vi iberoamerican congress on cochlear implants

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Organizing Committee Ricardo Ferreira Bento Chairman VI GICCA – May 20–23, 2015 OTORHINOLARYNGOLOGY Ocial Publication of the Otorhinolaryngology Foundation and Societas Oto-Rhino-Laryngologia Latina INTERNATIONAL ARCHIVES OF Editor-in-Chief Geraldo Pereira Jotz Co-Editor Aline Gomes Bittencourt

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Official Program Abstracts - GICCA 2015 (Iberoamerican Group of Cochlear Implants and Related Sciences)

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Page 1: VI Iberoamerican Congress on Cochlear Implants

Organizing CommitteeRicardo Ferreira BentoChairman

VI GICCA – May 20–23, 2015

OTORHINOLARYNGOLOGYOffi cial Publication of the Otorhinolaryngology Foundation and Societas Oto-Rhino-Laryngologia Latina

INTERNATIONAL ARCHIVES OF

Editor-in-ChiefGeraldo Pereira Jotz

Co-EditorAline Gomes Bittencourt

Page 2: VI Iberoamerican Congress on Cochlear Implants

For author instructions and further information about publishing in IAO,visit www.thieme.com/iao

http://mc.manuscriptcentral.com/iaorl

We look forward to receiving your submissions. Manuscripts must be submitted electronically

Why publish in IAO?• Rigorous peer-review by leading specialists• Over 17 years of Open Access publishing experience• Rapid online publication - eFirst• Web-based manuscript submission• Scienti�c Merit Journal Prize*

Now inPubMed

IAO ManuscriptSubmission Ad.indd 1 24.10.2013 13:11:03

IAO is an international peer-reviewed journal focusing on disorders of the ear, nose, mouth, pharynx, larynx, cervical region, upper airway system, audiology and communication disorders. Published quarterly, the journal covers the entire spectrum of otorhinolaryngology – from prevention, to diagnosis, treatment and rehabilitation.

• Indexations: PubMed and PubMed Central® (PMC), LILACS and LILACS-Express, Latindex, DOAJ, SciELO, SciVerse (Scopus).

*Scienti�c Merit Journal Prize. The IAORL Scienti�c Merit Journal Prize is awarded every year for up to three best systematic review (meta-analysis) papers published each year in the journal. The 2015 manuscript awards will be selected from articles published in issues 1-4 of volume 19, based on novelty, impact, data quality, and number of online downloads by the journal readers.The adjudication committee consists of the editorial board, assisted by comments received through the peer review process. The judgment of the papers will be published after issue number 4 of volume 19. The result will be communicated to the winners and o�cially published in volume 20 of IAORL.All authors and co-authors will receive certi�cates of award and the � rst author of each of the three selected manuscripts will receive $1,000 (USD).

CALL FOR PAPERSYou are cordially invited to submit the full articles presented at GICCA free of cost to the International Archives of Otorhinolaryngology.

Page 3: VI Iberoamerican Congress on Cochlear Implants

International Archives of Otorhinolaryngology

Organizing Committee Chairman

Ricardo Ferreira Bento

General Secretary

Anna Carolina Fonseca

Scientifi c Committee

Ana Tereza Magalhães

Danielle Penna Lima

Isabela Jardim

Jeanne Oiticica

Robinson Koji Tsuji

Rodolpho Penna Lima

Rubens de Brito

Valéria Goffi -Gomez

Local Scientifi c Board

Adriane Mortari

Alonso Alves Filho

Ana Maria Alvarez

André L. L. Sampaio

Arthur Menino Castilho

Beatriz Novaes

Cintia Yamaguchi

Cláudio Ikino

Danielle Penna Lima

Deborah Ferrari

Deodato Diógenes

Edigar Rezende de Almeida

Edilene Boéchat

Edson Bastos

Flavio Carvalho Santos

Gerissa Neiva

Gislaine Wiemes

Irene Marchesan

Jeanne Oiticica

Luiz Rodolpho Penna Lima Jr.

Mara Gandara

Marcelo Miguel Hueb

Marcelo Tepedino

Marco Aurélio Bottino

Marcos Alexandre F. Pereira

Maria Cecilia Martinelli Iorio

Maria Elza Dorfmann

Maria Isabel Kós

Miguel Angelo Hyppolito

Orozimbo Costa

Oswaldo Laércio M. Cruz

Paulo Roberto Lazarini

Pedro Mangabeira Albernaz

Regina Célia Mingroni Netto

Roberto Miquelino de O. Beck

Rogério Hamerschmidt

Roseli Saraiva Moreira Bittar

International Archives of OtorhinolaryngologyEditor

Geraldo Pereira Jotz

Co-Editor

Aline Gomes Bittencourt

GICCA - Iberoamerican Group of Cochlear Implants and Related SciencesFounding Members

Ricardo Ferreiro Bento (Brazil)

Juan Caballero (El Salvador)

Carlos Cenjor (España)

Julián Chaverri (Costa Rica)

Leopoldo Cordero (Argentina)

Carlos Curet (Argentina)

Jaime Marco (España)

Antonio Paz Cordobés (Cuba)

Ángel Ramos (España)

Carlos Ribeiro (Portugal)

José Antonio Rivas (Colombia)

Sergio Sahuenza (Chile)

Fernando Augusto Silva (Ecuador)

Antonio Soda Merhy (Mexico)

Board of GICCA

PresidentAntonio Soda Merhy

Vice PresidentRicardo Ferreira Bento

General SecretaryÁngel Ramos

TreasurerJuan Armando Chiossone

Page 4: VI Iberoamerican Congress on Cochlear Implants

International Archives of Otorhinolaryngology

VI GICCA – May 20–23, 2015

Thieme Publicações Ltda

Oral PresentationsS1 Date: May 20 & 22, 2015 Room: Sala Coral May 20, 2015 9am to 12:30pm / 2pm to 6:30pm May 22, 2015 8am to 12:30pm / 2pm to 6:30pm

E-PostersS26 Date: May 20 to May 23, 2015 Room: Exhibition Area Time: 8am to 6pm

S-iii Author Index

The content and the text of all published abstracts are of entire responsibility of the authors and have not suffered journal corrections.

CAPES PAEP 1474/2015-31 Picture: Assessoria de Comunicação da FMUSP.

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Oral Presentations

TL001. Genetic, Molecular And Clinical Study Of A LargeBrazilian Pedigree From Sergipe Presenting Deafness[Audiology]Silva J. S., Santos Junior R. C., Taguchi C., Alves L. U., Netto R. C.M., Hemza C. R. d. M. L., Grasel S. S., Bento R. F., Oiticica J.,Lezirovitz K.Universidade de São Paulo - São Paulo - Brazil

Date:May 20, 2015 Time: 9am to 9:10am Room: SalaCoral.

Introduction: Nonsyndromic deafness represents70% of all cases. To date, 131 loci responsible for this form ofdeafness have been mapped and 90 genes identified.

Objective: Characterize the genetic causes of deafnesssegregating in a Brazilian pedigree from Sergipe.

Methods and Results: Audiological evalutationthrough tonal audiometry, otoacustic emissions and BERA,and pedigree drawing to unravel different forms of deafnessand its inheritance pattern. Mutational search through ge-nome scan using SNP molecular markers and Next generationExome Sequencing. DNA samples were collected from 73individuals from a highly inbred Family from Sergipe. Amongthem, 33 were deaf or hard of hearing. Common causes ofgenetic deafness (35delG in Connexin 26 gene, GJB6 deletionsandA1555Gmitochondrialmutation)were ruled out in all butone individual with prelingual sensorineural deafness whopresented the 35delG mutation in homozygosis. Besides twoaffected subjects have clinical signs of MucopolysaccharidosisIV syndrome. From the remaining 30 subjects: one has lateonset postlingual deafness and was considered a phenocopy;one has mixed and two conductive hearing loss; 26 haveautosomal dominant nonsyndromic sensorineural deafness(1 prelingual and 25 postlingual) who belong to two differentbranches of the family that could not be traced back to acommon deaf ancestral. Genome scan was conducted and itsresults are currently under evaluation.

Conclusion: Two different genetic causes have alreadybeen identified and at least a third one will be revealed by thegenome scan, which explains deafness in this large family.

Keywords: genetic, deafness.

TL002. Auditory TrainingMusic with Cochlear Implant Users[Audiology]Paiva S. F.Universidade Federal de Sergipe - Sergipe - Brazil

Date: May 20, 2015 Time: 9:10am to 9:20am Room:Sala Coral.

Introduction: The perception of music still a vast fieldof studyand, at the same time, one of thebiggest challenges forthe therapeutic development of cochlear implant users.

Objective: Develop hearing musical training programand describe the perceptual musical process of adults CI usersin tasks of musical appreciation .

Methods and Results: This study is a series case withdescriptive design consisting of two adults with post -lingualhearing loss, cochlear implant, the first male with 68 yearsold and one female, with 47 years. A program of music

appreciation and auditory training with a degree of complex-ity consisting on average of fiveweeklymeetingswith 50 to 60minutes was prepared. Auditory stimulations were made,related phrases with melodic movements, melodic intervals,intensities and duration of musical notes were made. Results:Participant A started its activities being classified as level 1and during the meetings progressed to the point that duringthe fifth meeting was classified as level 4 of musical appre-ciation. Participant B began operations classified as level 2 andthe third meeting notice aspects described as a musical style,musical structures, musical sections and other leading ratingfinalizing its assessment activities between level 6 and 7.

Conclusion:We verified the effectiveness of preparedtraining, as well as the need of knowledge about the percep-tual processes related to musical learning in order to extractgreater possibilities for therapeutic intervention work withcochlear implant users.

Keywords: Training Music, Cochlear Implant, musicappreciation.

TL003. General Considerations Of The Cochlear Implant InChildren With Waardenburg Syndrome Treated At TheCuban National Group [Audiology]Quintana Mirabal S. E., Ceballos Villalón E., Diaz Monterrey M.,Martín García Y., González Sánchez G. A.Hospital pediátrico Marfán - Cuba

Date: May 20, 2015 Time: 9:20am to 9:30am Room:Sala Coral.

Introduction:Waardenburg syndromewas describedby the Dutch physician Petrus Waardenburg in 1948, ischaracterized by severe sensorineural hearing loss to pro-found bilateral, caused by defects in the organ of Corti, andpigmentary disorders eyes, hair and skin.

Objective: This studyaimed todescribe theelectrophys-iological and genetic clinical characteristics imaging in childrenwithWaardenburg syndromeand thebenefits obtainedwith thecochlear implant through aural rehabilitation.

Methods and Results: As material and methods aretrospective study of all implanted subjects was conductedbetween 1998 and 2013 at the National Cochlear ImplantGroup in Cuba. For this studywere selected only childrenwithWaardenburg syndrome (n ¼ 15). Results: It was found inhundred percent of patients, pigmentary changes in iris, hairor skin, which are presented through charts and graphs,highlighting aspects that characterized the group from thedata obtained in the review of medical records by consideringthe clinical findings.

Conclusion: Our study shows that patients withWaardenburg syndrome have benefited from the use of thistechnology, developing listening and expressive and receptivelanguage.

Keywords: Waardenburg, Syndrome, Cochlear,Implant.

TL004. Telefitting of cochlear implant patients incooperation in Poland and other countries [Audiology]Skarzynski P. H., Walkowiak A., Ludwikowski M., Bruski L.,Skarzynski H.Institute of Sensory Organs - Poland, Medical University of Warsaw -Poland,World Hearing Center, Institute of Physiology and Pathology ofHearing - Poland

Copyright © 2015 by Thieme PublicaçõesLtda, Rio de Janeiro, Brazil

DOI http://dx.doi.org/.ISSN .

Oral Presentations S1

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Date: May 20, 2015 Time: 9:30am to 9:40am Room:Sala Coral.

Introduction: The Nationwide Network of Teleaudi-ology has proved to be a reliable platform for telefitting,improving quality of service for the patients and providingsubstantial time and money savings. With proper models ofpostoperative care telemedicine can be amethod to copewithgrowing number of patients in the future, but still allowing forthe need of expert’s knowledge.

Objective: To present the use of National Network ofTeleaudiology for cochlear implant recipients, mainly by themeans of a telefitting method.

Methods and Results: The telefitting method allowsexperienced specialist from the WHC to use Internet connec-tion to fit cochlear implants for patients in cooperatingpoliclinics. Study groups consisted of 208 patients, 114 chil-dren (mean age 7.4 years) and 94 adults (mean age 34,5),remotely fitted according to the telefitting procedure intro-duced in the National Network of Teleaudiology. Patients orpatient’s parents, assessed quality and time effectiveness ofteleconsultation. Travel time and cost savings were alsocomputed. Patients, or patients’ parents, were satisfied withthe course and results of telefitting.

Conclusion: The Nationwide Network of Teleaudiol-ogy has proved to be a reliable platform for telefitting,improving quality of service for the patients and providingsubstantial time and money savings. With proper models ofpostoperative care telemedicine can be amethod to copewithgrowing number of patients in the future, but still allowing forthe need of expert’s knowledge.

Keywords: telefitting, network of teleaudiology, co-chlear implants.

TL005. Benefits assessment of the Naída CI Q70 andUltraZoom strategy for speech recognition in noise[Audiology]Goffi-Gomez M. V. S., Samuel P. A., Agrawal S., RodriguezC. M., Bento R. F.Hospital das Clínicas da Faculdade de Medicina da USP -São Paulo - Brazil

Date: May 20, 2015 Time: 9:40am to 9:50am Room:Sala Coral.

Introduction: The new speech processor Naída CI Q70combines advanced sound processing technology with asophisticated front-end acoustic signal processing like Ultra-Zoom, which purpose is to offer the opportunity of a comfort-able communication in various listening situations, either insilence or noise.

Objective: To evaluate the benefits of the Naída CI Q70and UltraZoom for understanding speech in noise.

Methods and Results: Five adults users of Harmonyfor at least six months were selected. Sentence recognitiontests were done using the recipient’s everyday program in theNaida CI Q70 in quiet, with the same program in the Naida CIQ70 without UltraZoom in noise, and with an UltraZoomprogram in noise. The sentences were presented in speakerat zero azimuth degree, and when the babble noise has beenused, it was presented at 90 ° ipsilateral, with signal ratio atþ5dB. After the tests, the participants gave a score in the scale,about the clarity of sound and difficulty in understandingspeech in test situations. Results: The average sentence recog-nition in quiet was 60% with Naida CI Q70. The averagesentence recognition in noise was 16% with Naida CI Q70without UltraZoom and 42% with UltraZoom. The programwith UltraZoom was the one with greatest clarity and leastdifficulty listening in noise.

Conclusion: The UltraZoom strategy allowed betterperformance in speech perception in noise, compared to themap without UltraZoom.

Keywords: Cochlear implants, speech perception,noise.

TL006. Satisfaction Of Patients With Auditory NeuropathyWith Cochlear Implant [Audiology]Carvalho G. M., Zago T. M., Fernandes F. L., Guimarães A. C.,Castilho A. M.Unicamp - São Paulo - Brazil

Date:May20, 2015 Time: 9:50am to 10amRoom: SalaCoral.

Introduction: The auditory neuropathy is a conditionin which there is a dyssynchrony in the nerve conduction ofthe auditory nerve fibers. Typically, patients with auditoryneuropathy exhibit moderate-to-profound sensorineuralhearing loss and the treatment with cochlear implants orhearing aids should be performed as early as possible to betterhearing rehabilitation.

Objective: To evaluate the satisfaction levels of neu-ropathy spectrum disorder patients treated with cochlearimplants.: The questionnaire SADL (Satisfactionwith Amplifi-cation in Daily Life) was selected to evaluate 10 patients withauditory neuropathy treated with cochclear implant.

Methods and Results: Study Design: Clinical studywith retrospective data analysis, genetic and clinical evalua-tion. Setting: Tertiary referral center. Patients: Clinical infor-mation and genetic evaluation of 10 patients with AuditoryNeuropathy Spectrum Disorder were analyzed. Intervention:Terapeutic. Main Outcome Measures: The mean of the sub-scales positive effects, services and costs, negative factors andpersonsal image were, respectively, 6.15, 4.6, 3.26, 3.33.

Conclusion: Patients with auditory neuropathy as-sessed consider themselves satisfied with the cochlear im-plant intervention, is this pilot study.

Keywords: Auditory neuropathy spectrum disorder;evoked auditory brainstem response; otoacoustic emissions;GJB2, hearing loss.

TL007. The bimodal benefits of cochlear implantation forunilateral deafness [Audiology]Tavora D., Rajan G.University Of Western Australia - Australia

Date:May20, 2015 Time: 10:30am to10:40amRoom:Sala Coral.

Introduction: Patients with unilateral deafness lackthe benefit of binaural hearing. They experience difficulties inunderstanding speech in the presence of background noise, inunderstanding speech that comes from the side of hearingloss, as well as an inability to localize the sound source.

Objective: This study aimed to evaluate the resultsfrom CI on speech understanding in the most challengingscenarios, on self-perceived improvement of hearing, and ontinnitus suppression in patients with unilateral deafness; toinvestigate the localization abilities of unilaterally deaf pa-tients who received CI; to investigate whether duration ofdeafness and age at implantation influence the outcomes.

Methods and Results: Speech perception was as-sessed using the BKB-SIN in three spatial configurations: (1)speech and noise from the front, (2) speech from the front andnoise from the hearing ear, and (3) speech from the CI side andnoise from the hearing ear. Subjective benefits were assessedusing the Speech, Spatial and Qualities of Hearing (SSQ)questionnaire and the APHAB (Abbreviated Profile of Hearing

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Oral PresentationsS2

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Aid Benefit). Localization abilities were also evaluated usingthe A§E®localization setup. Tinnitus was assessed using theTinnitus Reaction Questionnaire (TRQ). Analysis of the resultsreveal a significant improvement in signal to noise ratio in allspatial configurations as well as on the localization abilities,SSQ and APHAB scores. The benefits remain stable in the long-term. The outcomes are not influenced byduration of deafnessor age at implantation.

Conclusion: Cochlear implantation is a viable treat-ment option for unilateral deafness.

Keywords: CI unilateral deafness.

TL008. Cross-Modal-Plasticity before and after CochlearImplants in deaf and deafblind children: study with EvokedPotentials [Audiology]Charroo Ruiz L. E.Centro De Neurociencias De Cuba - Cuba

Date:May20, 2015 Time: 10:40am to10:50amRoom:Sala Coral.

Introduction: Significant neuroplastic changes occuras a result of impairment sensory in deafness/blindness.

Objective: This research focuses on Cross-Modal-Plas-ticity before and after Cochlear Implants through the Evoked-Potentials.

Methods and Results: Maps topography of Visual-Evoked-Potentials, Somatosensory-Evoked-Potentials of me-dian/tibial nerves and Cortical-Auditory-Evoked-Potentialwere obtained. Topographic maps the Somatosensory-Evoked-Potentials (N20) showed expansion. Cortical areas:temporal in deaf and temporal-occipital in deafblind wereactivated. These regions under normal physiological condi-tions processed information auditory and visual but no so-matosensory. The expansion of cortical response N20 wasinterpreted as evidence of Cross-Modal-Plasticity. Also offeredfor thefirst time, evidence of Cross-Modal-Plasticity through astudy post-implantation with Somatosensory-Evoked-Poten-tials, with reduced of the overall cortical response presentedbefore implantation. Cortical-Auditory-Evoked-Potentialshowed changes in relation with implantation age and resultsof the auditory rehabilitation.

Conclusion: These results are pointing neuroplasticchanges that occur as result of the loss input of the sensoryinformation during the critical period of neurodevelopment,as well as, the effect that may have the use of the hands forcommunication in these children, with consequent implica-tions of the Cross-Modal-Plasticity to the optimal use theCochlear Implant after implantation.

Keywords:Deafblind children, Deaf children, CochlearImplants, Cross-Modal-Plasticity, Evoked Potentials.

TL009. Cochlear Implant Technologies for Superior Hearingin Noise [Audiology]Agrawal S., Koch D. B.Advanced Bionics - USA

Date: May 20, 2015 Time: 10:50am to 11am Room:Sala Coral.

Introduction: Cochlear implant (CI) users need effec-tive solutions to hear better in noise.

Objective: To measure benefit provided by threeAdvanced Bionics (AB)/Phonak technologies: 1. T-mic - amicrophone placed at ear-canal level to access head and pinnacues 2. ClearVoice - a sound-processing strategy toreduce stimulation in processing channels with poor SNR 3.UltraZoom - an adaptive multi-channel dual-microphone

beamformer to focus on input from the front and attenuatesounds from the side and back.

Methods and Results: 20 adult AB CII/HiRes 90Kimplant recipients were evaluated using the Naida CI Q70processor. Speech understanding was measured in quiet andin noise in a multi-speaker set-up. Subjective ratings wereobtained to reflect the perceived difficulty of the listeningtasks in the various test conditions. Speech understanding innoise was significantly improved by T-mic and ClearVoice.UltraZoom was exceptionally effective. It allowed listeners toobtain speech scores that were almost as good as their scoresin quiet. Listeners also reported improved ease of listeningwith T-Mic, ClearVoice, and UltraZoom.

Conclusion: The three AB/Phonak technologieshelped CI users hear significantly better in noisy situationsand also improved ease of hearing. Notably, the benefitsoffered by UltraZoom and ClearVoice were of greater magni-tude than published results for other CI devices. Clinicalrecommendations and counseling for using these technolo-gies can significantly help CI users in real life.

Keywords: improved hearing in noise, Advanced Bi-onics, UltraZoom, directional microphone, T-mic, ClearVoice,Beamformer.

TL010. Air traffic controllers ability to filter speech in noise.Effects of auditory training on speech in noise identification[Audiology]Perez Zaballos M. T., Ramos De Miguel A., Perez Plasencia D.,Zaballos Gonzalez M. L., Ramos Macías A.Complejo Hospitalario Universitario Insular Materno Infantil de GranCanaria. España - Spain

Date: May 20, 2015 Time: 11am to 11:10am Room:Sala Coral.

Introduction: No studies have been specifically de-signed to explore the relevance natural long term auditorytraining and of frequencies above 8 kHz for speech in noiseidentification. Air traffic controllers (ATCs) have undergonenatural training in these situations.

Objective: to demonstrate that ATCs have better per-formance compared to the average normal-hearing (NH)individual and to study frequency bandwidth reduction above8 kHz effects on speech inteligibility in noise.

Methods and Results: 29 NH subjects (control group)and 45 ATCs, native speakers of Spanish language listened totwo sets (high frequency filtered and unfiltered) of 3 disyllabicword listswith background noise adjusted to construct signal-to-noise ratio (SNR) conditions of þ5, 0, and -5 dB. Compar-isons between the two groups shows that ATCs autperformsthe control group in all situations and the difference increaseswith task difficulty. For the control group, higher performanceis observed for unfiltered words atþ5 and�5 dB SNR, thoughnot at 0 dB SNR. For ATCs, higher performance is observed inall cases.

Conclusion: These findings support the use of speechin noise training techniques for people with hearing loss.

Keywords: speech perception, noise, high frequency.

TL011. Transcuteneous bone conduction implant:Audiological outcomes in 4 adolescent patients withbilateral microtia associated with atresia of the externalauditory canal [Audiology]Bravo Torres S., Fuentes López E.Hospital Dr. Luis Calvo Mackenna - Chile; Universidad AndresBello - Chile

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Date:May20, 2015 Time: 11:10am to11:20amRoom:Sala Coral.

Introduction: The outer ear hearing dysgenesis have aprevalence of 1: 10000 newborns worldwide. In Chile, thisprevalence is significantly higher, being 4.1: 10000 newborns.Large percentage of these patients with bilateral conductivehearing loss are implemented with traditional bone conduc-tion hearing aids. They report low adherence, aesthetic andhearing difficulties. One option is Bonebridge hearing aid, asystem of active bone conduction implant. However, there arefew reports about the auditory effects of these devices.

Objective: To describe the audiological outcomes inadolescent patients with bilateral microtia and atresia of theexternal auditory canal adapted to Bonebridge.

Methods and Results: Prospective study in 4 adoles-cent patients in the public health system and the studentJUNAEB program, attended at the Dr. Luis Calvo MackennaHospital during 2014-2015.Results: During the activation ofthe device the average functional gain was 33.3 dB, whichimproved in the second calibration. The subject speech per-ception score was 100%.

Conclusion: The transcuteneous bone conductionimplant was demostrated tobe safe and effective in adolescentpatients with bilateral microtia associated with atresia of theexternal auditory canal.

Keywords: microtia, atresia, transcuteneous boneconduction implant.

TL012. Satisfação Dos Pacientes Entre Digisonic SP ®Monaural Vs Binaura [Audiology]Fernandes F. L., Zago T. M., Carvalho G. M., Guimarães A. C.,Castilho A. M.Unicamp - São Paulo - Brazil

Date:May20, 2015 Time: 11:20am to11:30amRoom:Sala Coral.

Introduction: The satisfaction questionnaires are ef-ficient means to assess whether the device dispensed to thepatient met expectations and improved their quality of life.They reveal what is beyond the hearing aid performance.Show the perceptions of the use in everyday communicationsituations, the return to social life, improved self-esteem andoverall health.

Objective: To evaluate and compare the level of satis-faction of patients implanted with Neurelec Digisonic ® SP ®Monaural and Binaural cochlear implant.

Methods and Results: Patients implanted with thebrand NEURELEC ® (SP Digisonic ®Monaural and Binaural) ofthe Cochlear Implant Program at a tertiary hospital wereevaluated for clinical and demographic variables, pre andpost operative audiological data and personal satisfactionquestionnaire of cochlear implant use . Results: The overallmark and two subscales binaural patients weremore satisfiedcompared tomonaural (positive effect, and services and cost).However, there was no statistical significance for any of theanalyzes. Regarding the time of activation of IC, there was atrend of better positive effects for the group of binauralimplant (p ¼ 0.08).

Conclusion: You cannot say that the overall level ofsatisfaction of patients implantedwith the implant Neurelec®Digisonic ® SP Binaural is greater than patients implantedwith monaural, but there is a positive trend that the positiveeffects in the first group are larger than in the latter.

Keywords: cochlear implantation; patient satisfac-tion; hearing loss; questionnaires; hearing tests.

TL013. Evaluation Of Speech Perception Tests In CochlearImplant Users: A Review [Audiology]de Faria L. R., Gouveia M. C. L., Muniz L. F.Universidade Federal de Pernambuco - Pernambuco - Brazil

Date:May20, 2015 Time: 11:30am to11:40amRoom:Sala Coral.

Introduction: The cochlear implant is the best treat-ment for severe to profound hearing loss. The speech percep-tion tests are used to evaluate patients' preoperatively, forsurgical cochlear implant, and postoperative patient follow-up. There are several models with different tests methodsbeing used. This review was undertaken for better under-standing of the tests being applied.

Objective: To review the literature of testing speechperception in cochlear implant users.

Methods and Results: We performed an integrativereview through PubMed, Medline/Bireme and Lilacs throughdescriptors: speech perception test, and adult cochlear im-plant. Articles were selected according to the criteria ofinclusion and exclusion. 609 articles were collected and bythe end of the selection 35 articles were read in full, fromthose 11 were chosen to participate in this review. These 11were the only ones who had the test methodology appliedwell explained and evaluated. The most widely used tests arethe Hear in Noise Test (03), Consonant Nucleus Consonant(03) and BKB-SIN (02). The AzBio and HSM-ST are also usedonce. There are others with particular methodologies. Severalare the intensity of audio variations presented, as well assignal/noise ratio.

Conclusion: Few studies go deeply in the methodolo-gy of testing speech perception, there is little material pro-duced and published in Portuguese and they are muchneeded.

Keywords: Cochlear implant, bilateral hearing loss,adult, speech perception test.

TL014. Two Novel Methods For Assessing Hearing InDeafness Patients: Electrical Stimulation With RoundWindow Electrode (Rw-E) And With Intracochlear VeryShort Electrode (IC-VSE) [Audiology]Di Lella F. A., Galeazzi P., Polak M., Boccio C. M.Hospital Italiano de Buenos Aires - Argentina

Date:May20, 2015 Time: 11:40am to11:50amRoom:Sala Coral.

Introduction: Single sided deafness, long time hear-ing deprivation, cochlear nerve hypoplasia or aplasia andcochlear nerve monitoring during cerebellopontine anglesurgery (CAS) need further developments and strategies.Evaluate hearing pathways and eventually the candidacy oroutcomes with cochlear implants is now an issue in many ofthese cases.

Objective: To describe two methods of cochlear elec-trical stimulation in patients with profound or not evaluablehearing loss with conventional acoustic methods and inpatients who underwent CAS.

Methods and Results: Two groups were studied: A:Patients with profound sensorineural hearing loss; B: Patientswho went under CAS. Two test methods were used: electricalstimulation through round window with specially designedRW-E (in group A); and electrical stimulation directly insidethe cochlea with a specially designed IC-VSE (in group B).Electrical auditory brainstem response (eABR) were per-formed to analyze the auditory pathway. In group A subjectiveresponses were also be considered. A total of 10 subjects weretested, 7 in group A and 3 in group B. 5 of the 7 subjects ingroup A showed responses of the auditory pathway.

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Subjective responses of the 7 subjects correlated with ob-tained results. Only 1 case in group B showed eABR persistingafter tumor removal.

Conclusion: These preliminary results confirmedthese two methods as a way to electrically stimulate thecochlea and evoke electrical responses making a useful meth-od for evaluate the auditory pathway in deaf ears, as apredictor factor for cochlear implantation, tinnitus responseand a way for monitories acoustic nerve in CAS.

Keywords: electrical auditory brainstem response;cochlear implants; cochlear nerve monitoring; cerebellopon-tine angle surgery.

TL015. Cochlear Implant From A Rehabilitation AproachBased On Community (RBC) [Audiology]Aguirre Zarta A., Useche M. C., Silva M. J.Instituto Para Niños Ciegos Y Sordos Del Valle Del Cauca - Colombia

Date: May 20, 2015 Time: 11:50am to 12pm Room:Sala Coral.

Introduction: Acording to Furmansky H. (2003), Toobtain optimal results the patient candidate for a cochlearimplant CI must comply with features like: Professional:Availability of services, training and type of aproach. Family:Dynamic, participation and expectations. Child: ChronologicalAge However, it is common to find higher emphasis on thephysiological, cognitive and family aspects decreasing weightin the sociocultural factor who affects rehabilitation. It istherefore important to emphasize on an integral profilefrom the rehabilitation aproach based on community (RBC).

Objective: Recognize the importance of an integralprofile of the patient with CI, from a Rehabilitation aproachBased on Community.

Methods and Results: The 6 patients evaluated, thosewho belongs to an ethnic community do not get the expectedbenefits for lack of rehabilitation. The 6 patients have left thedevice for damage at the accesories, little auditory benefit forlack of programing, little use because of the conditions ofsociocultural lif.

Conclusion: The RBC, involves a process of interven-tion that can recognize the individual integrally, as a biosocialbeing,which rehabilitation process can be potentiated fromanindividualized intervention work, involving their members,generating training in the community. Convert the house intothe framework of the rehabilitation. The goal of the CI shouldexpand and focus it not only surgery but in rehabilitation. TheCI, from a RBC approach, allows ensure the benefits of thedevice and strenghten rehabilitation. The RBC, is a strategythat should be included in public policy from a differentialapproach.

Keywords: Rehab, Implant, deaf, RBC.

TL016. Potencial De Ação Composto Do Nervo AuditivoEvocado Eletricamente Em Crianças Usuárias De ImplanteCoclear Bilateral [Audiology]Caldas F. F., Júnior F. B.Instituto Braziliense de Otorrinolaringologia - Distrito Federal - Brazil

Date: May 20, 2015 Time: 12pm to 12:10pm Room:Sala Coral.

Introduction: Introduction: The cochlear implant de-vice has the capability to measure the electrically evokedcompound action potential of the auditory nerve (ECAP). TheNeural Response Telemetry (NRT) is used in order to measurethe ECAP of the auditory nerve. The system provides validneural responses and robust recordings that are recorded and

return to the programming interface system for clinicalanalysis.

Objective: Objective: To analyze the electricallyevoked compound actionpotential (ECAP), through theNeuralResponse Telemetry (NRT), in children with bilateral cochlearimplants.

Methods and Results: An analytical, observationaland prospective study was performed. Six children, aged1-4 years of age,with bilateral Cochlear Implant were assessedin five different moments during their first year of cochlearimplant use. Results: There were significant differences infollow-up time (p ¼ 0.0082) and electrode position(p ¼ 0.0019) in the T-NRT measure. There was a significantdifference in the interaction between time monitoring andelectrode position (p ¼ 0.0143) when measuring the wavesN1-P1 amplitude, between the three electrodes at eachfollow-up.

Conclusion: The ECAP measurement using NRT inchildren with bilateral cochlear implants during the firstyear of monitoring was an effective measurement to demon-strate the synchronized bilateral development of the periph-eral auditory pathway in the studied population.

Keywords: Children; Cochlear Nerve, Cochlear Im-plant, Evoked Potentials.

TL017. Hearing Loss And Gender Of The Elderly: Analysis OfThreshold Of Individuals Of Third Age Groups [Audiology]Kuse D., Silveira A. L., Flores L. S., Gonçalves A. K., Teixeira A. R.Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date: May 20, 2015 Time: 12:10pm to 12:20pmRoom: Sala Coral.

Introduction: Presbycusis is considered the maincause of hearing loss among the elderly. The presence anddegree of hearing loss in older people can be influenced bygender.

Objective: Verify the influence of gender in the audi-tory thresholds of elderly individuals.

Methods and Results: Study a retrospective cross-sectional comparative. A sample of 215 elderly individuals,32.1% male and 67.2% female, with a mean age of 69.95 years.Participants underwent a medical interview, otoscopy andpure tone audiometry. Sensorineural hearing loss prevailed inthe study sample (77.2% of the ears). Mean thresholds in themen, the right and left ears were respectively39.09 � 19.18 dB HL and 42.62 � 20.89 dB HL. In womenmean thresholds were 28, 98 � 16.58 dB HL and29.15 � 17.91 dB HL. Data analysis revealed significant dif-ferences between the means of the men and women thresh-olds (p ¼ 0.000).

Conclusion: The variable gender influenced the audi-tory thresholds of individuals.

Keywords: hearing loss, older people, elderly.

TL018. Study Of Electrically Evoked Compound ActionPotentials In Different Regions Of The Cochlea [Audiology]Martins J. H. F., Oliveira G. C. C., Magalhães I. M. P., Quadros J. M.C., Ribeiro C. A. R.Centro Hospitalar Universitário de Coimbra - Portugal

Date: May 20, 2015 Time: 12:20pm to 12:30pmRoom: Sala Coral.

Introduction: The measurement of ElectricallyEvoked Compound Action Potentials (ECAP) is a well-knownmethod to assess cochlear implant function as an objectivemethod. It provides confidence that electrical stimulationleads to action potentials as well as giving additional

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information helpful for implanting fitting, especially in diffi-cult cases and offers a possibility to glean information aboutthe placement of electrodes in the cochlea. In this study, theECAP performance of MED-EL cochlear implants was investi-gated using the auditory nerve response telemetry (ART).

Objective: to examine the underlying physiologicalbackground of neural responses from different regions.

Methods and Results: Two different ECAP measure-ments were recorded to 16 subjects in a multicentrical studybetween Covoes and La Paz hospitals. To assess differentparameters of the neural response: A) Amplitude growthrecordings by stimulating the apical electrode 2, the middleelectrode 5 and the basal electrode 10, was used, as well as B)Recovery sequences stimulating the same respective electro-des. To study the placement of the electrode array.

Conclusion: The results show that nerve cells have asimilar sensitivity to electrical stimulation throughout theentire cochlea, therefore we conclude that all regions are ableto work with the information delivered by electricalstimulation.

Keywords: ECAP, neural response, electrode position.

TL019. New tools for evaluating quality of life of Spanishcochlear implant patients [Otology, Neuro-Otology andSkull Base Surgery]Sanchez-Cuadrado I., Lassaletta L., Perez-Mora R.M., CalvinoM.,Gavilan J.Department of Otolaryngology, La Paz University Hospital - Madrid -Spain; IdiPAZ Research Institute, Madrid - Spain

Date:May 20, 2015 Time: 2pm to 2:10pm Room: SalaCoral.

Introduction: In recent years, reports of quality of life(QoL) gains in patients with a cochlear implant (CI) areincreasing. No Spanish validated questionnaire has beendescribed up to now. The Glasgow Benefit Inventory (GBI) isa reliable, sensitive and validated post-intervention test that isused to determine health-related QoL after otorhinolaryngo-logical interventions. In addition, the Nijmegen CochlearImplant Questionnaire (NCIQ) determines the subjective ben-efits of CI patients before and after implantation.

Objective: To determine the reliability and validity ofthe Spanish version of the GBI and NCIQ in Spanish patientswith a CI.

