Audiometric thresholds and auditory processing in children with early malnutrition: a retrospective cohort study

Abstract

CONTEXT AND OBJECTIVE: Malnutrition is one of the causes of changes in cell metabolism. The inner ear has few energy reserves and high metabolism. The aim of this study was to analyze whether malnutrition at an early age is related to impairment of auditory processing abilities and hearing abnormalities. DESIGN AND SETTING: Retrospective cohort study conducted in a tertiary public hospital. METHODS: 45 children participated, divided as follows: G1, children diagnosed with malnutrition in their first two years of life; G2, children without history of malnutrition but with learning difficulties; G3, children without history of malnutrition and without learning difficulties. Tympanometry, pure-tone audiometry and the Staggered Spondaic Word (SSW) test (auditory processing) were performed. Statistical inferences were made using the Kruskal-Wallis test (α = 5%) and the test of equality of proportions between two samples (α = 1.7%). RESULTS: None of the 45 children participating in this study presented hearing deficiencies. However, at six of the eight frequencies analyzed, the children in G1 presented hearing thresholds lower than those of the other groups. In the auditory processing evaluation test, it was observed that 100% of the children in G1 presented abnormal auditory processing and that G1 and G2 had similar proportions of abnormalities (P-values: G1/G2 = 0.1; G1/G3 > 0.001; G2/G3 = 0.008). CONCLUSIONS: Malnutrition at an early age caused lowering of the hearing levels, although this impairment could not be considered to be a hearing deficiency. Every child in this group presented abnormalities in auditory processing abilities. RESUMO CONTEXTO E OBJETIVO:A subnutrição é uma das causas das alterações no metabolismo celular. A orelha interna possui poucas reservas energéticas e alto metabolismo. O objetivo deste estudo foi de analisar se a subnutrição em idade precoce está relacionada a prejuízos em habilidades do processamento auditivo e a alterações auditivas. TIPO DE ESTUDO E LOCAL: Estudo de coorte retrospectivo conduzido em hospital público terciário. MÉTODOS: Participaram 45 crianças divididas em: G1, crianças que tiveram o diagnóstico de subnutrição nos dois primeiros anos de vida; G2, crianças sem histórico de subnutrição, mas com dificuldades de aprendizagem; G3, crianças sem histórico de subnutrição e sem dificuldades escolares. Realizou-se a timpanometria, audiometria tonal limiar e o teste de SSW [Staggered Spondaic Word] (processamento auditivo). Para a inferência estatística, usou-se o Kruskal-Wallis (α = 5%) e o teste igualdade de proporções entre duas amostras (α = 1,7%). RESULTADOS: Nenhuma das 45 crianças participantes neste estudo apresentou deficiência auditiva, porém em seis das oito frequências avaliadas, as crianças do G1 apresentaram limiares auditivos rebaixados quando comparadas às de outros grupos. No teste que avaliou o processamento auditivo, constatou-se que 100% das crianças do G1 possuem alteração do processamento auditivo, e que G1 e G2 possuem proporção semelhante de pr...

Relationship between child development and nutritional status of under-five Nigerian children

“…The effect of malnutrition on hearing and language, as observed in this study, has also been observed in other studies. [20][21][22] Previous studies [20][21][22] have shown that malnutrition causes delay in maturation of the auditory pathway and also affects both central and peripheral hearing. Nutritional deficiencies, even in acute form, impair the normal functioning of the middle ear, with negative consequences for the entire auditory system.…”

Early undernutrition as a cause of changes in phonological processing skills

“…As a consequence, there is a delayed maturation of the auditory pathways represented by an increased latency of I and V waves in the brain stem auditory potential 39,40 . Alterations have also been detected in children with a history of undernutrition during evaluation of the auditory pathways (central auditory processing tests) 11 .…”

“…Several studies have pointed out that undernutrition, when present during critical growth and brain development periods, severely affects cognition since the brain does not receive the nutrients necessary for its development. The adverse effects of macro-and micronutrient deficiency during childhood may not be fully reversible even after nutritional rehabilitation and continue to affect the various cognitive functions during school years and the quality of life during adulthood [3][4][5][6][7][8][9][10][11][12][13][14] .…”

Processamento auditivo central e desnutrição infantil: revisão sistemática / Central auditory processing and child undernutrition: a systematic review

“…11 Quando presente nos dois primeiros anos de vida, ocasiona alterações principalmente no cerebelo, hipotálamo e hipocampo, [12][13][14] sendo a gravidade das alterações proporcional à intensidade e à duração da deficiência nutricional. 15,16 Cabe salientar que a desnutrição, apesar da tendência de redução nas últimas décadas, ainda acomete 6% dos sujeitos menores de cinco anos, dos quais a grande parcela é pertencente a famílias com baixo nível socioeconômico. 17 A literatura aponta algumas hipóteses de interrelações entre a desnutrição e as alterações nas habilidades do PAC.…”