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- An alternative 3D numerical method to study the biomechanical behaviour of the human inner ear semicircular canalPublication . Santos, Carla F; Belinha, Jorge; Gentil, Fernanda; Parente, Marco; Jorge, Renato NThe vestibular system is the part of the inner ear responsible for balance. Vertigo and dizziness are generally caused by vestibular disorders and are very common symptoms in people over 60 years old. One of the most efficient treatments at the moment is vestibular rehabilitation, permitting to improve the symptoms. However, this rehabilitation therapy is a highly empirical process, which needs to be enhanced and better understood.
- Analysis of eardrum pathologies using the finite element methodPublication . Gentil, Fernanda; Garbe, Carolina; Parente, Marco; Martins, Pedro; Ferreira, António; Jorge, Renato Natal; Santos, Carla; Paço, JoãoThis work investigates the effect of eardrum perforations and myringosclerosis in the mechanical behavior of the tympano-ossicular chain. A 3D model for the tympano-ossicular chain was created and different numerical simulations were made, using the finite element method. For the eardrum perforations, three different calibers of perforated eardrums were simulated. For the micro perforation (0.6 mm of diameter) no differences were observed between the perforated and normal eardrum. For the numerical simulation of the eardrum with the largest perforation caliber, small displacements were obtained in the stapes footplate, when compared with the model representative of normal ossicular-chain, at low frequencies, which is related with major hearing loss in this frequency range. For the numerical simulations of myringosclerosis, the larger differences in the displacement field between the normal and modified model were obtained in the umbo. When observing the results in the stapes footplate, there were no significant differences between the two models, which is in accordance to the clinical data. When simulating an eardrum perforation along with myringosclerosis, there is a decrease in the displacements, both from the umbo and the central part of the stapes footplate, often associated with a pronounced hearing loss. It could be concluded that the reduced displacement of the stapes footplate may be related to a greater hearing loss.
- Audiologists’ preferences for patient-centredness: a cross-sectional questionnaire study of cross-cultural differences and similarities among professionals in Portugal, India and IranPublication . Manchaiah, Vinaya; Gomersall, Philip; Tomé, David; Ahmadi, Tayebeh; Krishna, RajalakshmiObjective Patient-centredness has become an important aspect of health service delivery; however, there are a limited number of studies that focus on this concept in the domain of hearing healthcare. The objective of this study was to examine and compare audiologists’ preferences for patient-centredness in Portugal, India and Iran. Design The study used a cross-sectional survey design with audiologists recruited from three different countries. Participants A total of 191 fully-completed responses were included in the analysis (55 from Portugal, 78 from India and 58 from Iran). Main outcome measure The Patient–Practitioner Orientation Scale (PPOS). Results PPOS mean scores suggest that audiologists have a preference for patient-centredness (ie, mean of 3.6 in a 5-point scale). However, marked differences were observed between specific PPOS items suggesting these preferences vary across clinical situations. A significant level of difference (p<0.001) was found between audiologists’ preferences for patient-centredness in three countries. Audiologists in Portugal had a greater preference for patient-centredness when compared to audiologists in India and Iran, although no significant differences were found in terms of age and duration of experience among these sample populations. Conclusions There are differences and similarities in audiologists’ preferences for patient-centredness among countries. These findings may have implications for the training of professionals and also for clinical practice in terms of optimising hearing healthcare across countries.
- Auditory event-related potentials in children with benign epilepsy with centro-temporal spikesPublication . Tomé, David; Sampaio, Mafalda; Mendes-Ribeiro, José; Barbosa, Fernando; Marques-Teixeira, JoaoBenign focal epilepsy in childhood with centro-temporal spikes (BECTS) is one of the most common forms of idiopathic epilepsy, with onset from age 3 to 14 years. Although the prognosis for children with BECTS is excellent, some studies have revealed neuropsychological deficits in many domains, including language. Auditory event-related potentials (AERPs) reflect activation of different neuronal populations and are suggested to contribute to the evaluation of auditory discrimination (N1), attention allocation and phonological categorization (N2), and echoic memory (mismatch negativity – MMN). The scarce existing literature about this theme motivated the present study, which aims to investigate and document the existing AERP changes in a group of children with BECTS. AERPs were recorded, during the day, to pure and vocal tones and in a conventional auditory oddball paradigm in five children with BECTS (aged 8–12; mean = 10 years; male = 5) and in six gender and age-matched controls. Results revealed high amplitude of AERPs for the group of children with BECTS with a slight latency delay more pronounced in fronto-central electrodes. Children with BECTS may have abnormal central auditory processing, reflected by electrophysiological measures such as AERPs. In advance, AERPs seem a good tool to detect and reliably reveal cortical excitability in children with typical BECTS.