Methods and Results: 121 Spanish CI recipients an-swered the Spanish GBI as well as 76 CI users returned theNCIQ. Reliability of the questionnaires was determined usingCronbach’s α coefficient; factor analyses was performed usingprincipal component extractionwith orthogonal rotation; andvalidity was confirmed using Pearson’s correlation coefficient.The mean Total Score (mean � standard deviation) of the GBIwas 35.1 � 23.6, 47.6 � 28.9 for General Health, 17.9 � 33.2for Social Benefit and 1.7 � 27.9 for Physical Health. In theNCIQ, all questionnaire respondents performed significantlybetter in all sub domains with a CI than before cochlearimplantation. The reliability was above 0.70 in all test do-mains. The objectivemeasures: Disyllables testedwithout lip-reading in quiet were correlated with the QoL questionnaires.

Conclusion: Both questionnaires are reliable andpracticable instrument for the assessment of health-relatedQoL in Spanish adult CI users.

Keywords: quality-of-life, Spanish, GBI, NCIQ,validation.

TL020. Posturographic Profile Of Patients With PersistentPostural-Perceptual Dizziness On The Sensory OrganizationTest [Balance]Söhsten E., Bittar R. S. M., Staab J. P.USP - São Paulo - Brazil

Date: May 20, 2015 Time: 2:10pm to 2:20pm Room:Sala Coral.

Introduction: Persistent postural-perceptual dizzi-ness (PPPD) is a new international consensus term for thecondition known as phobic postural vertigo or chronic subjec-tive dizziness. Two key symptoms are postural unsteadinessand visually induced dizziness.

Objective: Clinically, we observed patients with PPPDshowing impaired performance on multiple conditions of theSensory OrganizationTest (SOT) and sought to investigate thisphenomenon systematically.

Methods and Results: METHODS: In this cross-sec-tional study, we examined pair-wise group differences inmean scores from SOT conditions 1-6 and composite scoresamong 20 patients with PPPD, 15 patients recovered fromacute vestibular syndromes, and 15 normal individuals (allfemale, 43.4 � 9.2 years old). We also compared proportionsof patients in each groupwith visual dependence, somatosen-sory dependence, and poor performance across multipleconditions. RESULTS: Patients with PPPD had significantlylower mean scores than normal individuals on conditions2-6 and the composite index and lower than recoveredvestibular patients on conditions 2-3. Recovered vestibularpatients had significantly lower mean scores than normalindividuals on conditions 4-6 and the composite index. Pa-tients with PPPD had the greatest likelihood of visual orsomatosensory dependence.

Conclusion: Patients with PPPD had difficulties withpostural control across multiple sensory challenges, consis-tent with emerging data on neurophysiologic mechanism.

Keywords: posturography, Sensory Organization Test,vestibular function tests, Persistent postural-perceptual diz-ziness, anxiety.

TL021. Analysis of an interdisciplinary service with familiesof cochlear implanted patients [General]Bagatini F. A., Rigamonti C., Peralta C. O., Scarabeli L. N., JulioM.M.Programa Espaço Escuta - São Paulo - Brazil

Date: May 20, 2015 Time: 2:20pm to 2:30pm Room:Sala Coral.

Introduction: The cochlear implant represents a pow-erful resource for children with sensorioneural hearing loss.However, there are other factors that contribute to the devel-opment of language of thosewho use this device. The engage-ment of family and the quality of social interactions aredeterminative in this process, but the parents must be orient-ed, involved and supported. There are a few services in Brazilthat work with an interdisciplinary approach such as Pro-grama Espaço Escuta, considering the psychic and socialaspects of language.

Objective: The aim of this paper is to comprehend: 1)how an interdisciplinary team structures and sustains aquality service for families of cochlear implanted children;2) how this procedure engages parents as co-responsible indeveloping different forms of communication with theirchildren.

Methods and Results: This study is descriptive andqualitatively analysed. The data was collected both among theprofessionals’ records and the systematic observation of theactivitieswith the families. The team consists of psychologists,

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speech therapists, social worker and occupational therapist.The implanted children enrolled in the project are between 2and 12 years old.

Conclusion: Results show that the interdisciplinaryapproach provides new work structures related to the inter-ventionwith the families. Experience shows that guidance andholding are keys to take critical decisions. Furthermore, it ispossible to build different ways to interact with the children,experiencing the construction of spontaneous language out-side a clinical setting.

Keywords: Cochlear implant, families, social program,interdisciplinary approach, language.

TL022. Childhood Deafness And Cochlear Implant:Optimizing The First Psychological Interview (A Pilot Study)[General]Santos R. M. R., Lopes L., Benute G. G., Lucia M. C. S.Clínica Otorrinolaringológica - Hospital das Clínicas FMUSP - SãoPaulo - Brazil

Date: May 20, 2015 Time: 2:30pm to 2:40pm Room:Sala Coral.

Introduction: Childhood deafness can compromisecognition and psyche. However, this compromise does notdepend on deafness alone; it is closely linked to the family’scontribution toward psychic constitution. The child’s actionsand how it interacts with culture reveal whether this consti-tution is jeopardized. Hence, there is a need to evaluate theparents’ relationship with the deaf child and rectify aspectsthat pose a threat to the developing psyche and to gains fromcochlear implant (CI).

Objective: To ascertain the benefits of using theScripted Psychoanalytic Assessment at 3 Years (AP3) forpsychological evaluation at a CI center.

Methods and Results: Method Between 2010 and2011, nine children and families, selected by order of admis-sion and age, were assessed with the AP3. During the firstinterview, two psychoanalysts administer the AP3 in twoparts: one to assess how the family perceives and dealswith the child and another consisting solely of observationof the child in a playful setting. Results The AP3 rapidlyassessed and identified family issues and their reflectionson the child, indicating whether the child’s psyche is com-promised and the severity of this involvement. All familiesoverestimated the limitations caused by deafness, thus exac-erbating their expectations regarding CI.

Conclusion: The AP3 identifies points for psychologi-cal intervention during assessment, but the need for twoexaminers is a limitation. In future,wewill test administrationof the AP3 by only one psychologist.

Keywords: cochlear implant; childhood; psychologi-cal interview.

TL023. Psychical constitution and language development incochlear implanted children [General]Rigamont C., Peralta C. O., Bagatini F. A., Vilela F. A., Ahn J.Programa Espaço Escuta - São Paulo - Brazil

Date: May 20, 2015 Time: 2:40pm to 2:50pm Room:Sala Coral.

Introduction: The cochlear implant is a surgicallyimplantable device for peoplewith severe to profoundhearingloss which provides access to environmental sounds. Thistechnology allows, thus, that babies with hearing loss developspoken language, which would be able from the auditorystimuli provided by the cochlear implant. But language devel-opment is affected by other aspects besides hearing, what

implies in the professionals involved to look at the whole ofthe patients and their families in order to elaborate a strategyof teamwork. In this paper, the scope is on the importance ofpsychical constitution for language development.

Objective: The objective of this study is, therefore, toexplore fundamental processes of psychical constitution andassociate them to key points related to the cochlear implant.

Methods and Results: The following processes ofpsychical constitution will be presented: subject assumption,establishment of demand, alternate presence/ absence andpaternal function. The concepts will be exposed and discussedin face of questions concerning thehearing loss and its possibleeffects on the primary relationships of the baby. As a result,early intervention has shown positive effects, such as thepossibility of changing the process of psychical constitution.

Conclusion: When it comes to hearing and spokenlanguage, the success of the cochlear implant implies on thefollow up of a multidisciplinary team, so that each aspect willbe taken care of. The psychical aspect becomes importantwhen it is understood as a structural and and nececessaryprocess for the language development.

Keywords: psychical constitution, language develop-ment, cochlear implant, multidisciplinary team, earlyintervention.

TL024. Benefit of cochlear implantation in children withmultiple-handicaps: parent's perspective [General]Nasralla H. R.Hospital das Clínicas da FMUSP - São Paulo - Brazil

Date:May 20, 2015 Time: 2:50pm to 3pm Room: SalaCoral.

Introduction: Children multiple handicapped arebeen studying in cochlear implanted centers. 30 to 40% ofcases, heterogeneous, variable results.

Objective: To verify the subjective results in childrenwith multiple-handicaps.

Methods and Results: Methods: Adapted question-naire was applied with 6 families with handicapped children(cerebral palsy, Ushers syndrome, cytomegalovirus, Chargessyndromeandautismspectrumdisorder). Results:Weevaluatedpatients between 2 years 9 months to 29 years old who hadbetween 9months and 9 years of use the speech processor. Theyuse speech processor all time and were involved in additionaltherapies. Families were satisfied with the results expected,except one family who has childrenwithmild autism diagnosedafter 4 years to implantation. Although observe progress andbenefits. Objective questions showed increased vocalizations,signal communication, interests in music, therapies and school,and better family integration demonstrated by the increase ofinterest in the activities of house. The sociability was somethingthat differentiated post-implant. Although not all of the childrengained gold standard speech and language outcomes, the fami-lies’ perceived advantages have made the implant and recom-mend for others families with children in a similar situation.

Conclusion: Although the limited results for languageskills, resulting in better quality of life for the whole family. Afollow-up is important in all cases.

Keywords: Cochlear implant. Quality of life. Multiplehandicaps.

TL025. LifeQuestionnaire. A tool for continuous quality oflife assessment for patients with hearing loss [General]Ramos De Miguel A., Perez Zaballos M. T., Falcon GonzalezJ. C., Borkoski Barreiro S. A., Ramos Macías A.Complejo Hospitalario Universitario Insular Materno Infantil de GranCanaria. España - Spain

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Date:May 20, 2015 Time: 3pm to 3:10pm Room: SalaCoral.

Introduction: The parameters evaluated inmost qual-ity of life questionnaires are highly variable over short periodsof time. However, evaluation is still performed in a timelymanner through a patient interview. This makes the informa-tion report to be incomplete and only represents the quality oflife measured in the vicinity of that point in time.

Objective: Development of an online application thatsends questionnaires for quality of life at different times of theday over an interval set by the user. The platform enables therise of already validated or customized questionnaires andshows the evolution of each response along the time and theoverall average over attempts.

Methods and Results: development of web interfacein PHP, CSS and JavaScript. The developed tool allows to: 1)answer a test repeatedly under different personal situationsand 2) evaluate the patient remotely, eliminating the need toarrange an appointment with the patient to fill out the test.

Conclusion: a more reliable assessment of the qualityof life of the patient is obtained.

Keywords: LifeQuestionnaire, Evaluation, cochlearimplants, quality of life.

TL026. Interdisciplinary approach to improve the globaldevelopment of people with hearing disabilites [General]FalconGonzalez J. C., Borkoski Barreiro S. A., Quintana Carrillo F.,Garcia Hernandez R. D., Ramos Macías A.Equipo Específico de Discapacidades Auditivas de la Provincia de LasPalmas. Consejería de Educación, Universidades y Sostenibilidad.Dirección General de Ordenación, Innovación y Promoción Educativa yUnidad de Hipoacusia, Servicio de Otorrinolaringol - Spain

Date: May 20, 2015 Time: 3:10pm to 3:20pm Room:Sala Coral.

Introduction: Coordination Between the differentProfessionals that treat children with Hearing Disabilitiesand between them and their families allows for a globalview of their needs. Therefore, coordination is not only possi-ble but necessary and should be efficient and effective.

Objective: To analyze the profile of students withhearing disabilities of different educational levels in theacademic year 2012-2013 in the province of Las Palmas, toachieve a better understanding and assessing of children andteenagers with hearing impairment from a multidisciplinaryperspective.

Methods and Results: documentary analysis tech-nique, using various sources available to the team of specialeducation and Psicopedagogics for Hearing Impaired children:census, educational psychology reports, medical-audiologicalreports, educational projects and legislation. The total numberof students is 171. Of those attending secondary school, 30(53.51%) are carriers of hearing aids and 26 (46.49%) ofcochlear implants. Of students in primary school and kinder-garden, 111 (96.52%) use some type hearing prosthesis and 4(3.48%) do not use any kind of device. Of these, 109 (94.78%)use the oral language as their native language to communicateand 6 (5.22%) use sign language.

Conclusion: Our project has not meant an increase inresources, but has recycled currently existing ones. To haveaccurate human and material resources and to take the rightmeasures will ensure an appropriate response through amultidisciplinary approach to each and every one of the needsof our students with hearing disabilities, your patients.

Keywords: Educational Action. Interdisciplinary ap-proach. Hearing impairment.

TL027. Newborn Hearing Screening Program: earlydiagnosis and etiology [General]Costa K. C., Pereira T., Oliveira A. R., Costa S.M. S., Sartorato E. L.Unicamp/ CBMEG e Otorrinolaringologia - São Paulo - Brazil

Date: May 20, 2015 Time: 3:20pm to 3:30pm Room:Sala Coral.

Introduction: The Newborn Hearing Screening Pro-gram is a way to promote early diagnosis of hearing im-pairment. Concomitantly with early diagnosis andintervention, it is important to search for the primary cause.In developed countries about 50% of the causes of isolateddeafness have a genetic origin. In Brazil most of cases are dueto environmental factors, such as congenital infections, peri-natal asphyxia, kernicterus and meningitis.

Objective: To investigate the causes of hearing lossdiagnosed at Newborn Hearing Screening Program.

Methods and Results: Retrospective study of recordsof 21 deaf diagnosed from August 2003 to July 2014. Results oflaboratory tests, imaging and genetic testing were analyzed inorder tofind the cause of deafness.: Twenty four childrenhad asensorineural hearing impairment, of which 20were bilateral.Eight cases of newborns remained in Newborn Intensive Unit.One case showed craniofacial anomalies and 2 patients hadinner ear malformations. In 3 newborn the hearing loss wasdue to perinatal asphyxia. Two newborns had history ofinfectious disease. Considering the genetic factors, 4 individ-uals had a history family of deafness; 3 newborns were fromconsanguineous family, 4 newborn infants were homozygousfor 35delG in the GJB2 gene, and 2 presented the A827Gmutation in the MTRNR1 gene. Three cases the etiologyremains unknown.

Conclusion: The early etiological research hearingimpairment contributes to support and assist disabled hearingand their families and also for assistance in public healthmeasures.

Keywords: hearing loss, etiology, Universal NewbornHearing Screening.

TL028. Relationship between neonatal hyperbilirubinemiaand sensorineural hearing loss [General]Borkoski Barreiro S. A., Corujo Santana C., Falcón Gonzalez J. C.,Zaballos Gonzalez M. L., Ramos Macías A.Complejo Hospitalario Universitario Insular Materno Infantil de GranCanaria - Spain

Date: May 20, 2015 Time: 3:30pm to 3:40pm Room:Sala Coral.

Introduction: Severe jaundice that requires exchangetransfusion has become a relatively rare situation today. About60% of in-time born infants and 80% of premature ones willsuffer from jaundice within the first week of life. Hyper-bilirubinemia at birth is a risk factor associated with hearingloss that is usually further linked to other factors that mighthave an effect on hearing in a synergistic manner.

Objective: This study aimed to identify the relation-ship between hyperbilirubinemia at birth as a risk factor forsensorineural hearing loss in children born at the HospitalUniversitario Insular Materno Infantil de Gran Canaria, period2007-2011.

Methods and Results: Retrospective study of 796newborns who had hyperbilirubinemia at birth, using otoa-coustic emissions (TEOAE) and evoked auditory brainstem(ABR). 185 newborns (23.24%) were referred for ABR. 35(4.39%) were diagnosed with hearing loss: 18 (51.43%) with%) conductive hearing loss (CHL) and 17 (48.57%) with senso-rineural hearing loss (SNHL), 3 of which were diagnosedbilateral profound hearing loss. Half of the children had other

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risk factors associated, the most frequent being exposure toototoxics.

Conclusion: The percentage of children diagnosedwith sensorineural hearing loss who suffered hyperbilirubi-nemia at birth is higher than for the general population. Ofthose diagnosed, none had levels of indirect bilirubin� 20mg/dl, only 47% had hyperbilirubinemia at birth as a risk factorand 53% had another auditory risk factor associated.

Keywords: Hyperbilirribinemia. Neonatal hearingloss. Risk factor.

TL029. Quality Control for a Universal Program of Children'sEarly Detection of Hearing Loss. Our results [General]Borkoski Barreiro S. A., Falcón González J. C., Osorio Acosta A.,Perez Plasencia D., Ramos Macías A.Complejo Hospitalario Universitario Insular Materno Infantil de GranCanaria - Spain

Date: May 20, 2015 Time: 3:40pm to 3:50pm Room:Sala Coral.

Introduction: Documents issued by the CODEPEHshow what the quality criteria to be met by screening pro-grams in infant hearing loss are in relation to quality criteriafor screening, the diagnostic phase, indicators of quality ofcare and monitoring.

Objective: To determine the results in relation to thequality criteria of the Universal Program for Early Detection ofInfant Hearing loss in our hospital from its beginning in 2007until December 31, 2013.

Methods and Results: Observational, retrospective,descriptive study. Results of quality indicators are obtainedthrough the application of the computer software for theUniversal Program for the Early Detection of Hearing Loss inChildren Canary Islands. Screening Quality Indicators (QI):Program coverage: 95.73% Screened before one month of age:100% Re-screening: 97.74%. False negatives: 0.011%. Falsepositive: 0.58%. Diagnostic Phase QIs: Referral to DiagnosticPhase: 3.59%. Treatment QI: Establishment of Early care before6months: 97%. Establishment of treatment (prosthetic fitting,speech therapy control): 100%. Quality Indicators for moni-toring. Epidemiology: Uniting Technology and tool: ScreeningSoftware. Clinical Unit of hearing loss. Hospital UniversitarioInsularMaterno Infantil de Gran Canaria. Reference Unit of theAutonomous Community.

Conclusion: At seven years of its implementation theprogrammeets all CODEPEH recommendations regarding thequality control program in Universal Early Detection of InfantHearing Loss.

Keywords: Quality Control, Hearing loss, Screening.

TL030. Novel MITF mutation in a Brazilian patient withatypical Waardenburg syndrome type II [General]Silva J. S., Pardono E., de Oliveira E. U. d. S., Tsuji R. K., Bento R. F.,Oiticica J., Lezirovitz K.Universidade de São Paulo - São Paulo - Brazil

Date:May 20, 2015 Time: 3:50pm to 4pm Room: SalaCoral.

Introduction: Waardenburg syndrome II (WS2) is anautosomal dominant auditory pigmentary syndrome account-ing for 1.43% of congenital deafness. Heterozygous MITFmutations account for approximately 15% of WS2 with morethan 30 mutations reported.

Objective: Search for MITF pathogenic mutation in achild with possible Waardenburg syndrome type II.

Methods and Results: We ascertained a 3-year-oldboy presenting with congenital sensorineural profound deaf-

ness, associated with bilateral partial iris heterocromia and ablondwick located behind thehead.Mutation screening in theMITF gene revealed the variant c.1052C < A in exon 9(NM_198159). This mutation leads to a Serine to Tyrosineaminoacid change in position 351 (p.S2351Y), that was pre-dicted to be damaging by four bioinformatics tools (SIFT,Polyphen2 MutationTaster e PROVEAN). This mutation hasnot been reported so far, neither as pathogenic nor as normalvariant [1000 Genomes Project and Exome Variant Server].MITF is the core of the melanocyte development network oftranscription factors and signaling pathways and it is ex-pressed in themelanoblast-derived intermediate cells of innerear stria vascularis. Our mutation resides in the MITF Myc-type, basic helix-loop-helix (bHLH) domain, which is neces-sary for MITF DNA binding activity. Disruption of this domainmay decrease the ability of themutant MITF protein to bind tothe CATGTG core DNA sequence in the human tyrosinasepromoter.

Conclusion: The no penetrance of some signs andsymptons observed in the present report is an unusual findingin WS2, as deafness is described in up to 85% of cases.

Keywords: Congenital deafness, Waardenburg syn-drome, MITF gene.

TL031. Questionnaire: Evaluation of the Advanced BionicsNeptune Swimmable Processor [Audiology]Coelho S. B., Gonçalves M. V., Coelho A. E. V.Clínica Centro de Otorrino - Ceara - Brazil

Date: May 20, 2015 Time: 4:30pm to 4:40pm Room:Sala Coral.

Introduction: The Advanced Bionics (AB) Neptunesound processor is the first and only cochlear implant soundprocessor that is completely waterproof and dustproof, givingAB implant recipients the ability to hear in virtually allextreme environments. Neptune’s flexible wearing optionsallow users the freedom and comfort of nothing on the ear.When used with the AquaMic, Neptune wearers are able tohear around and in water with no restrictions. The Neptuneoffers all AB sound processing strategies and is compatiblewith phones, FM systems, induction loops, and awide range ofmusic players.

Objective: A questionnaire was designed aimed atproviding a better understanding of Neptune’s effectiveness,uses, and benefits for professionals counseling families and forrecipients considering using a Neptune. The questionnairecaptured information about the Neptune’s performance, easeof use, and comfort in a variety of listening environments andwith various wearing options. The questionnaire also cap-tured comparative data for recipients who had used other ABprocessors prior to Neptune. Families of children using ABcochlear implants with the Neptune were recruited to com-plete the questionnaire.

Methods and Results: The questionnaire was com-pleted in Brazil, Chile, Colombia, Costa Rica, Mexico, andPanama by 14 families of childrenwhowere newly implantedandby8 families of childrenwho alreadyhad cochlear implantexperience. Data were compiled and analyzed using descrip-tive statistics.

Conclusion: The majority of families favorably ratedtheir overall satisfaction with Neptune. Details will be pre-sented at the conference.

Keywords: Neptune processor, Waterproof soundprocessor, Advanced Bionics.

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TL032. Phonetics A Tool For Functional Gain And CochlearImplant Mapping [Audiology]Carvajalino Monje I., Cabuya E.Fundación CINDA - Medihumana - Colombia

Date: May 20, 2015 Time: 4:40pm to 4:50pm Room:Sala Coral.

Introduction: In people with cochlear implants is toensure that the signal being audible, be discriminated against,so it is important to consider the functional gain andphoneticsas a tool to achieve effective stimulation hearing for oralcommunication.

Objective:Use the tonal and verbal functional gain as atool for measuring the benefit of cochlear implantation. Opti-mize receptive language mapping with the results of func-tional gain. Use phonetics as an element of analysis andcontrol in mapping the cochlear implant.

Methods and Results: To intervene hearing loss notonly need to hear louder, but also understand what is heard.When evaluating an implanted hearing and adjust the sched-ule towhat is required should include the frequency range forauditory perception where the greatest concentration of thespeech spectrum is presented. The functional gain of hearingthreshold is obtained and using words discrimination subjectis checked. Formants differentiate speech sounds; each lan-guage has an formant hallmark, a different allocation of powerbetween the formants, allowing sorting. The brain doesformant analysis unconsciously giving elements to distinguishsounds. The suprasegmental speech arebetween35 and 45 dBHL, provide clues to the intelligibility of speech and give the40-70% of the semantic content of the Spanish. The first 2formants are sufficient to discriminate a phoneme. One groupunderwent implanted mapping fine adjustment using per-ceptual phonetic characteristics; independent description ofyour hearing.

Conclusion: Programming the implant requires studyand custom fit to achieve efficient and proper phoneticperceptio.

Keywords: Phonetics, functional gain, mapping.

TL033. Hearing aid use profile and associated factors[Audiology]Rivas A. S., Guzmán M., Forero V. H., Rivas J. A., Rivas A.Clínica Rivas - Colombia

Date:May 20, 2015 Time: 4:50pm to 5pm Room: SalaCoral.

Introduction: Hearing loss and visual disorders rep-resent the most frequent causes of impairment in adultpopulation with impact upon autonomy, pshycosocial well-being and quality of life. There are evidences of failures to takeadvantage of hearing devices during the rehabilitation processbetween those who get and use these hearing devices. It isnecessary to identify outcomes and factors that influence theprofile of usage of hearing aids to transfer information focusedon effectivity, efficiency, improvement of quality and consis-tency with rehabilitation programs.

Objective: To evaluate hearing aid usage profile inadult population, satisfaction and benefits adjusted by deter-mining factors.

Methods and Results: Retrospective study with hear-ing aid users. Main outcome: Hearing aid usage profile, autoreport of time of use (hours), correlation with the data logrecord. To determine relative over-estimate report equivalentto absolute report (autoreport data log), /report data log.Evaluation of determining factors (predictors): spontaneoushelp query, hearing aid use starting age, time of hearing loss,uni or bilateral usage, type of hearing loss, grade of hearing

loss, score by factors 1 and 2, International Questionary onHearing Aid Use Outcomes. Correlation coefficient analysis,bivariate analysis of potential predictor factors, multivariatemodelling with lineal regression.

Conclusion: Functional gains, speech perception, sat-isfaction and quality of life with the device are as expected.

Keywords: Hearing aids, adults, rehabilitation.

TL034. Late Cochlear Implant in Children [Audiology]Barros M.Desear Escuchar - Argentina

Date:May 20, 2015 Time: 5pm to 5:10pm Room: SalaCoral.

Introduction: Late cochlear implant opens doors forchildren older than 6 years of age to the auditory world.

Objective: Show that Late Cochlear Implant givesthem the oportunity to develop listening skills,improve lipreading,oral and written language.

Methods and Results: 25 prelingual deaf childrenwho were implanted at ages between 7 and 10 with sensorydeprivation time from 2 to 7 years, were tested at ages 7 and12 8 children using sign language 10 children using spokenlanguage who manage augmentative systems like lip readingor cued speech 7 children using spoken language whose solesupport is lip reading. Children were assessed 2 years afterthey started using their cochlear implant Results 2 childrenusing sign language and 3 children using spoken languagecould identify words by multiple spectral differences andbasic spoken language 5 children using lip reading couldidentify words using vowels and better their reading compre-hension and progress in their language skills.

Conclusion: All children in which the Auditory VerbalOral Therapy was applied (N25) Could improve speech per-ception in a noisy environment Could better development inlanguage, oral and written competence Still need support oflip reading and writing Children implanted during adoles-cence fail to speak by phone. Achieve limited open set Betterspeech production at suprasegmental level 20% of all childrenachieved segmental aspect with multiple cues .Access Catego-ry 3 ESP (Moog&Geers-1994) 20% of children achieved wordidentification varying vowels. Access Category 4 ESP(Moog&Geers-1994).

Keywords: listening skills-oral and written language.

TL035. Results of a decade of Auditory Rehabilitation of thedeaf children in Cuban Cochlear Implant Program[Audiology]Bermejo Guerra B.Clinica Internacional La Pradera - Cuba

Date: May 20, 2015 Time: 5:10pm to 5:20pm Room:Sala Coral.

Introduction: After receiving the IC, the child shouldundergo hearing rehabilitation, with outcomes different be-tween children.

Objective: To describe the results of a decade ofauditory rehabilitation of deaf children implanted at theCuban Cochlear Implant Program.

Methods and Results: of the transit of children reha-bilitation phases, the progress made in the mode of commu-nication, school and the role of the family. In addition, theresults of the Oral and Verbal Auditory Therapy are compared,and show the results of the rehabilitation following a decade.Results. Deaf children before being implantedwere in the firstphases rehabilitation (detection and discrimination), withcommunication based on sign language. Children advanced

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to higher phases of rehabilitation (Identification, Recognitionand Understanding) after of the rehabilitation, with a bimodalmode or oral communication. The best results were forchildren receiving auditory verbal therapy. Over 70% of chil-dren are incorporated into general education. The role of thefamily was crucial in the results of each child. Behavioralanalysis of the results of auditory therapyover the years showssignificant changes, between the first, third and fifth year.

Conclusion: The systematic work of rehabilitation indeaf children in the Cuban Cochlear Implant Program showscommunicative and school progress. The best progress thegroup of children included in auditory verbal therapy, wherethe role of the family has been crucial.

Keywords: Deafness, Cochlear Implants, Auditory Re-habilitation, Oral Auditory Therapy, Verbal Auditory Therapy.

TL036. Creating awhole newCochlear Implant Unit for adultpatients recently implanted and adapting it for the specificneeds of teenagers implanted as children years ago[Audiology]Calderon M., Sierra C., Tisaire A., Ferro V.Hospital Universitario La Princesa - Spain

Date: May 20, 2015 Time: 5:20pm to 5:30pm Room:Sala Coral.

Introduction: Introduction: A patient with a CochlearImplant requires follow-ups throughout their life. But some-times itis difficult to follow patients implanted in a childrenshospitalcloselywhen they reach adulthood. We present amodel of a new cochlear implantunit in a hospital for adults,whichwas initially created to take care of teenagers implantedin a children’s hospital.

Objective: Objectives: We have two main objectives:First, to diagnose, carry out the surgery, the hearing rehabili-tation and thefollow-up of adult patients indicated forCo-chlear Implants. Second, take care of patients implanted yearsago in a children’s hospital, and assess the following needs asadults: medical, social and rehabilitative.

Methods and Results: Resumen Report: Nowadays 71patients are being treated in our unit. Thirty-one adultswereimplanted in our hospital, and fortywere referred from achildrens hospital in our area. The results of the evaluation-carried out by a multidisciplinary team demonstrate that thehearing performance of every patientincluded in our rehabili-tation program (adults or referred teenagers)improves sub-stantially after the cochlear implantation.

Conclusion: Resumen Report: Nowadays 71 patientsare being treated in our unit. Thirty-one adultswere im-planted in our hospital, and fortywere referred from a child-rens hospital in our area. The results of the evaluationcarriedout by a multidisciplinary team demonstrate that the hearingperformance of every patientincluded in our rehabilitationprogram (adults or referred teenagers)improves substantiallyafter the cochlear implantation.

Keywords: Keywords: Cochlear Implant, Teenagers,Auditory Rehabilitation.

TL037. Music Auditory assessment of adolescents withhearing AASI: case’s study [Audiology]Paiva S. F.Universidade Federal de Sergipe - Sergipe - Brazil

Date: May 20, 2015 Time: 5:30pm to 5:40pm Room:Sala Coral.

Introduction: Introduction: Hearing deficiency is thetotal or partial loss of capacity of perception sounds anddifficulty in understanding words and can be classified

according to the time it occurs, site and the degree of injury.The Individual Sound Amplification Device (AASI) is an elec-tronic device that allows sound amplification providing theald disabled to understand the speech and to realize environ-mental sounds. Auditory training Musical is a program withmusical activities for auditory development in order to pro-mote music appreciation through music learning using musi-cal stimulus.

Objective: To evaluate the performance of hearingAASI users teenagers for musical training tasks related todiscrimination and recognition frequency.

Methods and Results: There were four sessions, ananamnesis, an assessment of perception and processing hear-ing through theMSVandMSNV testswith andwithout the useof hearing AASI and two sessions using the tonal frequencypattern test (TPF) with stimulus of different tones (keyboardand percussion instruments), with andwithout use of hearingAASI.: For the keyboard sound, the patient –without hearingAASI – obtained three hits total of 10 sequences presented foractivity with three stimulus and a hit activity with fourstimulus. There was no difference in performance with theuse of hearing AASI.

Conclusion: According to the evaluation performed,the patient presented better performance with the use hear-ing AASI for hearing perception percussion instruments.Which demonstrates, we used only not-melodic musicalsounds before the achievement.

Keywords: PercepçãoMusical; Protese Auditiva; Proc-essamento Auditivo.

TL038. Translation and Cultural Adaptation of Sound forBabies to Portuguese [Audiology]Costa I. M., Silva P. B., Silva V. C.Hospital CUF Universidade de Aveiro - Portugal

Date: May 20, 2015 Time: 5:40pm to 5:50pm Room:Sala Coral.

Introduction: Sound Foundations for Babies was sub-jected to translation and cultural adaptation to the EuropeanPortuguese in order to equip the Portuguese families of deafchildrenwith a tool that allows themadaily application of AVTstrategies (Auditory Verbal Therapy).

Objective: Produce efective intervention materials forbabies and their families in Portuguese language. The adaptedversion of this material was used in two families to be carriedout an exploratory study to indicate the strengths and weak-nesses experienced by families in the use of this tool.

Methods and Results: The adapted version of thismaterial was used in two families to be carried out anexploratory study to indicate the strengths and weaknessesexperienced by families in the use of this tool. Families in thisstudy belong to different areas of Portugal (North and Central)and children wear different hearing technologies. A semi-structured interview, created purposely for this study toacquire the information, was made.

Conclusion: Families in this study recognized thevalue and the necessity of intervention and habilitationmaterial for their children and to themselves. From theperformed interview came out some guidelines that willmake a more concrete adaptation to the Portuguesepopulation.

Keywords: Sound Foundation for Babies; adaptation;AVT; Deafness; Cochlear implant.

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TL039. Temporary Changes In Telemetry In PediatricPatients With Cochlear Implant And Its AudiologicalCorrelation [Audiology]Martinez A., Gutierrez I., Chamlati L. E., Alatorre E., Durand A.Instituto Nacional De Rehabilitacion - Mexico

Date:May 20, 2015 Time: 5:50pm to 6pm Room: SalaCoral.

Introduction: The Neural Response Imaging (NRI) isthe specific neural action potential in the cochlea. Its ampli-tude and recovery shows how much the neural populationresponds to electrical stimulation. Advantages: it predictsaudibility, easily obtained in a relatively short time anddoesn’t require sedation.

Objective: To compareNRI thresholdsmeasured at thetime of surgery, initial fitting and upon reaching normalhearing to determine if there are significant changes withtime; correlate NRI, M thresholds to the pre-surgical audiom-etry and upon reaching normal hearing. With the purpose ofconsidering NRI in normal hearing as an objective tool in theCochlear Implants programming.

Methods andResults: 47 implanted pediatric patientswere studied, measuring NRI during surgery, at the initialfitting and at normal hearing, correlating thesemeasureswithaudiometry and M levels.Results: There is no correlationbetween the threshold in dB in the pre-surgical audiometrywith NRI in the initial fitting, nor between the threshold in dBat normal hearing and the NRI of the same time. Significantchanges between the NRI surgery and ignition were found,although these were different in each electrode, so thisunstable behavior is not to be considered meaningful. Wefoundno significant differences between the current units andM level at initial fitting, but there were significant differencesbetween normal hearing NRI and M levels, as expected.

Conclusion: The NRI in normal hearing is not anobjective parameter to account for programming the cochlearimplant in the pediatric population.

Keywords: Electrically Evoked Compound Action Po-tential; Neural Response Telemetry; Cochlear Implants;Children.

TL040. Guidance for parents of children with hearingimpairment [Audiology]Ribeiro G. C. A., Paiva S. F., Santos A. C. N., Santos B. F. S.,Oliveira J. L.Universidade Federal de Sergipe-UFS - Sergipe - Brazil

Date:May 20, 2015 Time: 6pm to 6:10pm Room: SalaCoral.

Introduction: The timewhen the parents discover thechild’s hearing impaired is surrounded by conflicts, thus it is avery delicate moment (BEVILACQUA; FORMIGONI, 2012).Therefore, it is necessary a work of guidance and advice toparents of these children of these children in order to promoteknowledge on the subject and remove doubts about theauditory rehabilitation process, and thus provide the securitythey need.

Objective: Provide assistance to parents of childrenwith hearing deficiency, as well as guide them, remove theirdoubts andwarn about the importance of parental support forthe effectiveness of auditory rehabilitation.

Methods and Results: This study is being conductedwith parents of patients who are in auditory rehabilitation inspeech therapy school clinic of the Federal University ofSergipe Campus Teacher Antonio Garcia Filho, in the townof Lagarto / Sergipe. Services are offeredweeklywith durationof 40 minutes. During the service information materials areused as well as material developed specifically for instructing

parents.Three sessions were conducted to date. However, it isstill in execution phase.

Conclusion: Thus, it is expected that with this work ofadvice and guidance to parents of children with hearingimpairment, they motivate themselves and promote a qualityof life for your child freely, without limitations and thusexplain how they are able, evenwithwhatever their disability.

Keywords: Hearing Loss; Orientation; Parents; Heha-bilitation; Cochlear Implantation; Child; Orientation Program.

TL041. Hearing Rehabilitation In Child User Of CochlearImplant [Audiology]Ribeiro G. C. A., Paiva S. F., Santos A. C. N., Santos B. F. S.,Siqueira L. S.Universidade Federal de Sergipe-UFS - Sergipe - Brazil

Date: May 20, 2015 Time: 6:10pm to 6:20pm Room:Sala Coral.

Introduction: Currently, the cochlear implant is themost effective remedy to facilitate access of the hearingimpaired to the world of sound (FORTUNATO et al, 2009).The auditory and language development in children im-planted at an early age is similar to the development of theseskills in hearing children,when associatewith speech therapy.Themain purpose of the rehabilitation hearing is to develop orreturn the ability of auditory perception of individuals withhearing deficiency, with the use of electronic devices.

Objective: This study aims to report the auditoryrehabilitation process with a user child's cochlear implant.

Methods and Results: This is a four years old child,cochlear implant user, attended the outpatient clinic of edu-cational audiology in the Federal University of Sergipe –Campus Lagarto. Until the present moment 12 hearing reha-bilitation sessions were performed. The child entered thetherapeutic process being classified in Category 0 of hearingcategories because it was not detect speech in normal con-versational situations (GEERS, 1994), aswell as in the Category1 of the language categories because not to perform undiffer-entiated vocalizations (BEVILACQUA, DELGADO & MORET,1996). Currently, the child demonstrates be in Category 2 ofthe hearing categories, with perception pattern (GEERS,1994), and category 2 category donate language, speakingsingle words (BEVILACQUA, DELGADO & MORET, 1996).

