Abstract Introduction Auditory-evoked potentials are influenced by several factors, including polarity, filter, stimulus intensity and stimulation rate. The presentation of higher rates of stimuli per second enables the collection of a greater number of responses in a given period of time, promoting a shorter testing time; however, the collected recordings are subject to changes related to wave morphology. Objectives To compare the brainstem auditory-evoked-potential responses with click stimulus with the most commonly used stimulation rates in the clinical practice. Methods The present cross-sectional analytical study was performed with fifteen participants of both genders and normal hearing thresholds. The brainstem auditoryevoked potential was performed at four different stimulation rates (21.1, 26.7, and 27.7 stimuli/s, and a rate determined based on a mathematical calculation using the a measurement of the transmission frequency of the power grid at the time of the examination). Results We observed that the rate of 21.1 stimuli/s showed the highest amplitudes for waves I, III, and V when compared with the other rates. The rate of 26.7 stimuli/s, when compared with 27.7 stimuli/s, showed a higher amplitude for wave V. The latency if wave V was significantly lower with the rate of 21.1 stimuli/s than with 27.7 stimuli/s. Conclusions The stimulation rate interferes with wave latencies and amplitudes; its decrease from 27.7 to 21.1 stimuli/s decreases the latency of wave V and increases the amplitues and improves the morphology of waves I, III and V. In addition, we found evidence that suggests an improvement in the visualization of wave III by adjusting the stimulation rate based on a measurement of the local transmission frequency of the power grid.

RESUMO Objetivo analisar o efeito do mascaramento estável e modulado no Potencial Evocado Auditivo Cortical com estímulo de fala em adultos-jovens. Método participaram 14 indivíduos com idades entre 19 e 28 anos de ambos os sexos e sem perda auditiva. O exame de Potencial Evocado Auditivo Cortical foi realizado com estímulo de fala sintética /ba/ simultâneo ao ruído Speech Shaped Noise apresentado em três condições: ruído estável com intensidade de 30 dB NPSpe (ruído estável fraco), ruído estável com intensidade de 65 dB NPSpe (ruído estável forte) e ruído modulado em intensidade de 30 dB NPSpe e 65 dB NPSpe em 25Hz e com período de modulação de 40 ms. Resultados foram observadas maiores latências nos componentes corticais, exceto P2, na condição de ruído estável forte e medidas mais robustas de amplitude dos componentes corticais P1, N1 e P2 na condição de ruído modulado com diferença estatística significativa na comparação com a condição de ruído estável forte. Houve pior morfologia na condição de ruído estável forte, quando comparado aos demais registros. Os limiares eletrofisiológicos médios para as condições de ruído estável forte e ruído modulado foram 60 dB NPSpe e 49 dB NPSpe, respectivamente, mostrando 11,7 dB de diferença média. Conclusão podemos inferir que houve um menor efeito mascarante do ruído modulado, comparado à condição de ruído estável forte, nas medidas de amplitude dos componentes corticais e uma diferença média de 11,7 dB entre os limiares eletrofisiológicos (interpretado como a medida do Benefício do Mascaramento Modulado).

ABSTRACT Purpose To analyze the effect of masking on the Cortical Auditory Evoked Potential with speech stimulus in young adults. Methods Fourteen individuals aged between 19 and 28 years of both sexes with no hearing loss participated in the study. The Cortical Auditory Evoked Potential examination was performed with synthetic speech stimulus /ba/ simultaneous to Speech Shaped Noise presented under three conditions: steady noise with a 30 dB SPLep intensity (weak steady noise), steady noise with a 65 dB SPLep intensity o (strong steady noise) and modulated noise with 30 dB SPLep and 65 dB SPLep intensities at 25Hz and modulation period of 40 ms. Results Higher latencies were observed in the cortical components, except P2, in the condition of strong steady noise and more meaningful measures of amplitude of the cortical components P1, N1 and P2 in the condition of modulated noise with statistically significant difference in comparison to the strong steady noise condition. There was worse wave morphology in the condition of strong steady noise, when compared to the other records. The average electrophysiological thresholds for the conditions of strong steady noise and modulated noise were 60 dB SPLep and 49 dB SPLep, respectively, showing a 11.7 dB mean difference. Conclusion We could infer that there was a lower masking effect of modulated noise when compared to the strong steady noise condition, in the amplitude measurements of the cortical components and an average difference of 11.7 dB between the electrophysiological thresholds (interpreted as the measure of the Masking Release).

