Abstract Introduction Spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative diseases. Objective To evaluate the living standard of patients with SCA, by applying the Vestibular Disorders Activities of Daily Living Scale (VADL) and Activitiesspecific Balance Confidence Scale (ABC) questionnaires. Methods An uncontrolled clinical trial study was conducted with 28 patients who underwent anamnesis, ENT evaluation, and vestibular assessment and the application of questionnaires VADL and ABC before and after rehabilitation with virtual reality. Results The vestibular exam was altered in 64.3% of the cases. The result between the correlation of the VADL and ABC questionnaires showed significant results in all cases (p < 0.005). The correlation between the ages and disease length with the VADL and ABC questionnaires was significant in the T3 assessment (p = 0.015). The correlation between the disease length and the VADL questionnaire was significant in all cases (p < 0.005). The comparison of the vestibular rehabilitation result (T1 to T2) showed a significant difference for all the applied games, except for the ski slalom. The comparison of the vestibular rehabilitation result (T1 to T3) showed significant difference for all the applied games (p < 0.005) (1st assessment before the start of rehabilitation designated T1, after 10 rehabilitation sessions, considered T2 and, at the end of 20 rehabilitation sessions, called T3). Conclusion We can point out a direct improvement in the living standard, reflected by the reduction of falls, better balance, and march, contributing to a higher self-confidence in patients in daily activities. SCAs (SCAs diseases SCA (VADL (ABC 2 anamnesis evaluation reality 643 64 3 64.3 p 0.005. 0005 0.005 . 0 005 T 0.015. 0015 0.015 015 0.015) T1 (T slalom 1st st 1 sessions T3. falls balance march selfconfidence self confidence activities 6 64. 000 0.00 00 001 0.01 01 0.0 0.

Abstract Introduction Hereditary spastic paraplegia (HSP) encompasses a heterogeneous group of degenerative diseases that cause spastic paraparesis and progressive weakness in the lower limbs. Objective To evaluate the quality of life (QoL) of patients with HSP using the World Health Organization Quality of Life Questionnaire (WHOQOL-bref) applied pre- and post-rehabilitation with virtual reality (VR). Methods This is a pilot randomized controlled clinical trial, registered on the Rebec Platform, test RBR-3JMX67, involving 16 adult diagnosed with HPS, regardless of the type (pure or complicated), randomly allocated into two groups: balance group (BG) and strength group (SG). All were submitted to anamnesis, otorhinolaryngological and labyrinthine evaluation. Next, the WHOQOL-bref questionnaire was applied at three moments: T0 (before rehabilitation with VR), T1 (after 10 ses-sions) and T2 (after 20 sessions). Results The application of the WHOQOL-bref questionnaire showed differences in the comparison of T0, T1 and T2 in SG for the physical, psychological, environmental, and general QoL domains (p ≤ 0.009). When comparing T1 and T2, considering the VR game scores, both groups improved their performance (p ≤ 0.005). Conclusion There was an improve-ment in QoL, especially in SG, after VR with the Nintendo Wii®, suggesting that the integration of strength exercises + balance exercises can improve balance and QoL. VR is a low-cost tool that improves functional capacity and reduces the risk of falling, which is fundamental for the QoL of patients with HSP. The WHOOQL-Bref quantified the effects of the therapy. Performance in the games provided motivation and rapid feedback. (HSP limbs (QoL WHOQOLbref WHOQOL bref (WHOQOL-bref pre postrehabilitation post VR. . (VR) trial Platform RBR3JMX67, RBR3JMX67 RBRJMX RBR 3JMX67, 3JMX67 JMX RBR-3JMX67 1 HPS pure complicated, complicated , complicated) BG (BG SG. (SG) anamnesis evaluation Next moments T before VR, VR) sessions ses sions ses-sions 2 sessions. sessions) physical psychological environmental p 0.009. 0009 0.009 0 009 0.009) scores 0.005. 0005 0.005 005 0.005) improvement ment Wii Wii® lowcost low cost falling WHOOQLBref WHOOQL Bref therapy feedback (VR RBR3JMX6 3JMX6 RBR-3JMX6 (SG 000 0.00 00 RBR3JMX 3JMX RBR-3JMX 0.0 0.