Conclusion: We conclude that way, the benefits ofcochlear implant in hearing impaired children are remarkablewhen associated with auditory rehabilitation, favoring audi-tory and language development.

Keywords: Cochlear Implantation; Rehabilitation;Hearing; Hearing Loss.

TL042. Cochlear implant, sound environments andrecognition of speech [Audiology]Trivella P., Muratore J.Tecnosalud - Argentina

Date: May 20, 2015 Time: 6:20pm to 6:30pm Room:Sala Coral.

Introduction: Cochlear implants provide the patientthe possibility of selecting between different sound environ-ments, the one that best suits the listening situation in order tofacilitate speech perception in different auditoryenvironments.

Objective: The aim of this research is to identify themost common environment sound and analyze the recogni-tion of speech –words and sentences- in cochlear implantusers.

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Methods and Results: We interviewed 20 male/fe-male patients aged 15 to 76 years, who were CP810 orFreedom processors users and with an experience of 6 ormore months at using speech processor. A semi-structuredinterview based on a questionnaire was performed to eachpatient. Speech recognition of words and sentences wasevaluated in sound environments: Everyday, Noise and Fo-cused. All interviewed patients generally used one soundenvironment of their preference. 11 patients chose Everydaysound environment, 6 patients preferred Focused and 3patients chose Noise sound environment. In all sound envi-ronments, the recognition of speech –word and sentence-wasgenerally very good.

Conclusion: All the patients chose a sound environ-ment according to their preference. In most cases, chosensound environment allow them the greatest speech recogni-tion. To conclude, we know that there is a relationshipbetween the most used sound environment and very goodspeech recognition.

Keywords: cochlear implant, sound environments,recognition.

TL043. HiFocus Mid Scala Electrode: A Surgical Survey onUsability and Applicability [Otology, Neuro-Otology andSkull Base Surgery]Narvaez J. J., Prieto A.Hospital De Alta Especialidad De Veracruz - Mexico

Date:May 22, 2015 Time: 8am to 8:10am Room: SalaCoral.

Introduction: The Advanced Bionics HiFocusMid-Scala(HFMS) electrodewasdesigned (1) to offer surgeonsflexibility inelectrode insertion techniques, and (2) to provide optimalcochlear placement for full-spectrum electrical hearing.

Objective: To evaluate surgeons’ experience with theHFMS electrode and insertion tools in cochlear implant re-cipients of varied ages, audiologic profiles, and anatomicalcharacteristics.

Methods and Results: The global survey consists ofthree questionnaires. The first questionnaire collects data onsurgeon experience and preferences. The second question-naire provides data about electrode insertions for specificindividual surgical cases. The third questionnaire summarizesoverall surgeon experience with the HFMS electrode across anumber of surgical cases. Data from over 100 surgeries acrossmultiple surgeons and sites in North and Latin Americaindicate the type and frequency of surgical techniques appli-cable with the HFMS electrode, and provide selection, accep-tance, and use preferences. For reported surgeries, the HFMSelectrode design was preferred by the majority of surgeons.Minimal deviations from preferred surgical techniques werenoted.

Conclusion: The HFMS electrode design effectivelysupports surgeon preferences for soft-surgery techniques,including roundwindow insertions. It also allows for flexibili-ty in surgical technique depending upon individual patientanatomical constraints.

Keywords: cochelar implant, electrode insertion, soft-surgery.

TL044. The Importance of Reference Electrode Position inCochlear Implants [Otology, Neuro-Otology and Skull BaseSurgery]Ramos De Miguel A., Ramos Macías A., Viera Artiles J., PerezZaballos M. T.Complejo Hospitalario Universitario Insular Materno Infantil de GranCanaria - Spain

Date: May 22, 2015 Time: 8:10am to 8:20am Room:Sala Coral.

Introduction: Extensive research has been conductedon intracochlear electrode position, but very little is availableon the influence of the RE on the electrical stimulationparameters. This study aims to determine whether the vari-ability in RE placement in the temporal bone might be apossible contributing factor to variability in auditory ability inCI patients. We look at whether the placement has a measur-able effect on consumption, and if the electrode position has afunctional effect on the stimulation intensity.

Objective: To determine the effect of Reference Elec-trode (RE) position on electrical current, impedance andpower within the cochlea.

Methods and Results: Three different methods wereused: 1) classical circuit analysis; 2) 2D numerical simulationsand 3) real temporal bone measurements using a purpose-made Cochlear Implant. These three approaches show asignificant decrease in current intensity and electrical resis-tance for distances that are closer to the intracochlear elec-trode. The results also show that to keep a given currentconstant, shorter distances require 33% less power.

Conclusion: This result has attractive perspectives asit shows away to decrease consumption that might result in alonger battery life or more power to be devoted to codingstrategy complexity.

Keywords: Reference Electrode, Cochlear Implant,Electrode position.

TL045. Detecting Deafness Before Birth [Otology, Neuro-Otology and Skull Base Surgery]Covarrubias M.FOL UNAM - Mexico

Date: May 22, 2015 Time: 8:20am to 8:30am Room:Sala Coral.

Introduction: We have studied the developement ofthe human central auditory system in order help detectdeafnees before birth.

Objective: Using a transuterine method to simulate ina non invasive way the fetus and observ by ultrasound theCochleopalpebral réflex and heart rate modificactions. Verifythe otoacustic emissions in the new born.

Methods and Results: Multicentric census simple inregular pregnant patients in between weeks 30 to 32, Plus,developement andWelfare fetus evaluation. Evaluate the fetalheart rate, visualize the fetus head through a transverse plane,the actívate the transuterine stimulator, next observ if theCochleopalpebral réflex occurs, evaluate once again the fetalheart rate and send the information to database and includethe probale date of birth. After birth, apply otocaustic emis-sions and send them to the same database. We use an analysisset with a frecuency database in order a to realize test ofdescriptive statics, behavior data in analized gradually addingup to 2000 subjets.

Conclusion: The results from the new born hearingscreeaning, so far have been useful but limited. The methodWe propose has the ability to detect also neuropathy hearingproblems, fetuses who do non respond to this test, must bestudied with electrophysiogical test, even if traditional new-born screening is normal. The accesibility to repoduce thescientific model, and the willingness of profesionals to diag-nose deafness posibility, made the study a new way of erlydetectionThis afordable device and the simplicity of the test incertainly very useful for our developing countries.

Keywords: Detecting Deafness Before Birth.

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TL046. Bilateral osseointegrated hearing implant: Clinicalevaluation [Otology, Neuro-Otology and Skull Base Surgery]Rivas J. A., García L. E., Rincón L. A., Rivas A. S., Rivas A.Clínica Rivas - Colombia

Date: May 22, 2015 Time: 8:30am to 8:40am Room:Sala Coral.

Introduction: Ossteointegrated hearing implant is awidely recommended alternative for conductive or mixedhearing loss rehabilitation when conventional amplificationis contraindicated or anatomical conditions of the patient notallow the use of conventional amplification.

Objective: To evaluate audiological and quality of lifebenefits of percutaneous bilateral implants.

Methods and Results: Intra-subject study in 10 regu-lar users with more than 6 months of implantation. Mainoutcomes measures are audiometries, sound perception andquality of life surveys. Results: Satisfactory auditory resultsare reported in all cases. Similar auditory results in back-ground noise in unilateral and bilateral use of implants. Betterperception of quality of life.

Conclusion: Auditory outcome is satisfactory in allcases. Bilateral use was related to a better quality of life.Influence of cochlear symmetry and benefits of binauralityare identified.

Keywords: Bilateral osseointegrated implant, audio-logical benefits, quality of life.

TL047. Auditory performance and quality of life in eldersusers of cochlear implant [Otology, Neuro-Otology and SkullBase Surgery]Rivas J. A., Bernal E., Díaz M., Rivas A. S., Rivas A.Clínica Rivas - Colombia

Date: May 22, 2015 Time: 8:40am to 8:50am Room:Sala Coral.

Introduction: There is an increasing number of olderadults that receive cochlear implant and at the same time theacknowledgement to take care the biopschycosocial needs ofthis group of patients. It is fundamental to identify thebenefitsachieved in the rehabilitation process in the deafness of theolder adult patient.

Objective: To identify audilogical benefits, auditoryskills acquisition, satisfaction and quality of life in older adultsusers of cochlear implant.

Methods and Results: Restrospective study witholder adults with profound bilateral sensorineural hearingloss users of cochlear implant. Audiometric evaluation, speechrecognition, auditory skills evaluation protocol, survey foridentification of pre and post implant needs and expectations,discrimination in noise tests and Glasgow Benefit Inventory.Results: Mean improvement in auditory performance of30 � 8 dB was identified. Mean Speech Recognition Thresh-old of 40 � 5 dB. At six months 80%, and at twelve months100% of recognition were observed.

Conclusion: Audiometric gains similar as achieved inyounger patients were identified. Evidence of benefits insocial, familiar, enjoy and quality of life by reintegration.Auditory skills acquisition is influenced by time of deafnessand previous auditory training.

Keywords: older adults, bilateral cochlear implant.

TL048. Cochlear implantation in neurofibromatosis type 2patients [Otology, Neuro-Otology and Skull Base Surgery]Roca-Ribas F., Amilibia E., Perez M., Miro N.Hospital Germans Trias i Pujol - Spain

Date:May 22, 2015 Time: 8:50am to 9am Room: SalaCoral.

Introduction: The evolution or treatment of neurofi-bromatosis type 2 eventually leads to profound deafness. Thetraditional approach is waiting for hearing loss before resec-tion of the vestibular schwannoma, that means often removalof large tumours, and auditory brainstem implantation as theonly auditory rehabilitation option. This implant usually donot allow open set speech discrimination. Vestibular schwan-noma resection with preservation of the cochlear nerve andcochlear implantation has emerged as a reasonable therapeu-tic option.

Objective: Vestibular schwannoma resection withpreservation of the cochlear nerve for a cochlear implantation.

Methods and Results: A retrospective review wasconducted to evaluate 5 patients with bilateral vestibularschwannomes, who underwent resection of the ipsilateralvestibular schwannoma with preservation of the cochlearnerve and cochlear implantation. For the assessment of thecochlear nerve functional integrity an intracochlear test elec-trode was placed via round window before tumour removal.Results: 5 patients (4 unilateral, 1 bilateral sequentially), 6cochlear implants included in the study. 5 cases were im-planted simultaneously in the schwannoma removal surgeryand 1 implant after 2 months removal surgery. Follow upranged from 6 to 132 months (average 48 months). Results:Average disyllabic word recognition score was 88% and puretone average was 34dB.

Conclusion: Cochlear implantation after vestibularschwannoma resection in NF2 patients can be successful,achieving better auditory results than the traditional ap-proach, with auditory brainstem implantation.

Keywords: Cochlear Implant, neurofibromatosis type 2.

TL049. Hearing Preservation In Cochlear ImplantationSurgery [Otology, Neuro-Otology and Skull Base Surgery]Trotic R., Ries M., Ajduk J., Iva K., Andro K.University ENT Dpt. Sestre milosrdnice Zagreb - Croatia

Date:May 22, 2015 Time: 9am to 9:10am Room: SalaCoral.

Introduction: Hearing preservation is possible incochlear implant surgery.

Objective: The purpose of the study was to investigatewhether cochlear implantation using the “soft surgery tech-nique” ( round window approach) provided better preserva-tion of residual hearing than the “classic technique”(cochleostomy approach).

Methods and Results: 15 patients (8 females and 7males) underwent classique CI technique, and 15 patients (7females and 8 males) underwent soft surgery technique. Allpatients got MED-EL CI Pulsar device. The residual hearing ofthe operated ear was measured before and after surgery. Thevariables analyzed were the pure-tone average threshold at250, 500, and 1,000 Hz and the residual hearing at frequenciesof 125 to 12,000 Hz. The residual hearing was considered aspreservedwhen the audiometric changeswere<5 dB hearingloss for each variable. The audiological results of the twogroups were compared.

Conclusion: Preservation of residual hearing is possi-ble in cochlear implant surgery. Residual hearing can bepreserved in a good percentage of cases due to minimisingsurgical trauma (soft surgery). Reducing the extent of traumato cochlear structures must be the goal of every cochlearimplantation procedure.

Keywords: Cochlear implantation, hearing preserva-tion, cochleostomy, round window approach.

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TL050. Electroacoustic stimulation. Development of residualhearing during time [Otology, Neuro-Otology and Skull BaseSurgery]Pinto S. M., Orfila D., Tiberti L., Villani P., Marengo R.ICEM – Implante Coclear Equipo Multicéntrico / CIAC-CEMIC-FLENI -Argentina

Date: May 22, 2015 Time: 9:10am to 9:20am Room:Sala Coral.

Introduction: Hybrid cochlear implants have beendesigned for severe high frequency hearing loss and normalor nearly normal low frequency hearing. As these patientshave no benefits from hearing aids, particularly in noiseenvironments, the combination of both technologies allowsstimulation of mostly the complete frequency range.

Objective: The aim of this study is tomeasure residualhearing function long after surgery (up to 5 years) of Hybrid Lcochlear Implant and to compare the ear implanted with thecontralateral (not implanted).

Methods and Results: At present, three ears receivedHybrid L Cochlear Implants, with preserved hearing aftersurgery and have been using electroacustic stimulation con-stantly. Air and bone conduction is evaluated searching possi-ble auditory changes up to five years both on the implantedand on the contralateral ear to compare evolution. Results:Hearing thresholds were measured before implant, 3 and 6months after first fitting and annually up to 5 years. In thethree caseswas obtained air boneGap between12 and 17.5dB.for 256 to 4096 Hz after surgery. Not evidence of significantshift in hearing thresholds in the implanted ear comparedwith the no implanted one was found.

Conclusion: In three ears with hybrid cochlear im-plant with permanent use and follow up 5 years not evidenceof hearing loss due to electrostimulation or foreign object wasfound. All patients obtained significant benefits from elecro-troacoustic stimulation both in quiet and noisy environments.

Keywords: Electroacoustic stimulation; hybrid sys-tem; bimodal stimulation; residual hearing; residual hearingdevelopment.

TL051. Cuban Cochlear Implant Program: main results indeaf-blind [Otology, Neuro-Otology and Skull Base Surgery]Paz Cordoves A.Hospital Hermanos Ameijeiras - Cuba

Date: May 22, 2015 Time: 9:20am to 9:30am Room:Sala Coral.

Introduction: Cuban Cochlear Implant Program, cov-ering all provinces in Cuban, was created with priority fordeaf-blind.

Objective: To describe the main results: clinical as-sessment, neurophysiological, imagenological, surgical andrehabilitation in deaf-blind.

Methods and Results: Retrospective study of deaf-blind who received a cochlear implant in Cuba between 2000and 2014. From the medical and surgical database wasextracted information. Of the 35 deaf-blind, 30 were candi-dates for Cochlear Implants, two of them adults. The mostfrequent cause of deafblindness was Usher Syndrome and thepresence of risk factors. Furthermore, 23% had an associatedpathology. Deafnesswas verifiedwith electrophysiology tests.Imaging studies do not highlight significant changes andsurgery was without complication in all subjects. The implan-tation was unilateral. The 80% of the Cochlear Implant wereplaced in right ear. Over the last 15 years, the more activitysurgical occurred in 2005, corresponding to a national identi-ficationprogram for the deaf and deaf-blind individuals acrossthe country, after, to date, have continued to give priority to

the deaf-blind. The provinces with the largest number wereHavana, followed by Cienfuegos and Santiago de Cuba. Today,26/27 children received hearing rehabilitation, regularly,showing progress.

Conclusion: Cuban Cochlear Implant Program hasachieved sustained work in the evaluation and implantationof deaf-blind. As result of intensive hearing rehabilitation thedeaf-blind children show progress in language and quality oflife in general.

Keywords: Deaf-blind, Cuban Cochlear Implant Pro-gram, Usher Syndrome, unilateral implantation, hearingrehabilitation.

TL052. Reducing time for medical assistance for treatmentof patients with active transcutaneous bone conductionimplants [Otology, Neuro-Otology and Skull Base Surgery]Tomas M. D.Hospital Son Espases - Spain

Date: May 22, 2015 Time: 9:30am to 9:40am Room:Sala Coral.

Introduction: Hearing loss may have several degreesand causes. When they cannot be treated with hearing aids,implantable hearing solutions are used. However, the initialdisbursement required by implantable solutions has set off anew debate about its cost-effectiveness. When evaluating thehospital costs related to these patients, period of treatment isone of the main elements that should be studied.

Objective: To study the decrease in the time ofmedicalassistance for treatment recipients of active transcutaneousbone conduction implants in comparison with other boneconductionhearing aids, and if thatdecrease is similar to othertranscutaneous implants (i.e. middle ear or cochlear).

Methods and Results: Two patients were implantedwith the BONEBRIDGE active transcutaneous bone conduc-tion system (MED-EL). Since the surgery, carried out onOctober 2012, both patients have been followed up monitor-ing several key issues which will allow evaluating the treat-ment time.

Conclusion: Surgical times were short. No postopera-tive difficulties appeared. Both the time from the surgicalprocedure to the first fitting of the audio processor and thenumber of postoperative consultations were lower than thosewith other bone conduction devices. This data shows that thecost of treatment time is lower than for other bone conductiondevices, and similar to other transcutaneous implants, such ascochlear and middle ear implants, while maintaining similarhearing performance.

Keywords: Treatment time, cost-effectiveness, boneconduction, transcutaneous.

TL053. History of hearing preservation surgery withresidual hearing in children [Otology, Neuro-Otology andSkull Base Surgery]Skarzynski P. H., Lorens A., Skarzynski H.Institute of Sensory Organs - Poland, Medical University of Warsaw -Poland, World Hearing Center, Institute Physiology of Pathology ofHearing - Poland

Date: May 22, 2015 Time: 9:40am to 9:50am Room:Sala Coral.

Introduction: Hearing preservation surgery becamehot topic in otology recently.

Objective: It is very challenging situation due topossibilities of decreasing of hearing thresholds. Especiallyimportant is hearing at low frequencies. The first child withsubstantial hearing was implanted in July 2004 (Partial

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Deafness Treatment-Electric Complement). After that till to-day only several clinics started to perform such surgery onchildren population unlike Partial Deafness Treatment –Elec-tro-Acoustic Stimulation, which was implemented in moreclinics and first cases were implanted over 15 years ago.

Methods andResults: In that study different groups ofchildren with different electrode were assessed. Analysisinclude over 500 children implanted from 1997 to 2014. Inconclusion authors presented individual experience withimplantation different children with different electrodes.Also hearing preservation classification was used to comparedifferent groups.

Conclusion: In conclusion hearing preservation sur-gery in children is safe procedure. Very important is assess-ment period when meticulous analysis should be carried out.Long term observation (over 10 years) is important to showleads for less experienced centers.

Keywords: hearing preservation, cochlear implanta-tion, electric complement, electric-acoustic stimulation.

TL054. Results of the Active Bone Conduction ImplantBONEBRIDGE TM [Otology, Neuro-Otology and Skull BaseSurgery]Bravo Sarasty A. C., Kosaner Kließ M.MEDEL - Colombia

Date:May22, 2015 Time: 9:50am to 10amRoom: SalaCoral.

Introduction: MEDEL .Objective: Bone conduction implants are indicated for

patients with conductive and mixed hearing loss withoutbenefit of conventional hearing aids, patients that cannotuse it for anatomy abnormalities or medical conditions andalso those patients with single sided deafness (SSD). The newtranscutaneous technology avoids several complications ofthe percutaneous bone conduction implants including skinreaction, growth of skin over the abutment, implant extrusionand/or wound infection. Bonebridge is a semi-implantablehearing system with two parts: the inner contains a magnetthat holds the external audio processor. Bonebridge could beimplanted through different approaches: the transmastoid,retrosigmoid or middle fossa approach.

Methods andResults: Several databasewere searchedto identify articles published as of 1st December 2014 usingvariations of the key word bone conduction implant/deviceand Bonebridge. Non-systematic literature reviews, laborato-ry studies, case report, letters and editorials were excluded. Of24 publications identified, nine were eligible to be included inthe systematic review. These covered a total of 73 children andadults, 63 with conductive or mixed hearing loss and 10 withsingle sided deafness.

Conclusion: The Bonebridge is a novel solution forpatients with conductive/mixed hearing loss and Single SidedDeafness. Less complications than percutaneous bone conduc-tion implants and proven benefits for the patients not only interms of profit in speech discrimination and functional gain,are present. Finally BB decreases post-surgical complicationsdue to intact skin.

Keywords: Bonebridge, Bone conduction implants,Hearing Loss.

TL055. Determination of the presence of vestibularmyogenic potential evoked in pediatric patients withcochlear implants using acoustic and electrical stimulation[Balance]Ramos Maldonado D., Gutierrez Farfan I., Luna F., ChamlatiAguirre L. E., Durand A.Instituto Nacional De Rehabilitacion - Mexico

Date:May22, 2015 Time: 10:30am to10:40amRoom:Sala Coral.

Introduction: Potential evoked vestibular myogenic isa myoelectric response of short latency that is created whenthe vestibular system is stimulated by a change in soundpressure high intensity bone vibration or galvanic stimulationreflecting adequate organ function otolith. The sternocleido-mastoid muscle is the site most commonly used clinically forregistration. Potential evoked vestibular myogenic presencedetermines if the saccule and / or the inferior vestibular nerveand central connections are intact and functioning normally.The saccular otolithic organ is more sensitive to sound fre-quencies of 500-750 Hz with 5.1 Hz rate and tone bursts. TheVEMP is present regardless of the hearing threshold and theresults are only comparable between both ears of the patient.A cochlear implant (CI) is a device that processes sound stimulitransforming them into electrical energy that is transmitted tothe.

Objective: To determine if the VEMP is caused byelectrical stimulation through a cochlear implant operation.

Methods and Results: 34 children under 6 years oldwere studied with unilateral cochlear implant which under-went cervical VEMP in the implanted ear and in the non-implanted with acoustic and electrical stimuli using softwareprogramming cochlear implant, comparing the results anddetermining the Potential vestibular myogenic presence. Re-sults: 17 of the 34 patients had VEMP in the non-implantedear, 2 had Potential evoked vestibular myogenic ear implantedwith acoustic stimulation and no patient had VEMP byelectrical stimulation of.

Conclusion: the normal operation of the cochlearimplant stimulation does not produce the vestibular system.

Keywords: myoelectric response, VEMP, cochlearimplant.

TL056. Regenereation of the mandibular branch of rats'facial nerve regenereation after implantingundifferenciated mesenchymal stromal multipotent cellsand differenciated Schwann-like cells in vitro [thesis][General]Salomone R., Bento R. F.HC/FMUSP - São Paulo - Brazil

Date:May22, 2015 Time: 10:40am to10:50amRoom:Sala Coral.

Introduction: Severe lesions in the facial nerve mayhave extensive neural tissue loss leaving isolated stumps thatimpose technical difficulties for nerve grafting.

Objective: The objective of this study is to evaluate thefunctional and histological improvement of the mandibularbranch after neurotmesis and implantation of the undiffer-enciated mesenchymal stromal multipotent (UMSC) and dif-ferenciated mesenchymal stromal multipotent cells (DMSC).

Methods and Results: A Neurotomesis of the rightmandibular branch of the facial nerve with a 3mm-hiatusformation and tubulization of the wounded nerve area wasperformed in 48 Wistar rats. Four groups were dividedaccording to the restoration method: empty silicone tubing(control group); silicone tubing with non-cell gel; siliconetubing with non-cell gel and UMSC and silicone tubing with

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non-cell gel and DMSC. A fifth group was created from thenormal nerve segments to perform histological evaluation.The nerve conduction study evaluated the functional results;quantity and quality evaluation of the distal and proximalsegment evaluated the histological results. RESULTS: Groups Cand D had the highest CMAP potentials amplitude values.Group C had shorter CMAP duration than groups A, B and D.Distal axonal number and density were increased in group Ccompared to groups A and B.

Conclusion: Both UMSC and DMSC benefited regen-eration of the mandibular branch of the facial nerve in Wistarrats, although UMSC presented better functional and histo-logical results.

Keywords: Facial Nerve; Stem cells; Nerve Regenera-tion; Schwann cells; Electromyography; Neural Conduction.

TL057. Compared outcomes in users of percutaneous versustranscutaneous osseointegrated bone conduction hearingimplants [Otology, Neuro-Otology and Skull Base Surgery]Rivas J. A., García L. E., Rincón L. A., Rivas A., Rivas A. S.Clínica Rivas - Colombia, Vanderbilt University - USA

Date: May 22, 2015 Time: 10:50am to 11am Room:Sala Coral.

Introduction: Osseointegrated hearing implants havebecome an option for hearing rehabilitation in individualswith conductive/mixed hearing loss or unilateral deafnesswho cannot be users of conventional hearing aids due tosequels of pathologies or congenital malformation in themiddle/outer ear.

Objective: To compare the audiological outcomes inpatients with conductive/mixed hearing loss or unilateraldeafness implanted with percutaneous or transcutaneousosseointegrated bone conduction hearing implant. To evaluatesatisfaction, health benefit and quality of sound of the devices.

Methods and Results: Transversal study. Surgical,audiological, satisfaction surveys records review with theHearing Device Satisfaction Scale; Speech, Spatial and Qualityof Sound -SSQ; and Glasgow Benefit Inventory; t test (alpha¼ 0.05). 139 percutaneous, 22 transcutaneous implantedpatients were evaluated. In conductive hearing loss, percuta-neous and transcutaneous audiological gains were35 � 11.7 dB SPL and 41 � 9.2 dB SPL (t test, p ¼ 0.137)with 58 � 7.5 dB and 63 � 2.4 dB thresholds for 100% worddiscrimination (p ¼ 0.203) respectively; for unilateral deaf-ness audiological gains were 80 � 16.5 dB SPL and68 � 23 dB SPL (p ¼ 0.048) and thresholds for 100% worddiscrimination at 64 � 5.4 dB and 66 � 7.4 dB (p ¼ 0.654)respectively. There were no statistical differences in thesatisfaction surveys except in the speech quality perceptionSSQ sub-item (p ¼ 0.023).

Conclusion: Percutaneous and transcutaneous os-seointegrated bone conduction hearing implants are effectiveand safe for the auditory rehabilitation in conductive/mixedhearing loss and unilateral deafness patients.

Keywords: Bone conduction hearing implants, percu-taneous, transcutaneous.

TL058. Is headache a complication of retrosigmoidimplantation of the Bonebridge™bone conduction implant?[Otology, Neuro-Otology and Skull Base Surgery]Lassaletta L., Calvino M., Sánchez-Cuadrado I., Zernotti M. E.,Gavilán J.Department of Otolaryngology, La Paz University Hospital, Madrid -Spain; Division of Otolaryngology and Head and Neck Surgery,Sanatorio Allende, Ciudad de Córdoba - Argentina; IdiPAZ ResearchInstitute, Madrid - Spain

Date: May 22, 2015 Time: 11am to 11:10am Room:Sala Coral.

Introduction: The transcutaneous Bonebridge (BB) isan alternative to the percutaneous bone conduction systems.As many patients suffer from chronic otitis media (COM), theretrosigmoid approach avoids any contact of the device withthe pathologic ear, and no side effects are expected.

Objective: To describe our experience with the BBusing retrosigmoid approach. To evaluate disability due toheadache in these patients compared with other auditoryimplants (AIs).

Methods and Results: 22 patients with conductivehearing loss due to COM underwent BB implantation. TheHeadache Impact Test (HIT-6) was used pre and postopera-tively to measure the degree of disability caused by migrainein everyday situations, quantified using 4 impact grades.Additionally, 10 patients with Vibrant Soundbridge middleear implant, and 70 Cochlear Implant users answered the HIT-6 postoperatively. Different grades of retraction of the durawere needed; in 7 subjects, lifts were used to fit the implant inthe bone. Functional gain demonstrated a significant benefit(mean 47dB). No complications occurred in this series. None ofthe subjects increased the HIT-6 scale scores after surgery,with all patients showing none or little impact from headache.Similar results according to the degree of headache impactwere found with the other AIs.

Conclusion: The BB is an effective transcutaneoussolution for patients with conductive or mixed hearing loss.Retrosigmoid implantation is an excellent option for patientswith middle ear diseases or previous surgeries. No risk ofpostoperative headache is expected with this approach.

Keywords: Bonebridge; headache; retrosigmoid ap-proach; outcomes; auditory implants.

TL059. Tinnitus prevalence in the city of São Paulo [Otology,Neuro-Otology and Skull Base Surgery]Oiticica J., Lins E. v. S., Bittar R. S. M.Universidade de São Paulo - São Paulo - Brazil

Date:May22, 2015 Time: 11:10am to11:20amRoom:Sala Coral.

Introduction: The public and private health care inthe city of São Paulo has no data on tinnitus prevalence.

Objective:Determine tinnitus prevalence in São Paulocity.

Methods and Results: Cross-sectional study by fieldquestionnaire with 1960 interviews. Predictor variables in-cluded gender, age, tinnitus. The prevalence of tinnitus was22%. It affects more women (26%) than men (17%) andincreases with advancing age. Approximately one third ofcases (32%) assert that they have constant tinnitus (i.e.,‘‘ringing’’), while most describe intermittent tinnitus (68%).The majority (64%) reported feeling annoyed, while others(36%) denied any annoyance. Among women, the occurrenceof an annoying tinnitus was significantly higher (73%) thanamong men (50%). The percentages were: mildly annoying(11%), moderately annoying (55%), and severely annoying(34%). Tinnitus interferes with daily activities in 18% of thosereporting to be annoyed.

Conclusion: The population in the city of São Paulosuffering from tinnitus was more prevalent than previouslyestimated. Generally, it affects more women and those with-out occupation, and increases significantly with age. Mostrespondents described the tinnitus as annoying, and this wasmore prevalent in females. The degree of discomfort mea-sured by a Visual Analogue Scale showed moderate tinnitus,with responses averaging 6.3.

Keywords: Tinnitus, Epidemiology, Prevalence.

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TL060. Osseointegrated percutaneous auditory implantstability: Resonance Frequency Analysis study [Otology,Neuro-Otology and Skull Base Surgery]Rivas J. A., Bernal E., Forero V. H., Rivas A. S., Rivas A.Clínica Rivas - Colombia

Date:May22, 2015 Time: 11:20am to11:30amRoom:Sala Coral.

Introduction: Stability achievement in osseointe-grated implants and its continuity are requirements for theclinical success. Clinical studies have identified a 4-6 monthsin adults and 6-8months of waiting variable period to load theprocessor. It remains the question regarding the safety ofshortening the time to load the processor. A simple method tomeasure implant stability is the Resonance Frequency Analy-sis (RFA) that measures the percutaneous implant stability asfunction of integration of the bone-implant complex.

Objective: To evaluate and to identify stability (pri-mary and secondary trend) of the osseointegrated percutane-ous auditory implant through RFA.

Methods and Results: Prospective study in patientsimplanted with osseointegrated percutaneous auditory im-plant. Measurement of implant stability quotient (ISQ) byresonance frequency analysis at surgery, 3, 6 and 12 monthspostoperative. Analysis by age group, and correlation of ISQwith age, weight, body mass index, co-morbidities. Results:Significant differences in the ISQ values between the basal(perioperative) and firstmonth postoperative aswell betweenfirst – fourth months with a stabilization trend after 4 monthswere observed. At 4 months, significant difference in meanISQ values between children and adults were observed.Inverse relation of ISQ values with age and height wasobserved. ISQ value is less variable at he ages 27 to 47 years.

Conclusion: Stability decrease during first twomonths. As long as there are new bone formation and healing,stability becomes higher.

Keywords: Percutaneous osseointegrated auditoryimplant, stability, resonance frequency analysis.

TL061. Current indications of Vibrant Soundbridge:audiological and surgical issues [Otology, Neuro-Otologyand Skull Base Surgery]Gavilán J., CalvinoM., Sánchez-Cuadrado I., Muñoz E., LassalettaL.Department of Otolaryngology, La Paz University Hospital, Madrid -Spain; IdiPAZ Research Institute, Madrid - Spain

Date:May22, 2015 Time: 11:30am to11:40amRoom:Sala Coral.

Introduction: The Vibrant Soundbridge (VSB) middleear implant is a treatment option for patients with a variety ofmiddle ear conditions such as open cavities. The VORP 503 andnewcouplers havebeen introduced to expand the possibilitiesof treatment.

Objective: To report our experience in adults withopen cavities implanted with the VSB placed in the roundwindow (RW), and our preliminary experience with the VSBattached on the short process of the incus using the newVORP503 and SP-Coupler.

Methods and Results: 12 patientswithmixed hearingloss, all with previous middle ear surgery underwent RWvibroplasty. Intraoperative electrocochleography was com-pleted during surgery to ensure the FMT coupling to theRW. Subjective benefit was evaluated using the NijmegenCochlear Implant Questionnaire (NCIQ), Glasgow Benefit In-ventory (GBI) and Hearing Implant Sound Quality Index(HISQUI29) tests. Besides, in 1 patient suffering from sensori-neural deafness the new SP-Coupler was chosen.RW vibro-

plasty: mean follow-up was 42mo. Mean functional gain was34dB and speech discrimination score at 65dB (SDS) improvedfrom14 to 83%. All NCIQ domains improved following surgery.All patients had a positive overall GBI score. The mean qualityof sound was defined as “very good”. SP-Coupler: at firstfitting, the functional gain was 17dB, and SDS shifted from 35to 100%.

Conclusion: The VSB represents a safe and reliablesolution of hearing restoration in adults with open cavitiessuffering from mixed/conductive deafness. Preliminary re-sults with the SP-Coupler are promising.

Keywords: Vibrant Soundbridge; open cavities; vibro-plasty; SP-Coupler; hearing outcomes.

TL062. HES-1 And COUP-TFI Shrna Knocking Down Give RisesTo New Hair Cells And Supporting Cells In Organ Of CortiOrganotypic Culture [Otology, Neuro-Otology and SkullBase Surgery]Batissoco A. C., Lezirovitz K., Bissoli M. M., Zanatta D., StraussB., Vasques L. d R., Mingroni–Netto R. C., Haddad L. A., Bento R.F., Oiticica J.University Of São Paulo - São Paulo - Brazil

Date:May22, 2015 Time: 11:40am to11:50amRoom:Sala Coral.

Introduction:Notch pathway proteins, includingHes-1, may play a role in keeping SC phenotype and prevent themfrom becoming HC by lateral inhibition mechanism.COUP-TFIis expressed during early otic vesicle development and itsexpression is correlated with the differentiation of HC and SCin the organ of Corti (OC).

Objective: Compare the expression of HC and SCmarkers and quantify the mRNA and protein levels afterknocking down Hes-1 and COUP-TFI transcripts in OC organo-typic cultures of postnatal day 3 (P3) mouse pups.

Methods and Results: About 48h after lentiviraltransfectionwe evaluated the results through three strategies:(i) qRT-PCR for quantify the mRNA levels; (ii) Immunofluores-cence of organ of Corti cryostat sections and (iii) flow cytom-etry to investigate the protein expression. Six differentconditions were analyzed; control (without transfection),scrambled (only lentivirus), two target for silencing of Hes1and two target for silencing of Coup-Tf1 silencing.Weused thescrambled as the reference sample. Among the conditionswilling to silence Hes1 gene, the one with the highest level ofsilencing (Hes1.I�30%), though not too high, showed remark-able results such as increased levels of expression of Myo7a(HC marker) and Connexin 26 (SC marker). On the other handamong the conditions willing to silence Coup-Tf1 gene, theonewith highest level of silencing (Coup-Tf1.VII�1%), thoughreally low, revealed increased levels of expression of Myo7a(HC marker) and Connexin 26 (SC marker).

Conclusion: These findings suggest minor silencing ofHes1 gene or Coup-Tf1 gene leads to cell proliferation, bothhair and supporting cells.

Keywords: hearing, shRNA, knocking down, Hes1,Coup, mouse.

TL063. Importance of Hearing Preservation to ensure aHearing Future [Otology, Neuro-Otology and Skull BaseSurgery]Bravo Sarasty A C., Jolly C.MEDEL - Colombia

Date: May 22, 2015 Time: 11:50am to 12pm Room:Sala Coral.

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Introduction: Hearing preservation could be under-stood as the combination of technology, training and techni-ques to ensure that the delicate neural structures in thecochlea are left undamaged. For the last decade, 2 conceptsand 2 strategies have dominated the approach for intracochlear stimulation: 1.Perimodiolar placement of short preshaped electrodes usually with many contacts over a shortdistance andmainly covering the basal turn (up to 22 contactsover 15 mm in one design). 2.Lateralwall placement of severalcontacts over a long distance reaching the apical region andcovering 2 cochlear turns or more (down to 12 contacts over26 mm). The 1st concept assumes that partial cortical remapping allows patients to perceive low frequency pitch afteran adaptation time lastingup to several years. The 2nd conceptassumes that low frequency neural elements are directlystimulated by electrodes located in the 2nd turn and closeto the apical region.