Abstract Objective Investigate the auditory function of the elderly using the middle latency potentials. Methodology Group 1 (G1): 20 healthy individuals of both genders, older than 60 years, without hearing loss. Group 2 (G2): 20 healthy individuals of both sexes, older than 60 years, with hearing loss in frequencies from 4 to 8 kHz. Potential recording was performed with unilateral and bilateral stimulation and the Binaural Interaction Component was calculated. Results Na latency in C3A1 was greater in the stimulation of the right ear in G2 and the amplitude of Na-Pa was greater in the stimulation of the right ear and recording in C3A1 in G1. The latency of the Pa component was higher in the stimulation of the right ear recorded in C4A2. The Pb component in G2 by bilateral stimulation and recorded in C4A2 had higher latency. The first and second negative and positive peaks presented greater amplitude in G1. In C3A1, the 1st negative peak was more negative in G1 and the 2nd positive peak showed greater amplitude in C4A2 in both groups. Conclusion The transmission of auditory information to the primary auditory cortex is impaired with aging, especially in unilateral stimulation, reinforced by losses in elderly people with peripheral hearing loss, such as in the binaural interaction at the cortical and subcortical levels. Thus, the AMLR has shown to be a sensitive examination to investigate neuroauditory disorders in the elderly, especially related to high-frequency hearing loss and primary auditory cortex dysfunctions caused by the aging process.

RESUMO Objetivo Identificar a prevalência da Síndrome da Fragilidade em idosos e suas relações com o risco para quedas. Método Estudo clínico descritivo, transversal e analítico. Cento e um voluntários com mais de 60 anos, foram submetidos à avaliação audiológica, Dynamic Gait Index – Brazilian brief (DGI), Timed Up and Go(TUG) e Escala de Fragilidade de Edmonton (EFE) que determinaram, respectivamente, os limiares auditivos, síndrome da fragilidade, equilíbrio funcional e dinâmico e risco para quedas. Utilizou-se a distribuição percentual simples, o teste de Wilcoxon e de Correlação Bivariada com coeficiente de Pearson para a análise estatística. Foram adotados limites iguais inferiores a 1,0 e 5,0%. Resultados A EFE identificou 22,8% dos voluntários como frágeis e 22,8% como vulneráveis. O DGI e o TUG classificaram 34,6 e 84,1% de riscos para quedas. Ocorreu correlação significativa entre a EFE e o DGI (p<0,01), a EFE e o TUG (p<0,01) e o DGI e TUG (p<0,01). O coeficiente de Pearson entre EFE e o DGI, entre o EFE e o TUG e DGI e TUG foram -0,26, -0,41 e 0,46 respectivamente. Ocorreu associação entre DGI e TUG e idade (p<0,01). Não houve correlação entre a EFE com sexo e idade. Conclusão A fragilidade e pré-fragilidade foi identificada em uma parcela expressiva dos voluntários, sobretudo nos mais longevos. O equilíbrio funcional e o dinâmico se correlacionaram moderamente com fragilidade, o que demonstrou que a Síndrome da fragilidade aumenta o risco para quedas.

