Conclusion: The use of the CR220 provided successful records for impedance telemetry and automatic neural response telemetry.

Abstract Introduction The cochlear implants centers in the world are studying the cochlear implantation in children with multiple handicaps. Objective To develop a questionnaire to analyze the subjective benefits of the cochlear implantation in multiple handicapped children according to their parent's perspective. Methods A questionnaire was applied to 14 families of multiple handicapped children, aging from 2–12 years old and having from 11 months to 11 years of implant use. Results The social-emotional abilities were improved because of many factors, such as: auditory exposure, which happened in 84% of the children; recognition of their own names, which increased in 56%; and development of eye contact, in 28% of the subjects. Other benefits appeared to be: music appreciation and more attention and adherence to other therapies and school activities. Besides, some children became interested in objects, playing with other children, and more adapted to daily routines. Thirty-five percent of the children acquired oral language, mainly the bilaterally implanted, while 14% of them were engaged in sign language. Although all of the children showed a significant improvement in communication, the emotional issues of some families and the severity of the handicaps negatively impacted the outcomes. In spite of the families' acknowledgement of some benefits, the diagnosis of autism spectrum disorder caused frustration, requiring a readjustment of the expectations. Conclusion The questionnaire turned out to be an adequate tool to reveal the social-emotional benefits of cochlear implantation. Although oral language was not the major outcome in these cases, the cochlear implant benefits involved the whole family. All of the families recommended the implant to other children in a similar situation.

RESUMO Objetivo: verificar a aquisição de vocabulário em crianças surdas, usuárias de implante coclear, bem como os fatores que influenciam esse desenvolvimento. Métodos: foi aplicada a parte de vocabulário do teste de linguagem infantil ABFW em 20 crianças usuárias de implante coclear por no mínimo três anos. Além disso, foi avaliada a participação familiar no desenvolvimento dessas crianças. Resultados: foi observado que as crianças implantadas apresentam possibilidade de alcançar o desenvolvimento normal de vocabulário, quando comparadas às crianças ouvintes, a depender de diversos fatores. O fator que apresentou influência estatisticamente significante no vocabulário foi a participação familiar, sendo que quanto maior o envolvimento da família no processo terapêutico, melhores os resultados no teste de vocabulário. Conclusão: as crianças implantadas podem apresentar desempenho similar às crianças ouvintes no teste de vocabulário, a depender das variáveis que transcendem a idade à implantação ou mesmo o tempo de uso do implante coclear. A estimulação/ participação familiar no desenvolvimento das crianças se mostrou de extrema importância no desenvolvimento da linguagem oral.

ABSTRACT Objective: to verify whether children with cochlear implants (CI) acquire vocabulary at the same pace as normally hearing children, and which factors influence their acquisition. Methods: the vocabulary test of the ABFW was performed on 20 children who had been using the cochlear implant for at least three years. Historical information, such as age at time of implant, hearing age (i.e., at time of implant use), and family participation in the rehabilitation process, was gathered from patients’ files. Correlation statistical analysis was then performed. Results: it was observed that children with CI may acquire vocabulary similar to that of hearing children, depending on many aspects. The age at time of implantation and hearing age did not significantly correlate to the vocabulary results. The factor that demonstrated statistical significance was family participation, which showed a positive correlation: the more the family was involved in the rehabilitation process, the better the children’s results on the vocabulary test. Conclusion: it was, thus, possible to conclude that children with CI develop their vocabulary in a similar manner as hearing children, depending on factors that transcend the child’s age at time of implantation and hearing age. Family participation, in the rehabilitation process, was shown to be of critical importance in the child’s vocabulary development.

Abstract Introduction Usher syndrome (US) is an autosomal recessive disorder characterized by hearing loss and progressive visual impairment. Some deaf Usher syndrome patients learn to communicate using sign language. During adolescence, as they start losing vision, they are usually referred to cochlear implantation as a salvage for their new condition. Is a late implantation beneficial to these children? Objective The objective of this study is to describe the outcomes of US patients who received cochlear implants at a later age. Methods This is a retrospective study of ten patients diagnosed with US1. We collected pure-tone thresholds and speech perception tests from pre and one-year post implant. Results Average age at implantation was 18.9 years (5-49). Aided average thresholds were 103 dB HL and 35 dB HL pre and one-year post implant, respectively. Speech perception was only possible to bemeasured in four patients preoperatively, who scored 13.3; 26.67; 46% vowels and 56% 4-choice. All patients except one had some kind of communication. Two were bilingual. After one year of using the device, seven patients were able to perform the speech tests (from four-choice to close set sentences) and three patients abandoned the use of the implant. Conclusion We observed that detection of sounds can be achieved with late implantation, but speech recognition is only possible in patients with previous hearing stimulation, since it depends on the development of hearing skills and the maturation of the auditory pathways.