Objective: Demonstrate that patients with long freefitting lateral wall electrodes perform better than patientimplantedwith short lateral wall electrodes unless significantresidual hearing is present and conserved and electro acousticstimulation is used.

Methods and Results: Several databases weresearched to identify articles published using variations ofthe key word between hearing preservation, residual hearingand cochlear implant. More than 90 publications wereidentified.

Conclusion: Deep electrode insertion up to 2 turn ofthe scala tympani may not compromise the structures of thecochlea and with atraumatic electrodes, the young patientscould have access to future pharmacological therapies.

Keywords: Cochlear Implant, Residual Hearing, Hear-ing Preservation.

TL064. Postoperative quality of life in patientswith cochlearimplants [Otology, Neuro-Otology and Skull Base Surgery]Ordóñez-Ordóñez L. E., Mora Diaz C., González Marín N. R.,Rodriguez S. R.Clínica Colsanitas. Clínica Universitaria Colombia - Colombia; HospitalMilitar Central - Colombia

Date: May 22, 2015 Time: 12pm to 12:10pm Room:Sala Coral.

Introduction: The benefits of cochlear implantationoutweigh the hearing rehabilitation and encouragement ofspoken communication, and include an improvement inquality of life, an aspect with increasing interest for study.

Objective: To assess the health related quality of life inpatients with cochlear implant who have completed theauditory-verbal therapy.

Methods andResults:Methods: Cross-sectional studyconducted at the otolaryngology department of HospitalMilitar Central; Bogotá, Colombia. Adolescents and children(>8 years) with cochlear implant who have completed theauditory-verbal therapy (therapy �5 years) were included.The study was conducted in two phases. Phase I, pilot testing,the measuring instrument was selected by evaluating theKINDL and KIDSCREEN scales. Phase II, the descriptive studyof health related quality of life between patients with cochlearimplants, with the scale selected in the phase I. Results: 13patients were analyzed in Phase I and the KIDSCREEN scalewas selected as the measurement instrument (Spanish ver-sion validated in Colombia). In Phase II 20 patients wereincluded (female ¼ 11, Male ¼ 9) with an average age ¼ 9.6� 1.04 years. In the patient version the overall score was68.4 � 3.7., lower value than that reported by healthy peers inColombia. The subscale with the better performance was

School Environment ¼ 73 � 5.9. In the proxy version theoverall score was 76.9 � 7.4.

Conclusion: The study patients reported a healthrelated quality of life with lower levels than those reportedby healthy peers in Colombia.

Keywords: Cochlear Implant. Health Related Qualityof Life. Neurosensorial Hearing Loss.

TL065. Audiometric thresholds and speech perceptionsentence test outcomes in adults and elderly after cochlearimplantation [Otology, Neuro-Otology and Skull BaseSurgery]Santos M. D., Guimaraes A. C., De Carvalho G. M., Rocha V. B C.,Castilho A. M.Unicamp - São Paulo - Brazil

Date: May 22, 2015 Time: 12:10pm to 12:20pmRoom: Sala Coral.

Introduction: The cochlear implant is an option forthe treatment of post-lingual, severe to profound sensorineu-ral hearing loss. Although the elderly may have limited resultsafter cochlear implantation due to degeneration of spiralganglion cells and the conduction pathways to the cortex,there are few studies on the topic.

Objective: To compare the audiometric thresholds andspeech perception sentence test, between two groups withpost-lingual, severe to profound bilateral sensorineural hear-ing loss.

Methods and Results: Retrospective study, with 59patients that were divided into 2 groups (30 adults and 29elderly). We compared the hearing thresholds at frequencies250Hz, 500Hz, 1kHz, 2kHz, 3kHz, 4kHz, 6kHz and 8kHz, andthe results of speech perception sentence test. We includedonly patients with at least one year of CI experience. The studygroup included 29 patients with a mean age of 69 years. Theaverage audiometric threshold was 29 dB and the averagevalue of speech perception test was 90%. The control groupincluded 30 patients with a mean age of 44 years. Theaudiometric threshold value in the medium group was26 dB, and the average value of speech perception test was94%. The Mann-Whitney test was considered significant(p < 0.05) only for speech perception test and 6-8 KHzfrequencies.

Conclusion: Both groups had excellent outcomes inaudiometric and speech testing with the use of cochlearimplant, but with a significant better performance in theadult group.

Keywords: cochlear implants; elderly; speech test;rehabilitation of hearing impaired.

TL066. Using the HISQUI29 to assess the sound quality levelsof Spanish adults with unilateral cochlear implants and nocontralateral hearing [Otology, Neuro-Otology and SkullBase Surgery]Sánchez-Cuadrado I., CalvinoM., Lassaletta L., Pérez-Mora R.M.,Gavilán J.Department of Otolaryngology, La Paz University Hospital, Madrid -Spain; IdiPAZ Research Institute, Madrid - Spain

Date: May 22, 2015 Time: 12:20pm to 12:30pmRoom: Sala Coral.

Introduction: There has been clinical interest in as-sessing cochlear implant (CI) users quality of life (QoL) andsound quality.

Objective: To evaluate CI users’ self-reported level ofsound quality and QoL.

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Methods and Results: Sound quality was self-evalu-ated using the Hearing Implant Sound Quality Index (HIS-QUI29). QoL was self-evaluated using the Glasgow BenefitInventory (GBI). Scores were further examined in 3 subsets.Possible correlations between the HISQUI29 and GBI wereexplored. Possible correlations between these scores andsubjects’ pure tone averages, speech perception scores, ageat implantation, duration of hearing loss, duration of CI use,gender, and implant type were explored. Subjects derived a“moderate” sound quality level from their CI. TV, radio, andphone tasks were easier in quiet than in background noise.89% of subjects reported their QoL benefited from having a CI.Mean total HISQUI29 score significantly correlated with allsubcategories of the GBI. Age at implantation inversely corre-lated with the total HISQUI29 score and with TV and radiounderstanding. Sentence in noise scores significantly corre-lated with all sound perception scores. Women had a bettermean score in music perception and in phone use than didmen.

Conclusion: CI users’ levels of sound quality signifi-cantly correlated with their QoL. CI had a beneficial impact onsubjects’ QoL. Understanding speech is easier in quiet than innoise.Music perception remains a challenge formany CI users.The HISQUI29 and the GBI can provide useful informationabout the everyday effects of future treatment modalities,rehabilitation strategies, and technical developments.

Keywords: HISQUI; sound quality; cochlear implant.

TL067. Cochlear Implant In Labyrinthitis Ossificans [Otology,Neuro-Otology and Skull Base Surgery]Lavor M. S., Coelho G. V., Guimarães A. C., Carvalho G. M.,Castilho A. M.UNICAMP - Universidade Estadual de Campinas - São Paulo - Brazil

Date:May 22, 2015 Time: 2pm to 2:10pm Room: SalaCoral.

Introduction: Labyrinthitis ossificans is a pathologicossification in the otic capsule due to an inflammatory ordestructive process. The main causes are meningitis, traumaand otosclerosis. A Cochlear ossification result in sensorineu-ral hearing loss, and its presence is associated with technicaldifficulties and poorer functional results. Advances in surgicaltechniques and bioengineering provided the development ofspecial electrodes for this condition.

Objective: This study aimed to evaluate the functionalresults and describe the performance of patients that under-went to cochlear implantation with short compressed ordouble-array cochlear implantation in ossified cochlea.

Methods and Results: A retrospective and transversalanalysis of data on demographic aspects, auditory perform-ances and surgical findings was made. A transorbital radio-graph was used to evaluate electrode migration and insertiondepth and the position of the internal component. All patientswho underwent either partial insertion of a standard elec-trode array or double-array electrode insertion for theircochlear implantation in a quaternary centre in the last fiveyears were included. Results: Eight patients (six adults andtwo children) were included. The cause of labyrinthitis ossi-ficans was bacterial meningitis in six cases, Cogan's syndromein one patient and trauma in another patient. Most patientswere implanted in adulthood and the average duration ofdeafness was 104.5 months.

Conclusion: Patients with ossified cochlea benefitssignificantly from double-array and compressed short arraycochlear implantation.

Keywords: Cochlear implant; labyrinthitis ossificans;hearing loss.

TL068. Experience with the new SAMBA audio processor forthe Vibrant Soundbridge [Otology, Neuro-Otology and SkullBase Surgery]Ruiz De Erenchun I., Boleas M. S., Ansorena P., Bulnes M. D., DelCarmen M.Complejo Hospitalario De Navarra - Spain

Date: May 22, 2015 Time: 2:10pm to 2:20pm Room:Sala Coral.

Introduction: Nowadays the conductive, sensorineu-ral and mixed hearing losses associated with medical prob-lems can be treated using middle ear semi-implantableprosthesis with very successful results. One of this implantsystems is Vibrant Soundbridge. The new technology imple-mented in the internal parts combined with the state-of-the-art signal processing used in the audio processor (externalpart) allow more surgical possibilities and better results incomplicated listening conditions.

Objective: To evaluate the benefits of the semi-im-plantable prosthesis Vibrant Soundbridge and to establish theimprovement from using the new audio processor SAMBAcomparing with the older processor.

Methods and Results: Subjects adults with sensori-neural, conductive and mixed hearing loss implanted mono-aurally with Vibrant Soundbridge in the poorer hearing ear,experienced with the older audio processor ranged from 3 to38 months are evaluated. Each subject served as his or herown control. These subjects will try the new audio processorSAMBA for a time, enough to compare between both devices.Functional gain and speech discrimination using the newSAMBA audio processor will be compared to data obtainedwith the older audio processor. The average of the functionalgain obtained with the older audio processor is 33 þ/- 10 dBand speech recognition with the Vibrant increases 16 þ/-14dB and the speech discrimination@65dB increased 20þ/-27 %. An improvement is expected.

Conclusion: The middle ear implant Vibrant Sound-bridge is an effective method of hearing restoration for theirmixed and conductive hearing losses for the majority of thesubjects.

Keywords: Semi-implantable systems, sensorineural,conductive, mixed hearing loss, Vibrant Soundbridge, audioprocessor, Samba.

TL069. Sociodemographic And Clinical Characteristics,Complications And Use Profile Of Cochlear Implant PatientsOf Clinica De Occidente De Otorrinolaringologia DeMedellin: 11 Years Of Experience [Otology, Neuro-Otologyand Skull Base Surgery]Schwarz M. J., Marulanda M., Mazuera N., Vanegas G. A.,Perez P. I.Clínica Occidente De Otorrinolaringologia De Medellin - Colombia;Universidad De Antioquia - Colombia

Date: May 22, 2015 Time: 2:20pm to 2:30pm Room:Sala Coral.

Introduction: The cochlear implant is a safe andeffective besides, a proportion of patients do not use it. InMedellin, Colombia, there are no studies that describe thesociodemographic and clinical characteristics of patients withcochlear implants.

Objective: Describe the main demographic and clini-cal characteristics and the complications related to cochlearimplant surgery likewise the usage profile of the device, inpatients undergoing cochlear implantation in Clínica de Occi-dente de Otorrinolaringología in Medellín.

Methods and Results: A descriptive retrospectivestudy was conducted in 283 between 2001 and 2012. Median

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agewas 16 years and 56.2%were female. 42.4% had a diagnosisof prelingual; Perilingual 9.2%, and 48.4% poslingual. Themedian age of implantation of prelingual patients was 4.8years, periliguals 16 years and poslinguals 48 years. Mostrelevant perinatal history were STORCH. Abnormal findingson CT were chronic otitis media in 11% and large vestibularaqueduct at 4.6%. The main intraoperative complication wasthe need to insert the backup, in 1.1%. During the first 24hours: severe vertigo in 2,8%. At 2 weeks facial palsy 1,4%. andafter two weeks the presence of pain 5.7%. 65.4% of patientsuse the implant more than two hours a day and 20% do not useit. The main reason of not use was technical failure.

Conclusion: It is essential to develop strategies toimprove diagnosis and early rehabilitation, in the same man-ner ensure in the long term the adecuate maintenance of thedevice and monitor them prospectibly for the use of theimplant.

Keywords: cochlear implantation, Population Charac-teristics, Complications, non-use.

TL070. Bilateral cochlear implant in postlingual adults[Otology, Neuro-Otology and Skull Base Surgery]Rivas J. A., Díaz M., Rivas A. S., Rivas A., Forero V. H.Clínica Rivas - Colombia

Date: May 22, 2015 Time: 2:30pm to 2:40pm Room:Sala Coral.

Introduction: To overpass the limitations imposed bynoisy environments, to increase the speech discriminationand accurate localization of sound in patients with profounddeafness, bilateral implantation is an increasing clinicalpractice.

Objective: To show audiological outcomes, speechperception in noise, sound perception and quality of life inadults users of bilateral cochlear implant.

Methods and Results: Eighteen cochlear implantusers evaluated with audiological tests, performance withbackground noise, speech performance in different compe-tence situations with Speech Spatial and Quality of Life scale.Quality of life evaluated with Glasgow Benefit Inventorysurvey. Evaluations were made under three conditions (right,left cochlear implant alone and both). Results: Postlingual deafadults, mean age 40 years-old (minimum 23, maximum 72),70% men. Time of deafness 4 years, 12 months minimum useof cochlear implant. Preop postop difference 56dB þ /-12p < 0.001. Discrimination difference of 15% between unilat-eral en bilaterals was observed. Improvement of 15% in threedimensions of SSQ. Better scores in GBI by bilateral users.

Conclusion: Better performance in tests with noise;less difficult in the speech perception and spatial localizationin Speech Spatial and Qualities of Life aspects are shown.Improvement in social life and 50% in work performance arereported.

Keywords: Adult, bilateral cochlear implant, quality oflife.

TL071. Single sided deafness: Options for rehabilitation[Otology, Neuro-Otology and Skull Base Surgery]Rivas A. S., Rincón L. A., Forero V. H., Rivas J. A., Rivas A.Clínica Rivas - Colombia, Vanderbilt University - USA

Date: May 22, 2015 Time: 2:40pm to 2:50pm Room:Sala Coral.

Introduction: In single sided deafness patients, torecommend options for rehabilitation is a challenge for theevaluation team and a dilemma for patients. Undoubtedly thedebate is rising and it is modelled by the needs and prefer-

ences of the patients, as well as by the options in hearingprosthesis available in continuous technological evolution.

Objective: To evaluate and to compare the effectivitybetween different options of treatment for single sided deaf-ness patients: cochlear implant, bone conduction systems,hearing aids and none.

Methods and Results: Intra-subject study with pro-found single sided deafness patients users of cochlear implantor bone conduction implants exposed to a test with profoundinsertion earmold hearing aid and/or CROS system during 4weeks. Outcomes to evaluate: Audiological measurementswith and without background noise, satisfaction perceptionand quality of life with the device. Results: At the wordrecognition threshold, the best results are obtained with thetranscranial transmission. In the spatial feature, higher benefitis identified with cochlear implant. Benefit in word discrimi-nation in noise with implantable devices, transcranial trans-mission, as well as cochlear implant is superior than thoseachieved with hearing aids.

Conclusion: An adjustment to the auditory require-ments for eachpatient is needed in order to achieve the properindication for the auditory aid.

Keywords: Single sided deafness, rehabilitation, co-chlear implant, hearing aid.

TL072. Intraoperative objectivemeasurements – experiencewith the CR220 Remote Assistant [Otology, Neuro-Otologyand Skull Base Surgery]Hocsman E.Universidad de Buenos Aires - Argentina

Date:May 22, 2015 Time: 2:50pm to 3pm Room: SalaCoral.

Introduction: Neural Response Telemetry of cochlearimplant system is a quick and non-invasive way of recordingthe electrically evoked compound action potential (ECAP) ofthe peripheral auditory nerves in-situ. It gives cliniciansvaluable information for programming the T- and C-levels ofthe recipient’s speech processor MAP, and records the neuralresponses to electrical stimulation at discrete sites along thealong the electrode array. The impedances tests allow anenhanced comprehension of the setting of the CI in the cochleaand of its performance. Intraoperative threshold measure-ment and impedances tests are part of the cochlear implanta-tion procedure and in the current setting are conducted byclinicians by a standard set-up with a software, computer,speech processor and cables. The newly CR220 IntraoperativeRemote Assistant is a handheld device and can also be used bysomeone already in the operating theatre.

Objective: Ensure the general performance and us-ability of the CR220. Compare the Custom Sound softwareresults with the remote and determine the feasibility ofremote testing to improve time efficiency and reduce cost.

Methods and Results: The study was prospective,single site, between subject measurements. It was conductedat the otolaryngology department of the Hospital de Clinicas –Universidad Buenos Aires 26 intraoperative tests were done.Age, time of auditory deprivation, etiology of hearing loss.cochlear anatomy and also the insertion were evaluated.Thesame results were find in Custom Sound and CR220.

Conclusion: The CR220 Intraoperative Remote Assis-tant is very useful tool and the results are similar to the onesmea.

Keywords: Cochlear Implant. NRT. ECAP, Impedances.

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TL073. Bonebridge surgery under local anesthesia [Otology,Neuro-Otology and Skull Base Surgery]Manrique M., Manrique R., De Abajo J.University of Navarra Clinic - Spain

Date: May 22, 2015 Time: 4:30pm to 4:40pm Room:Sala Coral.

Introduction: The Bonebridge (BB) system is a re-markable solution for certain types of conductive or unilateralhearing losses with head shadow effect.

Objective: To describe the surgical technique underlocal anaesthesia and to show the results obtained. The habitof working with local anaesthesia in middle ear surgery andthe reduction of costs (ambulatory procedure, no expenses forsurgical room occupancy and general anaesthesia), were themain reasons to carry out this surgery under local anaesthesia.

Methods andResults: 6 patientswere selected for thisprocedure under local anaesthesia with the BB. 5 sufferedfrom a chronic otitis media (COM) with antecedents of failedtymplanoplasties. The sixth patient was surgically intervenedof a left acoustic neuroma. A CT scan processed with the3DSlicer and BBFastview software allows us to accurately planour surgery by digitally placing the BC-FMT on the selectedarea according to the skull thickness. For the local anaesthesia,we use a combination of lidocaine and 2% epinephrine. Aspecially designed surgical cover was used to avoid a claus-trophobic effect. To mask the drilling sound, we used a mp3player with a headphone on the contralateral ear. All patientstolerated the surgery without complication and were inter-vened under local anaesthesia and the BCI was placed satis-factory. In 3 cases the selected location to implant the BC-FMTwas sinodural angle and in the other 3 the retro sigmoid area.The dura and the sigmoid sinus were exposed and slightlycompressed in 3 cases.

Conclusion: Implantation of the BB with local anaes-thesia is a safe and feasible procedure.

Keywords: Local anaesthesia, Cochlear Implantation,BAHA, Bonebridge.

TL074. Preliminay results using the new “Couplers” for theVibrant Soundbridge implant and the new VORP 503[Otology, Neuro-Otology and Skull Base Surgery]Manrique M., manrique R., De Abajo J., Girón L.University of Navarra Clinic - Spain

Date: May 22, 2015 Time: 4:40pm to 4:50pm Room:Sala Coral.

Introduction: The middle ear active implant VibrantSoundbridge is a device designed for the treatment of thesensorineural, mixed and conductive hearing losses. Depend-ing on the type of the hearing loss and the anatomicalcondition of the different middle ear structures, the place-ment of its FloatingMass Transducer (FMT) can be carried outin different ossicular chain points or directly on the round oroval window, aimed to obtain a direct stimulation of theinternal ear. Recently, new Couplers have been designed toobtain a better coupling of the FMT with this structures.

Objective: To expose the preliminary results using theCouplers and the new VORP 503.

Methods and Results: At the moment of this abstract,a sample of three patients treated with VSB-Couplers is beingstudied. Two of them suffered amixed hearing losswith a highconductive component, RW-Soft-Couplers were used in thesecases. The other case suffered a sensorineural hearing loss anda Incus-LP-Coupler was used. The results were comparedwitha control group of 18 patients implantedwith this device, withthe FMT attached to the ossicular chain or round windowwithout a Coupler. The surgeon perceives that the Couplers

simplify the surgical process, allow for a more stable couplingand minimize the risks of post-surgical FMT movement aswell. The preliminary analysis of the audiometric studies, incomparison with the control group, shows equivalent resultsin both groups.

Conclusion: The results confirm the benefit obtainedwith the cochlear stimulation using the Couplers with theVibrant Soundbridge.

Keywords: IHA, Hipoacusia, Couplers in Implantablehearing aid surgery.

TL075. Active Bone Conduction Implant - Retrosigmoidimplantation of Bonebridge in Chronic Otitis Media[Otology, Neuro-Otology and Skull Base Surgery]Oliveira E. B., Souza T. d S., Jorge J. C., Lourençone L. F M., BritoNeto R. V.Hospital de Reabilitação de Anomalias Craniofaciais da Universidadede São Paulo - São Paulo - Brazil

Date:May 22, 2015 Time: 4:50pm to 5pm Room: SalaCoral.

Introduction: The Bonebridge is a semi-implantablehearing system, the first active bone conduction implantsystem in the world. The system consists of an externalcomponent and an internal component, which is positionedcompletely below the intact skin and contains a magnet thatholds the audio processor over the implant.

Objective: This study aims to describe four cases ofBonebridge implantation in patientswith chronic otitismedia,using a retrosigmoid approach.

Methods and Results: Four subjects affected by con-ductive/mixed hearing loss due to previous bilateralwall downmastoidectomies for cholesteatoma treatment, underwentimplantation of the Bonebridge by retrosigmoid approach.Soundfield thresholds were assessed with warble tones in asoundproof audiometric booth, andword recognition scores asspeech reception thresholds (SRTs) were used to compare theunaided versus the post-implantation condition. The Satisfac-tionwith Amplification in Daily Life questionnaire was admin-istered pre- and postoperatively. Therewere no intraoperativeor postoperative complications. Activation was performedafter 30 days. All implanted patients presentedwith SRT below30dB and reached 100% word recognition, with an averageimprovement of the SRT in quiet with the Bonebridge incomparison to the unaided condition of 21.25 dB.

Conclusion: The Bonebridge was a safe alternative forpatients with conductive hearing loss and anatomical limi-tations for the use of conventional sound amplification devicesand with advantages over other bone conduction devicescurrently available.

Keywords: Bonebridge, chronic otitis media, retrosig-moid, bone conduction implant.

TL076. Electroacoustic Stimulation. Assessment of auditorygain in older adults [Otology, Neuro-Otology and Skull BaseSurgery]Pinto S. M., Raggi V., Orfila D., Tiberti L., Marengo R.ICEM – CIAC - CEMIC – FLENI - Argentina

Date:May 22, 2015 Time: 5pm to 5:10pm Room: SalaCoral.

Introduction: Hybrid cochlear implants have beendesigned for severe high frequency hearing loss and normalor nearly normal low frequency hearing. As these patientshave no benefits from hearing aids, especially in noise envi-ronments, the combination of both technologies allows stim-ulation of mostly the complete frequency range. Audiological

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candidates are frequently in the population older than 65years old.

Objective: The aim of this study is to assess auditorygain and permanent use of electroacoustic stimulation (Hy-brid L Cochlear Implant) in 2 patients older than 65 years oldat the moment of surgery.

Methods and Results:Material andMethods: To assesauditory gain in quiet and noise to two hybrid cochlearimplant users who received their cochlear implant at 76and 71 years old. Auditory discrimination of words wasevaluated in different equipment conditions: without assis-tive device, with hearing aid alone, with implant alone andwith hybrid cochlear implant plus hearing aid. Results: Hear-ing thresholdsweremeasured before implant, 3 and 6monthsafter first fitting and annually up to 5 years. Not evidence ofsensorioneural hearing deterioration during or post surgerywas found. Speech discrimination was improved from 0-30%to 70-90% in noise when the two devices are on.

Conclusion: In the two cases of older adults withhybrid cochlear implant with permanent use and follow up5 years not evidence of hearing loss due to electrostimulationor foreign object was found. The two patients obtainedsignificant benefits from elecrotroacoustic stimulation bothin quiet and noisy environments. Both patients use bimodalstimulation permanently.

Keywords: Electroacoustic stimulation; cochlear im-plant; hybrid system; bimodal stimulation; older adults.

TL077. Otosclerosis and cochlear implants: technicalfeatures, medium and long-term results [Otology, Neuro-Otology and Skull Base Surgery]Bebear J. P., Bonnard D., Darrouzet V.Bordeaux ENT School. Bordeaux University - France

Date: May 22, 2015 Time: 5:10pm to 5:20pm Room:Sala Coral.

Introduction: Otosclerosis is a relatively commoncause of acquired severe to profound bilateral deafness andrepresents 7-10 % of cochlear implants indications in adults.However, the presence of otosclerosis remains classicallyconsidered a poor prognostic factor in terms of functionaloutcomes of cochlear implantation, particularly in cases ofadvanced peri-cochlear lesions witch may complicate elec-trode array insertion.

Objective: The objective of this study is to present ourexperience and medium and long-term results on 38 patientswith otosclerosis implanted in University Hospital ofBordeaux.

Methods and Results: Quality MRI and thin-sectionCT imaging is essential to take stock of the lesions and provideany surgical difficulties, especially near the round windowand basal turn of the cochlea. The choice of implanted sidepartly depends on this radiological diagnosis. In our experi-ence, surgical difficulties are often minimal, and a posteriortympanotomy with round window approach allowed fullinsertion of the electrode array in 31 cases out of 38. In caseof obstruction of the basal turn of the cochlea, milling 3 to4 mm deep into the basal turn usually can remove theobstacle. The functional results are quite comparable to thoseof other etiologies of deafness receiving cochlear implants. Inour series, more than 70% of patients with otosclerosis haveachieved good or very good audiometric results 18 monthsafter cochlear implantation. When possible, bilateral cochlearimplantation further improves performance, primarily forsound localization and speech understanding in noisyenvironments.

Conclusion: Cochlear implantation in otosclerosis hasfunctional results quite similar as other etiologies of deafness.

Keywords: otosclerosis, cochlear implants, functionalresults.

TL078. Experience In Elderly Poslingual Patients WithCochlear Implant [Otology, Neuro-Otology and Skull BaseSurgery]Santamaria S., Perez B., Valencia J.Fundacion Clinica Valle Del Lili - Colombia

Date: May 22, 2015 Time: 5:20pm to 5:30pm Room:Sala Coral.

Introduction: Introduction. This is a clinical studyreport with 3 women and 1 man with a cochlear implant,age above 60, a deep bilateral hearing loss evolution between20 and 30 years, and serious difficulties in auditory discrimi-nation, communicative abilities and quality of life.

Objective:Objective. Demonstrate that patients above60 years old diagnosed with a deep bilateral hearing loss mayimprove their auditory discrimination, communicative abili-ties and quality of life with the cochlear implant.

Methods and Results: Sample. It was comprised by 4subjects: 3 female and 1 male; average age 70.5; and with ahearing loss progression time between 20 and 30 years. Theywere taken to surgery after fulfilling the cochlear implantcriteria. Two types of implants were used: Hi Res 90 K-Neptune of Advance Bionics, and Contour Advance-Freedomof CoClear. A lower-anterior cochleostomy techniquewas usedwith all patients. Instruments. Several test were used, such as:Ling sounds Test, two syllables Test: open lists, No supportsentences Test, Quality of life andHealth Inventory (InCaViSa),and the Cochlear Implant psychiatric evaluationQuestionnaire.

Conclusion: Conclusion. Patients above 60 years old,have benefits in auditory discrimination, communicative abil-ities, and quality of life with the cochlear implant and therehabilitation process.

Keywords: Key words: Cochlear Implant, senior adult,post-lingual, deep bilateral hearing loss.

TL079. Binaural Hearing Benefit after Cochlear Implantationin a child with Single-Sided Deafness [Otology, Neuro-Otology and Skull Base Surgery]Altuna X., Martinez Z., Alvarez L., Fernández M d P.Servicio De Otorrinolaringología Hospital Universitario Donostia SanSebastian - Spain

Date: May 22, 2015 Time: 5:30pm to 5:40pm Room:Sala Coral.

Introduction: The incidence of Single Sided-Deafness(SSD) in children is relatively high. It is well known that SSDhas an impact on social-emotional development in addition toaudiological disadvantages in challenging listening condi-tions. Recently the cochlear implant indication in these pa-tients has been extended to children for MED-EL CochlearImplants.

Objective: To evaluate the benefits of cochlear implan-tation in a child with SSD. We evaluate the localization abilityand the subjective perception of these benefits.

Methods and Results: Sumary: Our patient is a10 year old child with congenital SSD. Her binaural hearingability was evaluated comparing the condition with andwithout cochlear implant, using speech tests in quiet andnoisy conditions in different positions of the loudspeakers.The localizationmeasurements were performed in the sound-field with a frontal semi-circle 7 equidistant loudspeakers.Tests intervals were pre- and post-operative (1, 3, 6 and 12months). The subjective perception of the benefits in daily life

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was assessed using the Speech, Spatial and Quality of HearingScale answered by the parents as well as adapted for children.

Conclusion: The preliminary results suggest consis-tent binaural benefits from one month after the first fitting inspeech discrimination in noisy environments. The differencebetween monaural and binaural condition is more significantwhen the signal-to-noise ratio is -5 dB. At the 6 monthinterval the results in noise obtain 100% in the aided condi-tion. The subjective perception in the 3 first months increased30% in speech perception and other auditory qualities and 75%in spatial hearing.

Keywords: Single-sided Deafness, Cochlear Implant,Child, Speech in noise, Localization.

TL080. Music appreciation after cochlear implantation[Otology, Neuro-Otology and Skull Base Surgery]Melo A. S., Martins J. H., Quadros J., Ribeiro C., Paiva A. D.Centro Hospitalar e Universitário de Coimbra - Portugal

Date: May 22, 2015 Time: 5:40pm to 5:50pm Room:Sala Coral.

Introduction: Auditory processing in general andmusic perception in particular are hampered in adult cochlearimplant users. The inability to hear music well may contributeto decreased quality of life for cochlear implant users.

Objective: To assess the music perception skills andmusical enjoyment by postlingually-deafened adult cochlearimplant users and compared with normal-hearing listeners.

Methods and Results: The Munich Music Question-naire was administered to assess cochlear implant subjects’subjective previousmusical experience and ratings of musicalsounds before and after cochlear implantation. Participantswere adults with severe to profound sensorineural post-lingual deafness with a time of use of cochlear implant atleast six months. Cochlear implant participants performedsignificantly more poorly than normal-hearing listeners. Lis-tening to music after implantationwas more likely in youngerpatients, those with higher speech perception scores andthose with a shorter length of deafness, but was not foundto be related to gender, type of implant, time since implant ormusic enjoyment before becoming deaf.

Conclusion: Cochlear implant users have difficultyperceiving prosodic information accurately. Difficulty in un-derstanding different aspects of musicmay be associatedwithreduced pitch perception ability.

Keywords: Music appreciation, cochlear implant,emotion.

TL081. Cochlear Implant in an adult active population[Otology, Neuro-Otology and Skull Base Surgery]Huarte A., Manrique R., De abajo J., Lezaun R., Martinez P.University of Navarra Clinic. ENT Department - Spain

Date:May 22, 2015 Time: 5:50pm to 6pm Room: SalaCoral.

Introduction: Adults suffering from a large decreasein their hearing do have in general difficulties inmaintaining agood active professional life. After a CI and some months ofusing it, these adults recuperate a large amount of hearing andare able again to communicate correctly with others. There-fore, we assume that they are able to recuperate their level ofprofessional activity and even develop it further.

Objective: The objective of this project is to evaluatethe impact of CI implantation in the professional life ofseverely to profound bilateral deaf patients.

Methods and Results: The study look both retrospec-tively and prospectively at 60 patients implanted, aged from

26 to 64 years old, subjects within the standard criteria forCochlear Implant and at least 6months of working experience.Single-subject design was used in which each subject acts ashis/her own control. Two questionnaires (Prospective andRetrospective) were created and the subjects will have toanswer the questions in relation to the status of their profes-sional activity and their satisfaction at work, comparing theirprofessional status before and after implantation. The ques-tionnaire identified an increase of active patients after CI, ahigher satisfaction at work for CI users, with remarkableimprovement in his communication with their hearing col-leagues. In general, CI user feel that CI do improve theircareers.

Conclusion: The developed questionnaire is a usefultool for evaluating theworking life of implanted people.CI hasa significant impact on professional life of the subject, and ontheir productivity for the general economy. An increase innumber of active p.

Keywords: Outcomes CI, working insertion in deafpeople, questionnaire for active population.

TL082. Auditory Performance In Post-Lingual DeafenedPatients, 15 And 20 Years After Cochlear Implantation[Otology, Neuro-Otology and Skull Base Surgery]Laffont J. T., Martins J. H., Alves M., Ribeiro C., Paiva A. D.Centro Hospitalar e Universitário de Coimbra - Portugal

Date:May 22, 2015 Time: 6pm to 6:10pm Room: SalaCoral.

Introduction: Cochlear implantation has revolution-ized the treatment of profound deafness. In the last 40 years,more than 150000 patients were implanted in the world,many of them in young ages, therefore it is fundamental toevaluate the stability and fidelity of cochlear implants in thelong-term.

Objective: This study’s goal is to evaluate the cochlearimplant auditory performance stability in the long-term, inpost-lingual deafened adults at 15 and 20 years after cochlearimplantation.

Methods and Results: This is a longitudinal retrospec-tive study of 5 post-lingual deafened, cochlear implantedpatients, with auditory performance testing between 15 to20 years after cochlear implantation. Inclusion criteria wereunilaterally cochlear implanted patients, without cochlearmalformations or ossification, and 18 years or older whenimplanted. All patients were implanted with “Nucleus 22”model. Auditory performance was evaluated with sound fieldpure tone and vocal audiometry, numbers test, monosyllablestest and phrases test. Statistical analysis was realized withnonparametric test 2 independent samples Mann Whitneywith p < 0,05. Deafness etiologies were Usher Syndrome in 1patient and progressive deafness in 4. Mean age of implanta-tion was 33 years old. Auditory performance at 15 and 20years post-implantation didn’t show statistically significantdifference in any of the 5 patients.

Conclusion: Long-term auditory performance showsstability at least until 20 years of follow-up. These resultsdemonstrate the long-term fidelity of the technology andbiological stability of the electrode-nerve interface alongthe years.

Keywords: Cochlear-implant; long-term; deafness.

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TL083. Prevenção De Perdas Auditivas Em Recém NascidosCom Fissura Palatina [Otology, Neuro-Otology and SkullBase Surgery]Morales D. S. R.USP - Hospital Universitário - São Paulo - Brazil

Date: May 22, 2015 Time: 6:10pm to 6:20pm Room:Sala Coral.

Introduction: A detecção de perdas auditivas emrecém nascidos é uma premissa de saúde, pois possibilita odiagnóstico precoce permitindo o tratamento e possibilitandoaquisição de linguagem ao longo da primeira infância, o queocasionará uma alfabetização e pleno poder de aprendizagemao longo de todo ciclo escolar.

Objective: Pacientes com fissura de palato mole apre-sentam grande incidência de otite média serosa com perdaauditiva, em geral do tipo condutiva, o diagnóstico e trata-mento inicial destes pacientes que será detalhado nestetrabalho.

Methods and Results: O rápido reconhecimento dafissura de palato e o acompanhamento multidisciplinar é achave para bons resultados. Além das Otoemissões Acústicas,estes pacientes deverão passar por avaliação otorrinolaringo-lógica, visando observar alterações da tuba auditiva, pois amaior parte dos autores citam a otite média como universalentre os pacientes com fissuras pós forame e transforame,associado a hipoacusia do tipo condutiva aferidas por examesda deglutição e também audiometria comportamental e imi-tanciometria. O otorrinolaringologista poderá indicar a tim-panotomia com colocação de tubo de ventilação (de médiaduração, Armstrong) junto da queiloplastia e palatoplastiaprimária, no primeiro mês de vida, prevenindo otites derepetição e melhorando a audição.

Conclusion:A intervenção otorrinolaringológica facil-itará a prevenção e tratamento da perda auditiva empacientescom fissura de palato, permitindo um melhordesenvolvimento.

Keywords: otite, fissura, palato, auditiva.

TL084. Intrapetrous malformation of carotid and C.I.[Otology, Neuro-Otology and Skull Base Surgery]Ruiz H. E., Comelli L., Grassano C. P., Ruiz B., Filas E., Dotto G.XX - - Argentina

Date: May 22, 2015 Time: 6:20pm to 6:30pm Room:Sala Coral.

Introduction: Cochlear Implant in a 18-month oldpatient with diagnosis of parcial lissencephaly and carotidimportant in cochlear spiral malformation un a case report.The interesting thing is the abnormality that has the carotidintrapetrous in both ears in a sequential bilateral implanta-tion, and risk, and the technique to be used in similar cases.

Objective: Lissencephaly is a rare gene-linked brainmalformation characterized by a failure of the normal patternof cortical neuronal migration resulting in a smooth cerebralcortexwith absent gyral formation. It may be suspected on thebasis of neonatal behavior (poor responsiveness and feeding,hypotonia and early-onset seizures), appearance (microceph-aly), and the presence of commonly associatedmalformations.When the defect is partial the diagnosis may be later.