ABSTRACT Purpose To identify the prevalence of Frailty Syndrome in the elderly and the relationship with risk of falling. Methods Descriptive, cross-sectional, and analytical clinical study. One hundred and one volunteers over 60 years old were submitted to audiological evaluation, Dynamic Gait Index - Brazilian brief (DGI), Timed Up and Go (TUG) and Edmonton Fragility Scale (EFE) that verified, respectively, hearing thresholds, frailty syndrome, functional and dynamic balance, and risk of falling. The simple percentual distribution, the Wilcoxon´s test and the Bivariate Correlation with Pearson's coefficient were used for statistical analysis. Limits equal to or less than 1.0 and 5.0% were adopted. Results EFE identified 22.8% of volunteers as fragile and 22.8% as vulnerable. DGI and TUG found 34.6% and 84.1% of at risk for falls, respectively. Significant correlations between EFE and DGI (p <0.01), EFE and TUG (p <0.01), and DGI and TUG (p <0.01) were observed. Pearson's coefficient between EFE and DGI, EFE and TUG, and DGI and TUG were -0.26, -0.41, and 0.46, respectively. An association between DGI and TUG and age (p <0.01) was identified. No correlation between EFE and sex or age was found. Conclusion Frailty and pre-frailty were identified in a significant segment of the volunteers, especially in the oldest subjects. Functional and dynamic balance were moderately correlated with frailty, which demonstrated that frailty syndrome increases the risk of falls.

ABSTRACT Purpose: to compare cortical auditory evoked responses using two speech stimuli, /ma/ and /da/, in normally hearing young adults. Methods: a cross-sectional, observational and analytical study, with a sample composed of nineteen normally hearing young adults, recruited by convenience, ages between 18 and 25 years old, from both genders, participated in the study. Cortical auditory evoked potentials (CAEP) were monaurally recorded in two conditions: 1) with a pair of speech stimuli /ba/ and /da/, and 2), with a pair of speech stimuli /ba/ and /ma/. The order of the experiments was randomized in a proportion of 50% for each of the two stimuli, totaling 100 stimuli for each experiment. Speech sounds were presented at 70 dB SPL. Descriptive and analytical statistical tests were performed. Results: mean latency values of the complex P1, N1, P2, N2 and P3 were lower for the /ma/ when compared to those of /da/ (p <0,05). There was no difference in amplitude values between responses evoked using /ma/ and /da/. Conclusion: cortical auditory evoked potentials, elicited by the speech stimulus /ma/ had, on average, lower latency peaks of P1-N1-P2-N2 and P3, when compared to those of speech stimulus /da/.

OBJECTIVE: To evaluate the relationship between cognitive performance and long-latency auditory evoked potentials in an elderly population. METHODS: The sample consisted of adults between 20 and 58 years of age and elderly adults between 60 and 70 years of age. The screening procedures adopted were an inspection of the external auditory canal, tonal and vocal audiometry, tympanometry, brain stem auditory evoked potential, the Montreal Cognitive Assessment test, and long-latency auditory evoked potential. RESULTS: The latency and amplitude values of cortical components by age group showed significant differences under the following conditions: (i) signals evoked by the speech stimulus /da/ and by the pure-tone stimulus at 2,000 Hz for the N2 amplitude (p=0.008 and p=0.001, respectively) , which were both higher for adults, and (ii) signals evoked by the speech stimulus /da/ for N1 latency (p=0.018) and by the pure-tone stimulus at 2,000 Hz for P2 latency (p=0.017), which were both higher in the elderly population. The cognitive component (P300) showed a significant difference when evoked by speech stimuli, with higher latency in the elderly population (p=0.013). When correlated with cognitive processes, the latency and amplitude of cortical potentials showed direct and medium-strength correlations between abnormal scores obtained on the Montreal Cognitive Assessment test and P2 amplitude (p<0.001 and r=0.452). CONCLUSION: There is a relationship between long-latency potentials and cognitive performance in the elderly, which was observed by the increase in the P2 amplitude and the impairment of the process of sound decoding.

