Audiogram Estimation by Auditory Brainstem Response with NB CE-Chirp LS stimulus in Normal Hearing Infants

Abstract Introduction NB CE-Chirp LS was developed to improve the audiogram estimation by auditory brainstem response (ABR) thresholds during audiological assessment of infants and difficult to test children. However, before we know how the stimulus behaves in several types of hearing loss, it is important we know how the stimulus behaves in normal hearing infants. Objective To describe ABR thresholds with NB CE-Chirp LS stimulus for 500, 1,000, 2,000, and 4,000 Hz, as well as the amplitude and absolute latency for ABR thresholds. Methods Auditory brainstem response thresholds were evaluated with the Eclipse EP25 system. NB CE-Chirp LS was presented using an ER-3A insert earphone. EEG filter was 30 Hz high-pass and 1,500 Hz low-pass. The ABR threshold was defined as the lowest intensity capable of clearly evoke wave V, accompanied by an absent response 5 dB below. Results Eighteen normal hearing infants were evaluated. The mean and standard deviation (SD) of the ABR threshold (dB nHL) were: 23.8 (±4.2); 14.4 (±5.7); 6.0 (±5.0); and 7.0 (±5.9). The mean and SD of the absolute latency (ms) were: 8.86 (±1.12); 9.21 (±0.95); 9.44 (±0.78); and 9.64 (±0.52). The mean amplitude (nV) and SD were: 0.123 (±0.035); 0.127 (±0.039); 0.141 (±0.052); and 0.105 (±0.028), respectively, for 500, 1,000, 2,000 and 4,000 Hz. Conclusion Auditory brainstem response threshold with NB CE-Chirp LS reaches low levels, in special for high frequencies. It provides absolute latencies similar between frequencies with robust amplitude. The results obtained brings to the examiner more confidence in the results registered.

Study on gene therapy for DPOAE and ABR threshold changes in adult Otof-/- mice / 临床耳鼻咽喉头颈外科杂志

Objective:This study aims to analyze the threshold changes in distortion product otoacoustic emissions（DPOAE） and auditory brainstem response（ABR） in adult Otof-/- mice before and after gene therapy, evaluating its effectiveness and exploring methods for assessing hearing recovery post-treatment. Methods:At the age of 4 weeks, adult Otof-/- mice received an inner ear injection of a therapeutic agent containing intein-mediated recombination of the OTOF gene, delivered via dual AAV vectors through the round window membrane（RWM）. Immunofluorescence staining assessed the proportion of inner ear hair cells with restored otoferlin expression and the number of synapses.Statistical analysis was performed to compare the DPOAE and ABR thresholds before and after the treatment. Results:AAV-PHP. eB demonstrates high transduction efficiency in inner ear hair cells. The therapeutic regimen corrected hearing loss in adult Otof-/- mice without impacting auditory function in wild-type mice. The changes in DPOAE and ABR thresholds after gene therapy are significantly correlated at 16 kHz. Post-treatment,a slight increase in DPOAE was observeds,followed by a recovery trend at 2 months post-treatment. Conclusion:Gene therapy significantly restored hearing in adult Otof-/- mice, though the surgical delivery may cause transient hearing damage. Precise and gentle surgical techniques are essential to maximize gene therapy's efficacy.

A comparison of the human voice (“Baah”) test and the automated auditory brainstem response in detecting neonates with hearing loss in a community setting

Objective@#To assess the usage of the “Baah” Test compared to the AABR (Automated Auditory Brainstem Response) in detecting hearing loss of neonates in the community setting. @*Methods@#This is a retrospective cross-sectional study. The targeted sample population are infants less than a month old who underwent screening at a testing facility in Malolos, Bulacan spanning the years 2011 and 2012. @*Results@#A total of 201 infants were included in the study, with a mean age of 10.77 days with a standard deviation of 7.79. The ratio of males to females was almost equal at 1:1.01. For infants who passed hearing screening on at least one ear, 96% (193 infants) correlated with the results of “Baah” testing. For those with bilateral refer results on AABR, 4 out of the 6 correlated with the “Baah” Test. @*Conclusion@#There is potential in using the “Baah” Test as a tool for hearing loss assessment of infants in situations wherein the usual hearing screening tests are inaccessible. It makes use of little resources, and though it does have its limitations in assessing for unilateral hearing loss (as the test cannot test ears in isolation), it would be able to identify infants likely to have bilateral hearing loss.

Assessment of Wave V latency and Wave I-V Interpeak latency in preterm babies by Brainstem Evoked Response Audiometry

Background: Early screening of hearing impairment optimizes communication, social, academic, and vocational outcomes for each child with hearing loss measurement of the auditory brain stem response which is considered the most sensitive method of assessing the auditory activity of neonates. Aims and Objectives: This study aims to compare wave V latency and interpeak I-V latency by brainstem auditory evoked response in preterm babies (32 weeks–36 weeks) with age-specific normal response and intergroup comparison (Group 1–32 weeks, Group 2–34 weeks, and Group 3–36 weeks) for the identification of hearing impairment if any. Materials and Methods: The present study was done on 50 preterm newborn, and after satisfying inclusion and exclusion criteria, preterm babies were subdivided into three groups on the basis of gestational age (Group A: 32 weeks [n = 12], Group B: 34 weeks [n = 18], and Group C: 36 weeks [n = 20]). Babies were subjected to brainstem evoked response audiometry (BERA) test on RMS EMG EP MARK-II machine in the neurophysiology unit of the Department of Physiology, Gandhi Medical College, Bhopal. Interpretation of the data as compared to normal values was done. Results: A trend toward decrease in absolute peak latencies of wave V with advancing gestational age was observed indicating progressive maturation, but the values recorded in all the three groups were longer as compared to the normal term values suggesting impairment in the maturation process. Wave I-V interpeak latencies values showed appreciable prolongation in all groups as compared to normal term values. Conclusion: The present study has shown that the preterm babies had altered BERA findings signifying hearing impairment.

