Limiares auditivos em altas frequências e emissões otoacústicas na fibrose cística.

© 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Publicado por Elsevier Editora Ltda. Este é um artigo Open Access sob a licença CC BY (https://creativecommons.org/licenses/by/4.0/deed.pt).

www.bjorl.org.br

OTORHINOLARYNGOLOGY

Brazilian Journal of

KEYWORDS

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Aminoglycosides; Audiometry

Abstract

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Methods: Cross-sectional study. The study group consisted of 39 patients (7-20 years of age)

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* Autor para correspondência.

E-mail: geyer.lucia@gmail.com/%*H\HU

$57,*225,*,1$/

High frequency hearing thresholds and product

distortion otoacoustic e

P

issions in cystic

À

brosis

patients

Lucia Bencke Geyer

_{*, Sergio Saldanha Menna Barreto}

_,

Liese Loureiro Weigert

_{, Adriane Ribeiro Teixeira}

a_{Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil}

E_{Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil}

c_{Toronto University, Toronto, Canadá}

d_{Gerontologia Biomédica, Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS, Brasil} e_{Departamento de Saúde e Comunicação Humana, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil}

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Conclusion: $VLJQLÀFDQWQXPEHURISDWLHQWVZLWKF\VWLFÀEURVLVZKRUHFHLYHGUHSHDWHGFRXUVHV RIDPLQRJO\FRVLGHVVKRZHGDOWHUDWLRQVLQ+LJK)UHTXHQF\$XGLRPHWU\DQG'LVWRUWLRQ3URGXFW

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Resumo

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Resultados

$DPRVWUDIRLFRQVWLWXtGDSRULQGLYtGXRVVHQGRGR*(H GR*&$PpGLDGHLGDGHIRLGH“DQRVQR*( H“DQRVQR*&VHQGRDQRVDLGDGHPtQLPDH DQRVDLGDGHPi[LPD1R*(HUDPGRJrQHUR PDVFXOLQRHQR*&1DWDEHODVmRDSUHVHQWDGRV RVUHVXOWDGRVGDDQiOLVHGHVFULWLYDGDYDULiYHOLGDGHHJrQHUR

Tabela 1 &DUDFWHUL]DomRGDDPRVWUD

9DULiYHLV *UXSR

de estudo (n = 39)

*UXSR

controle

Q

p

Idade (anos), média “ DP

“ “ a

Faixa etária, n (%) E

DQRV

12-17 anos

> 18 anos

Gênero, n (%) E

0DVFXOLQR

)HPLQLQR

Mutação, n (%) —

'HOWD) —

5; —

/;H$( —

Ciclos AG, n(%) —

—

> 10 —

'3GHVYLRSDGUmR$*DPLQRJOLFRVtGHRV a _{Teste t6WXGHQW}

E_{7HVWH4XLTXDGUDGRGH3HDUVRQ}

Tabela 2 &RPSDUDomRGRVOLPLDUHVDXGLWLYRVG%1$HQWUH

os grupos

)UHTXrQFLD +]

*UXSRGH

estudo (n = 39)

*UXSRFRQWUROH Q

pa

0G33 0G33

250 5 (0-5)

500

1.000

2.000

3.000

4.000

8.000

0pGLD +]

9.000

10.000

11.200

12.500

14.000

0 (0-0)

0pGLD

9.000-+]

+]+HUW]

IUHTXrQFLDHSRUJUXSRQmRKRXYHGLIHUHQoDVLJQLÀFDWLYD HQWUHHODVS!

4XDQGRFRPSDUDGDVDVDPSOLWXGHVGDV(2$3'HQWUHRV JUXSRVR*(DSUHVHQWRXDPSOLWXGHVPDLVEDL[DVQDVIUHTXrQ

-FLDVGH+]+]H+]WDEHOD 4). Quando

FRPSDUDGDVDVRUHOKDVHVTXHUGDHGLUHLWDTXDQWRjVDPSOL

-WXGHVGDV(2$3'KRXYHGLIHUHQoDVLJQLÀFDWLYDDSHQDVQD IUHTXrQFLDGH+]QR*(S

2EVHUYRXVHTXHDDOWHUDomRGDV(2$3'RFRUUHXFRPDOWD IUHTXrQFLDWDQWRQRJUXSRGHHVWXGRFRP$$)QRUPDO TXDQWRQRJUXSRFRP$$)DOWHUDGDHPERUDFRP PDLRUIUHTXrQFLDQHVWH~OWLPRJUXSR$DQiOLVHHVWDWtVWLFD HYLGHQFLRXFRQWXGRTXHQmRKRXYHDVVRFLDomRHQWUHDVDO

-WHUDo}HVQD$$)HQDV(2$3'GR*(S ÀJ. 3).