ABSTRACT Purpose: to analyze forward masking in normally hearing young people, by using frequency-following responses. Methods: the synthetic syllable /da/ was used for the recordings of ten individuals, in the following conditions: /da/ with no masking, and /da/ after 4, 16, 32, and 64 milliseconds of masking. F-test (ANOVA) was applied for repeated measures with the Greenhouse-Geisser correction to compare testing conditions. For significant differences, multiple comparisons (between pairs of conditions) and Bonferroni correction were used. Data normality was verified by applying the Shapiro-Wilk test, and statistical significance was used at 5%. Results: wave latencies of all masking conditions were compared with those of no masking. A latency delay was observed in the transient region of the response (PV and A) in all masking conditions, except for 64 milliseconds. Latency delay also occurred for waves PW, PX, and PY, which corresponded to the sustained region of the response. Conclusion: forward masking was observed, by using frequency-following responses with /da/ syllable in four intervals (4, 16, 32, and 64 ms) of preceding masking. Forward masking was more evident in the transient region of the response than in the sustained one. This study highlights the importance of electrophysiological testing in temporal processing assessment.

RESUMO Objetivo O aparelho de amplificação sonora individual propicia benefícios para indivíduos com deficiência auditiva. No entanto, ainda são observados baixos níveis de adesão ao tratamento, devido às dificuldades no processo de adaptação. Neste sentido, destaca-se o uso de sites ou aplicativos com os objetivos de auxiliar no processo de orientação aos usuários e de avaliar a satisfação de usuários de aparelho de amplificação sonora individual, após a utilização de um site responsivo desenvolvido para auxiliar no processo de adaptação. Métodos Estudo quantitativo analítico experimental, ensaio clínico não randomizado, com 20 participantes, divididos em dois grupos. O grupo estudo fez uso do site responsivo como ferramenta de auxílio na adaptação, além de receber as orientações em seu formato tradicional. O grupo controle foi orientado somente pelo formato tradicional já existente no serviço. Após um mês, os participantes responderam a um questionário de avaliação de satisfação e também foi realizada a análise da ferramenta datalogging. Resultados O site responsivo contou com orientações sobre manutenção e dicas de uso do aparelho de amplificação sonora individual, permitindo fácil acesso às principais orientações ao usuário inexperiente. A análise dos dados demonstrou respostas mais positivas ao questionário pelo grupo estudo, bem como maior tempo de uso diário dos aparelhos de amplificação sonora individuais. Conclusão o grupo que utilizou o site responsivo como ferramenta complementar ao processo de adaptação do aparelho de amplificação sonora individual mostrou, a partir da avaliação da satisfação e dos dados da ferramenta datalogging, maior satisfação e maior tempo de uso diário do aparelho.

ABSTRACT Purpose The hearing aid provides benefits for individuals with hearing impairment. However, low levels of treatment adherence are still observed due to difficulties in the adaptation process. In this sense, the use of websites or applications stands out in order to assist in the process of orienting users. To evaluate the satisfaction of users of hearing aids after using a responsive website designed to assist in the adaptation process. Methods Quantitative analytical experimental study non-randomized clinical trial whit 20 participants, divided into two groups. The study group made use of the responsive website as an aid tool in adapting, in addition to also receiving the guidelines in their traditional format. The control group was guided only with the traditional format already existing in the service. After one month, the participants answered a satisfaction assessment questionnaire, as well as an analysis of the datalogging. Results The responsive website had guidance on maintenance and tips on using the individual hearing aid, allowing easy access to the main guidelines for inexperienced users. The analysis of the data showed more positive responses to the questionnaire by the study group, as well as a longer time of daily use of hearing aids. Conclusion The group that used the responsive website as a complementary tool to the adaptation process of the hearing aid showed, from the assessment of satisfaction and data from the datalogging tool, greater satisfaction and a longer time of daily use of the hearing aid.

