Unilateral and asymmetric hearing loss in childhood
Perda auditiva unilateral e assimétrica na infância
Fernanda Navarro Gouveia; Lilian Cássia Bórnia Jacob-Corteletti; Bárbara Cristiane Sordi Silva; Eliene Silva Araújo; Regina Célia Bortoleto Amantini; Eduardo Boaventura Oliveira; Kátia de Freitas Alvarenga
Abstract
Purpose: To describe unilateral and bilateral asymmetric sensorineural hearing loss in children and its etiological, audiological and demographic characteristics. Methods: Retrospective cross-sectional study developed in the Seção de Implante Coclear of Hospital de Reabilitação de Anomalias Craniofaciais, through the analysis of medical records. Results: Data from 1152 patients were analyzed: 424 (37%) adolescents, adults or elderly, and 728 (63%) children, of whom 691 (95%) had bilateral symmetrical hearing loss, and 37 (5%) had unilateral hearing loss (n=10) or bilateral asymmetric (n=27) sensorineural hearing loss. The mean age at diagnosis of unilateral sensorineural hearing loss was 33.58±21.69 months, and for asymmetric bilateral it was 33.12±21.69 months, with a prevalence of 1.4% and 3.7%, respectively. The highest risk indicator for hearing loss for both groups was the family history of permanent deafness, which began in childhood. The majority of the relatives of children with unilateral sensorineural hearing loss presented the highest low socioeconomic classification (50%), while children with bilateral asymmetric sensorineural hearing loss were also be subdivided into upper (37%) and lower (37%). Conclusion: We observed a greater occurrence of asymmetric bilateral sensorineural hearing loss compared to unilateral hearing loss, as well as the hereditary risk indicator, with a predominance of the deep ear and female preponderance in both groups. Although neonatal hearing screening provides early identification of unilateral sensorineural hearing loss, the age at the audiological diagnosis is still above the recommended level. In addition, the majority of the children’s family members presented a low level of income
Keywords
Resumo
Objetivo: Descrever a perda auditiva sensorioneural unilateral e bilateral assimétrica em crianças quanto às características etiológicas, audiológicas e demográficas. Método: Estudo retrospectivo transversal, desenvolvido na Seção de Implante Coclear do Hospital de Reabilitação de Anomalias Craniofaciais, por meio da análise de prontuários. Resultados: Foram analisados os dados de 1152 pacientes, sendo 424 (37%) adolescentes, adultos ou idosos e 728 (63%) crianças, dentre as quais, 691 (95%) apresentavam perda auditiva bilateral simétrica e 37 (5%) perda auditiva sensorioneural unilateral (n=10) ou bilateral assimétrica (n=27). A idade média ao diagnóstico na perda auditiva sensorioneural unilateral foi de 33,58±21,69 meses e na bilateral assimétrica de 33,12±21,69 meses, com prevalência de 1,4% e 3,7%, respectivamente. O indicador de risco para a deficiência auditiva de maior ocorrência para ambos os grupos foi o de antecedente familiar. A maioria dos familiares das crianças com perda auditiva sensorioneural unilateral apresentaram a classificação socioeconômica baixa superior (50%), enquanto que as crianças com perda auditiva sensorioneural bilateral assimétrica se subdividiram igualmente em baixa superior (37%) e média inferior (37%). Conclusão: Houve uma maior prevalência da perda auditiva sensorioneural bilateral assimétrica em relação à unilateral, bem como do indicador de risco de hereditariedade, com predomínio do grau profundo na pior orelha e preponderância do sexo feminino, em ambos os grupos. Apesar de a triagem auditiva neonatal propiciar a identificação precoce da perda auditiva sensorioneural unilateral, a idade no diagnóstico audiológico ainda se encontra acima do recomendado. Adicionalmente, a maioria dos familiares das crianças apresentou nível de rendimento baixo.