Methods and Results:We present a rare case of a 18-month old male patient with psychomotor retardation anddeafness. Magnectic resonance imagines inform partial lis-sencephaly and computed tomograpghy revels an abnormalrelation between the cochlea and the internal carotid artery.

Conclusion: The interesting thing is the abnormalitythat has the carotid intrapetrous in both ears in a sequential

bilateral implantation, and risk, and the technique to be usedin similar cases.

Keywords: cochlear complications; intrapetrous ca-rotid; hearing loss; cochlear implant.

TL085. Cochlear Implant In Far Advanced Otosclerosis -Performance-Complications-Long Term Results [Otology,Neuro-Otology and Skull Base Surgery]Curet C., Salvadores M., Romani C., Rubiño L., Robledo H.,Muiño J. C., Ruiz H., Dotto G., Queirolo A.Centro Otoaudiológico e Implantes Cocleares Curet - Córdoba -Argentina; ERIC - Centro ORL Dr. Ruiz - Rosario - Argentina

Date: May 22, 2015 Time: 6:30pm to 6:40pm Room:Sala Coral.

Introduction: To evaluate clinical characteristics ofthese patients, complications, and observation of the benefitsof implants to medium and long term.

Objective: Design: retrospective.Methods and Results: 32 adult patients, range age 50

years old, 22 women and 10 men, with profound neuro-sensorial hearing loss and otosclerosis far advanced, weretreated with implants multi-channel cochlear implants (CI). 3patients had initially stapedectomy in the same ear of thecochlear implant. All patients had a previous otological medi-cal examination, psychological, audiometry and 0% of speechdiscrimination with well fitted hearing aid, CTS (4 of themwith RMI) in order to determine hypodensity or morphologicchanges within the cochlea. Clinical and audiological obser-vations of their performance were analyzed. Implants and n°:Advanced Bionics 4,Med-El 2, Nucleus 26. The time of use of CIin the sample, was of 1 to 16 years. Results: CTS withmorphologic changes in the cochlea in 24/32 patients (Rotte-vel' s grading): 9 had type 2 (localized retrofenestral disease), 6types 3 (retrofenestral diffuse). Full insertion inside thecochlea in 28/32 cases, where in 6 patients it was necessaryto drill the bone in 4 to 6 mm in the tympanic basal turn of thecochlea. 4 patients had partial insertion of electrodes, one ofthemwith 2 electrodes in the IAC and leakage of CSF (otoscle-rosis Type 3). 1 with stimulation of the facial nerve (FNS)(otosclerosis type 3) and was managed with deactivation ofthe offending electrodes and resetting the current levels forcomfort level. 4 patients experienced diminution of theauditory skill in the time by failures of the device, where 3were reimplanted, with upgrade of the same brand and theyobtained improvement of the performance. Auditory diminu-tion and presence of sudden episodes of tinnius, with sensa-tion of resounds, were observed in 5 patients (otosclerosistype 3), where in 1 the tinnitus diminished with fitting. Gooddiscrimination in the speech in 26/32 patients. Mediocreperformance in 5/6 patients (otosclerosis type 3) being goodin one of them.

Conclusion: Patients with far advanced otosclerosisdemonstrated good performancewith CI in 26/32 cases. In thecaseswith otosclerosis type 3, 5/6 patients hadmore difficultyin the insertion of electrodes, 1 of them with 2 electrodeswithin the IAC and leakage of LCR, and 5 of themwith tinnitusand smaller auditory outcome, with greater number of cali-brations and adjustments in levels T and C. Onlyone patient, 1/32 had FNS and was in otosclerosis type 3 with straightelectrodes. None with perimodiolars electrodes.

Keywords: Otosclerosis; stapedectomy; hearing loss;cochlear implant.

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EPO001. Auditory Deprivation In Monitoring AudiologicalTen Elderly PatientWith Sensorineural Hearing Loss In OverSix Years [Audiology]Silveira A. L., Teixeira A., Paniagua L. M., Faria M. R d.Clínica Lavinsky - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The deprivation caused by hearing losshas been studied because of the increasing the number ofelderly and life expectancy.

Objective: This study aimed to compare the hearingresults of elderly patients in six years and check for possibledamage caused by the lack of auditory stimulation.

Methods and Results: Subjects were assessed bypure tone audiometry and assessment of speech perception.The sample in the right-handed individuals with bilateralhearing loss. Users of hearing aids were excluded, withhistorical exposure to noise and with a history of tinnitus,vestibular and neurological disorders. Were ten individuals,six men. Their ages ranged between 72 and 90 years. Thedegree of loss varied between mild and severe.The meanhearing thresholds at the first audiological evaluation com-pared to the latter, three cases remained at the same levels,and seven, the maximum difference reached 10 dB in one ormore frequencies. The speech percepcion assessment wasdecisive in finding the effect of auditory deprivation. Thelargest percentage differences were evident in the last fouryears of each patient. The two patients who underwent onlytwo audiological evaluations showed no effects of depriva-tion hearing.

Conclusion: The presence of auditory deprivation canbe observed in 60% of patients with significant worsening inintelligibility in the last four years. Currently, all patientsaccepted the importance of hearing and are motivated touse. All patients followed the medical monitoring.

Keywords: auditory deprivation, speech perception,hearing loss.

EPO002. Case Report: Perversion Caloric InVideonystagmography Evaluation [Balance]Heinen L. d R., Silveira A. L., Teixeira A.Clínica Lavinsky - Rio Grande do Sul – Brazil; Universidade Federal doRio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The caloric test is among one ofmain inthe standard battery of tests in the videonystagmographyevaluation. It is possible to assess each labyrinth separately,performing a quantitative and qualitative assessment of ves-tibular disorders. Caloric responses involve connections to thecentral nervous system, which is important in differentiatingbetween central and caloric vestibular periféricas. A perver-sion (vertical nystagmus observation during the caloric test),is a rare change, which the phenomenon has been associatedwith diseases that affect the structure of the 4th ventriclefloorin the brain stem, as an example we can mention multiplesclerosis.

Objective: Report an analysis of caloric responsesobtained from videonistagmography evaluation of a patientwith 73 years at the service.

Methods and Results: The patient was referred by aneurologist for evaluation videonystagmography with vertigofor about six months, with a vegetative symptoms such asvomiting and sudoreses. Based on videonystagmographyevaluation could observe response within the normal rangein oculomotor tests and the presence of nystagmus suppres-sion of ocular fixation, presenting as single central changesignal the inverted nystagmus in thewarm caloric stimulationof the right ear and caloric perversion in hot and coldstimulation of the right ear.

Conclusion: The presence of vertical nystagmus calo-ric test identified the presence of caloric perversion.

Keywords: videonistagmography, perversion caloric,multiple sclerosis.

EPO003. Cochlear Implants: Patient Monitoring In DifferentAge Groups [Audiology]Pires S. C., Silveira A. L., Teixeira A., Kochhann D. S.,Weigert L. L.Hospital de Clínicas de Porto Alegre - Rio Grande do Sul – Brazil;Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Enabling and auditory rehabilitation inpatients with cochlear implants provide better answers dur-ing the intervention for hearing loss.

Objective: To assess the development of listeningskills in different age groups in patients with different audito-ry deprivation times.

Methods and Results: Patients are being monitoredfrom the detection of hearing loss and use of hearing aids andfollow after surgery to place the cochlear implant. Audiologi-cal and detection and speech recognition data were collectedduring the use of hearing aids and after cochlear implantsurgery. All perform speech therapywith audioverbalmethod.The acquisition and language development in children andrehabilitation of adults and the elderly is related to a numberof factors, from the surgical results and intraoperative, map-ping and to the participation of the speech therapist andfamily to stimulation of auditory skills. Speech recognitionand nonverbal sounds is closely related to auditory depriva-tion of time and age, showing better development in speechintelligibility in patients with shorter hearing and youngerdeprivation. Adults the strongest growth in speech recogni-tion that seniors.

Conclusion:Minor periods between diagnosis, audio-logic, auditory stimulation and surgical and speech therapyprovide better results in the treatment of patients withhearing loss with cochlear implants in different age groups.

Keywords: cochlear implant, auditory deprivation,hearing rehabilitation.

EPO004. Importance Of Otoneurological Evaluation InPatient With Multiple Sclerosis: A Case Report [Balance]Silveira A. L., Heinen L. d R., Teixeira A.Clínica Lavinsky - Rio Grande do Sul – Brazil; Universidade Federal doRio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Infectious mononucleosis is caused bythe Epstein barr virus and is associated with the onset ofmultiple sclerosis.

Objective: Analyzing data from the otoneurologicalevaluation on a female patient, presenting with multiplesclerosis.

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Methods and Results: In the otolaryngologycal con-sult the patient had vestibular complaints without hearingcomplaints. Was referred for audiological evaluation andlabyrinthic videonystagmography. The results were as fol-lows: in the audiological evaluation found is normal hearing inboth ears, type A tympanometric curves (Jerger, 1970) andipsilateral and contralateral acoustic reflexes present. In vid-eonystagmography, therewas no spontaneous nystagmus andsemi spontaneous nystagmus multidirectional. In rotationalchair test and caloric test responses were symmetrical. Still inthe caloric test was suppressing failure nystagmus to eyefixation. In oculomotor tests it was found optokinetic re-sponseswith dysrhythmia and asymmetric responses, saccad-ic movements with change speed and accuracy, and type IIIpendulum tracking. In ENT revaluation was referred fordiagnostic imaging tests. It was found areas of demyelinationconsistent with the diagnosis of multiple sclerosis. Hence, theimplementation of the labyrinthine reviewwas of great use todirect the otolaryngologycal diagnosis.

Conclusion: Vestibular evaluation of the patient withmultiple sclerosis, showed the presence of significant resultsof central lesion, contributing to the direction of otolaryngo-logycal diagnosis.

Keywords:multiple sclerosis, otoneurological evalua-tion, videonystagmography.

EPO005. Observation Of Maturity Neural With AuditoryBrain Evoked Response And Auditory Steady-StateResponse: Two Cases Report [Audiology]Silveira A. L., Teixeira A.Hospital de Clínicas de Porto Alegre - Rio Grande do Sul – Brazil;Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The maturation of the auditory path-way can determine changes in auditory responses.

Objective: Evaluate auditory maturation and verifychanges in two neonates thresholds, with the combination oftwo techniques.

Methods and Results: Neonates, one female and onemale, were referred for audiological diagnosis after failed thehearing screening. Both were born at term and without riskhistory for hearing loss. The evaluations were performed innatural sleep. The female patient underwent the first evalua-tion at three months of life and the second at six. The maleheld at four, seven and ten months. Were conducted withBrain Auditory Brain Evoked Response (ABR) click the intensi-ty of 80 dB HL and auditory steady-state response (ASSR) withtonemodulatedwith simultaneous display on both ears in thefrequencies of 0.5; 1.0; 2.0 and 4.0KHz. In thefirst, both infantshad ABRwith absolute latency of wave I and interpeak latencyIII-Vwith normal values andwaves III and Vand interpeak I-IIIand IV changed. The ASSR showed findings suggestive of mildhearing loss in both ears. In the second evaluation, the femalepatient has presented ABR and ASSRwithin normal limits. Themale patient improved both absolute and interpeak latencies,as in the ASSR thresholds were considered normal in the thirdassessment.

Conclusion: In neonates, the neural maturation wasobserved in the ABR by reducing latencies and ASSR throughbetter hearing threshold found.

Keywords: newborn, neural maturation, electro-physiology.

EPO006. Profile Vestibular Patients Treated In A Hospital InPorto Alegre [Balance]Silveira A. L., Teixeira A., Ferreira D. A., Weigert L. L.Hospital de Clínicas de Porto Alegre - Rio Grande do Sul – Brazil;Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Vestibular assessment reveals the laby-rinthine operation and its correlations with other organs andsystems. Videonystagmography (VNG) makes up the vestibu-lar profile allowing confirm or deny if there is a change thatjustifies the labyrinthine dizziness, vertigo or instabilityreported by the patients.

Objective: Describe the vestibular profile of patientsseen within one year in the National Health System in ahospital in Porto Alegre.

Methods and Results: This descriptive study. Allpatients were seen by the ENT team and sent to VNG, heldat the ICS equipment Chartr 200 (Otometrics), between Janu-ary and December 2014. We evaluated 57male patients (30%)and 159 females (70%), aged between 11 and 92 years. Thealterations found in VNG, 17 patients (8%) had spontaneousnystagmus; 6 (3%) semi spontaneous nystagmus; 179 (83%)with abnormal saccadic movement speed, latency and/oraccuracy; 143 (66%) screening with low gain; and 75 (35%)asymmetric optokinetic nystagmus. The results of the assess-ment, 6 patients (3%) had normal test results; 8 (3.5%) hadperipheral vestibular disorder; 63 (29%) central vestibularinvolvement; 138 (64%) mixed commitment and 1 (0.5%)patients did not complete the caloric test.

Conclusion: The evaluation helped to guide the medi-cal staff for diagnosis and management. The results point tothe possibility of comorbidities in most patients seen.

Keywords: videonistagmography, dizziness, balance.

EPO007. Risk Of Falls In A Patient With Group ComplaintSubmitted For Screening With Posturography [Balance]Silveira A. L., Teixeira A.Hospital de Clínicas de Porto Alegre - Rio Grande do Sul – Brazil;Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Falls are a multifactorial event and cangenerate multiple consequences. The use of an assessmentthat aims to estimate the risk of falls can prevent further boutson the health of individuals and their quality of life.

Objective: To assess the risk of patients falling indifferent age groups with dizziness.

Methods and Results: The patients performed ascreening with posturography in a static platform ICS BalancePlatform equipment (Otometrics). Four sensory conditionswere evaluated. The patient is maintained for a brief period25 to 30 seconds over the eyes open and closed platformwithor without a foam pad. Variations obtained by the pressure ofthe feet on the platform as low risk, moderate and high risk offalling were considered. The sample consisted of 57 individu-als,most elderly (52.6%) and females (70%).Low-risk responseswere observed in 49% of patients, moderate risk and high risk38% drop in only 19% of patients.

Conclusion: In most patients had low or medium riskof falls, despite all present vestibular complaint.

Keywords: fall, balance, posturography.

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EPO008. Spoken language acquisition in children withcochlear implant [Audiology]Moret A. L. M., Antonio F. L., Silva L. T. N., Yamaguti E. H.,Alvarenga K. F.Hospital de Reabilitação de Anomalias Craniofaciais, Universidade deSão Paulo, Campus Bauru - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Introduction: Hearing is an importantprerequisite for the acquisition of oral language. In the last twodecades, language acquisition in children with cochlear im-plants has been of great interest.

Objective: Objective: Assess language acquisition inimplanted children.

Methods and Results:Methods: A total of 11 childrenwith pre-lingual bilateral sensorineural hearing impairmentand 2 children with severe/profound bilateral Auditory Neu-ropathy Spectrum Disorder, maximum age of 36 months atsurgery, assessed in three different points in time in the firstyear post-activation. The tools used included Denver Devel-opmental Screening Test II - DDSTII, Understanding andExpression Scale Reynell Developmental Language Scales –RDLS, and Family development assessment scale. Results:Eight out of the 13 participants presented growing languageevolution with DDST II–Language and four presented noevolution in some point in the assessment. With RDLS, fourchildren had growing evolution in receptive language and sixchildren had no progress in some point in the assessment.Regarding expressive language, 2 children kept a growingdevelopment rate and 10 children kept the same languageacquisition level in some point in the assessment. One childhad no evolution in any of the tools used. Family evaluationsuggested regular to appropriate adherence to the therapeuticprocess.

Conclusion: The group assessed showed progress asregards oral language skills and progresswas different for eachchild.

Keywords: Language development, Child develop-ment, Cochlear implant.

EPO009. Analysis Of Association BetweenHearing Loss LevelAnd The Acquisition Of Hearing Aids [Audiology]Otavio A. C. C., Coradini P. P., Teixeira A. R.Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: There are few studies that relate, in theBrazilian population, purchase of hearing aids to the degree ofloss.

Objective: Examine whether the degree of hearingloss affects the purchase of hearing aids.

Methods and Results: Participated in this researchsubject who sought a hearing center interested in purchasinghearing aids. The evaluation included pure tone audiometry,hearing aids selection and home trial. The degree of loss wascategorized by the WHO criteria. The variables were associat-ed and statistically analyzed using SPSS version 2.0 and 5%significance levels were accepted. This study was approved bythe Research Ethics Committee. Thirty-two subjects wereincluded in the study. Of these 59.4% were women. Themean age was 71.41 � 12.14 years. There was, on the left, asignificant association between the degree of hearing loss andthe purchase of hearing aids (p ¼ 0.046), indicating acquisi-tion of concentrated prosthesis in severe degrees (47.8%) anddeep (34.8%) . The right ear was no significant association

(p ¼ 0.879) between the degree of loss the purchase ofhearing aids.

Conclusion: There was a greater number of hearingaid purchases in individuals with severe / profound hearingloss in at least one ear.

Keywords: hearing loss, hearing aids, hearing,audiology.

EPO010. Association of the frequency and intensity oftinnitus interference a sleep patient [Audiology]Lessa A. H., Fraga R. B., Teixeira A. R., Freitas L. A., Rosito L. S.Clinical Hospital of Porto Alegre - Rio Grande do Sul – Brazil;Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Tinnitus is a disorder that has a highprevalence in the population. The presence of tinnitus fre-quently becomes a negative impact factor in the individual'slife, making it difficult to focus on daily activities and canchange emotional balance and interfere with sleep.

Objective: To assess the association of loudness andtinnitus pitch with the interference of tinnitus in sleep.

Methods and Results:Were sampled patients of bothsexes, the Tinnitus Clinic of a university hospital. Underwentacuphenometry and research on the interference of tinnitus insleep by means of a questionnaire applied in the clinic. Adescriptive statistical analysis and using the Spearman corre-lation test, we evaluated the sleep interference associationwith variable frequency and intensity of tinnitus. Results: Westudied 64 individuals, 24men (37.5%) and 41women (63.0%)aged between 13 and 81 years (mean 59.14 � 12.75 years).The analysis showed that the acuphenometry a fuck frequencytinnitus in both ears was 250 Hz and 12,500 Hz maximum inthe right ear and 11,200 Hz in the left, since the minimumintensity was 0 dB in both ears, while the maximum was62 dB in the right ear and 50 dB on the left. No variablestatistical correlation, since the P values were greater than0.05.

Conclusion: The data analysis showed that there wasno correlation between the frequency and intensity of tinnitusand sleep interference in the studied sample.

Keywords: tinnitus, sleep, hearing.

EPO011. Characteristics Of Tinnitus Presented By NormalHearing Thresholds Subjects [Audiology]Teixeira A. R., Benin L., Lessa A. H., Freitas L. A., Rosito L. S.Hospital de Clínicas de Porto Alegre - Rio Grande do Sul – Brazil;Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Tinnitus is a symptom that may affect8% to 10% of individuals with normal hearing.

Objective: Analyze the characteristics of tinnitus pre-sented by patients with normal hearing.

Methods and Results: This study is retrospective,which evaluated data from patients with tinnitus protocolstreated at a specialized university clinic.Were selected for thisstudy the protocols of patients with normal hearing in bothears (thresholds of between -10 and 25 dB HL, in the frequen-cies of 250 Hz to8000Hz).We assessed 760medical records ofpatients treated between 2002 and 2014, of which 34 werefrom individualswith normal hearing (4.47%). The average agewas 48.21 � 14.21 years and 23 (67.64%) were female. Thetinnituswas bilateral in 15 (44.12%) patients, 8 (23.53%) in theright ear, 8 (23.53%) in the left ear and in 3 (8.82%) in the head.

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The length of time varied from 1 to 32 years (mean,6.09 � 6.43 years). The pitch of tinnitus in the right ear rangedfrom 250 Hz to 9000 Hz (mean � 5000Hz 3239,62Hz andmedian of 6000 Hz). On the left ear ranged from 250 Hz to11200 Hz (mean � 2511.96 3356.95 Hz and 6000 Hz medi-an). The loudness of tinnitus in the right ear ranged from 0 to75 dB HL (average 23.92 � 19,04dBNA and median 20dBHL).On the left ear loudness ranged from 0 to 70 dB (average29.57 � 17,02dBNA, median 25dBHL).

Conclusion: It was found that most of the individualshad bilateral tinnitus for over five years with pitch highfrequency and loudness with higher intensity to that de-scribed in the literature.

Keywords: tinnitus, hearing, audiology.

EPO012. Otitis Media And Posturography Exam: SystematicReview [Balance]Seimetz B. M., Nehring C., Teixeira A. R., Dornelles S., Costa S. S.Clinical Hospital of Porto Alegre - Rio Grande do Sul - Brazil,Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Otitis media is an inflammation of themiddle ear,which can be divided into suppurative otitismedia(acute otitis media and chronic otitis media) and non-suppu-rative (serous and secretory). Several conditions may changebody balance, which is a complex process that depends on theintegration of visual, vestibular and proprioceptive systems.One of the causes of balance disorders is otitis media, as thiscondition may cause changes in the middle ear and labyrin-thine dysfunction. A test that assesses body balance andreports on the individual's ability tomaintain postural stabili-ty is posturography.

Objective: To perform a systematic review of theliterature on otitis media and the posturography test.

Methods and Results: MedLine, Lilacs, SciELO,PubMed and IBECSwere the databases searched.Were includ-ed only original articles, in humans, published in the last 20years (1994-2014), in Portuguese, English or Spanish. Thekeywords "otitis", "otitis media" and "suppurative otitis me-dia" were used in combination with "postural balance","vestibular function tests", "vestibular diseases" and "postur-ography". As a result, were found 1021 articles with thedescriptors above. However, after the necessary exclusions,only four items were included in the review.

Conclusion: There was a significant relationship be-tween otitis media and changes in posturography test in thefour articles included in this research.

Keywords: otitis, postural balance, vestibular functiontests.

EPO013. Rivermead Behavioral Test: results in elderlypatients with and without hearing loss [Audiology]Teixeira A. R., Olchik M. R., Gonçalves A. K.Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Behavioral Test Rivermead memoryreproduces activities of daily living, such as the memory ofnames, messages, people's faces, among other tasks.

Objective: To evaluate the results obtained in River-mead test in a group of elderly people with and withouthearing loss.

Methods and Results: The Rivermead test was ap-plied in 20 participants, 18 (80%) were female. Their ages

ranged between 60 and 85 years, mean 72.1 � 6.6 years. Theaverage educational level was 12 � 4.3 years. The audiometryshowed that average hearing thresholds, the better ear was 2512,09dBNA. Regarding the degree of hearing loss, 55% of theevaluated subjects had normal hearing, 35% hearing loss mildand 10% sensorineural hearing loss of moderate degree. Thescore of the Rivermead ranged from 9:22 points, averaging15.6 � 4.0 points and 17 subjects with abnormal results.Statistical analysis, however, showed no relationship betweenthe presence and degree of hearing loss and Rivermead testresults (p ¼ 1.00).

Conclusion: The analysis of the sample evaluated datashowed no relationship between the presence and degree ofhearing loss and the results of the Rivermead test.

Keywords: hearing loss, elderly, cognition, olderpeople.

EPO014. Self-Assessment Of Hearing And Acquisition OfHearing Aids Between New And Old Users [Audiology]Otavio A. C. C., Coradini P. P., Teixeira A. R.Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The use of hearing aids may be relatedto self assessment of hearing.

Objective: Examine the acquisition of hearing aids andself assessment of hearing in old and new users of hearingaids.

Methods and Results: Were invited to participate inthe study subjects who sought a private hearing center forselection of hearing aids. The guy answered the question: "Ona scale from 1 to 10, 1 being the worstand 10 being the best,how would you rate your overall hearing ability?" (Palmer,Solodar, Hurley et al, 2009). The following were carried outaudiometry, hearing aid test and home trial. There wasconsultation with the auditory center database in order tocheck if it was new or old user of hearing aids. The sampleconsisted of 31 subjects, there was a female predominance(58.1%). The average agewas 70.93 � 12.04. Inmost were newusers (70.9%). Among the old users, 77.8% opted for theacquisition, while among new users, the percentage of acqui-sition was lower (68.2%). Regarding the self-assessment ofhearing, considering lower scores equal to or greater than five,it was observed that among older users, there was an equaldistribution (33.3%). In the group of newusers, 27.3% scored inthe lower range than 5; 18.2% of 5 and 54.5% higher than 5.There was a higher percentage of purchase of prostheses forold users.

Conclusion: The self-assessment of hearing showedthat among new users most attributed to his hearing a higherscore than five, which was not observed in the former users.

Keywords: hearing aids, hearing loss, aging.

EPO015. Verbal fluency test: results in a group of elderlypeople with and without hearing loss [Audiology]Teixeira A. R., Olchik M. R., Gonçalves A. K.Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Verbal fluency tests are used to evalu-ate executive functions, memory, language and verbal ability.

Objective: To analyze the performance of elderlypeople with and without hearing loss in verbal fluency tests.

Methods and Results: The tests of verbal semanticfluency (animals) and phonological (FAS) were applied to 20

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elderly, (80%) were female. Their ages ranged between 60 and85 years, mean 72.1 � 6.6 years. Theminimum educationwas4 years andmaximum 18 years, mean agewas 12 � 4.3 years.Regarding the hearing, 55% of the evaluated subjects hadnormal hearing, 35% mild sensorineural hearing loss and10% moderate sensorineural hearing loss. Only two seniorshave changes in verbal fluency test with phonological restric-tion with no association between the mean hearing thresh-olds in the better ear and the test result (normal or abnormal -p ¼ 0.9) nor between the presence of hearing loss and changein test scores (p ¼ 1.0). In categorical verbal fluency test, allpatients included were normal.

Conclusion: In our sample there was no associationbetween hearing loss and results in verbal fluency test.

Keywords: hearing loss, cognition, older people.

EPO016. Audiogram Comparison Of Workers From FiveProfessional Categories [Audiology]Duarte A. S. M., Guimaraes A. C., Castilho A. M., da Costa E. A.,Gusmão R. J.Unicamp - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Noise is considered the third majorcause of environmental pollution and it may be seen as arisk factor of worsening health conditions. It becomes morecomplex when dealing with noise in the work environment,due to its intensity, exposure time, and other risk factors.When noise is intense and the exposure to it is continuous,structural changesmayappear in the inner ear, which can leadto noise-induced hearing loss (NIHL).

Objective: The purpose of this study is to evaluate thearithmetic mean of the auditory thresholds at frequencies 3, 4and 6 kHz of workers from five professional categories ex-posed to occupational noise.

Methods and Results: We propose a retrospectivecross-sectional cohort study to analyze 2.140 audiogramsfrom seven companies having five sectors of activity: onefootwear company, one beverage company, two ceramicscompanies, two metallurgical companies, and two transportcompanies.

Conclusion: When we compared two categories, wenoticed a significant difference only for cargo carriers incomparison to the remaining categories. In all activity sectors,the left ear presented theworst values, except for the footwearprofessionals (p > 0.05).We observed an association betweenthe noise exposure time and the reduction of audiometricvalues for both ears. There existed significant differences forcargo carriers in relation to other groups. This evidence maybe attributed to different forms of exposure. There appeared aslow and progressive deterioration as the exposure timeincreased.

Keywords: audiometry; labor medicine; NIHL (Noise-Induced Hearing Loss), sensorineural hearing loss; otorhino-laryngology; deafness.

EPO017. Cortical Auditory Evoked Potential In ChildrenPrelingual With Bimodal Stimulation [Audiology]Rodrigues A. G., Vicente L. C., Maia T., Silva L. T. N., Alvarenga K.F.Faculdade de Odontologia de Bauru FOB/USP - São Paulo – Brazil;Hospital de Anomalias Craniofaciais HRAC/USP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The unilateral cochlear implant canhelp to establish thehearing function but can cause difficultiesto the users in performance skills as the location and speechperception in noise. Bilateral hearing may be provided withbilateral implantation or with fitting a hearing aid in oppositeear, this condition is referred to as bimodal stimulation.Objective measures as to benefit are necessary but scarce inthe literature about he cortical development in bimodal users.

Objective: Characterize the P1-N1-P2 complex inprelingual children users of bimodal stimulation.

Methods and Results: A cross-sectional observationalstudy that was conducted cortical potential in three childrenwith sensorineural hearing loss, pre-lingual, with an averageage of four years, implemented in the period sensitive, userseffective of the hearing aid in contralateral ear. The record ofthe cortical potential was performed with equipment SmartEP USB Jr Intelligent Hearing Systems with presentation of thespeech sound /da/ in the open field. The test was performedthree situations: only cochlear implant; bimodal (Implant/hearing aid) and only hearing aid. Results: P1 component wasobtained in all children in situations evaluated, averagelatency - bimodal: 115ms; implant: 115ms; hearing aid:120ms. The complex P1-N1-P2 was observed in two childrenwithmorphologyand latency next to the normal range. The P1latencies intra-patient differ when obtained in monaural andbimodal situations.

Conclusion: The capture of cortical potential is feasi-ble in electric and acoustic stimulation, when it is performedin bimodal situation no harm in getting the cortical potential.

Keywords: cochlear implant; cortical potential; hear-ing aids.

EPO018. Outcomes of late implantation in Usher syndromepatients [Audiology]Hoshino A. C. H., Echegoyen A., Valéria G. S., Tsuji R. K., Bento R. F.HCFMUSP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Usher syndrome is an autosomal reces-sive inherited disorder characterized by profound sensorineu-ral hearing loss associated with progressive pigmentaryretinal degeneration. Some deaf Usher syndrome children,who had had no opportunity of receiving a cochlear implantearly in life, develop sign language. Since visual disorders areusually progressive and start in the adolescence, their familiesbring them as cochlear implant candidates. Is a late implanta-tion of any benefit for these children?.

Objective: To describe the outcomes of Usher Syn-drome patients who received cochlear implants at a later age.

Methods and Results: Methods: Retrospective studyof eight patients diagnosed as Usher Syndrome type I. Puretone thresholds and speech perception tests were collectedfrom pre and one year post implant evaluations. Results:Average age at implantation was 15,87 years (5-27). Preimplant average thresholds were 74 dBHL and 29 dBHL oneyear post implant. Speech perception was only possible to bemeasured in three patients preoperatively, who scored from10 to 27% in closed set sentences. All of the others did not havespeech recognition at all. Four patients were fluent in signlanguage. Those patients who had speech recognition preop-eratively, improved their score in 100% closed set, 40% and 60%open set sentences recognition. One year post implant, threeof these patients abandoned the use of the device (37.5%).

Conclusion:Detection of sounds can be achievedwithlate implantation, but speech recognition is possible in pa-tients with previous hearing stimulation, since it depends onthe development of hearing skills.

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Keywords: Usher Syndrome, Cochlear Implantation,Early diagnosis, Life quality.

EPO019. Comparative Study BetweenThe Auditory FindingsIn Individuals With And Without Diabetes Mellitus[Audiology]Nunes D. P d R M., Sanders A. P., Vieira L. F., Maruiti G.Faculdade Ingá - Uningá - Parana - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The non-communicable diseases (NCD)of larger importance for public health are cardiovasculardiseases, cancer and Diabetes Mellitus (DM). Among these,DM is considered a complication for all, because brings macroand microvascular alterations, that gradually appear by hy-perglycemia effects, causing dysfunction, damage and failureof several organs, inclusively hearing. In spite of some studiesaffirm the relation between hearing loss and Diabetes Melli-tus, other studies demonstrated that Diabetes Mellitus andhearing loss are independent factors among themselves, andno necessarily diabetes will cause the hearing loss.

Objective: The aim of this study was to verify theexistence of complaints and/or hearing alterations in individ-uals with diagnosis of Diabetes Mellitus.

Methods and Results: Adescriptive studywas accom-plished, in which 30 subjects (60 ears) were evaluated. Theselected population was in the age group from 25 to 60 yearsold and was divided into a diabetic group and a non-diabeticgroup.All the subjects answered an initial interview andaccomplished audiologic evaluation,being submitted to oto-scopy, pure tone audiometry,speech intelligibility test andacoustics immittance. In the hearing exam, only twelve ears(40%) presented neurosensory hearing loss,with prevalence inhigh frequencies,all of them from diabetic group.

Conclusion: It is concluded that the hearing andvestibular changes may be due to Diabetes Mellitus, beingnecessary monitoring hearing of the diabetic population,because they are more frequent in the risk group and thecorrect approach of these alterations improves their prognos-tic and control.

Keywords: Diabetes Mellitus. Hearing. Hearingcomplaints.

EPO020. Public Education Of Maringá Teachers’ KnowledgeAbout Auditory Processing Disorders [Audiology]da Silva E. C., Sanders A. P., Strumiello L. F d O., Maruiti G.Faculdade Ingá - Uningá - Parana - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: This article aims to investigate theknowledge of teachers in the city of Maringa, about auditoryprocessing disorders. It is intended to investigate the degree ofknowledge of teacherswithin the school, their performance inthe classroom, and whether they can recognize, in the class-room, children with auditory processing disorders.

Objective: The study will be based on a literaturereview with the aim of conceptualizing the Auditory Process-ing and its Disorders.

Methods and Results:We administered the question-naire of 11 questionswith alternatives to be identified, amongthemonlyone question open, in total 25 teachers participated.Finally an analysis was drawn from the data collected, quan-titativel.We can observe that only 12% of teachers whoparticipated in data collection, heard about the subject duringtheir pedagogical formation, among the interviewed teachers

only 8% knew correctly describe what Auditory ProcessingDisorder would be.

Conclusion:Wecan conclude that there is need for theissue disclosure for elementary school teachers, in order toprovide a better performance of students, and therefore nochild is disadvantaged by lack of knowledge among educators.

Keywords: Auditory Processing; Disorders; Teacher,Fundamental Education.

EPO021. Quality Criteria In Newborn Hearing ScreeningProgram: Correlation Between The Failure Rate And TheRisks Indicators For Hearing Impairment [Audiology]Rocha R. d C O., Sanders A. P., Mello J. M., Maruiti G.Faculdade Ingá - Uningá - Parana - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: For a child dont suffer the hearingimpairment (HI) effects in global development and especiallyin oral communication, it is recommended to perform thenewbornhearing screening (NHS) that aims to early detect theHI for an immediate medical intervention and/or speechtherapist in newborn with and without risk indicators forHI, however it is estimated that the prevalence of newbornwith risk indicators for HI that present hearing functioncompromising is 2 to 4% larger than in the newborn withoutrisk indicators.

Objective: The aim of the present studywas to analyzethe quality criteria of the Newborn Hearing Screening Pro-gram (NHSP), as well as correlate the failure rate in the firstevaluation with risk indicators for HI in newborn born in theperiod fromMay toDecember, 2007 at theMaringaUniversityHospital (HUM).

Methods andResults: In relation to the quality criteriaof NHSP, it was verified that the cover index of NHSP was by66,05%. Of the 286 newborn evaluated in the maternity,66,78% presented positive response for NHS and 33,21% ofthe newborns were directed to retesting with an attendancereturn index of 67,33% and the false-positive rate can not beconclude yet, due to the fact that such rate depends on the HIconfirmation of the newborn.

Conclusion: Given the above, these findings suggestthat there is still much to be done to achieve the qualitycriteria in a NHSP and reinforce the importance of investigat-ing neonates with and without risk factor for HI.

Keywords: Newborn Hearing Screening. OtoacousticEmission. Risk indicators to Hearing Impairment.

EPO022. Cochlear Implant Simulator to Aid (Re) HabilitationProcess [Audiology]Rodrigues A. P. S. C., Monteiro D. C., Araújo A. M. L., da SilvaFilho M., Cordeiro J. C. B.Instituto Federal do Pará - Pará – Brazil; Universidade Federal do Pará -Pará - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: In cochlear implant (CI) user the qualityof sound is different from natural hearing, with less soundinformation being received and processed by the brain. The(re) habilitation process of CI users utilizes the same set ofwords without distinction, despite CI users have an individualprogramming, like numbers of channel and its respective gain.So different users have different perspective to the samestimulus in the rehabilitation process.

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Objective: Themain objective of this work is proposesa CI simulator that aids the (re) habilitation professionalchoose better words to enhance the rehabilitation sessions.

Methods andResults: The simulatorwas developed inMatlab native language, which has mathematics and filtersfunctions to implement it. The Cochlear Nucleus 5was used asmodel, and the software mapped the 22 channels. The usercan submit a wave file, select the active channels and executethe simulator. As output, the simulator generates a wave filewith attenuated frequencies like the sound picked up by the CIuser. In this process, some features of the original sounds arelost. The simulator can process soundfile of any size. So, beforethe rehabilitation sessions, it is possible to identify words andphrases that havemore possibilities to be understand by the CIuser.

Conclusion: With this software the (re) habilitationprofessional, like audiologist, can improve yours sessionschoosing the better stimulus to reach the good result. Thissimulator is now used to assist CI users and their families as afacilitator to improve the oral communication.

Keywords: (re) habilitation, cochlear implant,simulator.

EPO023. Bimodal Cochlear Implant Users: protocol toloudness balance [Audiology]Magalhães A. T. M., Goffi-Gomez M. V. S., Tsuji R. K., Brito NetoR., Bento R. F.HC FMUSP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The search for binaural balance is animportant factor to ensure symmetry between the auditoryinputs in bilateral cochlear implant users or contralateralhearing aid (bimodal stimulation).

