<strong style="text-align: justify;"><span style="font-size: 10pt; font-family: 'Times New Roman', serif;">Introdução</span></strong><span style="text-align: justify; font-size: 10pt; font-family: 'Times New Roman', serif;">: Após a implantação do Programa Nacional de Atenção à Saúde Auditiva (PNASA), em 2004, houve incontestáveis avanços na assistência ao deficiente auditivo. Porém, existem divergências na execução desse programa que dificultam o seu progresso e limitam o acesso à Saúde Auditiva. Tais evidências ilustram a necessidade da criação de uma rotina para avaliá-lo a fim de reorientar e monitorar as práticas dos atores envolvidos. <strong>Objetivo:</strong> Analisar os progressos e entraves da Política de Saúde Auditiva do país na atual conjuntura brasileira. <strong>Metodologia</strong>: Trata-se de um estudo exploratório com abordagem quantitativa realizado no período de junho a agosto de 2013, através da análise de dados secundários (SAI/SUS e CNES). <strong>Conclusão</strong>: Observou-se que a implantação do PNASA não é uniforme no país. A disparidade está evidenciada na cobertura nacional e distribuição local desse serviço, o que denota um imenso contingente de deficientes auditivos não contemplados com a assistência à Saúde Auditiva, ferindo os princípios de integralidade e universalidade do SUS.</span>

Endocochlear, retrocochlear and/or central origin hearing damage may be related to the absence of appropriate levels of thyroid hormone during morphogenesis and/or auditory system development. Hearing disorders related to the thyroid are not well studied, despite speculation on the pathophysiological mechanisms. The objective of this review was to characterize the main pathophysiological mechanisms of congenital hypothyroidism and to evaluate the relationship with central and peripheral hearing disorders. We conducted a literature review using the databases MedLine, LILACS, Cochrane Library, SciELO, Institute for Scientific Information (ISI), Embase, and Science Direct between July and September on 2016. We identified the studies that address hearing disorder mechanisms on the congenital hypothyroidism. Congenital hypothyroidism may have clinical and subclinical manifestations that affect the auditory system and may be a potential risk factor for hearing impairment. Hearing impairment can severely impact quality-of-life, which emphasizes the importance of monitoring and evaluating hearing during the clinical routine of these patients. Arch Endocrinol Metab. 2017;61(5):501-5

Aim To evaluate the hearing of children with congenital hypothyroidism (CH) and to analyze the knowledge that parents’ have on the possible auditory impacts of the disease. Methods A total of 263 parents/guardians were interviewed about aspects of CH and hearing. Audiological evaluation was performed on 80 participants, divided into two groups: with CH (n= 50) and without CH (n=30). Clinical and laboratory CH data were obtained from medical records, pure tone auditory thresholds and acoustic reflexes were analyzed. The auditory data was compared between groups. Student’s t-test and Chi-square were used for statistical analysis at a significance level of 5% (p ≤0.05). Results The majority (78%), of the parents were unaware that CH when not treated early is a potential risk to hearing. There was no correlation between socioeconomic class and level of information about CH and hearing (p>0,05; p=0.026). There was a statistically significant difference between the auditory tone thresholds of the groups and between the levels of intensity necessary for the triggering of the acoustic reflex. The group with CH presented the worst results (p≤0.05) and absence of acoustic reflex in a normal tympanometric condition. Conclusions Children with CH are more likely to develop damage to the auditory system involving retrocochlear structures when compared to healthy children, and that the disease may have been a risk factor for functional deficits without deteriorating hearing sensitivity. The possible impacts of CH on hearing, when not treated early, should be more publicized among the parents/guardians of this population.

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RESUMO Objetivo Analisar os gastos públicos em saúde destinados aos serviços ambulatoriais em Fonoaudiologia nas cinco Regiões Federativas do Brasil. Métodos Trata-se de um estudo ecológico realizado por meio da busca de dados secundários disponíveis em uma plataforma virtual de domínio público, DATASUS (Departamento de Informática do Sistema Único de Saúde). Os dados coletados referiram-se aos valores aprovados para os procedimentos da Fonoaudiologia no período de 2009 a 2018 nas cinco Regiões Federativas. Adotou-se análise descritiva dos dados e exposição dos resultados em valores absolutos, relativos e taxas de crescimento. Resultados Verificou-se que o investimento médio em reais (R$), por ano, nos serviços de Fonoaudiologia no Brasil foi de, aproximadamente, R$ 223.952.639.232,00; sendo 47,2% dos recursos destinados à Região Sudeste. Dentre as grandes áreas de especialização, a Audiologia foi responsável por 95,4% do investimento, seguida pelas áreas da Linguagem (4,0%), Motricidade Orofacial (0,5%) e Voz (0,1%). Conclusão Os serviços fonoaudiológicos demandam considerável parcela dos recursos públicos, sendo a área da Audiologia responsável por quase metade desses gastos, seguida pelas grandes áreas da Linguagem, Motricidade Orofacial e Voz.

The data obtained show a high frequency of lag symptoms in cognitive functions related to central auditory processing, particularly with regard to auditory attention, figure-background ability and auditory memory in patients with congenital hypothyroidism.

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Congenital hypothyroidism (CH) is an endocrine disease commonly found in newborns and is related to the absence or reduction of thyroid hormones (THs), which are essential for development since intrauterine life. Children with CH can develop hearing problems as THs are crucial for the auditory pathway’s development and maturation. Sensory deprivations, especially in hearing disorders at early ages of development, can impair language skills, literacy, and behavioral, cognitive, social, and psychosocial development. In this review we describe clinical and molecular aspects linking CH and hearing loss.