- Avaliação auditiva de comunidades escolares portuguesas: Audiologia Escolar versus Rastreio AuditivoPublication . Lopes, Paula; Tomé, David; Sousa, Aida; Magalhães, AntónioEstudo da incidência da perda auditiva e de problemas otológicos em comunidades escolares do Norte do país de um totalde 2550 participantes, entre os 3 e os 17 anos de idade. Desenho do Estudo: Levantamento estatístico nas próprias instituições de ensino sendo realizado um protocolo de avaliação auditiva de rastreio. Material e Métodos: A todos os participantes foi realizado o mesmo protocolo de avaliação que consistiu numa anamnese audiológica, otoscopia e exame audiométrico de rastreio, sendo considerado como critério de inclusão a autorização prévia por parte do encarregado de educação. Resultados: Foram identificados diversos problemas otológicos e a audiometria tonal de rastreio contabilizou limiares auditivos indicativos de hipoacusia, uni e bilateralmente, em cerca de 5,7% dos casos. Conclusões: O rastreio auditivo deve ser realizado o mais precocemente possível e fazer parte integral dos cuidados de saúde primários, de modo a orientar a criança para uma educação e acompanhamento apropriados.
- Avaliação da perda auditiva em doentes com tuberculose multirresistentePublication . Ribeiro, Leandro; Sousa, Cláudia; Sousa, Aida; Ferreira, Catarina; Duarte, Raquel; Almeida, António Faria e; Condé, ArturA tuberculose multirresistente e a extensivamente resistente constituem atualmente a principal ameaça ao controlo da tuberculose a nível mundial. O seu tratamento exige o uso de um esquema terapêutico com fármacos de segunda linha por um período mínimo de 20 meses, onde se incluem aminoglicosídeos durante um período de cerca de oito meses. Estes estão associados a alterações cocleovestibulares permanentes. Estudo transversal que pretende avaliar a função auditiva em indivíduos que terminaram tratamento por tuberculose multirresistente (com esquema que incluía aminoglicosídeos) no Centro de Referência Regional para a Tuberculose Multirresistente da Sub-Região de Saúde do Norte entre os anos de 2009 e 2012. Os doentes que preencheram os critérios de inclusão foram convocados para a realização de: exame objetivo otorrinolaringológico, audiograma tonal e vocal, otoemissões acústicas por produtos de distorção nas frequências de 2000-5000 Hz e timpanograma. Entre 2009 e 2012 foram referenciados 27 casos para o Centro de Referência para a tuberculose multirresistente da Região Norte, tendo-se verificado cinco óbitos. Dos 22 indivíduos convocados, compareceram 11. Estes possuíam idades compreendidas entre os 31 e os 59 anos (41 ± 10). A amicacina foi usada em 80% e a capreomicina nos restantes. Seis (60%) dos utentes estudados apresentaram surdez neurossensorial. As otoemissões acústicas foram negativas em todos os doentes com hipoacúsia neurossensorial, o que confirma a sua origem coclear. Os resultados deste estudo sugerem a necessidade de existir uma monitorização audiológica mais frequente nos indivíduos com tuberculose multirresistente tratados com aminoglicosídeos permitindo detectar mais precocemente a perda auditiva.
- Benign paroxysmal positional vertigo (bppv): case report with epley manoeuverPublication . Silva, Ana Rita; Tomé, David; Olsen, Unn SiriBenign paroxysmal positional vertigo (BPPV) is a peripheral vestibular dysfunction which represents about 70% of vestibular pathology presented at ENT clinics. However, a variety of first treatment approaches are reported among clinicians. Case report: We present the case of a 39-year-old woman who presented vertigo which worsened with head movement to the left. The patient reported dizziness and migraine over the previous three days. Audiological testing revealed normal hearing, but under postural examination the Dix-Hallpike manoeuver was positive to BPPV of the left posterior canal. The patient was treated with a single Epley manoeuver. Conclusions: After the Epley manoeuver the patient had no further symptoms of vertigo or dizziness. The Dix-Hallpike manoeuver was effective as a differential diagnosis. The Epley manoeuver was successful in a case in which canalithiasis was believed to be the cause of the vertigo.