Objective: To evaluate whether the use complexsounds limited to frequency bands allow the balance ofloudness in bimodal stimulation users.

Methods and Results: 12 adults cochlear implantusers (mean of 27 months of use) were selected when theyattended for adjustments of hearing aids. The protocol usedcomplex sounds limited to frequency bands andnormalized inamplitude (500,700,1K,1,5K,2K,3K,4K and 8KHz) at 0° azi-muth to the computer sound box in room acoustics. Thepatient had to report whether the soundwas perceived louderat one or the other ear, or centrally. The sounds were firstpresented to the initial setting used by the patient. After theidentification of the unbalanced frequencies, adjustments inthe gain of the hearing aidweremade. It was possible to applythe new protocol and reach balance at all frequencies in 11patients, except one patient who presented discomfort withincreased gain in the hearing aid. An interesting finding wasthat even the frequency of 8KHz was perceived centrally afterbalancing in 8 subjects, even though the frequency range ofhearing aids does not exceed 6900Hz. In two patients, it wasnot possible to achieve balance at some frequencies due to thelimit gain of the hearing aid. All patients were satisfied withthe new adjustment and reported improvement in soundquality.

Conclusion: It was possible to use the complex soundsof frequency bands to assist the loudness balance in bimodalusers.

Keywords: cochlear implants; sound; adult.

EPO024. Preliminary Results Of The Speech Perception AndQuality Of Life In Auditory Brainstem Implant Adults AndChildren [Audiology]Fernandes N. F., Magalhães A. T. M., Goffi-Gomez M. V. S.,Tsuji R. K.HC FMUSP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Auditory brainstem implant allows theopportunity of hearing for those who cannot benefit from thecochlear implant. Although outcomes are extremely variable,ranging from detection of environmental sounds to open setspeech recognition, is important to check if there is animprovement in quality of life, regardless of speechperception.

Objective: To evaluate the speech perception out-comes and the quality of life of auditory brainstem implantusers.

Methods and Results: Descriptive exploratory studyinvolving 15 users of auditory brainstem implant (5 childrenand 10 adults). Tests and questionnaires were applied toevaluate the auditory and language skills, the recognitionand discrimination of sentences in an open and closed setand quality of life. Quality of life improved in 64.1% after usingthe auditory brainstem implant in children evaluated and alladults reported improvement in quality of life. The speechperception could only be tested in two children that havedetection thresholds within the speech range, and bothshowed category of auditory perception showing supraseg-mental discrimination skills while one of them reached voweldiscrimination after one year and seven months of implantuse. One of the adults cannot detect speech sound in theauditory only mode, 4 patients have speech perception eitherclosed or open set, and 6 have suprasegmental discriminationskills after approximately four years of use.

Conclusion: The auditory brainstem implant im-proved the auditory perception of the most of users (80%),with a relative improvement in the quality of life for allpatients.

Keywords: auditory brain stem implants; quality oflife; speech perception.

EPO025. The influence of theminimum current levels on thehearing thresholds and on the speech recognition incochlear implant users [Audiology]Martins K. V. C., MAGALHAES A. T. M., Porto B. L., Goffi-GomezM. V. S., Tsuji R. K.HC FMUSP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The outcomes of cochlear implants andthe user satisfaction are strongly related to the fitting process.Fitting is essentially based on strategy, stimulation rate andminimum and maximum current levels. Inaccurate or inap-propriate current levels may interfere in the detection ofsounds and in the speech intelligibility.

Objective: To evaluate the influence of the minimumcurrent levels on the hearing thresholds and on the speechrecognition in cochlear implant users.

Methods and Results: Ten adult users of Nucleusdevices with at least 12 months of implant use were selected.They should have free field thresholds equal or better than25dBHL with the device. The program in use (original map:OM)was saved in slot 1 in their speech processor. Another twomaps were created, one with T levels set at 10 current levelsless than the OM T levels (map less T: MT-) saved in slot 2; and

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another with T levels set at 10 current levels higher than theOM T levels (map more T: MT þ ) saved in slot 3. Free fieldthresholds, Ling sounds detection and recorded monosyllabicword recognition presented at 65dBSPL. Evaluations of eachmap were randomized and compared using with the t test.There was an increase in the hearing thresholds and Lingsounds detectionwith theMT-map, and a decrease in hearingthresholds with the MTþmap, with no statistical significanceconsidering the OM results. Monosyllabic recognition scoreshave not shown statistical difference either.

Conclusion: Current levels below or above the realones, althoughmay interfere in thehearing thresholds, did notinterfere in the speech performance in quiet at 65dBSPL.

Keywords: cochlear implants; adults; speech percep-tion; audiometry.

EPO026. Incidence of tinnitus in adolescents MP3 playerusers [Audiology]Silvestre R., Ribas A., Lacerda A.Universidade Tuiuti do Paraná - Parana - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: References to recreational exposure tohigh sound pressure levels (SPL) and the risk of hearing lossand sensation of tinnitus has increased in the adolescentpopulation.

Objective: To identify the occurrence of tinnitus inadolescents who use personal sound systems (PSS).

Methods and Results: This was a descriptive cross-sectional study, using a sample of 153 normal-hearing ado-lescent students from a public school. Participants answered aself-administered questionnaire, addressing information re-garding sound habits with the use of PSS and symptomsassociated with this practice. RESULTS: The occurrence of ahabit of using PSS was 93%. Comparing the exposed andunexposed groups, the incidence of tinnitus was 40% and33% respectively, and 22% reported the occurrence of tinnitusinduced by the use of PSS. There was no significant differencefor the presence of tinnitus depending on the degree ofexposure.

Conclusion: Although no relation between the use ofPSS with tinnitus has been observed, the prevalence ofsymptoms of up to 40%, including noise-induced episodes,reinforces the possibility of subclinical hearing loss induced byhigh NPS and, because of the irreversible nature of theselosses, the urgency of educational and regulatory measures toreverse these habits and attitudes.

Keywords: Adolescents, MP3 Player, Tinnitus.

EPO027. Results Of A Test Of Temporal Resolution In ElderlyWith Different Levels Socioeconomic Cultural [Audiology]Ribas A., Vinci A. P., Fadel C., Almeida G., Mafra N.Universidade Tuiuti do Paraná - Parana - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Aging may affect the processing ofauditory information, either by peripheral changes, in thecase of presbycusis, for central alterations, in the case ofdecreased efficiency of auditory skills.One of the complaintsthat most annoys elderly individuals with cochlear hearingloss, a characteristic of presbycusis, is the difficulty in under-standing speech sounds even when wearing hearing aids.

Objective: To apply, analyze and discuss the results ofthe Random Gap Detection Test (RGDT) in two groups ofelderly people with hearing loss, consistent with presbycusis,

whowear hearing aids, but are in different socioeconomic andcultural levels.

Methods and Results: This was a cross-sectionaldescriptive study. The study included 85 elderly people withpresbycusis, divided into: Group A (those in a higher culturalsocioeconomic level); and Group B (subjects with less favoredsocioeconomic cultural status). All participants responded to aspecific interview, underwent pure tone audiometry for airand bone conduction andunderwent a RandomGapDetectionTest. Results: the group with higher socioeconomic andcultural status responded significantly better to the test, whilethe less favored group had significant difficulties in under-standing the purpose of the test.

Conclusion: The RGDT seems to be influenced bysocioeconom.

Keywords: Presbycusis; Elderly; Temporal Resolution;Hearing Tests.

EPO028. Newborn Hearing Screening in infants with riskindicators for hearing loss: a comparison between inpatientand outpatient approaches [Audiology]Rosa B. C. S., Lewis D. R.PUC-SP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: There are hospitals which didn’t imple-ment Newborn Hearing Screening for different reasons. Eitherthe hospital has a very low number of births, or they can be inrural areas without professionals available for this; or maybethey are not prepared yet for all the steps necessaries for theNewborn Hearing Screening. One option to deal with thisdifficulty could be to perform the infant’s screening with anoutpatient approach, in a hearing health care center.

Objective: To compare the result of the hearingscreening in risk infants with an inpatient approach, with agroup of risk infants who performed the hearing screening inan outpatient approach, in a hearing health care center.

Methods and Results: A retrospective study wasperformed, with two databases analyzed. The first databaserefers to 284 newborns and infants who were screened in thehospital discharge, in an inpatient approach; the second one,analyzed the data for 398 newborns and infants, screened asoutpatients, in a hearing health care center. The follow uprates in outpatient approach was observed on 78,20% infantsfor the process of test/retest and diagnostic. For the inpatientapproach, when the infants where screened at the hospitalbefore discharge, 100% of the babies were followed-up, in thetest/retest and diagnostic process.

Conclusion: The follow-up in infants at risk for hear-ing loss is more efficient when the hearing screening isperformed in the hospital, before discharge, in an inpatientapproach. Therefore, is recommended to perform the hearingscreening in an inpatient approach, even in infants at risk forhearing loss.

Keywords: hearing screening.

EPO029. Profile of patients treated in a VestibularRehabilitation Clinic at a tertiary hospital in São Paulo[Balance]Coró B. V., Barros C. d G C., Hyppolito M A., de Oliveira A. A.,André A. P d R.Faculdade de Medicina de Ribeirão Preto - São Paulo – Brazil;Universidade de São Paulo- USP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

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Introduction: It is estimated that the prevalence ofbalance disorders and vertigo events is 5% to 10% of medicalconsultation per year. Vestibular Rehabilitation (VR) is therapythat aims for vestibular compensation through specific andrepeated exercises that activate neural plasticity mechanismsin the Central Nervous System.

Objective: This study aimed to characterize the profileof patients submmited to VR Program in a clinic of a tertiaryhospital in the last 10 years.

Methods and Results:METHODS: Retrospective anal-ysis of 672 clinical files from patients under VR betweenMarch 2002 to December 2012. RESULTS: The prevalence oftreated subjects were female 65.3% (N ¼ 439). The mean ageof patients was 54.9 years old. Rotatory Dizziness type (verti-go) was more prevalent 33.04% (N ¼ 222). Tinnitus occurredin 58.33% (N ¼ 391) of the population. The dizziness starttime was less than 5 years in 70.68% (N ¼ 475). Neurovege-tative symptoms appeared in 63.98% (N ¼ 430) of the popu-lation. The bilateral normal audiogram was the frequentlyobserved pattern of hearing 35.26% (N ¼ 237). The clinicaldiagnosis of peripheral origin was the most usual 65.47%(N ¼ 440).

Conclusion: Peripheral neurotological disorders werethe most prevalent in this population. Most of the patientswere femalewith amean age of 54.9 years. Themost prevalentsymptoms were vertigo, nausea, tachycardia, sweating, vom-iting and tinnitus, featuring the peripheral vestibular disorder.The dizziness time was less than five years. Audiologicalstandard normal curve was predominant especially for tinni-tus symptom.

Keywords: dizziness, vertigo, vestibular rehabilitation.

EPO030. Characterization Of Population Assisted In TheEducational Audiology Department Of A Clinical Hospital InThe Country Side Of São Paulo State [Audiology]Barbeti G. S., Fortunato-Queiroz C. A. U., Reis A. C. M. B.Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP- São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: It is essential that individuals withhearing impairment are included in rehabilitation programsto improve the hearing and language development.

Objective: To characterize the population assisted inthe Educational Audiology department of a Clinical Hospital ofSão Paulo state.

Methods and Results:Methods: A analytic retrospec-tive observational study data has been described by analyzingthe folders of patients assisted in the Educational AudiologyProgram of this Hospital. The Profile was characterized by thefollowing aspects: gender, age, type of device, hearing im-pairment acquisition period, etiology, mode of communica-tion and associated impairments. Results: There was 30patients. 50% were male, 50% female; 90% children and 10%adults; 70% use only hearing aids and 30% cochlear implant;86.6% had pre-lingual hearing impairment, 13.3% had post-lingual hearing impairment; the predominant etiologies wereidiopathic (40%), following by prematurity (16.6%) and chron-ic otitis media (10%); 56.6% had a predominance of oralcommunication, 43.3% had gestural communication; 70%had some associated impairment, including mental retarda-tion (23.3%), epilepsy (10%), attention deficit hyperactivitydisorder(6,6%) and cerebral palsy (6,6%).

Conclusion: The most of patients was children, indi-vidual hearing aid users, whose hearing loss was acquired inpre-lingual period. The predominant etiologic factors wereidiopathic, prematurity and chronic otitismedia. The predom-

inant mode of communication was oral. The most commonassociated impairments were mental retardation, epilepsy,attention deficit hyperactivity disorder and cerebral palsy.

Keywords: hearing loss, speech therapy, profile.

EPO031. Evaluation Of Residual Hearing After CochlearImplant [Audiology]Fortunato-Queiroz C. A. U., Silva C. D., Massuda E. T., HyppolitoM. A.Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto -HCFMRPUSP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Studies havebeen reported the involve-ment of cochlear structures in the introduction of the CIelectrodes compromising residual hearing after cochlear im-plant surgery. The concept of conservative surgery for cochlearimplants is encouraging in the sense of not deteriorateresidual patients hearing.

Objective: To investigate the preservation of residualhearing in patients with multichannel cochlear implant com-paring pre and post pure tone audiometry.

Methods and Results: Methods: 18 patients withsevere and/or profound sensorineural hearing loss bilateral,users of cochlear implant. Of these patients, 12 received theNucleus 24 cochlear implant, one Nucleus 22, two Sonata, oneDigisonic SP and two HiRes 90K; 6 adults and 12 children ofboth genders. The pure tone audiometry were performed atfrequencies from 250 Hz to 8000Hz in the pre and postsurgical, only in the operated ear. Pure tone thresholds inthe two periods were compared. Results: Complete hearingpreservation occurred in 66,6% of patients, and these patientswere implanted with the Nucleus 22 and Nucleus 24. Therewas no hearing preservation in other types of CI. Preservationof hearing thresholds after insertion was higher in the lowfrequencies.

Conclusion: This study reports successful in completehearing conservation after CI using a conservative surgicaltechnique in 66,6% of the patients. Hearing levels could bemaintained evenwith standard intracochlear electrodes if thesurgery is performed atraumatically, with the preservation offunctional structures.

Keywords: cochlear implant, hearing preservation,hearing conservation, residual hearing.

EPO032. RDLS: An Option To Analyze The Language Of DeafChildren Using Cochlear Implant [Audiology]Fortunato-Queiroz C. A. U., Costa M. P. R., Bevilacqua M. C.Universidade Federal de São Carlos - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Cochlear implant (CI) is a surgical alter-native that can facilitate spoken language in young children.Early implantation may take advantage of neuronal flexibilityinherent in critical periods of auditory-based learning. VerbalCommunication involves the processes of Verbal Comprehen-sion and Expressive Language.

Objective: The objective of this work was to analyzethe language of deaf children using a CI.

Methods and Results: The tool used was the RDLS, ascale internationally used to evaluate the language of childrenwith comprehension and verbal expression impairment. TheRDLSwas applied to 10 deaf children using CI and 12 childrenwithout hearing impairment, with ages between 4 years1 month and 5 years 0 months. The data from the deaf

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children was compared to the data from the children withouthearing impairment. Mean of Score Comprehension Scale was58 for children without hearing impairment and 23 for deafchildren with CI. Mean of Score for Expressive Language Scalewas 56 for children without hearing impairment and 28 fordeaf children with CI.

Conclusion: Deaf children using CI had a worse per-formance compared to the children without hearing im-pairment, both on comprehension and on verbalexpression; however three of them had results that approxi-mate the results of the children without hearing impairment.These three children were the ones with shorter time ofhearing sense deprivation and longer time using the CI, whichreinforce the importance of early diagnosis and interventionof deafness for a better linguistic performance by the deaf.

Keywords: deafness, cochlear implant, language.

EPO033. Hearing Abilities In A Group Of Children WithExternal And/Or Middle Ear Malformations [Audiology]Mottecy C. M., Ribas A., Fonseca V. R. C. D., Klagenberg K. F.Universidade Tuiuti do Paraná - Parana - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: the central auditory processing disor-der is a hearing disorder in which there is an impairment ofthe ability to analyze and/or interpret sound patterns. Peoplewith external and/ormediumearmalformationmayhave, as aresult, a hearing loss that will affect the quality of auditoryprocessing.

Objective: to compare the hearing abilities of a groupof children with external and/or middle ear malformations tothe test results in children with normal ears.

Methods and Results: 20 subjects matched for ageand gender were divided into two groups: Study Group,composed of 10 individuals with external and/or middle earagenesis and Control Group, composed of 10 individuals withnormal ears. All subjects underwent the evaluation of thecentral auditory processing, which consists of the followingtests: Verbal Memory, Nonverbal Memory, Sound Localiza-tion, Auditory Discrimination, Pitch Pattern Sequence, Speechin Noise, Staggered Spondaic Words, Dichotic Listening andRandom Gap Detection Test. RESULTS: there was no statisti-cally significant difference between the two groups in Audi-tory Discrimination Test, Verbal Memory Test and NonverbalMemory Test. There was statistically significant difference inall other tests.

Conclusion: Control Group showed better results inCentral Auditory Processing tests than the Study Group.Statistically significant differences were found in the auditoryprocessing tests that compare the auditory sensation betweenthe two ears. The results of Central Auditory Processing testsindicate that the malformation interfered negatively on thedevelopment of listening skills of the studied population.

Keywords: hearing; auditory perception; externalear; middle ear; congenital abnormalities.

EPO034. Combination of electrical stimulation and acousticstimulation: Audiologic aspects, candidate selection andresults – Literature review [Audiology]Levy C. C. A. C., Talarico T. R., Bucuvic E., Barbosa L. L., IervolinoS. M. S.ISCMSP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The progression of implantable devicetechnologies has resulted in greater number of options ofauditory solutions. Currently, it is possible to determine thebest training with greater quality to indicate the appropriatetype of electronic device, set up and level of hearing loss.

Objective: Perform literature review of audiologicaspects, candidate selection and results obtained from com-bination of electrical stimulation and acoustic stimulation.

Methods and Results: Publications about audiologicaspects, candidate selection for combination of electricalstimulation and acoustic stimulation and the results obtainedwith this type of patient stimulation were reviewed. Theauthors have reviewed publications from the past 6 years(2007–2013). .These studies have shown the following bene-fits from the electrical and acoustic combination, as seenbelow: Users reported good sound quality and improvementin music recognition, considering that low frequencies areresponsible for understanding it; increase in speech recogni-tion index in monosyllable words in comparisonwith hearingaid use in quiet; improvement in sound quality; improvementin speech understanding; better performance and recognitionof isolated words in sentences in quiet and in noise. Users ofelectroacoustic stimulation presented better results in speechrecogn.

Conclusion: We could observe that electroacousticstimulation provides real benefits to patients, but the choiceof device requires special attention. Assessment of candidatesshould comply with the following criteria: appropriate audio-gram configuration; speech perception test and additionalselection criteria.

Keywords: Coclear Implantation, eletrical simulation,acoustic stimulation.

EPO035. Benefits Of Active Middle Ear Implant VibrantSoundbridge In Sensorineural Hearing Loss [Audiology]Miranda C., Silva V., Peixoto C.Hospital CUF Porto - Porto - Portugal

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Active middle ear implants (AMEI) areindicated for patients with sensorineural hearing loss (SNHL)who do not benefit from conventional hearing aids (HA).Previous studies reported improvements in overall soundquality and better speech recognition scores with AMEI ascompared with conventional HA.

Objective: The aim is to evaluate threshold level andspeech discrimination results in our patients with mild tosevere down-sloping SNHL who received AMEI VibrantSoundbridge (VSB).

Methods and Results: 16 patients with stable SNHLfitting all the audiologic criteria. In 3 patients VSB wassequentially implanted. Pre- and postoperative assessmentsof hearing thresholds and speech reception thresholds (SRT)were compared, in the unaided and the VSB-aided solution. 19VSBwere implanted in 16 patients with 19,9months of followup. Results pre and post surgery with unilateral and bilateralVSB are shown. Threshold improvement with the VSB at 2KHzand 3KHz were statistically significant. Average SRT pre-opwas 54dB with 88% of maximum discrimination, and onemonthwas 58 dBwith 80% ofmaximumdiscrimination.Withunilaterally VSB SRT improved to 28dB with 98% of maximumdiscrimination. An improvement in speech discriminationwith bilateral implantation was noticed: SRT with unilateralimplantation was 35dB with 100% of maximum discrimina-tion and with bilateral condition SRT was 22 dB.

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Conclusion: For patients who do not benefit from HA,AMEI constitute an excellent solution. Bilateral results, al-though in a small number of patients, are encouraging.

Keywords: Active middle ear implants (AMEI), senso-rineural hearing loss (SNHL), and hearing aids (HA).

EPO036. Subjective Auditory Benefit (Hisqui19) And ItsRelation With Audiological Test Results [Otology, Neuro-Otology And Skull Base Surgery]Miranda C., Araujo S., Silva V.Hospital CUF Porto - Porto - Portugal

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Cochlear implantation benefits are cur-rently assessed basically in terms of speech perception testsand various outcome analyses. However, it is also noticeablethe improvement in the user’s performance and benefits in hisdaily life. This subjective benefit has to be evaluated inconjunction with the evolution in the speech perception teststo obtain a wider perspective of the cochlear implantationbenefit.

Objective: To assess the level of auditory benefitperceived by Cochlear Implant (CI) users using the auto-evaluable test Hearing Implant Sound Quality Index (HIS-QUI19), and its relation with the audiological benefits.

Methods and Results: The audiological benefits wereassessed using speech perception tests and audiograms. 10patients with sensorineural hearing loss were evaluated. Itwas correlated with the subjective auditory benefit perceivedby the users using the HISQUI19. It consists of 19 items scoredon 1 point Likert scale related to the experience in every daylistening situations. These testswere assessed onCI users fromPortugal. An analysis of the correlation between HISQUI19questionnaire results and pure tone audiometries and speechreception thresholds, studying the relation between audio-logical results and the subjective hearing perception of thepatient will be presented.

Conclusion: HISQUI19 seems to be a valid tool forquantifying the self-perceived level of auditory benefit that CIusers experience in everyday listening situations which re-sults are related to regular auditory test outcomes. However,validation in Portuguese is required.

Keywords: Cochlear Implant, Hearing Implant SoundQuality Index, audiological results.

EPO037. Auditory Discrimination In Adults With CochlearImplant - Analysis Based On Age Of Implantation [Otology,Neuro-Otology And Skull Base Surgery]Ramos D. C., Jorge J. X., Ribeiro C. A., Paiva A. D.Centro Hospitalar e Universitário de Coimbra - Portugal; Faculdade deMedicina da Universidade de Coimbra - Portugal

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Many studies evaluate the auditorydiscrimination in children with cochlear implant. However,few assess this skill in adults with cochlear implant.

Objective: To study the auditory discrimination ofminimal pairs in adults with cochlear implant and correlateit with auditory perception based on age of implantation.

Methods and Results: Eighty eight adults with co-chlear implants, 41women and 47men, aged between 19 and79 years, divided in two groups according to the age ofimplantation, group I �60 years; group II >60 years, werestudied. The Test of Auditory Discrimination Minimal Pairsand the Categories of Auditory Performance were used. Mean

hearing age of group I was 5.8 � 5.3 years; in group II was3.9 � 2.6. The difference between them was not significant,p ¼ 0.16. In the comparative analysis of the scores obtained bygroup I vs group II, the results were: subtest voicing,17.96 � 3.43 vs 17.81 � 2.66, p ¼ 0.87; subtest mode,15.19 � 2.38 vs 14.31 � 2.91, p ¼ 0.20; subtest posture,25.06 � 3.89 vs 24.19 � 5.38, p ¼ 0.45. In these 3 subteststhere were no statistically significant differences. The averagetotal score in the 3 subtests was 58.21 � 8.26 in group I and56.31 � 9.20 in group II, p ¼ 0.41. The scale categories ofauditory performance ranged from 4 to 9. The total scoreobtained by subjects in the 3 subtests, distributed according tothe categories of auditory performance, showed statisticallysignificant differences, p <0.0001.

Conclusion: 1-Subjects implanted before or after 60years of age showed similar auditory discrimination. 2-Thescore of subtests increased significantly according to thecategories of auditory performance.

Keywords: cochlear implant, minimal pairs in adults,auditory perception.

EPO038. Oral language development in children withcochlear implants: the influence of parents' academic level[Otology, Neuro-Otology And Skull Base SurgeryRamos D. C., Jorge J., Teixeira A., Ribeiro C., Paiva A.Centro Hospitalar e Universitário de Coimbra - Portugal;Departamento de Eletrónica, Telecomunicações e Informática daUniversidade de Aveiro - Portugal; Faculdade de Medicina daUniversidade de Coimbra - Portugal

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Several factors influence the linguisticcapacity in children with cochlear implant. Parent’s academiclevel is referred to be one of this factors.

Objective: To evaluate the influence of parents’ aca-demic level in the language development in children withcochlear implant.

Methods andResults:Oral languagewas studied in 30children of both genders, aged between 8 years and 10 years,with cochlear implant. The instrument used was the Obser-vation Grid of Language-School Level, which assesses seman-tics,morphosyntax and phonology. Childrenwere divided in 3groups according to the parents’ academic level: 1-basic level,2-secondary level and 3-high level.There were no statisticallysignificant differences in the hearing age average of implantedchildren according to the academic level of their parents. Inthe analysis of semantics, according to the fathers academiclevel, the scores for group 1 vs 2 vs 3 were 11.63 � 7.44 vs19.10 � 10.34 vs 25.00 � 7.70; p ¼ 0.01. In morphosyntax,the scores were: 12.56 � 10.74 vs 22.30 � 12.57 vs30.25 � 9.77, p ¼ 0.01. In phonology, the scores were:22.06 � 11.21 vs 29.40 � 9.84 vs 35.00 � 2.16, p ¼ 0.05.In the analysis, according to mother’s academic level, thescores showed the same trend, in semantics and morphosyn-tax, since, in general, the fathers and mothers of each childhave similar academic levels. In phonology, however, thedifference was not statistically significant, p ¼ 0.15.

Conclusion: 1-The linguistic gains of implanted chil-dren increased significantly with the increase of the parents’academic level;2-Parents academic level influences the orallanguage development of children with cochlear implant.

Keywords: Cochlear implant, oral language, parentsacademic level.

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EPO039. Newborn Hearing Screening Program: an outlookof detection to the intervention of hearing loss [Audiology]Biaggio E. P. V., Bertuol B., David A. L. M., Costa L. D., Melo à d.Universidade Federal de Santa Maria - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Considering the importance of earlydetection of hearing impairment was elaborated this study.

Objective: To present the outlook of a Newborn Hear-ing Screening Program up to the process of hearing andspeech-language therapy, hearing and language issues, aswell as, aspects of auditory habilitation.

Methods and Results: It’s a retrospective and cross-sectional clinical. It was carried out a survey from the data-base, in search to identify the total screened in the 14months,in addition to this, the cases sent to the high complexityservice. It was identified 12 individuals who were evaluatedbymeans of: casehistory, questionnaires and an observationalassessment of language. RESULTS: In the analyzed period3164 neonates were screened, of whom 12 were referred toa service of high complexity. The occurrence of this deficit was0,38%. The ototoxic medication and staying in the neonatalintensive care unit were the most prevalent risk indicators.The average age at the moment of hearing screening was3,15months, 12,44months for final diagnosis and18,25months to start the intervention. Regarding the catego-ries of hearing and language, most of the individuals werewithin in the categories 0 and 1, on both.

Conclusion: The program outlook had an average of210,93newborns screened monthly, with a rate of 0,38% ofhearing impairment. The risk indicators for hearing im-pairment occurred frequently for ototoxic medication andremain in neonatal intensive care unit. The average age ofdetection to the intervention of hearing impairment is notrecommended, justifying the auditory and linguistic skillsperformance of the sample.

Keywords: Hearing; Newborn Screening; HearingLoss; Audiology.

EPO040. The effectiveness of auditory training from the useof the Scale of Auditory Behaviors: a pilot study [General]Biaggio E. P. V., Simone S. N d., Pazini E., Ferreira L., Quinto S. M.S.Universidade Federal de Santa Maria - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The therapeutic indication in cases ofauditory processing disorder is to realize hearing training, inwhich have exercises that will stimulate the auditory skillswhich are altered. Among the types of hearing training wemention one by formal hearing training and the other com-puterizes using softwares.

Objective: To measure the effectiveness of auditorytraining through the analysis of the result of Scale of AuditoryBehaviors applied before and after the hearing training.

Methods and Results: The pilot study was performedin a clinic school of a public universityl. Participated in thestudy four participants, two of them used the computerizedauditory training and the others two used the formal auditorytraining. The participants answered the Scale of AuditoryBehaviors before and after the accomplishment of auditorytraining. The participants answered Scale of Auditory preBehaviors and after the accomplishment of auditory training.This consists of 12 questions sorted by frequency levels:frequent, mostly, sometimes, sporadic and to finalize never.The analysis of the questionnaires were in a descriptive

manner. Results: The score in the questionnaire before andafter that the participants underwent, in the computerizedauditory training increased on average by 3.5 points. Already,in theparticipants of the formal training score increased by9.5points.

Conclusion: According to the analysis of the scalethere was an improvement in auditory perception amongparticipants who underwent auditory training, regardless oftype. This is way it is possible to make an inference of theeffectiveness of the auditory training in these cases.

Keywords: Auditory perception, Hearing, AuditoryPerceptual Disorders.

EPO041. Assessing the quality of Auditory (Re) habilitationServices to electronic devices user children: manager andtherapist’s perspective limitations [Audiology]Zabeu J. S., Morettin M., Moret A. L. M., Alvarenga K. F.Faculdade de Odontologia de Bauru - Universidade de São Paulo - SãoPaulo - Brazil; Hospital de Reabilitação de Anomalias Craniofaciais-Universidade de São Paulo - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The effective functioning of auditoryhealth net is a fundamental aspect to ensure the access andcomprehensive care of the childrenwith hearing impairment.However, barriers are found permeating this process, there-fore, studies that evaluate how the net is working and thequality become essential.

Objective: To investigate aspects those allow reflec-tion on the quality of auditory (re) habilitation of childrenwithhearing impairment users of electronic advices.

Methods and Results: We conducted a survey andcharacterization of different services that perform aural (re)habilitation in São Paulo by the National Register of HealthFacilities until April, 2013. 55 services took part. They weresent by email one questionnaire focused on the quality ofservices divided into two parts: therapist and manager.Regarding the first part, it can be verified that the aspect“Diagnostic Services”was the best evaluate by the SpecializedServices as well as the “Access” by the Primary Care Servicesand “Professional Abilities” by Centers, Hospitals and Institu-tions. In the perspective of managers have proposed thefollowing solutions to the limitations raised: encourage in-vestments in services as infrastructure, information systemsand access; and the integration of the health net and profes-sional staff.

Conclusion: It was possible to verifier limitations asregards the auditory (re) habilitation especially in the primarycare services. Thus, initiatives are necessary in order topromote the proper functioning of the health net to the fullcare of children with hearing impairment.

Keywords: Children, Therapy, Reabilitation.

EPO042. Quality of therapy focused on auditory (re)habilitation of children users of CI from the perspective ofthe family [Audiology]Zabeu J. S., Tanamati L. F., Yoshida F. S., Morettin M., Moret A. L.M.Faculdade de Odontologia de Bauru - Universidade de São Paulo - SãoPaulo - Brazil; Hospital de Reabilitação de Anomalias Craniofaciais-Universidade de São Paulo - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The appropriate auditory (re) habilita-tion process, associated with the family and school

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participation are crucial for the development of the commu-nication skills of the children cochlear implants (CI) user.

Objective: To investigate the quality of therapy fo-cused on auditory (re) habilitation of children users of CI fromthe perspective of the family.

Methods and Results: 30 children users of CI wereselected randomly from the spontaneous demand of theCentro de Pesquisas Audiológicas- Hospital de Reabilitaçãode Anomalias Craniofaciais during the months from Septem-ber to November 2014. A Questionnaire for Assessment ofQuality of Service was applied, translated and adapted fromParent's views: a survey about speech and language therapy. Itwas observed that 6.67% are not performing aural (re)habil-itarion. Among childrenwhoperform, only 39.29% do this truevia public health system, most of children do two or moretherapies per week over 45 minutes. According to 39.29% ofparents there is a failure of communication between theauditory healths net. Consequently, part of the sample musttravel to access rehabilitation. The services were well evaluat-ed for infrastructure, but note the need for training andorganization of the staff, organization of auditory health netand inclusion of the family.

Conclusion: This study showed that parents weresatisfied as to the physical space and structure of the services,however, others factors need to be improved, especially theaccess and availability of therapy near home, consolidation ofauditory health net, training of professionals, and revision ofpublic policies for hearing health.

Keywords: Child, cochlear implant, hearing loss,Questionnaires, Rehabilitation.

EPO043. Radiotherapyon cochlear implants: case report andliterature review [Otology, Neuro-Otology And Skull BaseSurgery]Silva I. B d O., Sampaio A. L. L., Lopes R. A. F., Araujo J. G., VenosaA. R.Hospital Universitário de Brasília - Distrito Federal - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Cochlear implants restore functionalhearing in patients with sensorineural deafness. As a conse-quence of an increasing number of cochlear implant recipientsworldwide, the potential need for radiotherapy is an issuerequiring consideration by both implantees and implantationcenters. However, little is known about the effect of radiationin cochlear implants.

Objective:Until nowadays, there are few studies aboutthe effect ionizing radiation on cochlear implants. The aim ofthis study is to describe a case of a patient with abnormalfunctioning of cochlear implants after radiotherapy and per-form a literature review.

Methods and Results: 54 year-old male with pro-found sensorineural hearing loss beginning 2 years ago afterantibiotic therapy with amikacin. Six months after implanta-tion, audiological evaluation revealed significant improve-ment of speech perception. About 1 year and 2 months aftercochlear implant, the patient was diagnosed with prostateadenocarcinoma and underwent radiotherapy. During treat-ment, there was a significant worsening of the speech per-ception, which improved after the end of radiotherapy.

Conclusion: The studies reviewed and the case re-ported demonstrated that, if monitoring and reprogrammingare properly carried out, there are no major complications tocochlear implants when patients undergo radiotherapy. How-ever, further studies are required.

Keywords: Cochlear implant, radiotherapy, deafness.

EPO044. Comparison Between Performance Of DHI ScoreAnd Cervical Range Of Motion In Patients With VestibularDysfunction: A Preliminar Cross-Sectional Study [Balance]Melo J. J., Silva C. R P d., Cardoso D. M. S., Marchiori L. L d M.Universidaade Norte do Paraná - Unopar - Parana - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Vertigo is one of the most commonhandicapping conditions among people.

Objective: The purpose of this pilot study was toevaluate the performance of dizziness handicap inventory(DHI) and the correlation with outcome the cervical rangeof motion in patients with vestibular dysfunction.

Methods and Results: This cross-sectional study con-sisted of 20 patients adults aged 40 year older with VestibularDysfunction. The samplewas underwent the vectoelectronys-tagmography. The measurement of cervical range of motionwas performed by goniometry. To interference of vertigo inthe quality of life questionnairewas applied the DHI (Castro etal., 2007). The research project was approved by the ResearchEthics Committee of our institution, number PP/0027/13. Theassociation between variables was performed with Spearmancorrelation. No significant differences in cervical range ofmotion were identified between performances of DHI scorein patientswithVestibular Dysfunction. The association ofDHI(score�50)with the cervical range ofmotionwas not found tobe statistically significant (p ¼ 0,533). However, the evidencesupporting that conclusion is not strong, and further studiesare needed to clarify the association between theseconditions.

Conclusion: The physical, functional and emotionalinvestigation, through the DHI and the comparison withcervical range of motion in patients with Vestibular Dysfunc-tion, can be avaluable and useful tool in clinical practice. In thelonger term, other studies can help to improve our under-standing of cervical range of motion in the quality of life ofpatients with vestibular dysfunction.

Keywords: Range of motion; Neck pain; Vestibulardysfunction vertigo.

EPO045. Longitudinal analysis of the development ofhearing and language skills in the Auditory NeuropathySpectrum Disorder: a case study [Audiology]Ogihara N. S., Araújo E. S., Yamaguti E. H., Lourençone L. F. M.,Alvarenga K. F.Centro de Pesquisas Audiológica - Seção de Implante Coclear doHospital de Reabilitação de Anomalias Craniofaciais, Universidade deSão Paulo - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Among the hearing loss in childhood,the Auditory Neuropathy Spectrum Disorder has pathophysi-ology still discussed and its prevalence ranges from 0.5 to 24%in children.

Objective: Describe, longitudinally, the developmentof hearing and language skills of a patient with interdisciplin-ary diagnosis of Auditory Neuropathy Spectrum Disorder.