Resumo Introdução A paraplegia espástica hereditária (PEH) abrange um grupo heterogêneo de doenças degenerativas que causam paraparesia espástica e fraqueza progressiva nos membros in-feriores. Objetivo Avaliar a qualidade de vida (QV) de pacien-tes com PEH por meio do Questionário de Qualidade de Vida da Organização Mundial da Saúde (WHOQOL-bref) aplicado pré e pós-reabilitação com realidade virtual (RV). Métodos Trata-se de um ensaio clínico piloto randomizado controlado, registrado na Plataforma Rebec, teste RBR-3JMX67, envolvendo 16 adultos com diagnóstico de PEH, independentemente do tipo (pura ou complicada), alocados aleatoriamente em dois grupos: grupo equilíbrio (GE) e grupo força (GF). Todos foram submetidos à anamnese, avaliação otorrinolaringológica e labiríntica. A seguir, aplicou-se o questionário WHOQOL-bref em três momentos: T0 (antes da reabilitação com RV), T1 (após 10 sessões) e T2 (após 20 sessões). Resultados A aplicação do questionário WHOQOL-bref mostrou diferenças na comparação de T0, T1 e T2 no GF para os domínios físico, psicológico, ambiental e QV geral (p ≤ 0,009). Ao comparar T1 e T2, considerando os escores do jogo RV, ambos os grupos melhoraram seu desempenho (p ≤ 0,005). Conclusão Verificou-se melhoria na QV, especialmente no GF, após a RV com Nintendo Wii®, sugerindo que a integração de exercícios de força + exercícios de equilíbrio podem melhorar o equilíbrio e a QV. A RV é uma ferramenta de baixo custo que melhora a capacidade funcional e reduz o risco de queda, o que é fundamental para a QV dos pacientes com PEH. O WHOOQL-bref quantificou os efeitos da terapia. O desempenho nos jogos proporcionou motivação e feedback rápido. (PEH inferiores. inferiores in feriores. feriores in-feriores (QV pacien tes WHOQOLbref WHOQOL bref (WHOQOL-bref pósreabilitação pós RV. . (RV) Tratase Trata se controlado Rebec RBR3JMX67, RBR3JMX67 RBRJMX RBR 3JMX67, 3JMX67 JMX RBR-3JMX67 1 pura complicada, complicada , complicada) GE (GE GF. (GF) anamnese labiríntica seguir aplicouse aplicou momentos T antes RV) sessões 2 sessões. físico psicológico p 0,009. 0009 0,009 0 009 0,009) 0,005. 0005 0,005 005 0,005) Verificouse Verificou Wii Wii® queda WHOOQLbref WHOOQL terapia rápido (RV RBR3JMX6 3JMX6 RBR-3JMX6 (GF 000 0,00 00 RBR3JMX 3JMX RBR-3JMX 0,0 0,

Abstract Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objectives To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA. system life disorders (OSA 8 mean 587 58 7 58. 175 17 5 17. old, , old) males month (THI questionnaire Scale STOPBang STOP Bang 27.8% 278 27 (27.8% 27.8%, r 0.582 0582 0 582 0.011 0011 011 (0.011 0.499 0499 499 0.035. 0035 0.035 . 035 0.035) 722 72 2 72.2 selfassessed self assessed poor 66.7%, 667 66.7% 66 (66.7%) 72.2%. (72.2%) selfrated rated Moreover 27.8 (27.8 0.58 058 0.01 001 01 (0.01 0.49 049 49 003 0.03 03 72. 66.7 6 (66.7% (72.2% 27. (27. 0.5 05 0.0 00 (0.0 0.4 04 4 66. (66.7 (72.2 (27 0. (0. (66. (72. (2 (0 (66 (72 ( (6 (7