Palavras-chave
Referências
1 WHO: World Health Organization. Relatório mundial sobre a deficiência [Internet]. São Paulo: Secretaria dos Direitos da Pessoa com Deficiência; 2003 [citado em 2018 Jun 3]. Disponível em: http://apps.who.int/iris/bitstream/10665/44575/4/9788564047020_por.pdf [ Links ]
2 WHO: World Health Organization. Prevention of blindness and deafness: estimates [Internet]. Genebra: WHO; 2018 [citado em 2018 Jun 3]. Disponível em: http://www.who.int/pbd/deafness/estimates/en/ [ Links ]
3 Lewis DR, Marone SAM, Mendes BCA, Cruz OLM, Nóbrega M. Comitê multiprofissional em saúde auditiva: COMUSA. Rev Bras Otorrinolaringol (Engl Ed). 2010;76(1):121-8. http://dx.doi.org/10.1590/S1808-86942010000100020. [ Links ]
4 Ghogomu N, Umansky A, Lieu JE. Epidemiology of unilateral sensorineural hearing loss with universal newborn hearing screening. Laryngoscope. 2014;124(1):295-300. http://dx.doi.org/10.1002/lary.24059. PMid:23553416. [ Links ]
5 Lieu JE. Speech-language and educational consequences of unilateral hearing loss in children. Arch Otolaryngol Head Neck Surg. 2004;130(5):524-30. http://dx.doi.org/10.1001/archotol.130.5.524. PMid:15148171. [ Links ]
6 Almeida GVM, Ribas A, Ataíde AL. Reabilitação de perdas auditivas unilaterais por próteses auditivas implantáveis: revisão sistemática. Audiol Commun Res. 2017;22(0):e1847. http://dx.doi.org/10.1590/2317-6431-2017-1847. [ Links ]
7 Mondelli MFCG, Hoshii LA, Garcia TM, Jacob RTS. Perda auditiva unilateral: adaptação CROS. Rev Bras Otorrinolaringol (Engl Ed). 2013;79(4):523-523. http://dx.doi.org/10.5935/1808-8694.20130093. PMid:23929157. [ Links ]
8 Zeitler DM, Sladen DP, DeJong MD, Torres JH, Dorman MF, Carlson ML. Cochlear implantation for single-sided deafness in children and adolescents. Int J Pediatr Otorhinolaryngol. 2019;118:128-33. http://dx.doi.org/10.1016/j.ijporl.2018.12.037. PMid:30623849. [ Links ]
9 Cadieux JH, Firszt JB, Reeder RM. Cochlear implantation in nontraditional candidates: preliminary results in adolescents with asymmetric hearing loss. Otol Neurotol. 2013;34(3):408-15. http://dx.doi.org/10.1097/MAO.0b013e31827850b8. PMid:23222962. [ Links ]
10 Ross DS, Visser SN, Holstrum WJ, Qin T, Kenneson A. Highly variable population-based prevalence rates of unilateral hearing loss after the application of common case definitions. Ear Hear. 2010;31(1):126-33. http://dx.doi.org/10.1097/AUD.0b013e3181bb69db. PMid:19816180. [ Links ]
11 Haffey T, Fowler N, Anne S. Evaluation of unilateral sensorineural hearing loss in the pediatric patient. Int J Pediatr Otorhinolaryngol. 2013;77(6):955-8. http://dx.doi.org/10.1016/j.ijporl.2013.03.015. PMid:23582232. [ Links ]
12 Mafong DD, Shin EJ, Lalwani AK. Use of laboratory evaluation and radiologic imaging in the diagnostic evaluation of children with sensorineural hearing loss. Laryngoscope. 2002;112(1):1-7. http://dx.doi.org/10.1097/00005537-200201000-00001. PMid:11802030. [ Links ]
13 Nakano A, Arimoto Y, Matsunaga T. Cochlear nerve deficiency and associated clinical features in patients with bilateral and unilateral hearing loss. Otol Neurotol. 2013;34(3):554-8. http://dx.doi.org/10.1097/MAO.0b013e3182804b31. PMid:23449441. [ Links ]
14 Clemmens CS, Guidi J, Caroff A, Cohn SJ, Brant JA, Laury AM, et al. Unilateral cochlear nerve deficiency in children. Otolaryngol Head Neck Surg. 2013;149(2):318-25. http://dx.doi.org/10.1177/0194599813487681. PMid:23678279. [ Links ]
