Equilíbrio postural de crianças com perda auditiva neurossensorial congênita: estudo de casos clínicos
Data
2024-11-06
Autores
Moraes, Nicolle Santos de 
Orientadores
Branco-Barreiro, Fátima Cristina Alves
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Comparar o controle postural de três crianças com perda auditiva neurossensorial congênita bilateral usuárias de implante coclear com o de crianças normo-ouvintes e com o implante coclear ligado e desligado. Métodos: Trata-se de um estudo de casos clínicos realizado no Ambulatório de Avaliação e Reabilitação Vestibular da Disciplina de Otologia e Otoneurologia do Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço da Escola Paulista de Medicina/ Universidade Federal de São Paulo. Participaram três crianças entre nove e 15 anos, usuárias de implante coclear, acompanhadas no Centro do Deficiente Auditivo da UNIFESP. Todos foram submetidos à posturografia estática com provas dinâmicas com o implante coclear ligado e depois com o implante coclear desligado. Resultados: Participaram do estudo três meninos usuários de implante coclear, sendo dois com implantação unilateral e um com bilateral. Na anamnese foram descritos por seus familiares como desajeitados, embora não relatassem queixas vestibulares. Todos mostraram algum tipo de atraso no desenvolvimento motor global, principalmente nos marcos de "sustentar a cabeça" e "andar sem apoio". O Caso 1 apresentou limite de estabilidade semelhante ao de uma criança controle com o implante coclear desligado, mas pior desempenho com o implante ligado. A análise sensorial mostrou aumento da dependência visual e diminuição do uso da pista vestibular com o implante coclear ligado. O Caso 2 apresentou desempenho semelhante na posturografia estática a uma criança normo-ouvinte da mesma idade e sexo no que diz respeito ao limite de estabilidade. No entanto, a análise sensorial mostrou aumento da dependência visual e diminuição do uso da pista vestibular com o implante coclear ligado. O Caso 3 apresentou menor limite de estabilidade quando comparado a uma criança normo-ouvinte de idade e sexo semelhante, mas aproveitamento semelhante das pistas visuais, somatossensoriais e vestibulares no controle postural, com os implantes cocleares ligados e desligados. Conclusões: Crianças com implante coclear unilateral tiveram pior desempenho no controle postural com o dispositivo ligado e a criança com implante coclear bilateral apresentou controle postural semelhante com os dispositivos ligados e desligados. As crianças usuárias de implante coclear apresentaram desempenho pior no controle postural quando comparadas a crianças normo-ouvintes com idade semelhante.
Objective: To compare the postural control of three children with bilateral congenital sensorineural hearing loss using cochlear implants to that of normal-hearing children, with the cochlear implant both turned on and off. Methods: This is a case study conducted at the Vestibular Assessment and Rehabilitation Outpatient Clinic of the Otology and Otoneurology Division, Department of Otorhinolaryngology and Head and Neck Surgery of Paulista School of Medicine/Federal University of São Paulo. The study included three children aged 9 to 15 years, cochlear implant users, followed at the Hearing Impaired Center of UNIFESP. All participants underwent static posturography with dynamic tests, first with the cochlear implant turned on and then turned off. Results: The study included three boys using cochlear implants, two with unilateral implantation and one with bilateral implantation. In their medical history, family members described them as clumsy, although no vestibular complaints were reported. All showed some degree of delay in global motor development, particularly in the milestones of "holding up the head" and "walking without support." Case 1 demonstrated a stability limit similar to a control child when the cochlear implant was turned off but showed worse performance when it was turned on. Sensory analysis revealed increased visual dependence and reduced use of vestibular cues with the implant on. Case 2 showed static posturography performance similar to that of a normal-hearing child of the same age and sex regarding the stability limit. However, sensory analysis revealed increased visual dependence and reduced vestibular cue usage with the cochlear implant turned on. Case 3 exhibited a lower stability limit compared to a normal-hearing child of the same age and sex but demonstrated similar use of visual, somatosensory, and vestibular cues in postural control with the cochlear implants both on and off. Conclusions: Children with unilateral cochlear implants showed worse postural control performance with the device turned on, while the child with bilateral cochlear implants demonstrated similar postural control performance with the devices on and off. Cochlear implant users exhibited poorer postural control performance compared to normal-hearing children of similar ages.
Objective: To compare the postural control of three children with bilateral congenital sensorineural hearing loss using cochlear implants to that of normal-hearing children, with the cochlear implant both turned on and off. Methods: This is a case study conducted at the Vestibular Assessment and Rehabilitation Outpatient Clinic of the Otology and Otoneurology Division, Department of Otorhinolaryngology and Head and Neck Surgery of Paulista School of Medicine/Federal University of São Paulo. The study included three children aged 9 to 15 years, cochlear implant users, followed at the Hearing Impaired Center of UNIFESP. All participants underwent static posturography with dynamic tests, first with the cochlear implant turned on and then turned off. Results: The study included three boys using cochlear implants, two with unilateral implantation and one with bilateral implantation. In their medical history, family members described them as clumsy, although no vestibular complaints were reported. All showed some degree of delay in global motor development, particularly in the milestones of "holding up the head" and "walking without support." Case 1 demonstrated a stability limit similar to a control child when the cochlear implant was turned off but showed worse performance when it was turned on. Sensory analysis revealed increased visual dependence and reduced use of vestibular cues with the implant on. Case 2 showed static posturography performance similar to that of a normal-hearing child of the same age and sex regarding the stability limit. However, sensory analysis revealed increased visual dependence and reduced vestibular cue usage with the cochlear implant turned on. Case 3 exhibited a lower stability limit compared to a normal-hearing child of the same age and sex but demonstrated similar use of visual, somatosensory, and vestibular cues in postural control with the cochlear implants both on and off. Conclusions: Children with unilateral cochlear implants showed worse postural control performance with the device turned on, while the child with bilateral cochlear implants demonstrated similar postural control performance with the devices on and off. Cochlear implant users exhibited poorer postural control performance compared to normal-hearing children of similar ages.
Descrição
Citação
MORAES, Nicolle Santos de. Equilíbrio postural de crianças com perda auditiva neurossensorial congênita: estudo de casos clínicos. 2024. 72 f. Trabalho de Conclusão de Curso (Graduação em Fonoaudiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.