Methods and Results: This is the case study of apatient assisted from three to 19 months of age. Althoughthe audiology diagnosis was kept throughout the monitoringprocess, with results characterizing Auditory NeuropathySpectrumDisorder, behavioral assessment showed significantchanges in the hearing thresholds obtained, initially with aprofound bilateral sensorineural hearing loss, reaching audi-tory thresholds within normality. Hearing aids were indicat-ed, however, as detection levels improved, interrupting the

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use of the device and maintaining speech therapy was theconduct adopted, when a mild hearing loss was confirmed. Adelay was observed in the development of hearing function,presenting only lateral localization at 19months of age and, inaddition, the hearing abilities of discrimination and recogni-tion were not yet performed by the child. A delay in languageacquisition and development was verified for both receptiveand expressive language.

Conclusion: Although presenting adequate levels ofsound detection, the patient has shown a delay in the acquisi-tion of hearing skills and also a language evolution belowexpectations for his age, being the discussion of what wouldbe the most assertive conduct raised and the importance ofmonitoring hearing and language skills evidenced.

Keywords: Language Development. Hearing. Hearingloss. Monitoring.

EPO046. Key findings in imaging exams of eligible patientsfor cochlear implant [Otology, Neuro-Otology And SkullBase Surgery]da Silva P. d S C., Reis L. A., Félix F., Laurindo R. S., Tomita S.Hospital Universitário Clementino Fraga Filho - Rio de Janeiro - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction:Deafness is a disorder that affects about1 in 1.000 children and 4% people over 45 years. Meningitis isthe leading cause of neurossensorial acquired deafness. Co-chlear implant partially replaces the cochlea function inpatients with significant hearing loss who failed hearingimprovement with conventional aids. Pre-surgical imagingstudy of candidates for cochlear implant is critical as it helps inmany aspects from the diagnosis to the surgical planning.

Objective: Evaluate epidemiological data and imagingfindings of candidates for cochlear implant in a otology serviceof a University Hospital in Rio de Janeiro - Brazil, in 4 years.

Methods and Results: Methods: Images and reportsof high-resolution CT scans and MRI in Ciss/Fiesta of 197patients were evaluated. Results: Only 30 patients had abnor-malities on imaging studies. Of these, 21 had abnormalfindings in both exams, 6 on CT only and 3 with exclusivechanges in MRI. The mean age was 26 years, with a predomi-nance of males. The most prevalent changes were: labyrin-thitis ossificans, enlarged vestibular aqueduct, temporal bonefracture, Mondini’s and Arnold-Chiari’s malformations, co-chlear nerve agenesis and changes in ossicular chain. Imagingstudies could contraindicate cochlear implant surgery in 7candidates.

Conclusion: Cochlear ossification was already ex-pected to be the most frequent change, since meningitis isthe leading cause of acquired sensorineural hearing loss. Allabnormalities found were, however, equally crucial for con-traindication or surgery planning.

Keywords: cochlear implant, temporal bone, imagingexams, hearing loss.

EPO047. Percentage Correct consonant in children withhearing impairment: influence of duration of therapy[Audiology]Splendor L., Gil D., Azevedo M. F., Silva P. B.Universidade Federal De São Paulo - Unifesp - Departamento DeFonoaudiologia - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Percentage of correct consonants canassist the therapist in Educational Audiology to set a parame-

ter during their practice, so that they are able to assess theeffectiveness of the rehabilitation plain order to check itsadequacy.

Objective: To compare the development of speech inhearing impaired children with hearing aids and cochlearimplant using the percentage of correct consonants and a selfassessment questionnaire.

Methods and Results: Method: 19 hearing impairedchildren using hearing aid users or cochlear implants partici-pated in this research and all of themwere enrolled in a speechtherapy program in aurioral approach. ABFW test concerningphonology (naming and imitation tasks) and spontaneousspeech sample were used to calculate the percentage ofcorrect consonants. Finally MAIS questionnaire was appliedwith parents. All procedures were applied and reapplied inselected children within a 12 month interval. Results: Therewas a statistically significant difference for both the percent-age of correct consonants and also for the scores of thequestionnaires. The correlation between the percentage ofcorrect consonants gain (average) with frequency in therapywas also revealed. It was also found that cochlear implantusers showed a greater improvement in the percentage ofcorrect consonants than hearing aids users.

Conclusion: From the comparison of the percentage ofcorrect consonants index, it can be concluded that the speechtherapy approach in hearing impaired children with cochlearimplant or Hearing Aid is effective for improving speaking andthat frequency in therapy directly influences the speechdevelopment.

Keywords: Hearing loss, Auditory Perception, Childdevelopment, language development, cochlear implants.

EPO048. Elaboração de um protocolo para a adaptação doSistema de Frequência Modulada Pessoal para usuários deaparelho de amplificação sonora individual e/ou implantecoclear [Audiology]Bucuvic E. C., Tanamati L. F., Araujo P. G. V., Paccola E. C. M.,Moret A. L. M.Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) -São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: A Portaria 1.274 inclui o sistema defrequência modulada (FM) na tabela de procedimentos doSistema Único de Saúde, o que permitiu a concessão destedispositivo para usuários de AASI e Implante coclear.

Objective: Propor um protocolo para a adaptação dosistema de frequência modulada pessoal considerando asseguintes etapas: seleção, programação, verificação e valida-ção do sistema FM e acompanhamento do usuário.

Methods and Results:O protocolo clínico proposto foidesenvolvido com base nos critérios estabelecidos pela ASHA(American Speech Language Hearing Association) no qualapresenta os itens básicos que devem ser avaliados durantea adaptação do sistema FM nos usuários de AASI e IC. Oprotocolo clínico para adaptação do sistema FM nos usuáriosde AASI e IC foi aplicado em 467 pacientes atendidos noHospital de Reabilitação de Anomalias Craniofaciais entresetembro/2013 a dezembro/2014 e contemplou os seguintesitens: dados técnicos da seleção do sistema FM (modelo dotransmissor, receptor e adaptadores) informações dos ajustesdo AASI(s) e IC(s) ; verificação do funcionamento dos dispo-sitivos por meio da checagem do sinal FM, testes de percepçãode fala, avaliação eletroacústica e avaliação subjetiva dopaciente ; orientação; validação do uso por meio de ques-tionários e procedimentos para o acompanhamento do uso epara a avaliação dos benefícios.

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Conclusion: O protocolo elaborado trata-se de umroteiro clínico para orientar os profissionais envolvidos naconcessão do sistema FM especialmente no que se refere asdiferentes etapas do processo de adaptação deste dispositivo eacompanhamento do usuário.

Keywords: Implante coclear, auxiliares de audição,sistema FM.

EPO049. Relationship Between Auditory Perception AndVocal Production In Cochlear Implantees: IntegrativeReview [Audiology]Muniz L. F., Cisneyros H. R., de SouzaM. B., Leal M. C., de LucenaJ. A.UFPE - Piaui - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The impact of hearing loss in commu-nication is linked to the loss of auditory feedback and itsimportance in monitoring and adjustment of articulation andspeech production (PINHO, 2003). The cochlear implant ap-pears as an alternative for feedback restoration. The literaturefocuses mostly in speech production and auditory perception,while studies associating vocal production and auditory per-ception are rarer, especially when it comes to Brazilianliterature.

Objective: Conduct a literature review of scientificpublications studying the relationship between vocal produc-tion and auditory perception in cochlear implant users.

Methods and Results: It is an integrative literaturereview, in which were consulted the following platforms/databases: Bireme, SciELO, Cochrane, Scopus and Web ofScience. Studies published in English, French, Spanish orPortuguese were selected and there was not restriction onthe publication year of articles. Studies published until July2014 were included. A total of 5.228 articles were found. Afterthe application of inclusion and exclusion criteria defined andsubtraction of repeated publications, a total of 6 articles wasselected, 5 of these published in United States and 1 in Brazil,with publication years ranging from 1992 to 2012. the resultsdemonstrate that there is a direct relationship betweenspeech recognition and a good vocal production.

Conclusion: The findings point to the existence ofpositive relationship between vocal production and auditoryperception and indicate that the implantation time has apositive effect on this relation. but none of the few publica-tions found got level 1 of scie.

Keywords: auditory perception, voice production,cochlear implant.

EPO050. Vocal Acoustic Parameters In Post-Lingual AdultImplantees [Audiology]Cisneyros H. R., de Souza M. B., Leal M. d c., de Lucena j. A.,muniz l. f.UFPE - Pernambuco - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: For the constitution of subject’s vocalidentity, the fundamental frequency and vocal intensity areimportant acoustic parameters.Considering that any restric-tions on auditory feedback bring negative impacts in produc-tion of segmental aspects of speech and vocal parameters,such as deviations in frequency, variations in vocal intensity,as well as resonance. Hearing loss requires intervention.Although the literature is consistent about the benefits ofcochlear implant for auditory perception and language pro-

duction, vocal production reports of these benefits are not yetwell established.

Objective: To characterize vocal acoustic parametersin post-lingual implanted adults.

Methods and Results: this is a quantitative, cross-sectional, observational, case-series study. All participantswere adult volunteers.Sample selection was done by conve-nience and carried through the records of otorhinolaringologyand fonoaudiology sectors.Variables studiedwere: fundamen-tal frequency, vocal intensity, auditory deprivation time,implantation time, phonatory deviation diagram. Data wascollected through voice recording of sustained vowel /ε/ and acount from1 to 10 in VoxMetria program (4.0). Only 2 subjectspresented abnormal values: a man with 74.44 Hz and awoman with 250.07 Hz. And there was not any alterationfor vocal intensity, The study group had a mean of 58.13months of auditory deprivation,withmeanof 31.65months ofimplantation time. The diagram of phonatory deviation wasaltered in 65%. Was not any significant difference for all tcorrelations among variables.

Conclusion: Implantees presented normal acousticparameters.

Keywords: auditory perception, voice production,cochlear implant.

EPO051. Monitoring auditory habilitation through thecochlear implant: analysis of electrophysiological andbehavioral measures [Audiology]Silva L. A. F., Magliaro F. C. L., Tsuji R. K., Matas C. G.,Carvalho A. C. M.Universidade de São Paulo - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Long latency auditory evoked poten-tials are a tool to evaluate the functionality of the centralauditory pathways; thus, can be used to monitor the neuro-physiological changes after activation of cochlear implant.

Objective: To evaluate the cortical maturation byelectrophysiological analysis in children users of cochlearimplant, and its correlation with the development of hearingand language skills.

Methods and Results: A longitudinal study composedby 7 children with sensorineural hearing loss, severe and/orprofound congenital bilateral, which were awaiting activationof cochlear implant electrodes, with a mean age in theactivation of 31 months (study group), and 7 hearing childrenmatched for gender and chronological age (control group).Both groups performed an evaluation of long latency auditoryevoked potentials and the children in the study group werealso evaluated using hearing and language behavioral meas-ures. Each child was evaluated before the activation of theelectrodes and three and nine months of activation. In theelectrophysiological assessment of the study group was ob-served presence of the P1 component only in the last twoassessments; the latency values were 231 and 147ms, respec-tively in the second and third assessment, reaching thus valuesclose to those obtained in the control group. In behavioralexaminations, it was observed development of auditory andlanguage skills.

Conclusion: The electrophysiological evaluation, as-sociated with behavioral measures, proves to be a useful toolto monitor the changes occurring in the central auditorypathways following activation of the Cochlear Implant.

Keywords: Cochlear Implant; Electrophysiology;Auditory Perception; Language; Neuronal Plasticity; AuditoryEvoked Potentials.

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EPO052. Satisfaction with the use of middle ear implant inadolescents with ear malformations [Audiology]SantosM.M., MarianoT. C. B., Mondelli M. F. C. G., Brito Neto R. V.Faculdade de Odontologia de Bauru - Universidade de São Paulo - SãoPaulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The ear malformations are anomaliesthat occur in embryonic development period and may affectthe external ear, middle and / or internal, may be unilateral orbilateral. Hearing loss is one of the most common clinicalfindings in these patients. This hearing impairment reducesspeech intelligibility, compromises the language and conse-quently the quality of life of this population. Treatmentconsists of performing surgery and / or adjust the hearingaid. The Vibrant Soundbridge (VSB) is a partially implantablemiddle ear prosthesis, indicated for patients with sensorineu-ral hearing loss from severe to moderate, and conductive ormixed hearing loss. There are several factors that influencedifferent dimensions related to the use of electronic devicesthat can be measured by means of tools for assessment of theindividual satisfaction.

Objective: Check the satisfaction using the VibrantSoundbridge (SVB) through the questionnaire SADL (Satisfac-tion with Amplification in Daily Life) in adolescents with earmalformations.

Methods and Results: The questionnaire SADL wasapplied in three adolescents with ear malformations, semiimplantable prosthesis users, the VSB. The SADL is a question-naire that checks the level of hearing aid user satisfaction,consisting of 15 questions divided into four subscales: positiveeffects, services and costs, negative factors, personal image.Results: : The average global score-20, positive effects-6,7,negative aspects-4.3, service and costs-5.1, personalimage-3.7 .

Conclusion: The sample shows satisfaction with theuse of VSB.

Keywords: malformations, hearing loss,questionnaires.

EPO053. Early spoken language development followingcochlear implantation [Otology, Neuro-Otology And SkullBase Surgery]Alves M., Martins J. H., Alves H., Ribeiro C., Paiva A. D.Centro Hospitalar e Universitário de Coimbra - Portugal

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Cochlear implantation (CI) can facilitatespoken language development in children with severe toprofound congenital hearing loss, but a large variability inspoken language outcomes is observed.

Objective: To investigate spoken language develop-ment following CI in young children; to compare their lan-guage development to that of normal hearing (NH) children.

Methods and Results: Prospective and longitudinalstudy, over a 3 year period, with children with severe toprofound sensorineural congenital hearing loss implantedbetween 13 and 40 months of age (n ¼ 10). The outcomemeasure was a Portuguese language development test (Testede Avaliação da Linguagem na Criança). A comparison wasmade between the results of the children post CI and thenormative data available. Results show that, 2 years after CI,children achieve a performance similar to the NH children,when this comparison is made based on hearing age. Aconsiderable delay regarding their hearing peers is seen, ifonly chronological age is analyzed. This situation continues to

be seen at 3 years after cochlear implantation. Despite this fact,two children (both implanted at an earlier age) achieved ageappropriate performance by 24 months post-implantation.

Conclusion:On average, it is difficult for childrenwithsevere to profound sensorineural congenital hearing loss whouse cochlear implant to bridge the gap between them andtheir NH peers, although this is possible. Several factorsinfluence language development, but in this investigationyounger age at implantation seemed to promote steeperrate of language development and age appropriate perfor-mance by 24 months post CI.

Keywords: Cochlear Implant, Hearing Impairment,Language Development.

EPO054. Perception of consonantal phonemes and overallauditory performance in adult cochlear implant users[Otology, Neuro-Otology And Skull Base Surgery]Alves M., Martins J. H., Ramos D., Ribeiro C., Paiva A. D.Centro Hospitalar e Universitário de Coimbra - Portugal

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Cochlear implantation can allow indi-viduals with severe to profound sensorineural hearing loss toconsiderably improve speech perception. Nevertheless, thereis a great variability of results between individuals.

Objective: To characterize the perception of conso-nantal phonemes and overall auditory performance in cochle-ar implant (CI) adult users. To investigate if time of auditorydeprivation, time of CI use and implanted ear influenceperformance.

Methods and Results: The participants were individ-uals with post-lingual severe to profound sensorineural hear-ing loss implanted in adulthood (n ¼ 200). The outcomemeasures were: Categories of Auditory Performance (CAP)and consonantal phonemes perception test. In CAP, mostparticipants were in category 7. In the consonantal phonemesperception test, the phoneme with the highest percentage ofcorrect answers was the unvoiced pre-palatal fricative. Theaverage scores in the phonemes perception test werehigher asthe score in CAP was also higher. Statistically significantdifference in performance was found regarding time of audi-tory deprivation. No statistically significant differences werefound regarding time of CI use and implanted ear.

Conclusion: The majority of participants use thetelephone. The consonantal phonemes perception test is achallenging task for CI users. It is important to minimize timeof auditory deprivation before CI. Given that the average scoreon the consonantal phonemes perception test was higher thehigher the score in CAP, it is considered that perception ofconsonantal phonemes training is very relevant in auditoryrehabilitation after cochlear implantation.

Keywords: Cochlear Implant; Hearing Impairment;Consonantal Phonemes Perception; Auditory Performance.

EPO055. Auditory temporal resolution and acclimatizationin older people [Audiology]Costa M. J., Lessa A. H.Universidade Federal de Santa Maria - Rio Grande do Sul - Brazil;Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Introduction: In addition to hearingloss, the aging often results changes in auditory temporalprocessing. Therefore, considering that speech sounds andother environmental stimuli also vary over the time and that

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these deficits may influence the communication skills of theolder people, this aspect should be investigated. As a way ofrehabilitation, the use of hearing aids can not only improvehearing, but cause change in aspects related to auditoryprocessing of sounds too and thereby bring about improve-ments in the communication of these subjects.

Objective: Objectives: To evaluate the auditory tem-poral resolution in the older people at two moments: pre andpost hearing aids fitting and compare the results at thesedifferent times.

Methods and Results: Methods: 12 subjects agedbetween 61 and 81 years oldwith bilateralmild tomoderatelysevere sensorineural hearing loss, inserted in the Hearing AidGrant Program of the Ministry of Health developed in theinstitution were evaluated by the Random Gap Detection Testbefore and three months after the bilateral fitting, due toacclimatization. Results: There was a statistically significantdifference (p ¼ 0.018) between initial and final assessments.

Conclusion: Conclusion: After three months of hear-ing aids use, there was a significant increase in temporalresolution ability in the studied population of older people.This highlights the importance of the hearing aids fitting,because this is a necessary skill for understanding the speechstimuli of the day-to-day. Furthermore, these results showthat plasticity in the older people can be further enhanced.

Keywords: Aged, Hearing, Hearing Aids, Hearing Loss,Speech Perception.

EPO056. Auditory temporal resolution, cognition andmemory in older people [Audiology]Costa M. J., Lessa A. H.Universidade Federal de Santa Maria - Rio Grande do Sul - Brazil;Universidade Federal do Rio Grande do Sul - Rio Grande do Sul - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Presbycusis associated with degenera-tion of cognitive aspects in the older people contributes totheir communication difficulties. The abilities to detect, iden-tify, recognize and sequence properly auditory patterns in-volve cognitive, perception and memory acting. With theaging, anatomical and physiological changes occur in thecentral nervous system and that often affect these functions.

Objective: Objectives: To correlate the auditory tem-poral resolution ability with cognition and memory in olderadults candidates for the use of hearing aids.

Methods and Results: Methods: 12 subjects agedbetween 61 and 81 years oldwith bilateralmild tomoderatelysevere sensorineural hearing loss, inserted in the Hearing AidGrant Program of the Ministry of Health developed in theinstitution were evaluated before the bilateral hearing aidsfitting. These were submitted to the Random Gap DetectionTest, and the Clock Drawing Test and Word recognition(memory). Data were statistically analyzed and verified thecorrelation between auditory processing and cognition /memory tests. Results: There was significance in the analysisof the Random Gap Detection Test results with the ClockDrawing Test (p ¼ 0.002) and with the Word recognition(memory) (p ¼ 0.025). A strong negative correlation wasobserved for both analyzes, that is, the lowest (best) scoreon Random Gap Detection Test, the higher (better) score wasClock Drawing Test and Word Recognition (memory).

Conclusion: Research has shown that the evaluatedolder adults performed better in temporal processing, whenbetter were the cognitive status and memory.

Keywords: Key words: Aged, Cognition, Hearing,Hearing Loss, Speech Perception.

EPO057. Mi experiencia con Implante Coclear [Audiology]Gomez Alvarez M. E.Hospital Central Policía Nacional - Colombia

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: El habla es el medio que usa el serhumano para comunicarse por medio de sonidos y palabras.Desde el punto de vista acústico, es altamente compleja ydinámica. Las mayores dificultades para discriminar los soni-dos del habla las presentan las personas que sufren unaperdida sensorial de la audición, puesto que este tipo dedaño no solamente ocasiona una baja en la percepción en laaudibilidad del sonido, si no que afecta la capacidad deresolución frecuencial y temporal del individuo. La alteraciónde estas dos capacidades, se manifiesta principalmente en elproceso de rehabilitación como una dificultadmarcada para lacomprensión del habla en ambientes acústicamente comple-jos. En caso de los pacientes post linguales este tipo demanejoya lo tuvieron con su audición anterior (normal); y su cortezacerebral hace un papel importantísimo en el proceso deplasticidad y engramas con su huella previa de haber escu-chado antes.

Objective: Generar conciencia y potencializar la de-tección rápida de hipoacusia súbitas. Conocer un pacientedesde su parte emocional, sus necesidades, apoyar y acompa-ñar mediante un direccionamiento clínico auditivo como unopsicológico.

Methods and Results: Presentación de caso. Algo másde 20 anos los implantes cocleares en Colombia, mi país, hanfavorecido la estabilidad emocional, social y económica depacientes con hipoacusia que han logrado insertarse positi-vamente en el mundo sonoro.

Conclusion: El adulto que pierde la audición y tiene lanecesidad de volver a conectarse con el mundo oyente, con unimplante coclear puede volver a iniciar la audición a su vida.

Keywords: Hipoacusia, implante coclear, salud emo-cional, milagro meningitis, escuchar.

EPO058. Music Ratting Scale: Translation Into BrazilianPortuguese [Audiology]Frederigue Lopes N. B., Quental S. L. M., Zabeu J. S., AngeloT. C.S., Moreti A. L. M.Faculdade de Odontologia de Bauru/USP - São Paulo - Brazil; Hospitalde Reabilitação das Anomalias Craniofaciais/USP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Music perception has become a chal-lenge in the field of research related to cochlear implant,especially in the last decades. Given the need to use subjectiveand objective measures to evaluate music in CI users, severaltools have been proposed and used in clinical practice, includ-ing the Musicality Rating Scale, which is a subjective tool thatevaluates musicality in preschool children.

Objective: This study aimed to translate theMusicalityRating Scale in Portuguese.

Methods and Results: The translation process fol-lowed the methodological steps as recommended by theliterature: translation of the scale into Portuguese, evaluationby a committee of experts, back translation of the adaptedversion to check grammatical and idiomatic equivalence,comparison of both versions in English and semantic analysis.RESULTS: The scale was translated into Portuguese and keptthe same number of questions and answer options as theoriginal tool: 25 questionswith 3 closed-answer options, withscoring possibility of 0 (zero), 1 and 2. Finally, the score totals

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50 points, corresponding to 100%. The scale rates from simpleperception of rhythm to recognition of familiar songs.

Conclusion: In Portuguese, the tool was named Escalade Avaliação daMusicalidade. New studies have been initiatedby this group of researchers to culturally adapt the scale andassess the reproducibility inter and intra-researchers.

Keywords: music, cochlear implantation, child.

EPO059. Giant cell tumors of temporal bone andinfratemporal fossa [Otology, Neuro-Otology And Skull BaseSurgery]Dias N. H., Tagliarini J. V., Zanini M. A., Moraes M. P. T., MeiraJunior S. G.Botucatu Medical School, São Paulo State University (UNESP) - SãoPaulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Giant cell tumors (GCT) are rare benignneoplasms most commonly found in the long bones. Only 1–2% of these lesions present in the head and neck, skull basebeing a commonly reported site (temporal, sphenoid andethmoid bones) and other sites including the mandible,maxilla and the soft tissues of the neck. The temporal boneis a common site of occurrenceof GCT in the skull base, andhasa locally destructive character which can be potentiallydangerous.

Objective: Report a case of GCT in the temporal boneand infratemporal fossa.

Methods andResults:Male patient, 44, referred to ourhospital with progressive hearing loss the right for 6 years andear fullness. Submitted to three previous mastoidectomies noimprovement of symptoms, with diagnosis of cholesteatoma.Audiometry moderate mixed hearing loss. CT: expansivelesion infiltrating the temporal bone, 5 � 7cm, projected bythe deep lobe of the parotid gland, eroding the lateral marginof the jugular foramen and the carotid canal. High densitywith heterogeneous impregnation iodinated contrast. MRI:the lesion extended superiorly to the temporal fossa, howeverno the brain parenchyma signs of invasion. Thin peripheraluptake of paramagnetic contrast. Infratemporal fossa type Bapproach allowed the complete removal of the lesion andMRIpostoperatively showed no residual disease. The histologicalanalysis confirmed bone tumor giant cells associated withcholesteatoma.

Conclusion: GCT of temporal bone is a benign lesionthat is locally aggressive. Most patients present with slowlyprogressive hearing loss. Wide local excision is required toensure optimal outcomes in the treatment.

Keywords: Giant cell tumor, Temporal bone, Infra-temporal fossa approach.

EPO060. Audiological outcomes of children with cochlearimplant after ophthalmologic evaluation and intervention[Audiology]Samuel P. A., Magalhães A. T. M., Goffi-Gomez M. V. S.,Tsuji R. K., Bento R. F.Hospital das Clínicas da Faculdade de Medicina da USP - São Paulo -Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: After the diagnosis of deafness, allinterventions are directed to hearing rehabilitation, and fewfamilies are guided to perform ophthalmologic evaluation torule out the possibility of visual difficulties.

Objective: To determine the number of children withcochlear implant who underwent ophthalmologic evaluation;to analyze the impact of the correction of visual abnormalitieson auditory and communicative abilities.

Methods and Results: Families of cochlear implantchildren were asked whether the child had undergone oph-thalmologic evaluation after the activation of the device, andwhether the use of glasses was required. We selected thosewithmyopia, hyperopia (Otsuka, 1967 andMurray et al., 2005classification), and associated astigmatism. The mean puretone thresholds in free field audiometry, speech perception,language category and etiology of deafness were analyzed.Cases that had different results before and after the glasseswere discussed. Sixty families (51 %) reported having under-gone ophthalmologic evaluation. Thirty seven children (61 %)have ophthalmologic abnormalities. Twelve children (33%)have visual abnormality in accordance with the afore men-tioned classification. The most frequently etiology of deafnesswere unknown origin. Two children showed improvement inlanguage and speech perception after diagnosis of visualabnormalities and wearing eyeglasses.

Conclusion: The ophthalmologic evaluation of chil-dren candidates and users of cochlear implant should be doneroutinely, given the incidence of visual difficulties and benefitthe ophthalmologic intervention can cause to the develop-ment of these children.

Keywords: cochlear implants, speechperception, oph-talmological evaluation.

EPO061. Efectiveness Of Fractal Tones For The Treatment OfChronic Tinnitus [Audiology]Simonetti P., Oiticica J.University of São Paulo - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Tinnitus is a common symptom, and ischaracterized by a sound in the "ears" or "head",ie soundsensation not produced by mechanical-acoustic signals com-ing from the external environment (ASHA, 2009). While formost patients,medicalmanagement and appropriate counsel-ing would be enough, for others the symptoms are persistentand bothersome, interfering with daily activities and qualityof life.The sound therapy, either amplification or use of soundgenerators, aims to decrease the contrast in quiet environ-ments, promote sound enrichment, which in turn facilitatehabituation. There are different forms of utilization andseveral forms of stimuli delivered from sound devices. Recentstudies have revealed a great therapeutic potential for tinnitusrelief with the use of music. Recently, studies have shown thatthe use of fractals sounds can be a viable alternative.

Objective: The aim of this study is to conduct a clinicaltrial to evaluate the effectiveness of the use of fractal tones assound therapy to treat patients with chronic tinnitus.

Methods and Results: The sample consisted of sub-jects with mild hearing loss, not exceeding the 40dBHL from250 to 12000Hz, which do not have hearing difficulties ;chronic tinnitus, persistent (more than 6 months duration),and tinnitus annoyance and handicap discomfort level mod-erate, severe or catastrophic measured by THI (TinnitusHandicap Inventory) translated and validated into Portugueselanguage (Ferreira et al. 2005.

Conclusion: patients refer relief listening to onlyfractal tones but tinnitus was minimized when they listenedto amplification and fractal tones.

Keywords: tinnitus sound therapy fractal tones.

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EPO062. Use Of Audio-Visual Resource For CounselingPatients With Tinnitus [Audiology]Simonetti P., Oiticica J.HCFMUSP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Tinnitus is a common symptom, whichaccording to different studies, affects 10-17% of the worldpopulation, affecting the quality of life of the vast majority ofthese people. According to many patients, it causes greatdiscomfort, interfering in their daily activities. These patientsmay have one or more of the following complaints: concen-tration and sleep difficulties, emotional and psychologicalover reactions. Counseling alone, or combined with otheroptions, has proven to be fundamental for the treatment ofthese patients. It should be the timewhen the professional hasthe chance to review and clarify clinical history and to intro-duce neurophysiological concepts that explain part of thesymptoms. We can also address emotional issues and badhabits associated, and guide the patient to the best therapy.

Objective: To assess the feasibility and effectiveness ofa digital media (video) developed in the Tinnitus ResearchGroup of Public Health Hospital of Faculty of Medicine of theUniversity of São Paulo (HC-FMUSP) for counseling patientswith chronic tinnitus.

Methods and Results: Twenty patients of the TinnitusResearch Group of HC-FMUSP were ramdomly selected toparticipate. Ten patients were counseled individually usingthe video. The other ten participants (Control group) receivedindividual counseling without the use of the material. Allparticipants answered the THI (Tinnitus Handicap Inventory)before and after counseling.

Conclusion: The video has proved to be a viable andeffective resource in counseling chronic tinnitus patients.

Keywords: tinnitus; counseling; tinnitus treatments.

EPO063. Sound Foundation for Babies - adaptation forEuropean Portuguese [Audiology]Silva P. B d., Costa I. M., Silva V. C.Aveiro University - Portugal, ESTSPorto-IPP - Portugal, Hospital CUFPorto - Portugal

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The lack of intervention instruments inPortugal for the development of auditory-verbal skills ofchildren with hearing loss, users of hearing technology,motivated the translation and adaptation of Sound Founda-tion for Babies (CochlearTM) for European Portuguese.

Objective: The goal is to provide the rehabilitationteams a tool that allows guidance to families, allowing them todevelop the ability to promote the development of spokenlanguage in their children.

Methods and Results: The methodology involvedthree phases: 1) Translation into European Portuguese, 2)cultural and linguistic adaptation of the resulting translation,3) expert review panel (with Speech Therapists trained inAuditory-Verbal Therapy).The result allowed building a port-folio of auditory-verbal activities adapted to babies between12 and 24months of chronological age, during thefirst year ofhearing age. The major adjustments affected the type of toys,the songs and nursery rhymes, the European Portuguesespecific phonemes and suggested books.

Conclusion: This portfolio contributes to the goodsupport of families in promoting auditory-verbal skills in theirchildren.

Keywords: Sound Foundation for Babies (Cochle-arTM); deafness; children; support material; auditory-verbaltherapy.

EPO064. Indications, long-term experience and perspectiveswith bone conductive device [Otology, Neuro-Otology AndSkull Base Surgery]Skarzynski P. H., Mrowka M., Olszewski L., Pastuszak A.,Skarzynski H.Institute of Sensory Organs - Poland, Medical University of Warsaw -Poland,World Hearing Center, Institute of Physiology and Pathology ofHearing - Poland

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Bone conductive devices are more andmore popular during last years. On the onehand surgery is notdifficult, on the second hand many countries entered thatprocedure to reimbursement system.

Objective: The aim of the study was analysis of usageBonebridge, Baha trans and percutaneous systems and Ponto.

Methods and Results: Material consisted of 205 pa-tientswhere above systemswhere adopted. In almost all casespatients were satisfied and audiological outcomes were goodor very good. There were very few complications like notenough strong magnet or too thick subcutaneous tissue. InBonebridge there is high need to perform meticulous radio-logical analysis.

Conclusion: Such procedures are recommended as afirst choice surgery in congenital atresia with abnormal posi-tion of the facial nerve or not appropriate anatomical situa-tions into middle ear.

Keywords: bone conductive device, percutaneous sys-tem, transcutaneous system.

EPO065. Contribution of the residual hearing to theoutcomes in bilateral cochlear implant users [Audiology]Lopes-Fontanelli R. C. F., Magalhães A. T. M., Goffi-GomezM. V. S.,Tsuji R. K., Bento R. F.Hospital Das Clinicas FMUSP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The decision of which side should beimplanted is not unanimous. The doubt lies in that thecochlear implant (CI) can be nominated for best ear or bothwhen there is no benefit or for the worse ear when there isreasonable contribution of amplification in the contralateralear. However, there are doubts as to the fact that deploying theworst, in order tomaintain the bimodal stimulation, we couldbe leading the patient to get poorer outcomes.

Objective: To verify the influence of residual hearingto the performance of bilateral CI users.

Methods and Results: Case study of three adults whounderwent bilateral implantation, with preoperative asym-metrical performance between ears. Speech perception ineach ear taken preoperative with hearing aids and postopera-tively with speech processor was collected, as well as theintraoperative threshold of neural response telemetry (tNRT)in amiddle array electrode. All of the subjects, identified as (a),(b) and (c), performed better in the right ear, with no aidedaccess to speech sounds in the left ear. As for intraoperativetNRT for the right and left ear was (a) 210 and 211; (b) 194 and210; (c) 198 and 206. In the postoperative evaluation perfor-mance was for the right and left ear showed better scores forthe right ear in two patients and for the left ear in patient (c).Free field thresholds were equal for the three patients.

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Conclusion: In this small sample we could see a trendto a better performance and lower neural response telemetrythresholds in the ear withmore residual hearing, but researchwith larger samples will allow statistical analysis to confirmthe trend.

Keywords: Cochlear Implantation, HearingAids, Hear-ing Loss, Bilateral.

EPO066. Auditory comprehension of questions in patientsthat received a cochlear implant for single-sided deafness[Otology, Neuro-Otology And Skull Base Surgery]Araujo S. R. M., Silva V. C.Hospital CUF Porto - Portugal

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The cochlear implant is a device thatallows the restoration of hearing to patients with severe toprofound hearing loss that do not have benefit with conven-tional hearing aids. . Initially, patients with single sideddeafness and a contralateral normal ear, were not consideredfor implantation. Facing the advantages of binaural hearing forspeech discrimination in noise and sound localization, pa-tientswith single-sided deafness and asymmetric hearing losshave received cochlear implants due to the fact that thealternatives- osteointegrated implants and CROS hearingaids- do not restore binaurality.

Objective: To assess auditory comprehension of ques-tions addressed to patients with a cochlear implant and acontralateral normal ear.

Methods and Results: A series of fifteen questionswere asked to the four patients with a unilateral cochlearimplant one month after auditory training (twenty sessions).The assessment was carried out in a quiet environment andthe patient had an earplug and a headset with backgroundnoise in the ear with normal hearing.

Conclusion: There is a clear benefit of fitting cochlearimplants to patients with single-sided deafness because itgives them the chance of discrimination specially in noisyenvironments.

Keywords: Cochlear implant; adults; unilateral co-chlear implant.

EPO067. Vestibular rehabilitation in car accident victims[Balance]Paiva S. F., Santos A. F., Silva D. S. L., Santos I. D., Oliveira A. A.Universidade Federal de Sergipe - Sergipe - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Dizziness and imbalance are the con-sequences that accompany the patient after suffering headinjuries, especially when its cerebellar lesion. Vestibular sys-tem problems imply the appearance of continuous and inter-mittent vertigo, and reduced postural balance, includingincreased risk of falls. Vertigo head trauma can have immedi-ate or late occurrence after its cause. Generally, in some casesof BPPV, membranous labyrinth of injury or fistula endolym-phatic vertigo is immediate start with reports of nausea andvomiting associated. Already in classic cases of BPPVcan occurlate, and his appearance in days or weeks after the trauma. TheVR program must be integrated and customized, as well asfollow the guidelines drawn from the completion of neurologytest and kinetic-functional status of the patient.

Objective: Explain the importance of vestibular reha-bilitation in patients with complaints of dizziness after cranialtrauma.

Methods and Results: This is a bibliographic review.Conclusion: Speech therapy in the labyrinthine ther-

apy contribution is of paramount importance for the rehabili-tation of patients affected by head traumawith cerebellar andlabyrinthine consequences, and adds its power to comple-ment the treatment with new technologies for assessmentand rehabilitation in order to otoneurology reduced symp-toms and recovery of body balance, as well as the improve-ment of their quality of life through the joint work of theprofessionals involved.

Keywords: Vestibular rehabilitation; Vertigo.

EPO068. Cochlear reimplantation. Experience of theComplejo Hospitalario Universitario Insular MaternoInfantil of Las Palmas [Otology, Neuro-Otology And SkullBase Surgery]Falcón Gonzalez J. C., Gutierrez Salazar A., Osorio Acosta A.,Borkoski Barreiro S., Ramos Macías A.Complejo Hospitalario Universitario Insular Materno-Infantil de GranCanaria - Spain

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The most common cause of reimplan-tation is technical failure, although other causes do exists. Ourgoal is to understand the causes that have led to this procedurein our centre and to contrast it with the literature.

Objective: To analyze the results in our center inrelation to cochlear reimplantation.