ABSTRACT COVID-19 is a viral infection that mainly affects the lower respiratory tract and with the affinity of the Spike protein to the Angiotensin 2 converter enzyme, inducing a prothrombotic state which may lead to compromising of the cardiovascular, central nervous, auditory, and vestibular systems. Viral infections knowingly affect vestibular and auditory systems. This study aimed to present the auditory and vestibular findings of a woman without otoneurological complaints, before the infection with SARS-CoV-2. This is a longitudinal case report, presenting the evolution of the otoneurological clinical picture accompanied by the results of a battery of tests. The results evidenced a unilateral, permanent, cochlear sensorineural hearing loss through altered otoacoustic emissions albeit with normal tonal thresholds, accompanied by peripheral vestibular hypofunction which worsened with time, without any other factor that could justify these findings. This study shows the importance of the complete protocol of tests performed over time for a better understanding of long-time implications of the SARS-CoV-2 infection. COVID19 COVID 19 COVID-1 enzyme cardiovascular nervous systems complaints SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. report unilateral permanent thresholds longtime long SARS-CoV- COVID1 1 COVID- SARS-CoV

RESUMO A COVID-19 é uma infecção viral que afeta, principalmente, a via respiratória inferior e, com a afinidade da proteína Spike com a Enzima Conversora de Angiotensina 2, gerando estado protrombótico, pode haver comprometimento dos sistemas cardiovasculares, nervoso central e renal. As infecções virais são capazes, também, de causar alterações nos sistemas auditivo e vestibular. O presente estudo teve por finalidade apresentar os achados auditivos e vestibulares de uma mulher sem queixas otoneurológicas, previamente à infecção pela SARS-CoV-2. Trata-se de um relato de caso longitudinal, com apresentação da evolução do quadro clínico otoneurológico acompanhado de uma bateria de exames. Os resultados evidenciaram o aparecimento de uma perda auditiva neurossensorial unilateral prevista por emissões otoacústicas alteradas na presença limiares tonais normais. Com a sequência de exames, observou-se piora dos limiares auditivos e alteração da função vestibular, de maneira permanente, sem qualquer outro histórico que pudesse justificar a instalação do quadro. Em quadros infecciosos faz-se importante a longitudinalidade de avaliação com uso de protocolo completo de exames para melhor compreensão dos efeitos tardios. COVID19 COVID 19 COVID-1 afeta principalmente 2 protrombótico cardiovasculares renal capazes também vestibular otoneurológicas SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. SARS-CoV-2 Tratase Trata se longitudinal normais observouse observou permanente fazse faz tardios COVID1 1 COVID- SARS-CoV- SARS-CoV

ABSTRACT Objective: This systematic review aims to answer the following focus question: “Is there an association between atypical swallowing and malocclusions?”. Methods: Appropriate word combinations were chosen and tailored specifically for each of the following electronic databases: EMBASE, Latin American and Caribbean Literature in Health Sciences (LILACS), LIVIVO, PubMed/Medline, Scopus, Web of Science, and gray literature, without any restrictions, up to February 2021. According to the selection criteria, only cross-sectional studies were included. The following inclusion criteria were considered: a sample composed of children, adolescents, and adults; patients clinically diagnosed with atypical swallowing; patients with normal swallowing; and outcome of interest of atypical swallowing in patients with malocclusion. The data consisted of study characteristics, sample characteristics, results, and conclusion of each study. The risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies, and the certainty of evidence was assessed using the GRADE tool. Results: 4,750 articles were identified. After a two-step selection, four studies were included. A higher frequency of distal occlusion, extreme maxillary overhang, and open bite was related to swallowing disorders; most studies pointed to posterior crossbite as a malocclusion more associated with atypical swallowing. All studies had a moderate to high risk of bias, and the certainty of evidence was very low. Conclusion: The results indicate that atypical swallowing is associated with malocclusions and that posterior crossbite is the main malocclusion found, but only in the young population (3-11 years). Registration: PROSPERO (42020215203). Objective question Is malocclusions. . malocclusions?” Methods databases EMBASE LILACS, LILACS , (LILACS) LIVIVO PubMedMedline PubMed Medline PubMed/Medline Scopus Science literature restrictions 2021 crosssectional cross sectional included considered children adolescents adults characteristics CrossSectional Cross Sectional Studies tool Results 4750 4 750 4,75 identified twostep two step occlusion overhang disorders low Conclusion found 311 3 11 (3-1 years. years years) Registration 42020215203. 42020215203 (42020215203) malocclusions? (LILACS 202 475 75 4,7 31 1 (3- 4202021520 (42020215203 20 47 7 4, (3 420202152 (4202021520 2 ( 42020215 (420202152 4202021 (42020215 420202 (4202021 42020 (420202 4202 (42020 420 (4202 42 (420 (42 (4

