Avaliação audiológica em crianças com retinoblastoma
Data
2021-12
Autores
Rodrigues, Gabriela Borges [UNIFESP]
Orientadores
Gil, Daniela [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O retinoblastoma – tumor maligno intraocular da retina, apesar de considerado o mais comum dentre os cânceres na infância, consiste em uma doença relativamente rara, afetando aproximadamente um em cada 16.000 a 18.000 nascidos vivos da população global. O tratamento medicamentoso contra tumores é potencialmente prejudicial aos sistemas auditivo e vestibular, devido à ototoxicidade dos fármacos utilizados, em sua maioria, derivados da platina – cisplatina e carboplatina. Esses têm como consequência, não só a morte de células ciliadas da cóclea, atingindo a princípio sua base, mas também grande potencial de acometimento da porção central da audição. Assim, devido à possibilidade de se afetarem estruturas da via de audição, faz-se necessária a avaliação do processamento auditivo central. Objetivo: Caracterizar a avaliação comportamental do processamento auditivo central em crianças e adolescentes fora de tratamento de retinoblastoma tratadas com a carboplatina. Método: Avaliou-se dez crianças de 5 anos a 18 anos que passaram pelo tratamento de retinoblastoma há pelo menos dois anos. Os pacientes foram submetidos à avaliação comportamental do processamento auditivo central, constituída pelos testes: Teste de Localização Sonora, Teste de Memória Sequencial para Sons Verbais, Teste de Memória Sequencial para Sons Não Verbais, Teste de Fala com Ruído Branco, Teste Dicótico de Dígitos, Teste de Identificação de Sentenças Sintéticas (Mensagem Competitiva Ipsilateral), Teste de Padrão de Duração, Teste Dicótico Consoante-Vogal (Atenção Livre) e Teste de Identificação de Intervalos Aleatórios. Resultados: Observou-se na amostra, com a análise estatística, idade média de 10,53 anos, média da idade de diagnóstico de 1,57 anos, duração do tratamento de 8,8 meses e o tempo de remissão de 7,59 anos. Na avaliação comportamental do processamento auditivo central, alguns testes mostraram-se alterados na maioria dos indivíduos, por exemplo, o teste de memória sequencial de sons não verbais com 4 sons, o dicótico de dígitos, o consoante-vogal e o RGDT, todos com 50% ou mais de alteração nas avaliações realizadas. Quanto aos processos gnósicos alterados, 90% apresentou alteração de decodificação, 60% de organização, 50% de codificação e 40% de não verbal. Conclusão: Concluímos que crianças e adolescentes tratados de retinoblastoma com carboplatina apresentam Transtorno do Processamento Auditivo Central (TPAC). O TPAC envolve prioritariamente os processos gnósicos de decodificação, seguido de organização, codificação e, por fim, não verbal.
Introduction: Retinoblastoma – a malignant intraocular retinal tumor, despite being considered the most common among childhood cancers, it is a relatively rare disease, which affects approximately one in every 16 thousand up to 18 thousand live births in the global population. Drug therapy against tumors is potentially detrimental to the auditory and vestibular systems, due to the medications’ ototoxicity, which stem mostly from platinum – cisplatin and carboplatin. As a consequence of the latter, not only does the treatment result in the death of cochlear hair cells, progressing from the base of the cochlea, but it also poses a great potential risk to the central auditory nervous system. Therefore, the significant possibility of damage on auditory structures compels an evaluation of the central auditory processing. Objective: To characterize the behavioral evaluation of the central auditory processing in children and adolescents who have been treated with carboplatin for retinoblastoma. Method: Ten children aged 5 to 18 years who were treated for retinoblastoma at least in the previous two years. The patients underwent behavioral assessment of central auditory processing, consisting of the following tests: Sound Localization Test, Memory for Verbal and Nonverbal Sounds in Sequence Tests, Speech in Noise Test, Dichotic Digits Test, Synthetic Sentence Identification Test (Ipsilateral Competitive Message), Duration Pattern Test, Consonant-Vowel Dichotic Test (Free Recall) and Random Gap Detection Test. Results: Statistical analysis showed that the average age of the sample was 10.53 years, an average diagnosis age of 1.57 years, 8.8 months of treatment duration and 7.59 years of remission time. In the behavioral assessment of central auditory processing, some tests were altered in most individuals, such as the sequence memory test of non-verbal sounds with 4 sounds, the digit dichotic test, the vowel-consonant and the RGDT, all exhibiting an alteration of 50% or more in the performed evaluations. As for the altered gnostic processes, 90% revealed decoding alteration, 60% of organization, 50% of coding and 40% of non-verbal. Conclusion: Children and adolescents treated for retinoblastoma with carboplatin present Central Auditory Processing Disorder primarily involving the gnostic processes of decoding, followed by organization, encoding and, finally, non-verbal.
Introduction: Retinoblastoma – a malignant intraocular retinal tumor, despite being considered the most common among childhood cancers, it is a relatively rare disease, which affects approximately one in every 16 thousand up to 18 thousand live births in the global population. Drug therapy against tumors is potentially detrimental to the auditory and vestibular systems, due to the medications’ ototoxicity, which stem mostly from platinum – cisplatin and carboplatin. As a consequence of the latter, not only does the treatment result in the death of cochlear hair cells, progressing from the base of the cochlea, but it also poses a great potential risk to the central auditory nervous system. Therefore, the significant possibility of damage on auditory structures compels an evaluation of the central auditory processing. Objective: To characterize the behavioral evaluation of the central auditory processing in children and adolescents who have been treated with carboplatin for retinoblastoma. Method: Ten children aged 5 to 18 years who were treated for retinoblastoma at least in the previous two years. The patients underwent behavioral assessment of central auditory processing, consisting of the following tests: Sound Localization Test, Memory for Verbal and Nonverbal Sounds in Sequence Tests, Speech in Noise Test, Dichotic Digits Test, Synthetic Sentence Identification Test (Ipsilateral Competitive Message), Duration Pattern Test, Consonant-Vowel Dichotic Test (Free Recall) and Random Gap Detection Test. Results: Statistical analysis showed that the average age of the sample was 10.53 years, an average diagnosis age of 1.57 years, 8.8 months of treatment duration and 7.59 years of remission time. In the behavioral assessment of central auditory processing, some tests were altered in most individuals, such as the sequence memory test of non-verbal sounds with 4 sounds, the digit dichotic test, the vowel-consonant and the RGDT, all exhibiting an alteration of 50% or more in the performed evaluations. As for the altered gnostic processes, 90% revealed decoding alteration, 60% of organization, 50% of coding and 40% of non-verbal. Conclusion: Children and adolescents treated for retinoblastoma with carboplatin present Central Auditory Processing Disorder primarily involving the gnostic processes of decoding, followed by organization, encoding and, finally, non-verbal.
Descrição
Citação
RODRIGUES, G. B. Avaliação audiológica em crianças com retinoblastoma. São Paulo, 2021. 106 f. Trabalho de Conclusão de Curso (Graduação em Fonoaudiologia) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2021.