ABSTRACT Purpose: to investigate the relation between forward masking and cognitive-language skills in children as a function of literacy stage. Methods: twenty-seven children registered in literacy stage at public schools, aged from 6 to 9 years old, with no learning difficulties or audiological problems reported, participated in this study. Frequency Following Responses were registered in two test conditions: 1) /da/ alone; 2) /da/ presented 4 milliseconds after a speech noise. Two language protocols were applied: a cognitive-linguistic skills protocol and a phonological awareness one. Results: forward masking was evident in Frequency Following Responses of all children regardless of literacy stage. Frequency Following Responses latencies in both testing conditions showed no difference among participants’ age. Cognitive-language skills scores were below those expected for all children, with significant improvement noticed as a function of age. No correlation between language performance and forward masking was found. Conclusion: there was no relation between forward masking and cognitive-language skills in children, as a function of literacy stage.

OBJECTIVE: To determine the central tendency measures and variability of vestibular evoked myogenic potential (VEMP) with regard to the latency and wave amplitude when potentials are captured from the flexor muscles of the forearm. METHODS: Ten adult volunteers with normal hearing underwent examination of their forearm flexor muscles (right and left sides; 20 samples in total) for VEMP acquisition. To this end, 200 tone burst stimuli at a 500 Hz frequency and 95 dBnHL intensity were promediated. RESULTS: No statistical differences were observed in VEMP responses acquired from the right and left forearm flexor muscles concerning P34 and N44 latencies (p=0.32 and 0.90, respectively). The mean latency obtained for the P34 wave component was 34.9 ms (±2.6), with a lower limit equal to 29.3 and an upper limit equal to 40.4 ms. The average latency of the N44 wave component was 43.6 ms (±2.1), with a lower limit of 39.1 ms and an upper limit of 48.1 ms. The results were consistent and had low variability, and showed an average asymmetry index of 15.4 (±10.7). These findings indicate that potentials may be investigated in different age groups and in specific clinical populations, such as pathologies that may alter the neuronal transmission of the inferior vestibular pathway, especially when a longer portion is observed. CONCLUSIONS: VEMP recording from forearm flexors is both feasible and stable, with latency reference ranges between 29.3 and 40.4 ms for P34, and 39.1 and 48.1 ms for N44.

RESUMO Objetivo: investigar o pós-mascaramento em marcações com predominância de picos positivos comparado com as marcações com predominância de picos negativos nos registros de Frequency-Following Response (FFR) em indivíduos adultos jovens com audição normal. Métodos: trata-se de um estudo conduzido a partir de um banco de dados, onde foram selecionados 20 registros do FFR (10 homens; 10 mulheres, com idade entre 18 e 25 anos, com a audição normal) e realizada análise qualitativa por duas examinadoras experientes. Os registros foram analisados segundo dois protocolos distintos de marcação dos registros: (i) análise com predominância de picos positivos - marcação das ondas PV, A, PW, PX, PY, PZ e O; e, (ii) análise com predominância de picos negativos - marcação das ondas V, A, C, D, E, F e O. Foram realizados o teste de normalidade Shapiro-Wilk, o teste de Wilcoxon e o teste t de Student. Foi adotado o nível de significância de p<0,05. Resultados: a análise comparativa das marcações realizadas não mostrou diferença significante entre os protocolos estudados. Nos valores de desvio padrão, foram observados valores absolutos mais elevados quando houve a marcação dos picos negativos quando comparado com as respostas obtidas com a marcação dos picos positivos, demonstrando um padrão inverso ao que se espera. Conclusão: o pós-mascaramento foi identificado em ambas marcações propostas, sendo as marcações com predominância dos picos positivos se mostraram menos variáveis.

