Cochlear implant in postlingual children: functional results 10 years after the surgery

The benefits of cochlear implants (CI) for communication skills are obtained over the years. There are but a few studies regarding the long-term outcomes in postlingual deaf children who grew up using the electronic device. Aim: To assess the functional results in a group of postlingual children, 10 years after using a CI. Methods: Ten postlingual deaf children, implanted before 18 years of age, participated in this study. We assessed: sentence recognition and speech intelligibility. We documented: device use and function and the patient's academic/occupational status. Study design: series. Results: The mean scores were 73% for sentence recognition in silence and 40% in noise. The average write-down intelligibility score was 92% and the average rating-scale intelligibility score was 4.15. There were no cases of device failure. Regarding educational/vocational status, three subjects graduated from the University. Five quit education after completing high school. Eight subjects had a professional activity. Conclusion: This study showed that cochlear implantation is a safe and reliable procedure. The postlingual profoundly hearing-impaired children after 10 years of CI use developed satisfactory levels regarding speech perception and intelligibility, and completed at least high school and were inserted in the labor market. Clinical Trials Registry: NCT01400178.

Do estilo em ciência e em história das ciências

Ao considerar o conhecimento científico como uma forma de pensamento simbólico, entende-se com isso não simples sistemas de signos, mas conteúdos de pensamento (expressos por conceitos) ligados entre si e que fazem sentido, que são, no espaço das representações mentais, os substitutos do "dado objetivo" que se supõe subjazer à experiência que fazemos do "mundo" pelos sentidos e, nesse nível indissociavelmente, pelo entendimento. Esse pensamento simbólico adquire densidade e consistência pela "tecelagem" realizada graças ao trabalho dos pensamentos individuais que se comunicam, social e culturalmente, inscritos no tempo da história. Da tensão dinâmica entre o sujeito do conhecimento, que busca a inteligibilidade (pela operação de sua razão), e a objetividade dos conteúdos que ele se propõe (inicialmente dados, depois modificados ou produzidos), resulta o movimento do pensamento científico e a transformação dos conhecimentos. Esse trabalho do pensamento simbólico é marcado por um estilo próprio a cada um, mas que em parte pode ser comum em contextos, escolas ou tradições. Em ciência e em história das ciências, o estilo intervém em dois níveis: o da abordagem "objetal" da produção das obras pelos cientistas e o da abordagem "reflexiva" da história epistemológica e da filosofia, que se interrogam sobre a significação tanto dos próprios conteúdos de conhecimento quanto do pensamento racional, simbólico, cuja função é manifestá-los.

Auditory processing in children and adolescents in situations of risk and vulnerability

CONTEXT AND OBJECTIVE: Children and adolescents who live in situations of social vulnerability present a series of health problems. Nonetheless, affirmations that sensory and cognitive abnormalities are present are a matter of controversy. The aim of this study was to investigate aspects to auditory processing, through applying the brainstem auditory evoked potential (BAEP) and behavioral auditory processing tests to children living on the streets, and comparison with a control group. DESIGN AND SETTING: Cross-sectional study in the Laboratory of Auditory Processing, School of Medicine, Universidade de São Paulo. METHODS: The auditory processing tests were applied to a group of 27 individuals, subdivided into 11 children (7 to 10 years old) and 16 adolescents (11 to 16 years old), of both sexes, in situations of social vulnerability, compared with an age-matched control group of 10 children and 11 adolescents without complaints. The BAEP test was also applied to investigate the integrity of the auditory pathway. RESULTS: For both children and adolescents, there were significant differences between the study and control groups in most of the tests applied, with significantly worse performance in the study group, except in the pediatric speech intelligibility test. Only one child had an abnormal result in the BAEP test. CONCLUSIONS: The results showed that the study group (children and adolescents) presented poor performance in the behavioral auditory processing tests, despite their unaltered auditory brainstem pathways, as shown by their normal results in the BAEP test.