Medida da condução óssea em sujeitos ouvintes normais: radiação acústica e posicionamento do vibrador ósseo

Detalhes bibliográficos
Ano de defesa: 2008
Autor(a) principal: Cili, Tatiana Fernandes lattes
Orientador(a): Santos, Teresa Maria Momensohn dos
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Pontifícia Universidade Católica de São Paulo
Programa de Pós-Graduação: Programa de Estudos Pós-Graduados em Fonoaudiologia
Departamento: Fonoaudiologia
País: BR
Palavras-chave em Português:
Palavras-chave em Inglês:
Área do conhecimento CNPq:
Link de acesso: https://tede2.pucsp.br/handle/handle/12194
Resumo: Clinical audiology literature and practice raise questions about bone conduction assessment results. The most common questions are related to the reliability of bone conduction thresholds as they suffer a lot of artifacts that may mislead the results obtained. Silman & Silverman (1997) describe two important factors that could interfere in such measurement: acoustic radiation (escaping acoustic energy that can be heard by air conduction, mainly in the high frequencies) and bone vibrator positioning in the mastoid. In order to obtain bone conduction thresholds in 2 kHz, or at higher frequencies, researchers suggest the insertion of earplugs in either the tested ear or in both ears to prevent acoustic radiation. In order to increase reliability on bone conduction evaluation researchers suggest that the patient must position the bone vibrator at the point on mastoid that he has the biggest sensation of sound stimuli. Objectives: 1. to investigate the bone vibrator s positioning influence in bone conduction thresholds evaluation for 500, 1k, 2k, 3k, and 4 kHz in normal hearing subjects. 2. to investigate the influence of insert earplugs on bone conduction thresholds measurement for 2000, 3000 and 4000 Hz in normal hearing subjects. Specific Objectives: 1- to determine the bone conduction sensitivity due to the influence of the bone vibrator s positioning in the mastoid to obtain bone conduction thresholds at 500, 1k, 2k, 3k, and 4 kHz in normal hearing subjects. 2 - to determine bone conduction threshold with and without insert earplug in order to investigate the presence of the acoustic radiation phenomenon during the bone conduction assessment at 2k, 3k, and 4 kHz in normal hearing subjects. Methods: Thirty six ears from 18 subjects were examined. Both ears were tested for air and bone conduction in a sound booth. The RADIOEAR B71 bone vibrator was used to assess bone conduction at 500, 1k, 2k, 3k, and 4 kHz. Two audiometers were used: Interacoustics AC40 and Betamedical Beta 6000. To evaluate the effect of the bone vibrator positioning, bone conduction thresholds were obtained using narrow band noise, at the opposite ear, at 30 dB HL in 1 dB steps (Ritcher; Brinkman; 1981); and to assess the effects of the acoustic radiation the examiner positioned the bone vibrator and inserted a foam earplug in the tested ear (Robinson; Shipton; 1982). Results: Bone vibrator s positioning influence was present in bone conduction thresholds evaluation at 500, 1000 e 3000 Hz, in more than 20% of the cases. This study proved that, when assessing bone conduction, the acoustic radiation phenomenon was present at 2k, 3k, and 4 kHz in 70% of the cases, mainly at 3 kHz. Conclusion: The acoustic radiation phenomenon was present mainly at 3 kHz, besides being present at 2k and 4 kHz. This could lead to an inaccurate interpretation of test results, which depend on reliable air and bone conduction values