+RXYHDVVRFLDomRVLJQLÀFDWLYDHQWUHDVDOWHUDo}HVGRVOL

-PLDUHVDXGLWLYRVQD$$)FRPRQ~PHURGHFXUVRVGH$*UHD

-OL]DGRVS $UHDOL]DomRGHPDLVGHGH]FXUVRVGH$* LQWUDYHQRVRIRLDVVRFLDGDDXPDPDLRUSUHYDOrQFLDGD$$)

alterada (ÀJ. 4).

Discussão

$$$)pGHVFULWDFRPRRPpWRGRPDLVHIHWLYRSDUDGHWHFWDU SUHFRFHPHQWHDOWHUDo}HVFRFOHDUHVGHYLGRjRWRWR[LFLGD -de._{6XDXWLOL]DomRDLQGDpOLPLWDGDGHYLGRjIDOWDGH}

SDGURQL]DomRGDFDOLEUDomRHGRVSDUkPHWURVGHQRUPDOLGD

-GH_{HHVSHFLDOPHQWHSDUDDSRSXODomRSHGLiWULFDSRUWHU}

EDL[DFRQÀDELOLGDGHHPFULDQoDVPHQRUHVGHDQRV37

$VHPLVV}HVRWRDF~VWLFDVHYRFDGDVSRUVXDYH]VmRXP H[DPHUiSLGRHREMHWLYRDSUHVHQWDQGRJUDQGHYDQWDJHP WDQWRSDUDDSRSXODomRSHGLiWULFDTXDQWRSDUDDDGXOWDTXH PXLWDVYH]HVHPIXQomRGDGRHQoDHGRWUDWDPHQWRQmR SRVVXHPFRQGLo}HVGHUHVSRQGHUDGHTXDGDPHQWHjDXGLR -metria._{'HYLGRDRIDWRGHTXHDVHPLVV}HVRWRDF~VWLFDV}

SRGHPVHPRVWUDUDOWHUDGDVPHVPRHPLQGLYtGXRVFRPOLPLD

-UHVQRUPDLVTXDQGRKiFRPSURPHWLPHQWRLQLFLDOGDVFpOXODV FLOLDGDVH[WHUQDVHVWHSURFHGLPHQWRpEDVWDQWHXWLOL]DGRQR PRQLWRUDPHQWRGDRWRWR[LFLGDGH

&RQVLGHUDQGRVHTXHXPDGDVSULQFLSDLVFDXVDVGHRWRWR

-[LFLGDGHpRXVRGHDQWLELyWLFRVDPLQRJOLFRVtGHRVHTXHRV SDFLHQWHVFRP)&UHDOL]DPUHSHWLGRVFXUVRVGHVWHWLSRGH PHGLFDPHQWRHVWDSRSXODomRDSUHVHQWDDOWRULVFRGHGHVHQ

-YROYHUDOWHUDo}HVFRFOHDUHV7-10

$RDQDOLVDUDDPRVWUDHVWXGDGDQmRKRXYHGLIHUHQoDVLJ

-QLÀFDWLYDGRVOLPLDUHVHQWUHRVJrQHURVPDVFXOLQRHIHPLQLQR DVVLPFRPRQRHVWXGRGH$EXMDPUDHWDO29 _{Apesar de os}

DXWRUHVFLWDGRVSHVTXLVDUHPRVHIHLWRVGHRXWURWLSRGHPH

-GLFDPHQWRRWRWy[LFRFLVSODWLQDHOHVWDPEpPQmRFRQVWD

-WDUDPGLIHUHQoDVVLJQLÀFDWLYDV

1mRIRLGHWHFWDGDGLIHUHQoDVLJQLÀFDWLYDHQWUHRVOLPLDUHV DXGLWLYRVGDVRUHOKDVGLUHLWDHHVTXHUGDHSRUHVVHPRWLYR IRLXWLOL]DGDDPpGLDGDVRUHOKDVSDUDUHSUHVHQWDUWDLVOLPLD

-UHV(PHVWXGRVFRPLQGLYtGXRVDXGLRORJLFDPHQWHQRUPDLV 6DK\HEHWDO32_H6iHWDO33_{WDPEpPQmRGHWHFWDUDPGLIHUHQ}

-oDHQWUHDVRUHOKDVQD$7/H$$)

$RFRPSDUDURVOLPLDUHVDXGLWLYRVREWLGRVQD$7/ +]HQD$$)+]HQWUHRVJUXSRVIRUDP REVHUYDGRVOLPLDUHVVLJQLÀFDWLYDPHQWHPDLVHOHYDGRVQRJUX

-SRGHHVWXGRVHQGRTXHDVPDLRUHVGLIHUHQoDVRFRUUHUDPQD $$)1mRVHREVHUYRXSHUGDDXGLWLYDQD$7/QRHQWDQWR D$$)GHWHFWRXDOWDSUHYDOrQFLDGHSHUGDDXGLWLYDQRJUXSR