RESUMO Objetivo: A presente revisão sistemática tem como objetivo responder à seguinte questão focal: “Existe associação entre deglutição atípica e más oclusões?”. Métodos: Combinações de palavras e truncamentos apropriados foram adaptados para as bases de dados eletrônicas: EMBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), LIVIVO, PubMed/Medline, Scopus e Web of Science e a literatura cinzenta, sem qualquer restrição, até fevereiro de 2021. Os critérios de inclusão foram: estudos transversais; amostra composta por crianças, adolescentes e adultos; pacientes com diagnóstico clínico de deglutição atípica; pacientes com deglutição normal, e o desfecho de interesse foi deglutição atípica em pacientes com má oclusão. Os dados extraídos de cada estudo foram características do estudo, da amostra e a conclusão. O risco de viés foi avaliado usando a Lista de verificação de avaliação crítica da JBI para estudos transversais analíticos, e a certeza das evidências foi avaliada usando a ferramenta GRADE. Resultados: Foram identificados 4.750 artigos. Após uma seleção em duas fases, quatro estudos foram incluídos. Maior frequência de disto-oclusão, protuberância maxilar extrema e mordida aberta foram relacionadas a distúrbios da deglutição, com a maioria dos estudos apontando para mordida cruzada posterior como a má oclusão mais associada à deglutição atípica. Todos os estudos tiveram um risco de viés moderado a alto, e a certeza das evidências foi considerada muito baixa. Conclusão: Os resultados indicam que a deglutição atípica está associada à mordida cruzada posterior apenas na população jovem de 3 a 11 anos. Objetivo focal Existe oclusões. oclusões . oclusões?” Métodos eletrônicas EMBASE LatinoAmericana Latino Americana LILACS, LILACS , (LILACS) LIVIVO PubMedMedline PubMed Medline PubMed/Medline cinzenta restrição 2021 crianças adultos normal conclusão analíticos GRADE Resultados 4750 4 750 4.75 artigos fases incluídos distooclusão, distooclusão disto oclusão, disto-oclusão alto baixa Conclusão 1 anos oclusões? (LILACS 202 475 75 4.7 20 47 7 4. 2

ABSTRACT Purpose: to map, through a literature survey, which instruments are used to assess swallowing in patients after orotracheal extubation. Methods: available evidence was mapped through six electronic databases and gray literature. There were no restrictions regarding gender, ethnicity of the individuals, language of the studies, time of publication, and diagnosis. Results: the most mentioned protocol in the studies was the Dysphagia Risk Evaluation Protocol and the most cited objective assessment exam was the flexible endoscopic evaluation of swallowing. Conclusion: there is a need for a specific protocol to evaluate this profile of patients, in addition to comparative studies of subjective clinical evaluation and instrumental imaging.

Abstract Introduction The Sustained Auditory Attention Ability Test (SAAAT) is an instrument used to assess sustained auditory attention in children. Difficulties related to this ability are not unique to children alone, as adults have been observed to present with the same deficits. Therefore, there is a need to adapt instruments like the SAAAT and provide reference values for adults. Objective To assess adult performance on the SAAAT. Methods Approved by the Human Research Ethics Committee under n° 034/2011. The sample consisted of 30 participants aged between 18 and 30 years old (average age = 24.2 years old), female and male. The inclusion criteria were: peripheral hearing within normal limits, type A tympanometric curve, and no attention-related complaints. The participants were submitted to Tonal Audiometry, Logoaudiometry, Immitanciometry and to the SAAAT. Results The following mean values and standard deviations (SD) were observed: inattention = 1.7 (SD = 2.2) and impulsivity = 0.8 (SD = 0.9) error types. For the SAAAT, the mean value for the total error score was 2.4 (SD = 2.6), and for the decrease in vigilance, it was 0.3 (SD = 0.5). When comparing the performance of adults and children, a statistically significant difference was observed for inattention (p = 0.000) and impulsivity (p = 0.001) error types, as well as in the total error score (p = 0.000) and in decreased vigilance (p = 0.0003). Conclusion The performance of adults in the SAAAT differed from the children's parameters, since adults showed lower scores in all variables of the instrument.

