Estudo do benefício da amplificação em usuários de próteses auditivas antes e após o ajuste por meio da utilização do mapeamento com estímulo de fala em português
Data
2015-02-25
Autores
Tonelini, Carla Fonseca Moraes 
Orientadores
Iorio, Maria Cecilia Martinelli
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
OBJETIVO: Verificar o desempenho de pacientes adultos usuários de próteses auditivas, em testes de fala e questionário de auto avaliação após ajuste da regulagem, baseando-se nos resultados do mapeamento de fala em português. MÉTODO: A amostra foi composta por 20 adultos usuários experientes de suas próteses auditivas ajustadas de acordo com o ganho prescrito pela regra NAL-NL1 do software proprietário das empresas e o ajuste fino realizado pelo profissional do serviço. O mapeamento de fala foi mensurado por meio do equipamento Audioscan - Verifit® com sinal teste de fala em português brasileiro. Após a realização do mapeamento, nova regulagem baseada nesta medida, foi implementada em 100% dos casos. Antes (momento T1) e após dois meses de uso com a nova regulagem (momento T2) foi aplicado o protocolo de investigação elaborado para a presente pesquisa que constou do Teste de Listas de Sentenças em Português (LSP) e Questionário Internacional - Aparelho de Amplificação Sonora Individual (QI-AASI). O LSP possibilitou a pesquisa do Limiar de Reconhecimento de Sentenças no Silêncio (LRSS) e no Ruído (LRSR) bem como da Relação Sinal/Ruído (S/R). O Questionário QI-AASI foi aplicado a seguir. Para esse trabalho foi definido um nível de significância de 0,05 (5%). Foram utilizados testes nãoparamétricos: Teste de Wilcoxon, Teste de Mann-Whitney e Teste de Igualdade de duas proporções. RESULTADOS: Os participantes apresentaram idade média de 50,4 anos. A maioria (85%) apresentou grau de perda auditiva neurossensorial de grau moderado bilateral. A diferença entre o valor prescrito e o obtido (dB) com estímulo de 55dB NPS por meio do mapeamento de fala, por frequência, na Orelha Direita (OD) e Orelha Esquerda (OE) nos momentos T1 e T2 foram estatisticamente significantes, com exceção de 250Hz e 6000Hz. Em 65dB NPS, apenas 250 Hz não foi significante. Para o nível de apresentação em 75dB NPS na OD, todas as frequências demonstraram diferença significante. Para OE com este mesmo estímulo, apenas 3000 Hz não foi significante. Quanto aos níveis de saída máxima (MPO), em ambas as orelhas a diferença observada entre T1 e T2 foi significante. Não foi observada diferença significante entre as orelhas para todos os níveis de apresentação. Observou-se que em todas as frequências estudadas o ganho da prótese auditiva aproximou-se do alvo prescrito. Verificou-se que tanto para o LRSS quanto para a Relação S/R, a melhora significante dos resultados após a regulagem das próteses auditivas. Em ambas as medidas houve redução dos valores; o LRSS médio variou de 39,60dB para 34,41dB e a Relação Sinal/Ruído (S/R) que era 5,82dB após dois meses tornou-se 3,34dB. O estudo dos escores do QI-AASI revelou melhora estatisticamente significante entre os momentos T1 e T2 na pontuação total (p¿valor < 0,001), nas questões relativas ao fator 1 (p-valor = 0,010) e fator 2 (p-valor = 0,002). Houve melhora da interação dos pacientes com a sua prótese auditiva e com o seu meio ambiente. CONCLUSÃO: Usuários de próteses auditivas apresentam melhor desempenho em testes verbais e questionário da auto avaliação após o ajuste das características eletroacústicas de suas próteses auditivas por meio do procedimento de verificação - mapeamento de fala.