Tabela 3 &RPSDUDomRGDVDOWHUDo}HVQDV(2$3'SRUIUH

-TXrQFLDHSRURUHOKDHQWUHRVJUXSRV

)UHTXrQFLD +]

Orelha *UXSRGH

estudo (n = 39)

*UXSR

controle

Q

pa

1.000 'LUHLWD

(VTXHUGD

1.400 'LUHLWD

(VTXHUGD

2.000 'LUHLWD

(VTXHUGD

2.800 'LUHLWD

(VTXHUGD

4.000 'LUHLWD

(VTXHUGD

'LUHLWD

(VTXHUGD

+]+HUW]

a _{7HVWHH[DWRGH)LVKHU}

Pr

evalência (%)

40 35 30 25 20 15 10 5 0

30,8

2,8

AAF alterada (9.000-16.000 Hz)

Grupo de estudio Grupo controle

Figura 1 $OWHUDomRQD$$)QRVJUXSRVGHHVWXGRHFRQWUROH

$$)DXGLRPHWULDGHDOWDIUHTXrQFLD+]+HUW]

Pr

evalência (%) 25,6

66,7

74,4

33,3

EOAPD normal EOAPD alterada

Grupo de estudio Grupo controle 80

70 60 50 40 30 20 10 0

Figura 2 (2$3'QRVJUXSRVGHHVWXGRHFRQWUROH(2$3'HPLV

IUHTXrQFLDVDFLPDGH+]HPFULDQoDVFRP)&DSyV WUDWDPHQWRFRPJHQWDPLFLQD0XOKHUDQHWDO24_.DWEDPQD

et al.43_{H.DWEDPQDHWDO}44_{REWLYHUDPGHVIHFKRVHPHOKDQWH}

SRUpPXWLOL]DUDPGLIHUHQWHVPpWRGRVGHDYDOLDomRGDV (2$3'

$RYHULILFDUSRVVtYHODVVRFLDomRHQWUHDDOWHUDomRQDV (2$3'HDDOWHUDomRQD$$)YLVWRTXHDDOWHUDomRQDV(2$3' RFRUUHXFRPPDLRUIUHTXrQFLDQRVLQGLYtGXRVFRP$$)DOWH

-UDGDWDODVVRFLDomRQmRIRLGHWHFWDGD2UHVXOWDGRHQFRQ -trado pode estar relacionado ao tamanho da amostra

DYDOLDGD(VWHDFKDGRGLVFRUGRXGH$UQROGHWDO45_TXHFRQ

-FOXtUDPTXHDDXGLomRHPDOWDVIUHTXrQFLDVLQÁXHQFLDVLJQL

-ÀFDWLYDPHQWHDV(2$3'HPIUHTXrQFLDVPDLVEDL[DV(VWH HVWXGRSRUpPIRLUHDOL]DGRFRPLQGLYtGXRVDGXOWRVMRYHQV

sadios e audiologicamente normais.

&RPUHODomRDRHIHLWRGRV$*VDEHVHTXHRVUHSHWLGRV FXUVRVGHWUDWDPHQWRHVXDGXUDomRVmRIDWRUHVUHODFLRQD

-GRVDRULVFRGHDXPHQWRGDRWRWR[LFLGDGH_(PQRVVR

GHHVWXGR(VWHVDFKDGRVGHPRQVWUDPDLPSRUWkQFLDGRXVR GD$$)QRPRQLWRUDPHQWRGHSDFLHQWHVFRP)&

(VWHVUHVXOWDGRVGLIHUHPGRVREWLGRVSRU0DUWLQVHWDO41

TXHREVHUYDUDPSHUGDDXGLWLYDHPIUHTXrQFLDVFRQYHQFLRQDLV HHPDOWDVIUHTXrQFLDVQRVSDFLHQWHVDYDOLDGRV$O0DON\HW DO42_{FRQWXGRFRQVWDWDUDPSHUGDDXGLWLYDVRPHQWHGH}

D+]SRUPHLRGD$$)HDPSOLWXGHVUHGX]LGDVQDV (2$3'RTXHFRQFRUGDFRPRVUHVXOWDGRVREWLGRVHPQRVVR HVWXGR1RHVWXGRFLWDGRRVDXWRUHVUHVVDOWDPRIDWRGHTXH DSHVDUGHDSHUGDDXGLWLYDHVWDUDVVRFLDGDjDOWDH[SRVLomR DRV$*DPHVPDRFRUUHXHPDSHQDVGRJUXSRH[SRVWR 'LDQWHGHWDOIDWRRVDXWRUHVVXJHUHPTXHSRGHKDYHURXWURV IDWRUHVUHVSRQViYHLVSHODSHUGDDXGLWLYD

