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      Correlação entre limiares de reconhecimento de sentenças no silêncio e limiares tonais Translated title: Correlation between sentences recognition thresholds in quiet and tonal thresholds

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          Abstract

          INTRODUÇÃO: Testes de reconhecimento de sentenças no silêncio ainda são pouco utilizados na rotina clínica audiológica e até mesmo em pesquisas. Por isso, muitas vezes, ao realizar esta avaliação, o clínico não possui parâmetros para interpretar ou classificar os resultados. OBJETIVO: Assim, este estudo teve por objetivo investigar a correlação entre o limiar de reconhecimento de sentenças no silêncio (LRSS) e a média dos limiares tonais nas freqüências de 0,5, 1 e 2 kHz. MÉTODOS: Foram examinadas 200 orelhas de indivíduos normo-ouvintes, 50 homens e 50 mulheres (média 34,61 anos). Inicialmente, realizou-se anamnese, meatoscopia, audiometria tonal liminar e pesquisa do limiar de reconhecimento de fala e do índice percentual de reconhecimento de fala. Posteriormente, utilizando o teste Listas de Sentenças em Português, realizou-se a pesquisa dos LRSS. RESULTADOS: O LRSS médio obtido nas 200 orelhas examinadas foi 6,15 dBNA e a média dos limiares tonais para as freqüências de 0,5, 1 e 2 kHz foi de 8,55 dBNA. A análise estatística evidenciou correlação significante entre as variáveis em estudo. CONCLUSÕES: A média dos limiares tonais nas freqüências de 0,5, 1 e 2 kHz pode ser usada como referência para a análise dos resultados obtidos na pesquisa do LRSS. Além disso, pode-se esperar que os valores dos LRSS sejam melhores que os valores obtidos a partir das médias dos limiares tonais, pois as sentenças fornecem pistas acústicas e lingüísticas com significado.

          Translated abstract

          INTRODUCTION: Tests of sentences recognition in quiet still are neither very used in the clinical audiological routine and nor in researches. That's why, many times, when this evaluation is accomplished, the clinicians doesn't possess parameters to interpret or classify the results. AIM: Thus, the aim of this study was to investigate the correlation between the sentences recognition threshold in quiet (SRTs) and the average of the tonal thresholds in the frequencies of 0,5, 1 and 2 kHz. METHODS: 200 ears of normal-hearing individuals, 50 men and 50 women (average 34,61 years) were examined. First, an anamnesis, meatuscopy, pure tone audiometry, speech recognition threshold and speech recognition percent index were done. After that, by using the Portuguese Sentences Lists Test, the research of sentences recognition threshold in quiet (SRTs) took place. RESULTS: The medium SRTs obtained in the 200 examined ears was 6,15 dBHL and the average of the tonal thresholds for the frequencies 0,5, 1 and 2 kHz was 8,55 dBHL. The statistical analysis revealed significant correlation between the variables studied. CONCLUSIONS: The average of the tonal thresholds in the frequencies of 0,5, 1 and 2 kHz can be used as reference for the analysis of the results obtained in the research of SRTs. Besides, it can be expected that the values of SRTs are better than the values obtained with the average of the tonal thresholds, because the sentences supply acoustic and linguistic tracks with meaning.

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          Most cited references20

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          Auditory handicap of hearing impairment and the limited benefit of hearing aids.

          R Plomp (1978)
          The aim of this article is to promote a better understanding of hearing impairment as a communicative handicap, primarily in noisy environments, and to explain by means of a quantitative model the essentially limited applicability of hearing aids. After data on the prevalence of hearing impairment and of auditory handicap have been reviewed, it is explained that every hearing loss for speech can be interpreted as the sum of a loss class A (attenuation), characterized by a reduction of the levels of both speech signal and noise, and a loss D (distortion), comparable with a decrease in speech-to-noise ratio. On the average, the hearing loss of class D (hearing loss in noise) appears to be about one-third (in decibels) of the total hearing loss (A + D, hearing loss in quiet). A hearing aid can compensate for class-A-hearing losses, giving difficulties primarily in quiet, but not for class-D hearing losses, giving difficulties primarily in noise. The latter class represents the first stage of auditory handicap, beginning at an average hearing loss of about 24 dB.
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            Speech reception in quiet and in noisy conditions by individuals with noise-induced hearing loss in relation to their tone audiogram.

            Tone thresholds and speech-reception thresholds were measured in 200 individuals (400 ears) with noise-induced hearing loss. The speech-reception thresholds were measured in a quiet condition and in noise with a speech spectrum at levels of 35, 50, 65, and 80 dBA. The tone audiograms could be described by three principal components: hearing loss in the regions above 3 kHz, from 1 to 3 kHz and below 1 kHz; the speech thresholds could be described by two components: speech reception in quiet and speech reception in noise at 50-80 dBA. Hearing loss above 1 kHz was related to speech reception in noise; hearing loss at and below 1 kHz to speech reception in quiet. The correlation between the speech thresholds in quiet and in noise was only R = 0.45. An adequate predictor of the speech threshold in noise, the primary factor in the hearing handicap, was the pure-tone average at 2 and 4 kHz (PTA2,4, R = 0.72). The minimum value of the prediction error for any tone-audiometric predictor of this speech threshold was 1.2 dB (standard deviation). The prediction could not be improved by taking into account the critical ratio for low-frequency noise nor by its upward spread of masking. The prediction error is due to measurement error and to a factor common to both ears. The latter factor is ascribed to cognitive skill in speech reception. Hearing loss above 10 to 15 dB HL (hearing level) already shows an effect on the speech threshold in noise, a noticeable handicap is found at PTA2,4 = 30 dB HL.
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              Listas de sentenças em português: apresentação e estratégia de aplicação na audiologia.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rboto
                Revista Brasileira de Otorrinolaringologia
                Rev. Bras. Otorrinolaringol.
                ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (São Paulo )
                0034-7299
                October 2003
                : 69
                : 5
                : 672-677
                Affiliations
                [1 ] Universidade Federal de Santa Maria Brazil
                [2 ] Universidade Federal de Santa Maria Brazil
                [3 ] Universidade Federal de Santa Maria Brazil
                [4 ] Universidade Federal de Santa Maria Brazil
                Article
                S0034-72992003000500013
                10.1590/S0034-72992003000500013
                f0a9a224-94fc-469a-a815-17e74505ac01

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0034-7299&lng=en
                Categories
                OTORHINOLARYNGOLOGY

                Otolaryngology
                audiology,hearing,auditory perception,speech discrimination tests,audiometry-pure tone,audiologia,audição,percepção auditiva,testes de discriminação da fala,audiometria de tom puro

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