ABSTRACT Purpose: to investigate forward masking by comparing latencies values of positive and negative peaks in frequency-following responses (FFR) recordings, in normally hearing young adults. Methods: from a database, 20 FFR recordings were selected, 10 being from men, and 10 from women, aged 18 to 25 years, with normal hearing. They were qualitatively analyzed by two experienced researchers and also analyzed, according to two different protocols of recording identification: (i) predominance of positive peaks - PV, A, PW, PX, PY, PZ, and O waves; and (ii) predominance of negative peaks - V, A, C, D, E, F, and O waves. The Shapiro-Wilk normality test, the Wilcoxon test, and the Student’s t-test were conducted, by adopting the significance level of p<0.05. Results: the comparative analysis of latency peak values did not reveal any significant difference between the studied protocols. However, the standard deviation was higher for absolute latency values as compared to negative peaks, suggesting an inverted pattern of what was expected. Conclusion: forward masking was identified in both proposals and the protocol of predominant positive peaks was less variable.

Abstract Objective: To investigate the involvement of young Brazilian students about five behaviors: tobacco use, alcohol consumption, sexual intercourse, knowledge about HPV, and knowledge about oral and oropharyngeal cancer. Material and Methods: Through a cross-section design, we explored some factors that might be associated with boys and girls. Statistical Regression methods were applied to identify differences, considering the estimation of the Odds Ratio. Results: Half of the sample had already consumed alcohol and at least 1 in 10 individuals had already tried smoking. One-third of adolescents have had sexual intercourse. Three factors related to boys were associated in the multiple regression analysis: have heard about HPV, have not heard about oral cancer, and think that HPV can cause oropharyngeal cancer. In conclusion, it seems that boys and girls were equally exposed to smoking-alcohol-sex; however, some differences were verified concerning the knowledge about HPV and oral / oropharyngeal cancer. Conclusion: Keep monitoring adolescents should be a priority to our study area, considering that those youngers had already being exposed to the risk factors for cancer.

Resumo Introdução: A evolução do paciente na clínica fonoaudiológica atua como fator motivador do processo terapêutico, contribui para a sua adesão ao tratamento e possibilita ao terapeuta a revisão e/ou a manutenção de suas condutas. As medidas eletrofisiológicas, como o potencial evocado P300, auxiliam na avaliação, na compreensão e no monitoramento dos distúrbios da comunicação humana, facilitam, dessa forma, a definição do prognóstico de cada caso. Objetivo: Determinar se a terapia fonoaudiológica influencia na variação da latência e da amplitude do P300 em pacientes com distúrbio de linguagem submetidos à terapia fonoaudiológica. Método: Revisão sistemática com metanálise, na qual foram feitas buscas nas seguintes bases de dados: Pubmed, ScienceDirect, Scopus, Web of Science, SciELO e Lilacs, além das bases de literatura cinzenta: OpenGrey.eu e DissOnline. Foram considerados critérios de inclusão: ensaios clínicos aleatórios ou não, sem restrição de idiomas ou data, que submeteram crianças com distúrbio de linguagem à terapia fonoaudiológica, monitoradas pelo P300, comparadas a crianças sem intervenção. Resultados: A diferença média entre as latências do grupo submetido à terapia e do grupo controle foi de -20,12 ms com intervalo de confiança 95% entre -43,98 e 3,74 ms (p = 0,08; I2 = 25% e o valor de p = 0,26). A diferença média entre as amplitudes do grupo submetido à terapia e do grupo controle foi de 0,73 uV com intervalo de confiança de 95% entre -1,77 e 3,23 uV (p = 0,57; I2 = 0% e o valor de p = 0,47). Conclusão: A terapia fonoaudiológica não influencia nos resultados de latência e amplitude do potencial evocado P300 em crianças submetidas à intervenção fonoaudiológica.

