Avaliação audiométrica nas diferentes apresentações clínicas da Otite média

Avaliação audiométrica nas diferentes apresentações clínicas da Otite média

Author Araujo, Ana Luiza Papi Kasemodel De Autor UNIFESP Google Scholar
Advisor Penido, Norma De Oliveira Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Graduate program Medicina (Otorrinolaringologia)
Abstract Intruduction: Otitis media consists in a spectrum of correlated diseases: acute otitis media, otitis media with effusion and chronic otitis media (non-suppurative, noncholesteatomatous suppurative and cholesteatomatous). Hearing loss is the most frequent sequel of otitis media. However, there is no previous study comparing the audiometric thresholds among the different forms of otitis media. Objectives: To assess the hearing thresholds in otitis media patients and to compare the hearing outcomes with non-diseased ears (in bilateral cases) or contralateral healthy ears (in unilateral cases). Methods: Cross sectional, controlled study. We performed conventional audiometry (5008000 Hz) and tympanometry in patients with otitis media. Hearing loss was considered when the hearing thresholds were > 25 dBHL. Results: Of the 112 patients diagnosed with otitis media (151 ears), 48 were men (42,86%) and 64 were women (57,14%). The average age was 42,72 years. Of those, 25 (22,32%) were diagnosed as AOM, 15 (13,39%) were diagnosed with OME and the remaining 72 (63.28%) were diagnosed with COM (non-suppurative COM, n=31; suppurative COM, n=18; cholesteatomatous COM, n=23). As compared with controls, all forms of otitis media had significantly higher boneconduction thresholds (500-4000 Hz). Conductive hearing loss was the most frequent type of hearing loss (58,94%). However, the number of patients with mixed hearing loss was also relevant (39,07%). We noted that the presence of sensorioneural component occurred more frequently in: 1) higher frequencies; and 2) in groups of otitis media that were more active or severe in the inflammatory/infective standpoint (AOM, suppurative COM and cholesteatomatous COM). Conclusion: All types of otitis media, even those with infrequent episodes of inflammation and otorrhea, had worse bone conduction thresholds as compared with nondiseased ears (p<0,01). We observed worse hearing outcomes in ears with recurrent episodes of otorrhea and in ears with AOM, especially in high frequencies.

Introdução: A otite média compreende um espectro de doenças correlatas: otite média aguda (OMA), otite média com efusão (OME) e otite média crônica (OMC) (não supurativa, supurativa não colesteatomatosa e colesteatomatosa). A perda auditiva corresponde a sequela mais comum das otites médias. Não há na literatura nenhum estudo comparativo dos limiares auditivos nas diferentes formas de otite média entre si. Objetivo: Avaliar os limiares auditivos de pacientes com otite média e comparar com orelhas de indivíduos audiologicamente normais (no caso de doença bilateral) ou orelhas contralaterais saudáveis (no caso de doença unilateral). Métodos: Estudo clínico transversal controlado. Realizamos audiometrias convencionais (250-8000 Hz) e imitânciometria nos pacientes com otite média. Consideramos perda auditiva limiares > 25 dBNA. Resultados: Dos 112 pacientes com diagnóstico de otite média (151 orelhas), 48 (42,86%) eram homens e 64 (57,14%) eram mulheres. A média de idade encontrada foi 42,72 anos. Destes pacientes, 25 (22,32%) foram diagnosticados com OMA e 15 (13,39%) com OME, enquanto os outros 72 (63.28%) foram diagnosticados com OMC (não supurativa, n=31; supurativa, n=18; colesteatomatosa, n=23). Em comparação com controles, todos os grupos de otite média apresentaram aumento significativo dos limiares medidos por via óssea (500-4000 Hz). O tipo de perda auditiva mais comumente observado foi a condutiva (58,94%). Porém, houve também número relevante de pacientes com perda auditiva mista (39,07%). Considerando os limiares medidos por via óssea, observamos que o componente neurossensorial acometeu principalmente: 1) frequências agudas, e 2) grupos com processo infeccioso/inflamatório de orelha mais ativo ou severo (OMA e OMC supurativa e colesteatomatosa). Conclusão: Todas as otites médias cursam com piores limiares ósseos quando comparados com orelhas otologicamente normais (p<0,01). Nota-se piores resultados auditivos naquelas orelhas com episódios recorrentes de otorreia e nos pacientes com OMA, especialmente nas frequências agudas.
Keywords Average Otitis
Hearing Loss
Neurosensory
Hearing Loss
Buzz
Audiometry
Otite Média
Perda Auditiva
Perda Auditiva Neurossensorial
Zumbido
Audiometria
Language Portuguese
Date 2019-04-25
Publisher Universidade Federal de São Paulo (UNIFESP)
Extent 87 p.
Origin https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7728860
Access rights Closed access
Type Dissertation
URI https://repositorio.unifesp.br/handle/11600/59614

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