OBJECTIVE: To assess the performance of adults patients of hearing aids in speech tests and self-assessment questionnaire after adjustment based on the results of the speech mapping with the Brazilian Portuguese test signal. METHODS: The sample consisted of 20 adults experienced users of your hearing aids adjusted according to the gain prescribed by NAL-NL1, adjustment by proprietary software companies and professional service. The speech mapping was measured by the Audioscan equipment - Verifit® with speech test signal in Brazilian Portuguese. After the completion of the mapping, new adjustment based on this measure was implemented in 100% of cases. Before ( time T1) and after two months of use with the new setting ( time T2) was applied research protocol developed for this research consisted of Sentence List Test in Portuguese (LSP) and The International Outcome Inventory for Hearing Aids - IOH-HA) . The LSP enabled the Sentence recognition threshold in quiet (SRTS ) and in noise ( SRT) and the (S/N) ratio. The IOI-HA was applied below. For this work has defined a 0.05 significance level (5%). Nonparametric tests were used: Wilcoxon test, Mann -Whitney test and the two ratio equality test. RESULTS: Participants had a mean age of 50.4 years. Most (85%) had a degree of sensorineural hearing loss bilateral moderate. The difference between the prescribed and the value obtained (dB) with 55 dBSPL stimulus through speech mapping, by frequency, in the right ear and left ear in T1 and T2 times were statistically significant, except 250Hz and 6000Hz. In 65dB SPL, only 250 Hz was not significant. To the level of presentation 75dB SPL in OD, all frequencies showed significant difference. For lest ear with this same stimulus , only 3000 Hz was not significant. As for the maximum output levels in both ears the difference observed between T1 and T2 was significant. There was no significant difference between the ears for all presentation levels. It was observed that at all frequencies studied the gain of the hearing aid approached the prescribed target. It was found that both the SRTS as for the S/N ratio, better results after adjustment of hearing aids was statistically significant. In both measures decreased values; SRTS in the average fell to 39,60dB for 34,41dB and the S/N ratio which was 5,82dB after two months became 3,34dB . The application of the IOI-HA revealed that there is a statistically significant difference between pre and post in the total score (pvalue< 0.001), in matters relating to the factor 1 (p = 0.010) and factor 2 (pvalue = 0.002). There was improvement of the interaction of patients with the hearing aids and with their environment. CONCLUSION: hearing aids users perform better on verbal tests and self-assessment questionnaire after fitting adjustment of hearing aids through the verification procedure - speech mapping.
OBJECTIVE: To assess the performance of adults patients of hearing aids in speech tests and self-assessment questionnaire after adjustment based on the results of the speech mapping with the Brazilian Portuguese test signal. METHODS: The sample consisted of 20 adults experienced users of your hearing aids adjusted according to the gain prescribed by NAL-NL1, adjustment by proprietary software companies and professional service. The speech mapping was measured by the Audioscan equipment - Verifit® with speech test signal in Brazilian Portuguese. After the completion of the mapping, new adjustment based on this measure was implemented in 100% of cases. Before ( time T1) and after two months of use with the new setting ( time T2) was applied research protocol developed for this research consisted of Sentence List Test in Portuguese (LSP) and The International Outcome Inventory for Hearing Aids - IOH-HA) . The LSP enabled the Sentence recognition threshold in quiet (SRTS ) and in noise ( SRT) and the (S/N) ratio. The IOI-HA was applied below. For this work has defined a 0.05 significance level (5%). Nonparametric tests were used: Wilcoxon test, Mann -Whitney test and the two ratio equality test. RESULTS: Participants had a mean age of 50.4 years. Most (85%) had a degree of sensorineural hearing loss bilateral moderate. The difference between the prescribed and the value obtained (dB) with 55 dBSPL stimulus through speech mapping, by frequency, in the right ear and left ear in T1 and T2 times were statistically significant, except 250Hz and 6000Hz. In 65dB SPL, only 250 Hz was not significant. To the level of presentation 75dB SPL in OD, all frequencies showed significant difference. For lest ear with this same stimulus , only 3000 Hz was not significant. As for the maximum output levels in both ears the difference observed between T1 and T2 was significant. There was no significant difference between the ears for all presentation levels. It was observed that at all frequencies studied the gain of the hearing aid approached the prescribed target. It was found that both the SRTS as for the S/N ratio, better results after adjustment of hearing aids was statistically significant. In both measures decreased values; SRTS in the average fell to 39,60dB for 34,41dB and the S/N ratio which was 5,82dB after two months became 3,34dB . The application of the IOI-HA revealed that there is a statistically significant difference between pre and post in the total score (pvalue< 0.001), in matters relating to the factor 1 (p = 0.010) and factor 2 (pvalue = 0.002). There was improvement of the interaction of patients with the hearing aids and with their environment. CONCLUSION: hearing aids users perform better on verbal tests and self-assessment questionnaire after fitting adjustment of hearing aids through the verification procedure - speech mapping.
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Citação
TONELINI, Carla Fonseca Moraes. Estudo do benefício da amplificação em usuários de próteses auditivas antes e após o ajuste por meio da utilização do mapeamento com estímulo de fala em português. 2015. 97 f. Dissertação (Mestrado em Fonoaudiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.