Abstract Introduction: The patient's evolution in the audiology and speech-language clinic acts as a motivator of the therapeutic process, contributing to patient adherence to the treatment and allowing the therapist to review and/or maintain their clinical therapeutic conducts. Electrophysiological measures, such as the P300 evoked potential, help in the evaluation, understanding and monitoring of human communication disorders, thus facilitating the prognosis definition in each case. Objective: To determine whether the audiology and speech-language therapy influences the variation of P300 latency and amplitude in patients with speech disorders undergoing speech therapy. Methods: This is a systematic review with meta-analysis, in which the following databases were searched: Pubmed, ScienceDirect, SCOPUS, Web of Science, SciELO and LILACS, in addition to the gray literature bases: OpenGrey.eu and DissOnline. The inclusion criteria were randomized or non-randomized clinical trials, without language or date restriction, which evaluated children with language disorders undergoing speech therapy, monitored by P300, compared to children without intervention. Results: The mean difference between the latencies in the group submitted to therapy and the control group was −20.12 ms with a 95% confidence interval of −43.98 to 3.74 ms (p = 0.08, I 2 = 25% and p value = 0.26). The mean difference between the amplitudes of the group submitted to therapy and the control group was 0.73 uV with a 95% confidence interval of −1.77 to 3.23 uV (p = 0.57, I 2 = 0% and p value = 0.47). Conclusion: The present meta-analysis demonstrates that speech therapy does not influence the latency and amplitude results of the P300 evoked potential in children undergoing speech therapy intervention.

Resumo Introdução: A perda auditiva é conceituada como qualquer diminuição da capacidade de ouvir e/ou detectar sons da fala ou do ambiente, independentemente da causa, tipo ou grau e pode ocorrer em diversos estágios da vida, durante a gestação ou parto, na infância, vida adulta ou na terceira idade. Convém destacar que o envelhecimento é a primeira causa de perda auditiva do tipo sensorioneural e em segundo lugar a perda auditiva induzida pelo ruído, ambas estão intimamente relacionadas com a formação de espécies reativas de oxigênio. Evidências têm sido acumuladas indicando que a suplementação com antioxidantes via alimentação tornou-se estratégia terapêutica para prevenir e/ou retardar os riscos das principais doenças humanas. Objetivo: Avaliar ensaios clínicos aleatórios para determinar qual o efeito da suplementação com antioxidantes sobre o limiar auditivo na perda auditiva sensorioneural em pacientes de diversas faixas etárias. Método: A formulação desta revisão sistemática consistiu na busca dos estudos nas seguintes bases de dados: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO e ClinicalTrials.gov. Adicionalmente, a literatura cinzenta também foi pesquisada. A estratégia de busca incluiu termos relacionados à intervenção (suplementação de antioxidantes), o desfecho primário (perda auditiva sensorioneural), bem como termos relacionados aos ensaios clínicos randomizados para melhorar e a sensibilidade da busca. Resultados: A partir de 977 registros potencialmente relevantes identificados através da busca nas bases de dados, dez publicações em texto completo foram recuperadas para avaliação mais aprofundada. O aumento no limiar na frequência de 4 kHz foi estatisticamente maior no Grupo Controle (1,89 [1,01-2,78], p < 0,0001) quando comparados com o Grupo NAC e o Grupo Ginseng, já na frequência de 6 kHz o aumento no limiar foi maior no Grupo Controle (1,42 [-1,14-3,97], p = 0,28), porém, não foram encontradas diferenças estatisticamente significativas entre grupos. Conclusão: O Ginseng foi o antioxidante que evitou a piora do limiar auditivo na frequência de 4 kHz, mas não em 6 kHz, em pacientes com perda auditiva sensorioneural causada por exposição a elevados níveis de pressão sonora. Não foi observada melhora nos limiares com a suplementação com Vitamina E.

