Long-term Effects of Unilateral and Bilateral Otitis Media and Myringotomy on Long-Latency Verbal and Non-Verbal Auditory-Evoked Potentials

Abstract

Introduction Otitis media (OM) is considered one of the most common reasons patients seek medical care in childhood. The fluctuating nature of hearing loss in cases of OM leads to irregular sound stimulation of the central auditory nervous system. Objectives To analyze the long-latency auditory-evoked potential (LLAEP) by verbal and nonverbal sounds in children with a history of OM in the first six years of life. Methods A total of 106 schoolchildren participated in the study, 55 females and 51 males, aged between 8 and 16 years, who were divided into 3 groups: the control group (CG), the bilateral experimental group (BEG), and the unilateral experimental group (UEG). All children underwent a complete audiological evaluation (audiometry, logoaudiometry and immitance testing) and an electrophysiological evaluation (LLAEP with toneburst stimulus – LLAEP-TB, and LLAEP with speech stimulus – LLAEP-S). Results Both study groups (BEG and UEG) presented a statistically lower performance (p < 0.005) when compared with the CG regarding all of the electrophysiological tests with the prolongation of the latency values and decrease in the amplitude values: LLAEP-TB (BEG: latency - N1, P2, N2 [females] and P300, amplitude - N1 and P2), LLAEP-S (BEG: latency - P2 and N2 [females], amplitude - P2 /UEG: latency - P2 and P300, amplitude: N1 and P2). Conclusion Children who had suffered secretory OM in the first six years of life and who had undergone myringotomy for the placement of a ventilation tube, either unilaterally or bilaterally, presented worse performance in their electrophysiological responses to verbal and nonverbal LLAEPs.

Achados audiológicos na síndrome de Rubinstein-Taybi: revisão sistemática

“…Dentre os estudos selecionados, nenhum realizou o registro das emissões otoacústicas evocadas e avaliações das habilidades auditivas centrais através dos potenciais evocados auditivos de média e longa latência ou por meio da avaliação comportamental do processamento auditivo. Sabe-se que uma avaliação audiológicas ampla propicia a quantificação e a qualificação dos vários mecanismos no sistema nervoso auditivo central (SNAC) envolvidos nas habilidades auditivas [21]. Em alguns casos, pode-se observar crianças com dificuldades de compreensão e com uma audição periférica dentro dos padrões de normalidade, mas com testes comportamentais e eletrofisiológicos demonstrando alterações no sistema auditivo central [22].…”

“…Assim, é fundamental que as crianças estejam expostas a ambientes de linguagem oral desde o nascimento, para que ocorra o desenvolvimento adequado das funções do sistema auditivo [29]. Sabe-se que sujeitos que apresentam otites de repetição podem apresentar alterações no sistema auditivo nervoso central [21,30].…”

Otoacoustic Emissions in Children with Long-Term Middle Ear Disease

“…Another possibility is that lateral asymmetry in the efferent system may be related to the well-known cortical asymmetries that are believed to underline speech perception, speech production, and other hearing abilities [ 50 ]. It is already known that episodes of OME in early infancy can have a negative impact on learning and communication [ 51 , 52 , 53 , 54 , 55 ].…”

“…In addition, the auditory deprivation caused by OME during critical periods in a child’s central auditory nervous system development can lead to auditory processing disorder. If auditory messages become distorted, there can be failures in the coding and organization of auditory processing [ 35 , 38 , 40 , 51 , 52 , 53 , 54 , 55 ].…”

Electrophysiology and Auditory Training

“…One auditory evoked potential that seems to be more sensitive to deprivation from OM effects is the P300 cognitive potential [39]. The use of verbal stimuli when recording long latency auditory evoked potentials also seems to be very effective, providing additional information about auditory information processing [40].…”