Avaliação auditiva em adolescentes com diabetes mellitus tipo 1 por meio da audiometria das emissões otoacústicas

Abstract

Diabetes mellitus type 1 is one of the most frequent endocrine diseases of childhood and adolescence and can produce, over the years, several chronic complications related to the glycemic control. Many clinical studies have been conducted in order to establish the relationship between glucose metabolic disorders and changes in the inner ear. However, the effect of these disturbances on the cochlear vestibular system is still under debate. The study was conduct to evaluate the hearing of adolescents with type 1 diabetes and the association between hearing impairment, audiometric thresholds, amplitudes of otoacoustic emission and the variables gender, age, metabolic control and disease duration. We assessed 40 adolescents with Type 1 diabetes with a mean age of 14.12 + 2,55 years and mean disease duration of 6.75 +3,64 year and 40 adolescents in the control group with a mean of 13.98 + 2,48 years. They were submitted to clinical and laboratorial evaluation consisting of pure tone audiometry, immittance audiometry, transient otoacoustic emissions (TEOAE) and distortion products (DPOAE). To identify chronic complications and / or comorbidities, duration of DM and the glycemic control status hemoglobin glycosylated levels of last two years) medical records were used. Changes in audiometry were found in 7.7% of the ears of diabetics. Hearing loss was sensorineural affecting only the frequencies of 6000 and 8000 Hz, with mean thresholds of 36.4 and 42.1 dB which did not impair speech discrimination. The hearing thresholds increased with increasing age in the control group and in the diabetic group (p = 0.000). These were increased in boys in the control group when compared with girls (p = 0.031) and poorly controlled diabetes compared with well controlled diabetics (p = 0.000) and control regular (p = 0.006). Changes EAOT and DPOAE occurred in 5.1% and 32.1% of the ears of diabetic patients, respectively. TEOAE amplitudes were decreased in diabetic boys compared with girls with diabetes (p=0.027). The amplitudes of DPOAE decreased with increasing age in both groups (p = 0.000). These were reduced in boys in the group of diabetics (p = 0.043) and the control group (p = 0.042) when compared with girls. The cochlear damage could be detected early by means of DPOAE in a significant number of ears of individuals with type 1 diabetes despite hearing thresholds within normal limits in 92.3% of diabetics.