Avaliação do reconhecimento de fala e da habilidade de localização sonora na presença do ruído em indivíduos com perda auditiva unilateral usuários de próteses implantáveis

• Autor(a) principal: Almeida, Gleide Viviani Maciel
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do UTP
• Texto Completo: http://tede.utp.br:8080/jspui/handle/tede/1262
• topic: Perda auditiva unilateral; Prótese auditiva ancorada no osso; Implante coclear; Percepção de fala; Localização da fonte sonora; Unilateral hearing loss; Bone anchored hearing aid; Cochlear implant; Speech perception; Sound source localization; Pérdida auditiva unilateral; Prótesis auditiva anclada en el hueso; Implante coclear; Percepción del habla; Localización de fuente sonora; CIENCIAS DA SAUDE::FONOAUDIOLOGIA

The binaural hearing is a basic condition for the development of auditory abilities, for the localization of the individual in space, and for understanding speech in degraded situations and environments. In this respect, studies have been developed worldwide on the rehabilitation of unilateral hearing loss, and despite the favorable results, the implanted performance evaluation is still difficult due to the high costs of the tests or difficulties of installation of the existing equipment and protocols. Considering this condition, the objective of this thesis was to study the benefits of implantable prostheses for unilateral hearing loss, as well as the performance of subjects with unilateral hearing loss, cochlear implant or bone anchored prosthesis users, as to auditory skills for sound source localization and speech recognition in the presence of noise. In order to achieve the proposed objectives, specific strategies were established: a) Performing a Systematic Review to determine if there is scientific evidence establishing the ideal form of auditory rehabilitation in unilateral loss; b) Elaboration and validation of the Free Field Speech Recognition Test in the Presence of Noise (LISTEN-SOUND) in people with normal hearing; c) Elaboration and validation of the Sound Source Localization Test in the Presence of Noise (LOCATE-SOUND) in people with normal hearing; d) Evaluation of a group of subjects with unilateral hearing loss and users of implantable prostheses through the developed tests and the Speech, Spatial and Qualities of Hearing Scale questionnaire. The following results were obtained: a) The systematic review showed that despite the great clinical heterogeneity observed among the studies that evaluated the auditory rehabilitation of patients with unilateral hearing loss, it is possible to consider that the CI provides better results for both the localization of the sound source and for the recognition of speech in the presence of noise; b) The ESCUTA-SOM test was easy to organize and apply. The results obtained in the validation of the test suggest that individuals with normal hearing should hit between 88 and 100% of the presented stimuli. The test can be an important instrument in measuring noise interference on speech recognition skills; c) The LOCALIZA-SOM test proved to be practical in the organization and execution. The results obtained in the validation of the test suggest that individuals with normal hearing should locate 70% of the presented stimuli. Background noise, age, and gender do not interfere with this result. This test can be an important tool in the evaluation of sound localization ability. d) Six subjects with unilateral hearing loss were evaluated, three users of cochlear implant and three of bone anchored hearing aids. The two types of implantable hearing aids were efficient in rehabilitating the hearing of individuals with unilateral hearing loss. This study allowed to conclude that the use of implantable prostheses in unilateral hearing loss is a reality in the world scenario, although recent and little stimulated in Brazil. Even in the international literature the studies have small sampling and are heterogeneous in the way of evaluating the outcomes. Investing in the development of low-cost, easy-to-apply instruments is critical for researchers to better study and describe the benefits of implantable prostheses in this population. More standardization protocols can favor multicentric research and thus allow the extrapolation of the data, generating scientific evidence. The ESCUTA-SOM and LOCALIZA-SOM tests can be used in clinical practice to assess recognition and localization skills.