Abstract Introduction Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability. Objective To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation. Methods A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality. Results a) The instrumental subscale of the questionnaire showed statistically significant result (p = 0.022; 95 % CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale (p = 0.011; 95 % CI -0.85; -0.17) first and (p = 0.002, 95 % CI -0.88; -0.31) second assessments, and the functional subscale was only verified in the second assessment (p = 0.011, 95 % CI -0.85; -0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk (p = 0.034, 95 % CI -12.5; -0.3) and ski slalom games (p = 0.005, 95 % CI -34.8; -6.6). Conclusions Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.

Abstract Introduction Spinocerebellar ataxia (SCA) is part of a genetic and clinical heteroge- neous group of neurodegenerative diseases characterized by progressive cerebellar ataxia. Objective To describe the results of audiological and electrophysiological hearing evaluations in patients with sporadic ataxia (SA). Methods A retrospective cross-sectional study was carried out with 11 patients submitted to the following procedures: anamnesis, otorhinolaryngological evaluation, tonal and vocal audiometry, acoustic immittance and brainstem auditory evoked potential (BAEP) tests. Results The patients presented with a prevalence of gait imbalance, of dysarthria, and of dysphagia; in the audiometric and BAEPs, four patients presented with alterations; in the acoustic immittance test, five patients presented with alterations, predominantly bilateral. Conclusion The most evident alterations in the audiological evaluation were the prevalence of the descending audiometric configuration between the frequencies of 2 and 4 kHz and the absence of the acoustic reflex between the frequencies of 3 and 4 kHz bilaterally. In the electrophysiological evaluation, the patients presented changes with a prevalence of increased I, III and V wave latencies and the interval in the interpeak I-III, I-V and III-V. In the present study, it was observed that auditory complaints did not have a significant prevalence in this type of ataxia, which does not occur in some types of autosomal recessive and dominant ataxia.

Resumo Disfunção ventilatória subclínica tem sido observada em indivíduos com ataxias espinocerebelares (SCA). Não existem estudos relacionando disfunção ventilatória ao declínio clínico e funcional na SCA2. Objetivo: Avaliar a relação dos valores de Pico de Fluxo Expiratório (PFE), Pressão Inspiratória Máxima (PIMAX) e presença de queixas respiratórias com idade, tempo de doença, idade de início dos sintomas, escore de equilíbrio, independência para atividades básicas (AVD) e instrumentais (AIVD) de vida diária e gravidade da ataxia (SARA) em indivíduos com SCA2. Métodos: Estudo transversal, considerando: idade, tempo de doença, idade de início dos sintomas, escores nas Escalas SARA, Equilíbrio de Berg, Medida da Independência Funcional e de Lawton, valores de PFE, PIMAX e queixas respiratórias. Resultados: Foram avaliados 36 indivíduos com SCA2 com média de 42,5±2,4) anos de idade, 7,6±8,2 anos de tempo de doença, 33,7±11,5 anos de idade de início dos sintomas e 9,9±10,3 pontos na escala SARA. Os menores valores de PFE estiveram relacionados ao maior tempo de doença (p=0,021). Os menores valores de PFE e PIMAX estiveram relacionados ao maior comprometimento do equilíbrio (p=0,019; p=0,045, respectivamente), maior dependência para ADV (p=0,006; p=0,050, respectivamente) e AIVD (p=0,003; p=0,001, respectivamente) e maior gravidade da ataxia (p=0,006; p=0,017, respectivamente). Foram observadas queixas respiratórias em 12 (33,3%) indivíduos que não estiveram relacionadas à idade, idade de início dos sintomas, tempo de doença, equilíbrio, independência, gravidade da ataxia, ou valores de PFE e PIMAX. Conclusão: A disfunção ventilatória, mesmo quando assintomática, está relacionada ao comprometimento do equilíbrio, à independência e à gravidade da ataxia em indivíduos com SCA2.