RESUMO Objetivo Avaliar a satisfação e qualidade de vida em usuários de Implante Auditivo de Tronco Cerebral. Método Trata-se de um estudo transversal e descritivo realizado na Divisão de Clínica Otorrinolaringológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brasil. Para a realização da pesquisa, 19 usuários de implante auditivo de tronco cerebral responderam aos seguintes questionários: KINDLR (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents) para crianças e adolescentes, pais e/ou cuidadores; o questionário WHOQOL-BREF para os participantes adultos; e o questionário SADL (Satisfaction with Amplification in Daily Life), adaptado culturalmente para o português brasileiro. Resultados A qualidade de vida das crianças usuárias de implante auditivo de tronco cerebral do ponto de vista dos pais apresentou resultados acima da média para o resultado global e para a maioria dos domínios, exceto o domínio de bem-estar emocional. Os adultos apresentaram resultados acima da média para todos os domínios. Com relação à satisfação com o dispositivo, os adultos usuários de implante auditivo de tronco cerebral estavam satisfeitos de modo geral, exceto no que diz respeito à imagem pessoal, e os pais das crianças mostraram insatisfação para todas as subescalas, exceto para a subescala de serviços e custos. Conclusão Os resultados indicaram que, apesar de os pacientes estarem insatisfeitos em alguns aspectos com o dispositivo, de modo geral, a qualidade de vida foi classificada como boa, para a maioria dos aspectos avaliados.

ABSTRACT Purpose To evaluate satisfaction and quality of life of users of Auditory Implant Brainstem. Methods This is a cross-sectional and descriptive study conducted at Divisão de Clínica Otorrinolaringológica of Hospital das Clínicas of Faculdade de Medicina da Universidade de São Paulo, Brazil. For the research, 19 users of an Auditory Brainstem Implant answered the following questionnaires: KINDLR (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents), for children and adolescents, their parents and/or caregivers; WHOQOL-BREF questionnaire, for adult participants; and the Satisfaction with Amplification in Daily Life (SADL) questionnaire culturally adapted to Brazilian Portuguese. Results The quality of life of children using Auditory Brainstem Implant from the perspective of their parents showed global results above average, as for most domains, except for the emotional well-being domain. Adults showed results above average for all domains. Regarding satisfaction with the device, the adult users of auditory brainstem implant were satisfied in general, except with regard to personal image. The parents of the children showed dissatisfaction in all subscales, except for the subscale of services and cost. Conclusion The results indicated that although patients are dissatisfied with the device in some aspects, overall the quality of life was rated as good for most of the aspects assessed.

Resumo Objetivo: Caracterizar as alterações auditivas após o tratamento do câncer, segundo o tipo de tratamento identificando os fatores preditivos. Método: Foram avaliados prospectivamente duzentos pacientes que tiveram cancer na infância. A idade média ao diagnóstico foi de 6 anos e à avaliação audiométrica de 21 anos de idade. O tratamento incluiu quimioterapia sem uso de derivados de platina ou radioterapia em cabeça e pescoço em 51 pacientes; quimioterapia com uso de cisplatina sem radioterapia em 64 pacientes; radioterapia em cabeça e pescoço sem cisplatina em 75 pacientes; e 10 pacientes receberam o tratamento combinado de radioterapia em cabeça e pescoço e quimioterapia com cisplatina. Os pacientes foram submetidos à avaliação audiológica incluindo audiometria tonal, audiometria vocal e imitanciometria. Resultados: O tratamento envolvendo quimioterapia com cisplatina levou a 41,9% e 47,3% de perda auditiva na orelha direita e esquerda, respectivamente, apresentando risco 11,7 vezes maior de desenvolver perda auditiva na orelha direita e 17,6 vezes na orelha esquerda do que aqueles que não receberam cisplatina (p < 0,001 e p < 0,001; respectivamente). Crianças cujo diagnóstico do câncer ocorreu após os 6 anos de idade mostraram maior risco de apresentar perda auditiva do que crianças menores do que 6 anos de idade (p = 0,02). Conclusão: A característica audiológica encontrada após tratamento oncológico foi perda auditiva sensorioneural bilateral simétrica. A quimioterapia com cisplatina mostrou ser fator de risco, enquanto a radioterapia em cabeça e pescoço não foi determinante para aquisição da perda auditiva.