Methods and Results: Retrospective study of hearingloss in our Hospital between October 1993 and May 2013.Cases identified were classified according to the EuropeanConsensus Statement on Cochlear Implant Failures and Ex-plantation (ECSCIFE). 715 patientswith unilateral implant 571and 144 with bilateral implantation were evaluated. The totalof implants was 859. 53 cochlear reimplantations (CRI) wereperformed in 52 patients. Of these, 29 were children and 23adults at the time of the first implantation. CRI ratewas 6.16%.The most frequent causes of reimplantation were technicalfailure, 20 (37.7%); infection / rejection device, 10 (18.8%);Update, 8 (15.1%). Less common were: incorrect insertion ofthe electrodes, 3 (5.6%); ossification failure, 2 (3.8%); headtrauma, 2 (3.8%); NMR need, 2 (3.8%); psychiatric disease, 1(1.9%). In 9.4% of cases the cause was unknown or hadinsufficient documentation. The time between the first im-plant and reimplantation ranged from 1 month to 18 years,with a mean of 5 years and 2 months.

Conclusion: RIC rate at our center is similar to thatobserved in the literature. The most frequent cause wastechnical failure, in accordance with the literature. It isremarkable the number of procedures performed because ofdevice update, an unusual situation in the literature.

Keywords: cochlear implant, explant technical failure.

EPO069. Early Hearing Loss Detection Through OtoacousticEmissions [General]Borkoski Barreiro S. A., Falcón González J. C., Osorio Acosta A.,Perez Plasencia D., Ramos Macías A.Complejo Hospitalario Universitario Insular Materno Infantil - Spain

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Neonatal hearing loss is a public healthproblem that demands urgent and effective solutions.

Objective: To analyze the results obtained in theUniversal Program for Early Detection of Infant Hearing Lossimplemented in the Complejo Hospitalario Universitario

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Insular Materno Infantil, in Las Palmas de Gran Canaria, fromJanuary 2007 to December 2013.

Methods and Results: We studied otoacoustic emis-sions in 44597 newborns during both phases of the program.The diagnostic phase was done at the Hearing Loss Unit,Department of Otorhinolaryngology. Between January 2007and December 2013, 46587 childrenwere born, 44597 under-went screening, of which 41621 have positive otoacusticemissions and 1233 do not. In 8193 the second phase gavepositive otoacustic emissions in both ears and 649 failed thesecond phase. 9581 newborns presented risk factors associat-ed with hearing loss. The average referral to diagnostic phasewas 5.69%, the program reached a coverage of 95.73%. 32children entered the Cochlear Implant Program.

Conclusion: The Program in our hospital has provedadequate, achieving a coverage rate above 95%, consideringthe very positive relationship between effectiveness andefficiency.

Keywords: Neonatal hearing loss, Early Detection,Deafness.

EPO070. Our experience using the EARS Test Battery inchildren with cochlear implants [Audiology]Falcón González J. C., Borkoski Barreiro S., Ferro Llanos V.,Bastarrica Marti M., Ramos Macías A.Complejo Hospitalario Universitario Insular - Spain

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Cochlear implantation in children is acommon practice nowadays. For that reason, new exhaustivetest batteries have been designed for assessing the develop-ment over time of children’s auditory skills, and have finallybeen incorporated to the clinical routine.

Objective: Sharing the experience of the Insular Ma-ternity and Children University Hospital about the incorpo-ration of the MED-EL EARS® Test Battery into the follow-upprotocol of children with cochlear implants. The EARS testbattery allows evaluating the long-term hearing performance,supporting the patient (re)habilitation, especially speechtherapy and the regular fittings of the audio processors.

Methods and Results: The Cochlear Implant follow-up protocol established in our hospital includes the MED-ELEARS test battery for the periodic audiological evaluations inchildren above 2 years old. The MAIS and MUSS question-naires are used for the first time 18 months after the FirstFitting, and the GASP test after 4 years of age. The resultsobtained helpmonitor the evolution of the patient and the thefittings of the audio processor as well.

Conclusion: Including test batteries for the assess-ment of development of listening skills in a Cochlear Implantfollow-up protocol improves the adaptation to the needs thatimplanted children show at any given moment. But it alsoevidences the need to computerize the management of thesebatteries to improve the data collection and ease the evalua-tion of patients who have problems getting to the hospital.

Keywords: EARS, listening skills, MAIS, MUSS, GASP.

EPO071. The use of theMED-EL Assessment Database Tool tomanage the data remotely collected with the LittlEARSAuditory Questionnaire [Audiology]Borkoski Barreiro S., Falcón González J. C., Ferro Llanos V.,Bastarrica Martí M., Ramos Macías A.Complejo Hospitalario UNiversitario Insular Materno Infantil de GranCanaria - Spain

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: It is widely accepted nowadays that anearly cochlear implantation is crucial, and therefore morechildren are being implanted. New test batteries adapted foryoung children have been developed to evaluate their hearingperformance, so they can be used outside the hospital envi-ronment by parents and therapists, regardless of theirlocation.

Objective: Testing the usefulness of the MED-EL As-sessment Database Tool, which allows completing the Lit-tlEARS® Auditory Questionnaire using a computer withoutbeing physically present at the clinic. It makes possible toassess the hearing performance of children younger than 24months from afar. This is extremely useful because somepatients do not reside on the island where the cochlearImplant centre is located, and it can be difficult for them toget to the hospital.

Methods and Results: Resumen Report: As the Lit-tlEARSAuditory Questionnaire is includedwithin the protocolestablished by the hospital from the pre-implant evaluation ofthe candidate until the patient is two years old, the MED-ELAssessment Database has been used retrospectively with 30patients to fill in the questionnaire remotely and finally assessif it is easy to use.

Conclusion: The Assessment Database Tool makespossible that patients who have problems getting to thehospital due to geographical reasons, minimize their visitsto the clinic by carrying out thehearing evaluation remotely. Itis easy to use, and will also allow reducing the healthcareworkload of the hospital without modifying the stablishedprotocol, as well as managing online the results.

Keywords: LittlEARS, remote hearing evaluation, As-sessment Database.

EPO072. Transcutaneous osseointegrated implant systemwith magnetic holding without pedestal. Results in ourCenter [Otology, Neuro-Otology And Skull Base Surgery]Borkoski Barreiro S. A., Perez Plasencia D., Cuyas Lazarich J. M.,Falcon Gonzalez J. C., Ramos Macías A.Complejo Hospitalario Universitario Insular Materno Infantil de GranCanaria - Spain

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The treatment of hearing loss rangesfrom reconstructive surgicalmethods,medical treatments andsince several decades ago implantable active systems.

Objective: To evaluate audiological results and der-matological morbidity in the first patients treated with thetranscutaneouos osseointegrated implant system with mag-netic holding and without pedestal (Sophono ™).

Methods and Results: Descriptive observationalstudy in 15 patients implanted with the Sophono ™. Audio-logical evaluations performed: pure tone and free field audi-ometry at 65 dB and speech tests in quiet. Holgersclassification was used for the assessment of skin complica-tions. The gain in a free field audiometry was between 15 and30 dB. Improvements from 44% to 56% in speech tests com-pared to the preoperative evaluations were observed.

Conclusion: No dermatological complications wereobserved in the patients studied and these express satisfactionwith the new device.

Keywords: osseointegrated implants, conductivehearing loss, transcutaneous osseointegrated auditoryimplant.

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EPO073. Using datamining to predict bilateral implantationoutcomes [General]Pérez Zaballos M. T., Ramos De Miguel A., Pérez Plasencia D.,Falcon Gonzalez J. C., Ramos Macías A.Complejo Hospitalario Universitario Insular Materno Infantil de GranCanaria - Spain

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Data mining attempts to discover hid-den rules underlying large amounts of data.

Objective: to study which variables determine bilater-al implantation (BI) success in patients in our center, ComplejoHospitalario Universitario Insular Materno Infantil(CHUIMI)using data mining techniques (DM), measured with audiolog-ical disyllabic word tests.

Methods and Results: Data from Sequential BI 25patients was used. The information collected consists of 58attributes, organised into 5 categories; demographic, hearingaid use, use of CI, audiological and quality of life data. DMtechniques employed were: the classifier, the nearest neigh-bor (NN), estimation and linear regression (LR). The systemdeveloped allows to do a battery of analyses on the data setand report which attributes are better predictors. GlasgowHealth Status Inventory (GHSI) test was used to measurequality of life Hearing thresholds in the right and left earbefore implantation were 91.36 dB and 99.05 dB; 25.76 dBand 28.28 dB after implantation. The time between the firstand second implant was discretised at intervals [0-2], [2-4],[4-6] and [6-inf], with 10, 7, 5 and 3 patients in each group.The best classifier was found to be the NN(prediction rate of90.83%). The LR correlation was R ¼ 0.9301.

Conclusion: Out tool has an index of correlation of93.01%. Patients with unilateral disyllabic test results below70% get the highest benefits from BI. Finally the smaller theinter-implant time the higher the likelihood of a goodoutcome.

Keywords: data mining, cochlear implant, postlingualadult.

EPO074. Impacto da Deficiência Auditiva em Adolescentescom Malformação de Orelha [Audiology]Mariano T. C. B., Santos M. M., Mondelli M. F. C. G.,Brito Neto R. V.Faculdade de Odontologia de Bauru FOB-USP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction:Aperda auditiva é umdos achadosmaisfrequentes na população que apresenta malformação deorelha e pode causar alguns comprometimentos emocionaise psicológicos na vida do indivíduo, podendo ser variáveis edependentes das experiências de vida, das expectativas rela-cionadas à saúde, da habilidade de se adaptar as limitações edo grau de sociabilidade. Os questionários de auto-avaliaçãoforam desenvolvidos para quantificar a percepção do handi-cap, sendo utilizados na clínica para identificar as necessi-dades específicas de tratamento ou avaliar os resultados daintervenção.

Objective: Avaliar a percepção do handicap, por meiodo Questionário HHIA em adolescentes com malformação deorelha.

Methods and Results: O Questionário de HandicapAuditivo paraAdultos (HearingHandicap Inventory forAdults -HHIA), é composto por 25 questões que quantificam os efeitossociais e emocionais da deficiência auditiva em indivíduos comidade inferior a 65 anos. A pontuação é calculada pela pontua-ção total, bem como pelas sub-escalas emocional e social,

separadamente. A pontuação total pode variar de 0 a 100.Valores mais próximos de 100 indicam maior percepção dohandicap auditivo.O HHIA foi aplicado em 3 adolescentes, comidade entre 16 e 23 anos, commalformação de orelha, usuáriosde prótese semi implantável - Vibrant. A pontuação total dosquestionários foram: 54, 72 e 74. Esses resultados indicam queos indivíduos apresentaramumapercepção severa do handcapauditivo.

Conclusion: A aplicação deste questionário pode serconsiderado umauxílio para o profissional da área audiológicafavorecendo a condução da intervenção.

Keywords:malformação, orelhamédia, questionários.

EPO075. Cochlear Implant Intraoperative Telemetry areImportant? [Otology, Neuro-Otology And Skull BaseSurgery]Muruyama N. C., Damico T. A., Massuda E. T., Hyppolito M. A.HC FMRP-USP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Cochlear implant allows the partialrepair of the inner ear functions, delivers electrical impulsesto the direct stimulation of the cochlear nerve fibers. Demandan individual programming for each electrode aiming anappropriate level of electrical stimulation. Intraoperative te-lemetry allows measurement of impedance between electro-des and the intensity of electric current that will be requiredfor the stimulation of the cochlear nerve, reflecting on theactivation and rehabilitation with the implant.

Objective: Compare neuro-telemetry responses withthe free field audiometry, sentences recognition test, open/closed set and word discrimination as well as correlate theresponses of intraoperative neuro-telemetry with neuro-te-lemetry after six and twelve months of implant activation.

Methods and Results: Study with data from medicalrecords of patients above 18 years after cochlear implantsurgery. Responses of intraoperative neuro-telemetriy wascompared with free field audiometry, sentences recognitiontest and discrimination of words and correlation of theintraoperative neuro-telemetriy to six and twelve monthresponses after cochlear implant activation. A significantdifference between neurotelemetry intraoperative measure-ments and 1 year after cochlear implant activation, tonalaudiometry thresholds pre-IC with hearing aid and after1 year of the cochlear implant was worse.

Conclusion: Intraoperative auditory nerve stimula-tion thresholds are greater than the 1 year after speechprocessor activation; larger thresholds of the auditory nervestimulation do not correlate to the auditory performance after1 year of CI activation.

Keywords: Cochlear Implant, deafness, telemetry,rehabilitation.

EPO076. Facial Stimulation After Cochlear Implant [Otology,Neuro-Otology And Skull Base Surgery]Damico T. A., Barros C. G. C., Isaac M. L., Massuda E. T.,Hyppolito M. A.HC FMRP-USP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: Cochlear implant is an electronic devicethat captures and transform sound waves into electric im-pulse. It is surgically implanted inside the cochlea. Somecandidates have cochlea-vestibular anomalies. The electrical

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impulse propagated from the electrode to the cochlear nervecan achieve adjacent structure.

Objective: Report a case of facial stimulation aftercochlear implant surgery in a child with facial nerve pathanomalies.

Methods and Results: Brazilian 8 years oldmale child,prelingual hearing loss. Audiometry with bilateral profoundsensorineural hearing loss, no response at brainstem auditoryevoked potentials test, auditory steady state response testwith hearing loss. The computerized tomography and nuclearmagnetic resonance indicated a narrow internal auditorymeatus, with anomalies at the facial nerve path (close to thecochlea) in both ears. First surgery on the left side, with nocomplications. Used a full-banded electrode device. Withelectrical stimulation, the patient had facial stimulation be-side an adequate position of the electrode. Kept this device foralmost 3 years and due to the facial stimulation, no speechimprovement and no appropriate audiometric improvement,replaced the device for a half-banded electrode device. Thesurgery had no complications and today the patient has nofacial movements and fine audiometric increase.

Conclusion: This case presents a facial nerve malfor-mation, inside the cochlea, with facial stimulationwhen usinga full-banded electrode device. Using a half-banded electrodedevice, the stimulation kept inside the cochlea, without facialstimulation.

Keywords: Cochlear implant, deafness, facial stimula-tion, half-banded electrode.

EPO077. Radiological and Audiological Aspects ofPostlingual Patients with Meningitis Submitted to CochlearImplant [Otology, Neuro-Otology And Skull Base Surgery]Damico T. A., Oliveira A. A., Isaac M. L., Hyppolito M. A.,Massuda E. T.HC FMRP-USP - São Paulo - Brazil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction:Meningitis is the most important causeof profounddeafness in Brazil. Cochlear calcification and spiralganglion degeneration are the main causes of deafness aftermeningitis; the last one is a central cause of deafness.

Objective: Evaluate cochlear implant response in casesof post lingual deafness after meningitis, comparing comput-ed tomography and nuclear magnetic resonance images andaudiometry exam patterns before implant.

Methods and Results: We included patients usingcochlear implant for at least one year, with postlingualdeafness aftermeningitis diagnosed.We analyzed 14 patients,7 presenting normal cochlea (with no signs of calcification)and 7 with some level of calcification, especially in the basalturn. From the group of seven patients with normal cochlea,three presented no hearing improvement (auditory perfor-mance and speech intelligibility of Portuguese was response0) with cochlear implant and two presented poor hearingimprovement (response 1 and 3). The first three patientsexhibited total deafness and no benefit with hearing aidsbefore surgery. The other two patients had severe deafness formore than 10 years, without hearing aids. The last twopatients showed good improvement with the implant, re-

sponse 6. The other seven patients, with calcification of thebasal turn of the cochlea, all with profound deafness butbenefit with hearing aids, exhibited good response and im-provement with cochlear implant (response 6).

Conclusion: Total deafness before cochlear implant,even using hearing aids, represents a bad prognosis factor forthe cochlear implant in patients with sensorineural hearingloss after meningitis.

Keywords: Cochlear implant, post lingual deafness,meningitis, cochlear calcification.

EPO078. Decompression Of The Tympanic Segments AndLabyrithine Portion Of The Facial Nerve Via Middle CranialFossa [Otology, Neuro-Otology And Skull Base Surgery]Pereira A. d F A M., Brito Neto R. V., Tsuji R. K., Bento R. F.Faculdade de Medicina da USP - São Paulo - Brasil

Date:May 20, 2015 toMay 23, 2015 Time: 8am to 6pmRoom: Exhibition Area.

Introduction: The great aesthetic and functional im-pact of a facial paralysis, caused your topodiagnosis andtreatment to become a challenge to medicine since itsinception.

The aim of this study was to decompress the facialnerve from its intra-meatal portion to the mastoid segmentvia the middle cranial fossa andmeasure the distances amongthis and important hidden anatomical references in thepetrous portion of the temporal bone, so you can systematizea unique approach to the four facial segments.

Objective: Describe an alternative and innovative tech-nique for surgical decompressionof the facial nerve (labyrinthineand tympanic segments) via the middle cranial fossa.

Methods andResults: The studywas conducted in theLaboratório de Habilidades Cirúrgicas (The Surgical SkillsLaboratory) in Nova Esperança Faculty in João Pessoa, PB(FAMENE). There were 20 whole heads dissected of cadaversof both sexes which were obtained from by this collegementioned. The specific information of age, gender and raceof the corpses were not available. The study was approved bythe Ethics in Research Committre of the Faculty of Medicine ofUSP and of the Faulty of Medicine Nova Esperança (FAMENE).Protocol of Dissection. The heads were put in surgicalposition for access by the middle cranial fossa. The dissectionswere performed under microscope (MU- M19, DFV, Brasil)and photographedwithNikon (D50). Themeasurementswereperformed using surgical caliper Castroviejo (E2404, KarlStorz) with accuracy of 1 mm to determine the measureddistances. All measurements were performed by the sameexaminer. Results: The elliptical area formed by the longitu-dinal length of thebonewindowmade in tegmen tympani andthe transverse length of the bone window was calculatedusing the standard formula for ellipses A ¼ πa.b; where "a" isthe semi-major axis, i.e., half the longitudinal length of thebone window and "b" is the lower half shaft, or half thetransverse length of the bone window for each component ofthe sample of the two sides of the head.

Conclusion: The decompression of the tympanic por-tion of the facial nerve and mastoid middle fossa can beperformed safely providing adequate exposure of the nerve.

Keywords: cranial fossa, facial nerve, FAMENE.

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Author Index

Ade Abajo, J S22, S24Agrawal, S S2, S3Aguirre Zarta, A S5Ahn, J S7Ajduk, J S14Alatorre, E S12Almeida, G S33Altuna, X S23Alvarenga, K F S28, S30, S37, S38Alvarez, L S23Alves, H S41Alves, L U S1Alves, M S24, S41Amilibia, E S14André, A P d R S33Andro, K S14Angelo, T C S S42Ansorena, P S20Antonio, F L S28Araújo, A M L S31Araújo, E S S38 Araujo, J G S38Araujo, P G V S39Araujo, S S36Araujo, S R M S45Azevedo, M F S39

BBagatini, F A S6, S7Barbeti, G S S34Barbosa, L L S35Barros, C d G C S33Barros, C G C S47Barros, M S10Bastarrica Marti, M S46Batissoco, A C S18Bebear, J P S23Benin, L S28Bento, R F S1, S2, S9, S16, S18, S30,

S32, S43, S44, S48Benute, G G S7Bermejo Guerra, B S10Bernal, E S14, S18Bertuol, B S37Bevilacqua, M C S34Biaggio, E P V S37Bissoli, M M S18Bittar, R S M S6, S17Boccio, C M S4Boleas, M S S20Bonnard, D S23Borkoski Barreiro, S S7, S8, S9,

S45, S46Bravo Sarasty, A C S16, S18Bravo Torres, S S3Brito Neto, R S32Brito Neto, R V S22, S41, S47, S48Bruski, L S1Bucuvic, E S35, S39Bulnes, M D S20

CCabuya, E S10Caldas, F F S5Calderon, M S11Calvino, M S6, S17, S18, S19Cardoso, D M S S38del Carmen, M S20de Carvalho, G M S19Carvajalino Monje, I S10Carvalho, A C M S40Carvalho, G M S2, S4, S20Castilho, A M S2, S4, S19, S20, S30Ceballos Villalón, E S1Chamlati Aguirre, L E S16Chamlati, L E S12Charroo Ruiz, L E S3Cisneyros, H R S40Coelho, A E V S9Coelho, G V S20Coelho, S B S9Comelli, L S25Coradini, P P S28, S29Cordeiro, J C B S31Coró, B V S33Corujo Santana, C S8da Costa, E A S30Costa, I M S11, S44Costa, K C S8Costa, L D S37Costa, M J S41, S42Costa, M P R S34Costa, S M S S8Costa, S S S29Covarrubias, M S13Curet, C S25Cuyas Lazarich, J M S46

DDamico, T A S47, S48Darrouzet, V S23David, A L M S37Di Lella, F A S4Dias, N H S43Diaz Monterrey, M S1Díaz, M S14, S21Dornelles, S S29Dotto, G S25Duarte, A S M S30Durand, A S12, S16

EEchegoyen, A S30

FFadel, C S33de Faria, L R S4Falcon Gonzalez, J C S7, S8, S9, S45,

S46, S47Faria, M R d S26Félix, F S39Fernandes, F L S2, S4Fernandes, N F S32

Fernández, M d P S23Ferreira, D A S27Ferreira, L S37Ferro Llanos, V S46Ferro, V S11Filas, E S25Flores, L S S5Fonseca, V R C D S35Forero, V H S10, S18, S21Fortunato-Queiroz, C A U S12Fraga, R B S28Frederigue Lopes, N B S42Freitas, L A S28Fuentes López, E S3

GGaleazzi, P S4Garcia Hernandez, R D S8García, L E S14, S17Gavilan, J S6, S17, S18, S19Gil, D S39Girón, L S22Goffi -Gomez, M V S S2, S32, S43,

S44Gomez Alvarez, M E S42Gonçalves, A K S5, S29Gonçalves, M V S9González Marín, N R S19González Sánchez, G A S1Gouveia, M C L S4Grasel, S S S1Grassano, C P S25Guimaraes, A C S2, S4, S19, S20,

S30Gusmão, R J S30Gutierrez Farfan, I S16Gutierrez Salazar, A S45Gutierrez, I S12Guzmán, M S10

HHaddad, L A S18Heinen, L d R S26Hemza, C R d M L S1Hocsman, E S21Hoshino, A C H S30Huarte, A S24Hyppolito, M A S33, S34, S47, S48

IIervolino, S M S S35Isaac, M L S47, S48Iva, K S14

JJolly, C S18Jorge, J S36Jorge, J C S22Jorge, J X S36Julio, M M S6Júnior, F B S5

Author Index

Page 54: VI Iberoamerican Congress on Cochlear Implants

Author Index

KKlagenberg, K F S35Koch, D B S3Kochhann, D S S26Kosaner Kließ, M S16Kuse, D S5

LLacerda, A S33Laff ont, J T S24Lassaletta, L S6, S17, S18, S19Laurindo, R S S39Lavor, M S S20Leal, M C S40Leal, M d c S40Lessa, A H S28, S41, S42Levy, C C A C S35Lewis, D R S33Lezaun, R S24Lezirovitz, K S1, S9, S18Lins, E v S S17Lopes, L S7Lopes, R A F S38Lopes-Fontanelli, R C F S44Lorens, A S15Lourençone, L F M S22, S38de Lucena, J A S40Lucia, M C S S7Ludwikowski, M S1Luna, F S16

MMafra, N S33Magalhães, A T M S32, S43, S44Magalhães, I M P S5Magliaro, F C L S40Maia, T S30Manrique, M S22Manrique, R S22, S24Marchiori, L L d M S38Marengo, R S15, S22Mariano, T C B S41, S47Martín García, Y S1Martinez, A S12Martinez, P S24Martinez, Z S23Martins, J H S24, S41Martins, J H F S5Martins, K V C S32Maruiti, G S31Marulanda, M S20Massuda, E T S34, S47, S48Matas, C G S40Mazuera, N S20Meira Junior, S G S43Mello, J M S31Melo, A d S37Melo, A S S24Melo, J J S38Mingroni-Netto, R C S18Miranda, C S35, S36Miro, N S14

Mondelli, M F C G S41, S47Monteiro, D C S31Mora Diaz, C S19Moraes, M P T S43Morales, D S R S25Moret, A L M S28, S37, S39Moreti, A L M S42Morettin, M S37Mottecy, C M S35Mrowka, M S44Muiño, J C S25Muniz, L F S4, S40Muñoz, E S18Muratore, J S12Muruyama, N C S47

NNarvaez, J J S13Nasralla, H R S7Nehring, C S29Netto, R C M S1, S18Nunes, D P d R M S31

OOgihara, N S S38Oiticica, J S1, S9, S17, S18, S43,

S44Olchik, M R S29Oliveira, A A S33, S45, S48de Oliveira, A A S33de Oliveira, E U d S S9Oliveira, A R S8Oliveira, E B S22Oliveira, G C C S5Oliveira, J L S12Olszewski, L S44Ordóñez-Ordóñez, L E S19Orfi la, D S15, S22Osorio Acosta, A S9, S45Otavio, A C C S28, S29

PPaccola, E C M S39Paiva, A S36Paiva, A D S24, S36, S41Paiva, S F S1, S11, S12, S45Paniagua, L M S26Pardono, E S9Pastuszak, A S44Paz Cordoves, A S15Pazini, E S37Peixoto, C S35Peralta, C O S6, S7Pereira, A d F A M S48Pereira, T S8Perez Plasencia, D S3, S9, S45,

S46, S47Perez Zaballos, M T S3, S7, S13,

S47Perez, B S23Perez, M S14Perez, P I S20

Perez-Mora, R M S19Pinto, S M S15, S22Pires, S C S26Polak, M S4Porto, B L S32Prieto, A S13

QQuadros, J S24Quadros, J M C S5Queirolo, A S25Quental, S L M S42Quintana Carrillo, F S8Quintana Mirabal, S E S1Quinto, S M S S37

RRaggi, V S22Rajan, G S2Ramos de Miguel, A S3, S7, S13,

S47Ramos Macías, A S3, S7, S8, S9,

S13, S45, S46, S47Ramos Maldonado, D S16Ramos, D S41Ramos, D C S36Reis, A C M B S34Reis, L A S39Ribas, A S33, S35Ribeiro, C S24, S36, S41Ribeiro, C A S36Ribeiro, C A R S5Ribeiro, G C A S12Ries, M S14Rigamont, C S7Rigamonti, C S6Rincón, L A S14, S17, S21Rivas, A S10, S14, S17, S18, S21Rivas, A S S10, S14, S17, S18, S21Rivas, J A S10, S14, S17, S18, S21Robledo, H S25Roca-Ribas, F S14Rocha, R d C O S31Rocha, V B C S19Rodrigues, A G S30Rodrigues, A P S C S31Rodriguez, C M S2Rodriguez, S R S19Romani, C S25Rosa, B C S S33Rosito, L S S28Rubiño, L S25Ruiz, B S25Ruiz, H S25Ruiz, H E S25Ruiz De Erenchun, I S20

SSalomone, R S16Salvadores, M S25Sampaio, A L L S38Samuel, P A S2, S43

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Author Index

Sanchez-Cuadrado, I S6, S17, S18, S19

Sanders, A P S31Santamaria, S S23Santos Junior, R C S1Santos, A C N S12Santos, A F S45Santos, B F S S12Santos, I D S45Santos, M D S19Santos, M M S41, S47Santos, R M R S7Sartorato, E L S8Scarabeli, L N S6Schwarz, M J S20Seimetz, B M S29Sierra, C S11Silva, C D S34Silva, C R P d S38Silva, D S L S45da Silva, E C S31Silva, I B d O S38Silva, J S S1, S9Silva, L A F S40Silva, L T N S28, S30Silva, M J S5Silva, P B S11, S39Silva, P B d S44da Silva Filho, M S31da Silva, P d S C S39Silva, V S35, S36

Silva, V C S11, S44, S45Silveira, A L S5, S26, S27Silvestre, R S33Simone, S N d S37Simonetti, P S43, S44Siqueira, L S S12Skarzynski, H S1, S15, S44Skarzynski, P H S1, S15, S44Söhsten, E S6de Souza, M B S40Souza, T d S S22Splendor, L S39Staab, J P S6Strauss, B S18Strumiello, L F d O S31

TTagliarini, J V S43Taguchi, C S1Talarico, T R S35Tanamati, L F S37, S39Tavora, D S2Teixeira, A S26, S27, S36Teixeira, A R S5, S28, S29Tiberti, L S15, S22Tisaire, A S11Tomas, M D S15Tomita, S S39Trivella, P S12Trotic, R S14Tsuji, R K S9, S30, S32, S40, S43,

S44, S48

UUseche, M C S5

VValencia, J S23Valéria, G S S30Vanegas, G A S20Vasques, L d R S18Venosa, A R S38Vicente, L C S30Vieira, L F S31Viera Artiles, J S13Vilela, F A S7Villani, P S15Vinci, A P S33

WWalkowiak, A S1Weigert, L L S26, S27

YYamaguti, E H S28, S38Yoshida, F S S37

ZZaballos Gonzalez, M L S3, S8Zabeu, J S S37, S42Zago, T M S2, S4Zanatta, D S18Zanini, M A S43Zernotti, M E S17

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Some of the product names, patents, and registered designs referred to in this publication are in fact registered trade marks or proprietary names even though specifi c reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the Publisher that it is in the public domain.

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Important Note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their eff orts to provide in-formation that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error by the authors, editors, or publisher of the work herein, or changes in medical

knowledge, neither the authors, editors, or publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained here in is in every respect accurate or complete, and they are not re-sponsible for any errors or omissions or for the results obtained from use of such information. Because of rapid advances in the medical sciences, independent ver-ifi cation of diagnoses and drug dosages should be made. Readers are encouraged to confi rm the information contained herein with other sources. For example, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recom-mended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs.

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Copyright © 2015 by Thieme Publicações Ltda Inc. International Archives of Otorhinolaryngology is published four times a year in January, April, July, and October by Thieme Publicações Ltda, Argentina Building 16th fl oor, 228 Praia do Botafogo, Rio de Janeiro 22250-040, Brazil.

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PRELIMINARY SCHEDULE OF COURSES 2ND SEMESTER 2015SET UP AND MAKE YOUR ENTRY

JUNE DATE LOCATION107TH TEMPORAL BONE DISSECTION COURSE 08/09/10 SPSYMPOSIUM ON CENTRAL AUDITORY PROCESSING 1 19/20 SP26TH BIG EAR - THE MOST IMPORTANT OTOLOGY LIVE SURGERY COURSE 22/23/24 SP

JULY DATE LOCATIONV COURSE ON COCHLEAR IMPLANT FOR EDUCATION PROFESSIONAL 03 SP1ST LARYNGEAL MICROANATOMY AND ENDOSCOPY COURSE 10/11 POA

AUGUST DATE LOCATIONOTOMASTER (ENT RECYCLIN COURSE) 03/10/24/31 ONLINEV FACIAL NERVE COURSE - THEORY AND PRATICE (HANDS-ON) 10/11/12 SP94TH ENDOSCOPIC SINUS SURGERY COURSE - HANDS ON - BAHIA 27/28/29 BA13TH STOMATOLOGY JOURNEY 28/29 SP

IX PRACTICAL COURSE OF ELETRONISTAGMOGRAFY 31 AUGUST AND 01/02 SEPTEMBER SP

SEPTEMBER DATE LOCATIONXII COURSE OF SWALLOWING DISORDERS AND LARYNGOPHARYNGEAL REFLUX - THEORY AND PRACTICE (HANDS ON) 03/04 SP

VI POLYSOMNOGRAPHIC REPORT INTERPRETATION COURSE 09 SPXVII COURSE ON SNORING AND OBSTRUCTIVE SLEEP APNEA – THEORY, LIVE CLINIC AND LIVE SURGERY 10/11 SPCOURSE OF ENT FORENSIC 12 SPOTOMASTER (ENT RECYCLIN COURSE) 14/21 ONLINEII MULTICENTER COCHLEAR IMPLANT COURSE – AUDIOLOGIST MODULE 24/25/26 PRINTERNATIONAL WORKSHOP ON HEARING AID VERIFICATION 25/26 SP

ENDOSCOPY COURSE FOR OTOLARYNGOLOGISTS - THEORY AND PRACTICE - PART I AND II 30 SEPTEMBER / 01 AND 02 OCTOBER SP

OCTOBER DATE LOCATIONXII COURSE FOR SPEECH PATOLOGY IN COCHLEAR IMPLANT 02/03 SPOTOMASTER (ENT RECYCLIN COURSE) 05/19/26 ONLINEIV NOSE - LIVE ENDOSCOPIC ENDONASAL SURGERY COURSE 07/08 SPV MEETING OF COCHLEAR IMPLANT TEAM OF HCFMUSP WITH PARENTS OF CHILDREN WITH HEARING LOSS 17 SP

LARYNGEAL MICROSURGERY COURSE WITH DISSECTION – THEORY AND PRACTICE 21/22/23 SP2ND ADVANCED DISSECTION COURSE IN OTOLARYNGOLOGY - RINOLOGY 27/28 SP2ND ADVANCED DISSECTION COURSE IN OTOLARYNGOLOGY - OTOLOGY 28/29/30 SP

NOVEMBER DATE LOCATIONVI BROADCASTED COURSE IN RADIOLOGY IN OTORHINOLARYNGOLOGY 03/04/05/06 ONLINEOTOMASTER (ENT RECYCLIN COURSE) 09/16/23/30 ONLINE2ND ADVANCED DISSECTION COURSE IN OTOLARYNGOLOGY - PLASTIC 10/11/12 SP2ND ADVANCED DISSECTION COURSE IN OTOLARYNGOLOGY - LARINGOLOGY 12/13 SP

108TH TEMPORAL BONE DISSECTION COURSE 30 NOVEMBER / 01 AND 02 DECEMBER SP

DECEMBER DATE LOCATION95TH ENDOSCOPIC SINUS SURGERY COURSE - HANDS ON - BAHIA 03/04/05 BAOTOMASTER (ENT RECYCLIN COURSE) 07/14 ONLINE2ND LARYNGEAL MICROANATOMY AND ENDOSCOPY COURSE 11/12 POACOURSE BLEPHAROPLASTY AND FOREHEAD REJUVENATION SURGERY - HANDS ON 11/12 SP

* Schedule subject to changeFollow on Facebook

fundacao.otorrinolaringologiaInformations and Registration

www.forl.org.br

Teodoro Sampaio Street, 483Pinheiros - São Paulo / Braziltel.: +55 11 3068-9855e-mail: [email protected]

YEARS

YEARS

Cursos FORl 2015 ingles - versao 3.indd 1 29/04/2015 15:25:25

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ORGANIZATION

R. Teodoro Sampaio, 483 - PinheirosSão Paulo - SP - Brasil - 05405-000Tel.: (5511) 3081-4223www.forl.org.br

Av. Rebouças, 600 São Paulo - SPTel: 11 3898-7850http://www.facebook.com/fundacao.otorrinolaringologia

www.forl.org.br/congresso2015

VISIT LOCAL

YEARS

14º Congress of

YEARS

From 13 to 15 - August, 2015

Make your registration!

anuncio IAORL.indd 1 06/03/2015 12:45:54

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22

RESPONSABLES

Prof. Ricardo F. BentoOtorrinolaringologia

Prof. Alfredo Luiz JacomoAnatomia Topográfica Humana

REALIZACIÓN

curso avanzadode disección enotorrinolaringología

DISECCIÓN INDIVIDUAL EN PIEZAS FRESCAS (LIBRES DE FORMOL) COMO EN UNA CIRUGÍA REAL, TOTALMENTE “HANDS ON”

A H O R A E N

B R A S I LC A L I D A D D E

OTORRINOFMUSP YD E F O R L

CON LA

16 PORMÓDULO

CUPO LIMITADO

ÚNICO CURSO PRÁCTICO EN CADÁVERF R E S C O ENAMÉRICA LATINA

CIRUGÍA NASOSINUSAL AVANZADA

Richard Voegels

CIRUGÍA PLÁSTICA FACIAL Carlos Alberto Caropreso

CIRUGÍA DEL RONQUIDO Y APNEALuiz Ubirajara Sennes

CIRUGÍA OTOLÓGICAY NEUROTOLÓGICA

Ricardo F. Bento y Rubens Brito

27.OCT.2015A 30.OCT.2015

10.NOV.2015A 13.NOV.2015

MÓDULO I Y II

MÓDULO III Y IV

ESAS

FECHAS

0

5

25

75

95

100

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Rio de Janeiro • New York • StuttgartThieme Publicações Ltda, Av. Nilo Peçanha, 50, sala 2508, Rio de Janeiro 20020-906, Brazil

Oral PresentationsS1 Date: May 20 & 22, 2015 Room: Sala Coral May 20, 2015 9am to 12:30pm / 2pm to 6:30pm May 22, 2015 8am to 12:30pm / 2pm to 6:30pm

E-PostersS26 Date: May 20 to May 23, 2015 Room: Exhibition Area Time: 8am to 6pm

S-iii Author Index

The content and the text of all published abstracts are of entire responsibility of the authors and have not suffered journal corrections.

Offi cial Publication of the Otorhinolaryngology Foundation and Societas Oto-Rhino-Laryngologia Latina

OTORHINOLARYNGOLOGYINTERNATIONAL ARCHIVES OF

VI GICCA – May 20–23, 2015