Abstract Subclinical ventilatory dysfunction is observed in individuals with spinocerebellar ataxias (SCA). No studies have correlated ventilatory dysfunction to clinical and functional decline in SCA2. Objective: To evaluate the relationship between the values of peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and presence of respiratory complaints with age, disease duration, age at onset of symptoms, balance scores, independence in basic (ADL) and instrumental (IADL) Activities of Daily Living (ADLs), and severity of ataxia (SARA) in individuals with SCA2. Methods: Cross-sectional study evaluating age, disease duration, age at onset of symptoms, scores in the Berg Balance Scale and in the SARA, Functional Independence Measure and Lawton’s scale, values of PEF and MIP, and the presence of respiratory complaints. Results: The study included 36 individuals with SCA2, with a mean age of 42.5±2.4 years, disease duration of 7.6±8.2 years, age 33.7±11.5 years at onset of symptoms, and 9.9±10.3 points in the SARA scale. The lowest PEF values correlated with the longer disease duration (p=0.021). The lowest values of PEF and MIP correlated with greater balance impairment (p=0.019 and p=0.045, respectively), increased degree of dependence in the ADL (p=0.006 and p=0.050, respectively) and IADL (p=0.003 and p=0.001, respectively) scales, and highest severity of ataxia (p=0.00 and p=0.017, respectively). Respiratory complaints were observed in 12 (33.3%) individuals and were not related to age, disease duration, age at onset of symptoms, balance, independence, ataxia severity, or PEF and MIP values. Conclusion: Ventilatory dysfunction, even when asymptomatic, is related to balance impairment, independence, and ataxia severity in individuals with SCA2.

RESUMO Objetivo: demonstrar a viabilidade do uso da análise acústica dos sons da deglutição como método conjugado à avaliação clínica em pacientes traqueostomizados acometidos por traumatismo cranioencefálico. Métodos: estudo observacional do tipo transversal. Participaram deste estudo 10 pacientes adultos, com idade média de 43,6 anos internados em leito hospitalar, unidades de terapias intensivas ou semi-intensivas, no período de maio a julho de 2016. O critério para inclusão foi ser acometido por traumatismo cranioencefálico, confirmado por tomografia axial computadorizada. Foi aplicado o Protocolo Fonoaudiológico de Decanulação Traqueal para a avaliação clínica e a ausculta cervical por meio do Sonar Doppler. Foi aplicado o Test Fischer e não foi encontrada relação significante (p>0,05), entre as variáveis analisadas nas duas consistências e na decanulação. Resultados: foi observada a presença de sinal acústico de elevação laríngea, presença de ruído entre as deglutições, presença de sinal acústico sugestivo de resíduo em 50% dos pacientes, para as consistências testadas. Quando correlacionados a relação entre frequência de pico, tempo médio da onda, presença de resíduo entre as deglutições, sinal acústico sugestivo de resíduos e decanulação (Tabela 5), verificou-se que não existe correlação significante (p>0,05) entre as variáveis analisadas nas duas consistências e a decanulação. Conclusão: o estudo sugere que o uso do Sonar Doppler é viável como método conjugado na avaliação clínica das disfagias para a decanulação de pacientes acometidos por traumatismo cranioencefálico.