(PQRVVRHVWXGRR*(DSUHVHQWRXPDLRUQ~PHURGHDOWH

-UDo}HVSRUIUHTXrQFLDHDPSOLWXGHVPDLVEDL[DVQDV(2$3' HPUHODomRDR*&PHVPRFRPOLPLDUHVDXGLWLYRVQRUPDLVDWp +](VWHDFKDGRFRUURERUDRHVWXGRGH6WDYURXODNLHW DO8_{TXHGHWHFWRXGLPLQXLomRGDVDPSOLWXGHVGH(2$3'QDV}

Tabela 4 &RPSDUDomRGDVDPSOLWXGHVG%136GDV(2$3'HQWUHRVJUXSRV

)UHTXrQFLD+] Orelha *UXSRGHHVWXGRQ *UXSRFRQWUROHQ pa

0G33 0G33

1.000 'LUHLWD D D

(VTXHUGD D D

1.400 'LUHLWD D D

(VTXHUGD D D

2.000 'LUHLWD D D

(VTXHUGD D D

2.800 'LUHLWD D D

(VTXHUGD D D

4.000 'LUHLWD D D

(VTXHUGD D D

'LUHLWD îD D

(VTXHUGD îD D

G%136GHFLEHOQtYHOGHSUHVVmRVRQRUD+]+HUW] a _{7HVWHGH0DQQ:KLWQH\}

Pr

evalência (%) 33,3

66,7

8,3 91,7

EOAPD normal EOAPD alterada

AAF normal (n = 27) AAF alterada (n = 12)

100

80

60

40

20

0

Figura 3 $VVRFLDomRHQWUHDDOWHUDomRQD$$)H(2$3'QRJUXSR GHHVWXGR$$)DXGLRPHWULDGHDOWDIUHTXrQFLD(2$3'HPLVV}HV RWRDF~VWLFDVSRUSURGXWRGHGLVWRUomR

Pr

evalência (%)

16,7 83,3

78,7

21,2

> 10 cursos AG < 10 cursos AG

AAF normal AAF alterada 100

90 80 70 60 50 40 30 20 10 0

Figura 4 $VVRFLDomRHQWUHRQ~PHURGHFLFORVGH$*HDOWHUD

-omRQD$$)$$)DXGLRPHWULDGHDOWDIUHTXrQFLD$*DPLQRJOL

WHQD$$)HPGRSDFLHQWHVGR*(VXJHUHPTXHHVWD DYDOLDomRGHYDVHULQFRUSRUDGDQRPRQLWRUDPHQWRDXGLWLYR GRVSDFLHQWHVFRP)&

Conclusão

2SUHVHQWHHVWXGRPRVWURXTXHXPQ~PHURH[SUHVVLYRGH SDFLHQWHVFRP)&TXHUHFHEHUDPUHSHWLGRVFXUVRVGH$* DSUHVHQWRXDOWHUDo}HVQD$$)H(2$3'KDYHQGRDVVRFLDomR VLJQLÀFDWLYDHQWUHDUHDOL]DomRGHPDLVGHGH]FXUVRVGH$* LQWUDYHQRVRHXPDPDLRUSUHYDOrQFLDGHDOWHUDo}HVQD$$)

Financiamento

(VWHHVWXGRIRLÀQDQFLDGRSHOR&13T

Con

Á

itos de interesse

2VDXWRUHVGHFODUDPQmRKDYHUFRQÁLWRVGHLQWHUHVVH

Agradecimentos

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-WHV_{HRXWURGLYHUJHQWH}40_{(PVHXHVWXGR0XOKHUDQHW}

al.20_{FRQFOXtUDPTXHH[LVWHXPSRVVtYHODXPHQWRGRULVFRGH}

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-Apéndice I

Termo de consentimento livre e esclarecido – Grupo de Estudo

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30 minutos.

1RH[DPHGHLPLWDQFLRPHWULDpFRORFDGRXPIRQHHPXPDRUHOKDHQDRXWUDXPDVRQGDTXHFDXVDXPDOHYHSUHVVmRH HPLWHDOJXQVDSLWRV$GXUDomRPpGLDGHVWHH[DPHpGHPLQXWRV

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Referências

1. 5XELR7$PDUR*0DUWtQH]*$WHQFLyQPXOWLGLVFLSOLQDULDDSD

-FLHQWHVFRQÀEURVLVTXtVWLFD5HY&XEDQD3HGLDWU

2. /XEDPED%'KRRJKH%1RHO6/HDO7&\VWLFÀEURVLVLQVLJKW LQWR&)75SDWKRSK\VLRORJ\DQGSKDUPDFRWKHUDS\&OLQ%LR

-FKHP

3. 'DOFLQ375)LEURVH&tVWLFD(P0HQQD%DUUHWR66HGLWRU 3QHXPRORJLD QR FRQVXOWyULR 3RUWR$OHJUH$UWPHG

p. 279-91.

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