Abstract Objective: To characterize the hearing loss after cancer treatment, according to the type of treatment, with identification of predictive factors. Methods: Two hundred patients who had cancer in childhood were prospectively evaluated. The mean age at diagnosis was 6 years, and at the audiometric assessment, 21 years. The treatment of the participants included chemotherapy without using platinum derivatives or head and neck radiotherapy in 51 patients; chemotherapy using cisplatin without radiotherapy in 64 patients; head and neck radiotherapy without cisplatin in 75 patients; and a combined treatment of head and neck radiotherapy and chemotherapy with cisplatin in ten patients. Patients underwent audiological assessment, including pure tone audiometry, speech audiometry, and immittancemetry. Results: The treatment involving chemotherapy with cisplatin caused 41.9% and 47.3% hearing loss in the right and left ear, respectively, with a 11.7-fold higher risk of hearing loss in the right ear and 17.6-fold higher in the left ear versus patients not treated with cisplatin (p < 0.001 and p < 0.001, respectively). Children whose cancer diagnosis occurred after the age of 6 have shown an increased risk of hearing loss vs. children whose diagnosis occurred under 6 years of age (p = 0.02). Conclusion: The auditory feature found after the cancer treatment was a symmetrical bilateral sensorineural hearing loss. Chemotherapy with cisplatin proved to be a risk factor, while head and neck radiotherapy was not critical for the occurrence of hearing loss.

<sec><title>Introduction</title><p>Difficulties with telephone use by adult users of cochlear implants (CIs) are reported as a limitation in daily life. Studies to improve the speech understanding of CI users on the telephone are scarce in the Brazilian scientific literature.</p></sec><sec><title>Objective</title><p>To develop and evaluate the effectiveness of a training program of auditory abilities on the telephone for an adult CI user.</p></sec><sec><title>Resumed Report</title><p>The subject was a 55-year-old woman with a degree in accounting who used a CI for 24 months. The program consisted of three stages: pretraining evaluation, eight sessions of advanced auditory abilities training, and post-training evaluation. Auditory abilities with CI were evaluated before and after training in three conditions: sound field, telephone with the speech processor in the microphone function, and telephone with the speech processor in the telecoil function. Speech recognition was assessed by three different lists: one with monosyllabic and dissyllabic words, another with nonsense syllables, and another one with sentences. The Client Oriented Scale of Improvement (COSI) was used to assess whether the needs established by the CI user in everyday telephone use situations improved after training. The auditory abilities training resulted in a relevant improvement in the percentage of correct answers in speech tests both in the telephone use conditions and in the sound field condition. Conclusion The results obtained with the COSI inventory indicated a performance improvement in all situations presented at the beginning of the program.</p></sec>

OBJETIVO: verificar a efetividade da programação remota do implante coclear por meio dos níveis de estimulação e resultados nos testes de percepção de fala e audiometria em campo livre. MÉTODOS: Foram selecionados 12 pacientes de ambos os gêneros, com idade entre 18 e 59 anos, usuários de implante coclear do mesmo modelo de unidade interna e processador de fala por no mínimo 12 meses. As programações remota (PR) e presencial (PP) foram realizadas no mesmo dia, medindo-se os níveis mínimos (níveis T) e máximos (níveis C) de estimulação de cinco eletrodos, com interpolação dos demais. Foram aplicados testes de percepção de fala (frases em contexto aberto e monossílabos - gravação a 65 dBNPS) e audiometria em campo livre nas frequências de 250 a 8.000 Hz. Os resultados foram comparados entre PR e PP. RESULTADOS: Houve diferença na média dos níveis T em três eletrodos e dos níveis C em um eletrodo. Não houve diferença entre os resultados obtidos nos testes de percepção de fala e nos limiares audiométricos na PP e PR. CONCLUSÃO: A realização da programação remota é simples e eficaz para a programação dos dispositivos de implante coclear e, embora tenha mostrado diferenças nos níveis de estimulação, não interferiu no desempenho da percepção de fala.

PURPOSE: To verify the effectiveness of remote programming of cochlear implants by stimulation levels and results in the perception of speech and free-field audiometry tests. METHODS: Twelve patients from both genders, aged between 18 and 59 years, users of internal cochlear implant and speech processor of the same model for at least 12 months, were selected. Both the remote programming (RP) and the live programming (LP) were performed on the same day, measuring the minimum (T) and maximum (C) stimulation levels of five electrodes with the interpolation of the remaining ones. Speech perception tests were applied using 65 dBSPL (recorded open context sentences and monosyllables). The patients were submitted to free-field audiometry at 250-8,000 Hz frequencies. The results for the RP and LP were compared. RESULTS: Differences in mean of the T levels for three electrodes and the C levels for one electrode were found. No difference between the results was obtained in the speech perception tests and audiometric thresholds in the RP and LP. CONCLUSION: The RP is a simple and effective procedure for programming cochlear implant devices and, although there were differences in the stimulation levels of some electrodes, it did not interfere in the speech perception outcomes.