A utilização do estímulo ce-chirp® na triagem auditiva neonatal
The Automated Auditory Brainstem Response (AABR) test with click stimulus is a traditionally used procedure for the identification of hearing loss at birth. New stimuli have been developed and optimized to improve the efficiency of identification of different types and degrees of hearing loss. The a...
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| Formato: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2013 |
| País: | Brasil |
| Recursos: | Pontifícia Universidade Católica de São Paulo (PUC-SP) |
| Repositorio: | Repositório Institucional da PUC_SP |
| Idioma: | portugués |
| OAI Identifier: | oai:repositorio.pucsp.br:handle/11973 |
| Acesso em linha: | https://tede2.pucsp.br/handle/handle/11973 |
| Access Level: | acceso abierto |
| Palavra-chave: | Testes auditivos Audição Recém-nascido Perda auditiva Hearing tests Hearing Newborn Hearing loss CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
| Resumo: | The Automated Auditory Brainstem Response (AABR) test with click stimulus is a traditionally used procedure for the identification of hearing loss at birth. New stimuli have been developed and optimized to improve the efficiency of identification of different types and degrees of hearing loss. The aim of this thesis was to study the use of CE-chirp® stimulus in Newborn Hearing Screening (NHS) through AABR test. Participants were newborns both with and without Risk Indicators for Hearing Loss. AABR tests with click stimulus, CE-chirp® and Hi-Lo CE-chirp® were performed at intensities between 30 and 35 dBHL in both ears. Diagnostic ABR tests with click stimulus were performed on all newborns as the gold-standard procedure. The AABR test results for each stimulus and intensity were presented and compared to the diagnostic ABR tests with click stimulus. "Pass / refer" results were analyzed and validation values and response detection time were determined. The results showed that for sensorineural alterations, sensitivity measures were similar for the two stimuli types. However, the specificity was higher for the CE-chirp® in the two intensities. The average response detection time was lower for the CE-chirp® stimulus when compared to the click stimulus, being more statistically significant in the intensity of 35 dBHL for both ears and in the intensity of 30dBHL for the right ear (p<0,001). The Hi-Lo CE-chirp® stimulus presented high sensitivity and low specificity and considerably short average detection time. AABR tests with CE-chirp® stimulus showed to be effective in the identification of permanent and disabling hearing loss, however, new studies need to be performed with conductive and sensorineural mild hearing loss. The results showed that the band limited CE-chirp® still needs to be improved for future clinical application in automatic procedures for the purpose of hearing screening |
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