ABSTRACT Purpose: to demonstrate the feasibility of using the acoustic analysis of swallowing sounds as a combined method in the clinical assessment of tracheostomized patients affected by traumatic brain injury. Methods: an observational, cross-sectional study. A total of 10 adult patients, in the mean age of 43.6 years, participated. They were hospitalized in wards, semi-intensive, or intensive care units, from May to July 2016. The inclusion criterion involved being affected by traumatic brain injury, confirmed with a CT scan. The Speech Therapy Tracheal Decannulation Protocol was used in the clinical assessment, as well as the cervical auscultation with the Doppler sonar. Fisher’s test was used, resulting in no significant relationship (p > 0.05) between the variables analyzed in the two consistencies and decannulation. Results: the presence of an acoustic signal of laryngeal elevation was observed, as well as noise between the swallowings, and acoustic signal suggestive of residue in 50% of the patients for the consistencies tested. When the peak frequency, mean wave time, presence of residue in between swallowings, and acoustic signal suggestive of residues were correlated with decannulation (Table 5), no significant correlation was verified (p > 0.05) between the variables analyzed in the two consistencies and the decannulation. Conclusion: the study suggests that it is feasible to use the Doppler sonar as a combined method in the clinical assessment of dysphagia for the decannulation of patients affected by traumatic brain injury.

Abstract Introduction Speech tests such as logoaudiometry measure the ability to perceive and recognize oral sounds. The Speech Recognition Index (SRI) is one of the speech tests adopted in clinical routine; it uses standardized live voice and recorded speeches. The live voice speech method can be influenced by intra and interspeaker variability, as well as by regionalism variability, whereas recorded tests show consistency in their presentation. Objective Analyzing results of the SRI test applied to live voiceand recorded speeches from Paraná State, in different Brazilian counties. Method The sample comprised 125 individuals, 25 fromeach county (Rio de Janeiro, Florianópolis, Porto Alegre, Salvador and Curitiba), from both sexes, in the age group 20 to 70 years; the SRI was applied in both techniques. Results The recorded speech method showed prevalence of hit improvement in Rio de Janeiro (40%), Salvador, Porto Alegre and Florianópolis (28%). Individuals from Salvador and Florianópolis subjected to the recorded speech method showed better results in the left ear. Individuals from Rio de Janeiro and Porto Alegre showed satisfactory results in both ears, whereas those from Curitiba did not show statistically significant difference between the left and the right ear. Conclusion The recorded CD application method showed prevalence of hit improvement (%) in the SRI responses in comparison to the live voice speech technique in most of the studied counties. According to the hit rate measured in the herein investigated counties, Rio de Janeiro showed the best results in the recorded speech method.

Abstract Introduction Agrochemicals, also known as pesticides, are widely used in agriculture and in public health. They are organic and inorganic chemical substances with a high level of toxicity not only for the environment, but also for human health. Objective To verify findings on labyrinthine assessment in endemic disease control agents, and to recommend the inclusion of the vestibular exam in the set of tests for pesticide-exposed populations. Methods Descriptive, prospective, cross-sectional study with a sample comprising 15 endemic disease control agents, males,mean age of 51.6 years old (standard deviation [SD] = 5.9). All of the participants were submitted to anamnesis, otorhinolaryngological screening, and vestibular assessment. Results Regarding the most reported complaints, dizziness (73.4%), headache (60%), and tingling in the extremities (53.4%) were observed. The findings of the vestibular exams were normal in 53.3%, while 46.7% showed peripheral vestibular disorder, of which 26.7% were of deficitary type, and 20% of the irritative type. Conclusions Alteration in the vestibular system was verified in 50% of the workers, with a greater prevalence in the caloric testing. Several disorders related to pesticides intoxication are scientifically known. Actions promoting knowledge and qualification of this population for the proper handling of chemicals are suggested, in addition to the elaboration and inclusion of protocols of vestibular assessment in hearing health programs for the prevention, diagnosis and treatment of vestibular disorders.