15 Wellman MB, Sommer DD, McKenna J. Sensorineural hearing loss in postmeningitic children. Otol Neurotol. 2013;24(6):907-12. http://dx.doi.org/10.1097/00129492-200311000-00015. PMid:14600473. [ Links ]
16 Brasil. Lei nº 8.069, de 13 de julho de 1990. Dispõe sobre o Estatuto da Criança e do Adolescente e dá outras providências [Internet]. Diário Oficial da União; Brasília; 1990 [citado em 2018 Jun 3]. Disponível em: http://www.planalto.gov.br/Ccivil_03/leis/L8069.htm [ Links ]
17 WHO: World Health Organization. Grades of hearing impairment. Genebra: WHO; 2014 [citado em 2019 Mar 15]. Disponível em: http://www.who.int/pbd/deafness/hearing_impairment_grades/en/ [ Links ]
18 Conselho Federal de Fonoaudiologia. Sistema de Conselhos Federal e Regionais de Fonoaudiologia. Guia de orientações na avaliação audiológica básica. Brasília: CFFA; 2017 [citado em 2019 Mar 15]. Disponível em: http://www.crefono4.org.br/cms/files/Anexos/manualdeaudiologia.pdf [ Links ]
19 Graciano MIG. Instrumental de classificação sócio econômica. Serv Social Realid. 1999;5(1):109-28. [ Links ]
20 Vieira MR, Nishihata R, Chiari BM, Pereira LD. Perception of limitations on communicative activities, temporal resolution and figure-to-ground in unilateral hearing. Rev Soc Bras Fonoaudiol. 2011;16(4):445-53. http://dx.doi.org/10.1590/S1516-80342011000400014. [ Links ]
21 Bess FH, Dodd-Murphy J, Parker RA. Children with minimal sensorineural hearing loss: prevalence, educational performance, and functional status. Ear Hear. 1998;19(5):339-54. http://dx.doi.org/10.1097/00003446-199810000-00001. PMid:9796643. [ Links ]
22 José MR, Campos PD, Mondelli MFCG. Perda auditiva unilateral: benefício e satisfação com o uso do AASI. Rev Bras Otorrinolaringol (Engl Ed). 2011;77(2):221-8. http://dx.doi.org/10.1590/S1808-86942011000200012. PMid:21537624. [ Links ]
23 Jardim DS, Maciel FJ, Lemos SMA. Disabling hearing loss: analysis of associated factors. Audiol Commun. 2017;22(1):1765. http://dx.doi.org/10.1590/2317-6431-2016-1765. [ Links ]
24 Feder KP, Michaud D, McNamee J, Fitzpatrick E, Ramage-Morin P, Beauregard Y. Prevalence of hearing loss among a representative sample of Canadian Children and Adolescents, 3 to 19 years of age. Ear Hear. 2017;38(1):7-20. http://dx.doi.org/10.1097/AUD.0000000000000345. PMid:27556530. [ Links ]
25 Piatto VB, Oliveira CA, Alexandrino F, Pimpinati CJ, Sartorato EL. Perspectivas para triagem da deficiência auditiva genética: rastreamento da mutação 35delG em neonatos. J Pediatr. 2005;81(2):139-42. http://dx.doi.org/10.1590/S0021-75572005000300009. [ Links ]
26 Silva LP, Queiros F, Lima I. Etiology of hearing impairment in children and adolescents of a reference center APADA in the city of Salvador, state of Bahia. Rev Bras Otorrinolaringol (Engl Ed). 2006;72(1):33-6. http://dx.doi.org/10.1016/S1808-8694(15)30031-8. PMid:16917550. [ Links ]
27 Andrade CLT, Szwarcwald CL, Gama SGN, Leal MC. Socioeconomic inequalities and low birth weight and perinatal mortality in Rio de Janeiro, Brazil. Cad Saude Publica. 2004;20(1, Suppl 1):44-51. http://dx.doi.org/10.1590/S0102-311X2004000700005. PMid:16636734. [ Links ]
Submetido em:
15/11/2018
Aceito em:
19/05/2019
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email