- Characterization of middle-ear condition of Oporto daycare children up-to 3 years-old: A cross sectional studyPublication . Tomé, David; Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Costa, Daniel; Ferreira, JoãoObjective The aim of this study was to determine tympanometric values of children who attend Oporto daycare centers and further analyze any relations with host and environmental factors. Methods Cross sectional study in a randomly selected sample of 117 daycare children up-to 3-years old from Oporto. Tympanometric measures were collected. Results Children presented in left ear (LE) a mean peak pressure (PP) of −156.53 daPa and a mean compliance of 0.16 cm3. Right ear (RE) revealed a PP of −145.61 daPa and a compliance of 0.19 cm3. Normal tympanograms (type A) had a lower frequency than abnormal tympanograms (type B and type C). There was a positive association between age and compliance (LE: p = 0.016; RE: p = 0.013) and between the presence of rhinorrhea and PP (LE: p = 0.002; RE: p < 0.05). Abnormal tympanograms were more frequent in Spring (RE: p = 0.009), in younger children (LE: p = 0.03) and in children that had rhinorrhea (LE: p = 0.002; RE: p = 0.044). Healthy children had a mean PP of −125.19 daPa and a mean compliance of 0.21 cm3 in LE and a mean PP of −144.27 daPa and a mean compliance of 0.22 cm3 in RE. Conclusion Tympanometric measures presented in this paper may be applicable to Oporto daycare children up-to 3 years-old. Most of daycare children revealed abnormal tympanograms. Age, rhinorrhea and season influenced children's middle-ear condition.
- Cochlear hair cell regeneration based on stem cells: A systematic reviewPublication . Costa, Vítor Bruno; Tomé, David; Çirtlik, Zeynep Yağmur; Öztürk, Yaren; Clemêncio, Filomena; Pitt-Byrne, Theresa; Tomé, David; Costa Clemêncio, Filomena MariaAccording to the World Health Organization (WHO), by 2050 at least 700 million people will need access to hearing care and hearing rehabilitation services. The search for cell or gene therapies has been intensifying, and stem cell therapy looks a promising candidate to support hearing regeneration and reduce these numbers. The aim of this study is to provide an overview of current advances in stem cellbased therapies for cochlear hair cell regeneration and the processes being developed for future applicability. Identification and review of all articles in the databases PubMed, Web of Science, and PLoS One using the terms stem cell, auditory hair cell regeneration, and mammalian during February 2023 and following the PRISMA guidelines. 50 articles were obtained, published between 2003 and 2022 and were systematically analyzed. The current research quantity is limited and further studies are needed, particularly in human tissue. The simultaneous use of cell therapy and gene therapy may lead to more promising results. Moreover, advances in cochlear hair cell regeneration with stem cells suggest there is a realistic potential to make the technique a useful future therapy.
- Comparison of otoacoustic emissions in patients with tinnitus having normal hearing versus mild hearing lossPublication . Gentil, Fernanda; Meireles, Susana; Roza, Thuane; Santos, Carla; Parente, Marco; Almeida, Eurico; Natal, RenatoTinnitus is an auditory sensation whose source comes from external stimulus to the body. All studies that can help people with this disorder are very imperative. This study investigates the cochlear function in patients with tinnitus, using Distortion Products Otoacoustic Emissions (DPOAE). Ears where the subjects referred to feel the tinnitus were considered for the study group while other ears without this sensation of tinnitus acted as a control group. Fifty subjects suffering from unilateral or bilateral tinnitus with normal hearing sensitivity or mild hearing loss were recruited. Where comparing the control and study group, the highest percentage of cases of DPOAE detected was in the control group, although these differences were not statistically significant. When the analyzed frequency is the same as the tinnitus frequency, the prevalence of detected DPOAE is in tinnitus ears (50.0 %). In ears where tinnitus was not perceived (73.5 %) a p value of 0.024 (< 0.05) was found, which means that the undetected DPOAE could be influenced by tinnitus. Based on the results, tinnitus might not be caused by changes in the outer hair cells but seems to be affected by that.