RESUMO Objetivo: avaliar a prevalência de sintomas otológicos e hábitos parafuncionais em pacientes com Disfunção Temporomandibular. Métodos: foram analisados 768 prontuários clínicos de pacientes atendidos em um Centro de Diagnóstico da Articulação Tempormandibular do ano de 2010 a 2016, sendo o critério de inclusão os prontuários preenchidos de forma completa e de pacientes maiores de 18 anos. Foram excluídos 252 prontuários que não estavam preenchidos de maneira completa ou que o paciente tinha idade inferior a 18 anos, identificando uma amostra final de 516 prontuários. Foram anotados a presença ou não dos hábitos parafuncionais e de sintomas otológicos (zumbido, surdez, tontura, sensação de ouvido tampado e desequilíbrio). Resultados: houve diferença estatisticamente significante na prevalência de sintomas otológicos relacionados ao sexo e a presença de hábitos parafuncionais, sendo que a referência de sintomas otológicos foi mais prevalente nas mulheres e naqueles com a presença de pelo menos um hábito parafuncional. Conclusão: foi observada uma relação positiva entre os sintomas otológicos e os hábitos parafuncionais em pacientes com DTM’s.

ABSTRACT Objective: to verify the relationship between otological symptoms and parafunctional habits in individuals with temporomandibular joint dysfunction. Methods: evaluations were based on the clinical records of 768 patients treated at a temporomandibular joint diagnostic center from 2010 to 2016. The inclusion criteria were completely filled out charts of adult patients (> 18 years of age) and the final sample comprised 516 clinical records. The presence/absence of parafunctional habits and otological symptoms (tinnitus, hearing impairment, dizziness, the sensation of plugged ears and imbalance) was recorded. Results: statistically significant associations were found between otological symptoms and both sex and the presence of parafunctional habits, as otological symptoms were more prevalent among women and individuals with at least one parafunctional habit. Conclusion: in the present sample, otological symptoms were positively associated with parafunctional habits in individuals with temporomandibular joint dysfunction.

RESUMO Objetivo Analisar os achados audiológicos em indivíduos com desordem temporomadibular e comparar esses achados com indivíduos sem desordem temporomanbibular. Métodos A amostra foi composta por 39 participantes adultos, de ambos os gêneros, com diagnóstico prévio de desordem temporomandibular (grupo de estudo) e 39 participantes adultos, sem desordem temporomandibular (grupo controle). Todos os participantes foram submetidos à audiometria tonal limiar em altas frequências, imitanciometria e pesquisa das emissões otoacústicas evocadas por produto de distorção. Resultados Observou-se prevalência de desordem temporomandibular no gênero feminino e a média de idade ficou acima da quarta década de vida. Na audiometria tonal limiar, foi observada ocorrência de perda auditiva do tipo neurossensorial e condutiva, no grupo de estudo, além de piores limiares auditivos em altas frequências. Em ambos os grupos, houve maior ocorrência de curva timpanométrica do tipo A, bem como diferenças entre os grupos na pesquisa do reflexo acústico ipsilateral e contralateral e no registro das emissões otoacústicas evocadas por produto de distorção. Conclusão Indivíduos com desordem temporomandibular apresentam piores resultados nos limiares auditivos, na timpanometria, nos reflexos acústicos ipsilaterais e contralaterais e nas emissões otoacústicas evocadas, quando comparados com o grupo controle.

ABSTRACT Purpose To analyze the audiological findings in individuals with temporomandibular disorder and compare these findings with individuals without temporomandibular disorder. Methods The sample was composed by 39 adult participants, both genders, with previous diagnosis of temporomandibular disorder (study group) and 39 adult participants, without temporomandibular disorder (control group). All the participants were submitted to audiometry including high frequencies, Immittance acoustic (Tympanometry and contralateral acoustic reflexes) and distortion product evoked otoacoustic emissions. Results The prevalence of temporomandibular disorder on female gender was observed, average age was over forty years old. In the audiometry, it was observed the incidence of hearing loss of a sensorineural and conductive type in the Study Group, besides worst hearing thresholds in high frequencies. In both groups, there was a bigger incidence of a type A tympanometric curve, as well as there were differences between the groups in the research of the ipsilateral and contralateral acoustic reflex and in the recording of distortion product evoked otoacoustic emissions. Conclusion It’s possible to conclude that individuals with temporomandibular disorder show worst results in the hearing thresholds, in the tympanometry, in the ipsilateral and contralateral acoustic reflexes, in the evoked otoacoustic emissions, when compared to the control group.