Abstract Introduction: Hearing loss is conceptualized as any impairment of the ability to hear and/or detect speech or environment sounds, regardless of cause, type, or degree. It may occur at different stages of life; during pregnancy or childbirth, in childhood, adulthood or old age. It should be noted that aging is the most common cause of sensorineural hearing loss followed by noise-induced hearing loss, and both are closely related to the formation of reactive oxygen species. Dietary antioxidant supplementation has been employed as a therapeutic strategy to prevent and/or delay the risks of major human diseases. Objective: To assess randomized clinical trials to determine the effect of antioxidant supplementation on the auditory thresholds in patients of different age groups with sensorineural hearing loss. Methods: This systematic review consisted of a search in the following databases: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO and ClinicalTrials.gov. Additionally, the gray literature was also searched. The search strategy included terms related to the intervention (antioxidant supplementation), primary outcome (sensorineural hearing loss), as well as terms related to randomized clinical trials to improve search sensitivity. Results: Based on 977 potentially relevant records identified through the search in the databases, ten full-text publications were retrieved for further evaluation. The increase in threshold at the 4 kHz frequency was statistically higher in the control group (1.89 [1.01-2.78], p < 0.0001) when compared to the NAC group and the ginseng group, whereas at 6 kHz, the threshold increase was higher in the control group (1.42 [−1.14-3.97], p = 0.28), but no statistically significant differences were found between groups. Conclusion: Ginseng was the antioxidant agent that showed the best effect in preventing auditory threshold worsening at the frequency of 4 kHz, but not at 6 kHz in patients with sensorineural hearing loss caused by exposure to high sound pressure levels. There was no improvement in the thresholds with vitamin E supplementation.

Resumo Introdução: A cafeína pode ser considerada a droga mais consumida por adultos em nível mundial, podendo ser encontrada em inúmeros alimentos, como no chocolate, café, chá, refrigerante e outros. Em geral, a cafeína em doses moderadas, produz ótimos rendimentos físico e intelectual, aumenta a capacidade de concentração e diminui o tempo de reação aos estímulos sensoriais. Por outro lado, doses elevadas podem causar sinais perceptíveis de confusão mental e indução de erros em tarefas intelectuais, ansiedade, nervosismo, tremores musculares, taquicardia, alterações labirínticas e zumbido. Objetivo: Considerando que o potencial evocado miogênico vestibular é um teste clínico que avalia a resposta muscular decorrente de estimulação auditiva de alta intensidade, a presente revisão sistemática objetivou analisar o efeito da cafeína sobre o potencial evocado miogênico vestibular. Método: A formulação deste trabalho consistiu na busca dos estudos nas seguintes bases de dados: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO e Clinical-Trials.gov. Adicionalmente, a literatura cinzenta também foi pesquisada. A estratégia de busca incluiu termos relacionados à intervenção (consumo de cafeína ou café) e ao desfecho primário (potencial evocado miogênico vestibular). Resultados: A partir de 253 registros potencialmente relevantes identificados através da busca nas bases de dados, apenas duas publicações em texto completo foram recuperadas para avaliação mais aprofundada, sendo estas mantidas para a análise qualitativa. Conclusão: Diante dos artigos encontrados a cafeína não tem efeito sobre o potencial evocado miogênico vestibular em sujeitos normais.

Abstract Introduction: Caffeine can be considered the most consumed drug by adults worldwide, and can be found in several foods, such as chocolate, coffee, tea, soda and others. Overall, caffeine in moderate doses, results in increased physical and intellectual productivity, increases the capacity of concentration and reduces the time of reaction to sensory stimuli. On the other hand, high doses can cause noticeable signs of mental confusion and error induction in intellectual tasks, anxiety, restlessness, muscle tremors, tachycardia, labyrinthine changes, and tinnitus. Objective: Considering that the vestibular evoked myogenic potential is a clinical test that evaluates the muscular response of high intensity auditory stimulation, the present systematic review aimed to analyze the effects of caffeine on vestibular evoked myogenic potential. Methods: This study consisted of the search of the following databases: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO and ClinicalTrials.gov. Additionally, the gray literature was also searched. The search strategy included terms related to intervention (caffeine or coffee consumption) and the primary outcome (vestibular evoked myogenic potential). Results: Based on the 253 potentially relevant articles identified through the database search, only two full-text publications were retrieved for further evaluation, which were maintained for qualitative analysis. Conclusion: Analyzing the articles found, caffeine has no effect on vestibular evoked myogenic potential in normal individuals.