Hearing and language development in children with brainstem implants: a systematic review

Abstract Objective: To present scientific evidence, based on a systematic review of the literature, on the benefit of brainstem implants in auditory rehabilitation and language development in children. Methods: A systematic search was used to identify studies that contain information about the benefit of brainstem implants in the auditory rehabilitation and language development of children. The review was conducted based on a structured literature search, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. The search was carried out in the PubMed, Web of Science and Scopus databases, using the combination "Auditory brainstem implants" AND "Pediatric", without restriction of language, period, and location. The quality assessment of the articles was performed using the Study Quality Assessment Tools. Results: Regarding hearing, children with brainstem implants showed sound detection, access to most speech sounds, basic auditory perception skills, recognition of ambient sounds, recognition of some frequently used words and phrases, in addition to some closed-set word discrimination capability. Expressive and comprehensive language were identified in children using auditory brainstem implants, increasing significantly in the short and long terms in most cases; however, in some of the children, such skills remained stable. Conclusion: The auditory brainstem implant can be considered an effective alternative for children with cochlear malformation and/or auditory nerve deficiency and for those who cannot benefit from cochlear implant surgery.

The Relationship between Contralateral Suppression of Transient Evoked Otoacoustic Emission and Unmasking of Speech Evoked Auditory Brainstem Response

Abstract Introduction Several studies have shown that efferent pathways of the auditory system improve perception of speech-in-noise. But, the majority of investigations assessing the role of efferent pathways on speech perception have used contralateral suppression of otoacoustic emissions as a measure of efferent activity. By studying the effect of efferent activity on the speech-evoked auditory brainstem response (ABR), some more light could be shed on the effect of efferent pathways on the encoding of speech in the auditory pathway. Objectives To investigate the relationship between contralateral suppression of transient evoked otoacoustic emission (CSTEOAE) and unmasking of speech ABR. Methods A total of 23 young adults participated in the study. The CSTEOAE was measured using linear clicks at 60 dB peSPL and white noise at 60 dB sound pressure level (SPL). The speech ABR was recorded using the syllable /da/ at 80 dB SPL in quiet, ipsilateral noise, and binaural noise conditions. In the ipsilateral noise condition, white noise was presented to the test ear at 60 dB SPL, and, in the binaural noise condition, two separate white noises were presented to both ears. Results The F0 amplitude of speech ABR was higher in quiet condition; however, the mean amplitude of F0 was not significantly different across conditions. Correlation analysis showed a significant positive correlation between the CSTEOAE and the magnitude of unmasking of F0 amplitude of speech ABR. Conclusions The findings of the present study suggests that the efferent pathways are involved in speech-in-noise processing.

Frequency-Following Response and Auditory Behavior in Children with Prenatal Exposure to the Zika Virus

Abstract Introduction Prenatal exposure to the Zika virus can impair neurodevelopment and cause auditory damage. Objective To analyze the frequency-following response (FFR) and the auditory behavior (with the LittlEars® questionnaire) of children with and without prenatal exposure to Zika virus infection. Methods A total of 30 children participated in the present study, divided into 3 groups: 10 children with microcephaly and prenatal exposure to the Zika virus; 10 normocephalic children with prenatal exposure to the Zika virus; and 10 children with no evidence of prenatal exposure to the virus. The FFR test was performed with the /da/ syllable. The LittlEars® questionnaire was used with parents/guardians. Results For the FFR measurements, there was no difference between the groups. The children with exposure to the Zika virus presented a final score in the questionnaire below what is expected from children with normal hearing. A significant difference was observed for the final, semantic, and expressive scores between the group with microcephaly and the other groups. A strong negative correlation was seen between the LittlEars® questionnaire final score and the FFR measurements for the group with microcephaly when compared with the other groups. Conclusion Children exposed to the Zika virus, with and without microcephaly, presented FFR patterns similar to what was seen in children with no evidence of virus exposure. However, they showed signs of immature auditory behavior, suggesting auditory development delay.

Eficacia del «Programa de tamizaje auditivo neonatal universal¼ de la Caja Costarricense del Seguro Social en la detección de sordera en niñas y niños, entre 2016 y 2018 / Effectiveness of «Universal Newborn Hearing Screening program¼ of Caja Costarricense del Seguro Social, in detecting deafness in children, from 2016 to 2018

Resumen Introducción: el tamizaje auditivo es un método de detección y su propósito es intervenir de forma temprana para reducir las consecuencias negativas de una eventual afección auditiva en el desarrollo integral del infante. Costa Rica ha implementado en el sistema de salud público un programa de tamizaje auditivo neonatal universal, donde se examina todo niño o niña antes del primer mes de vida. Aunque se han percibido múltiples beneficios, es importante demostrar con evidencia científica si cumple sus objetivos. Metodología: se analizó la eficacia del «Programa de tamizaje auditivo neonatal universal» (TANU) de la Caja Costarricense de Seguro Social, a partir de la información registrada de 37 656 infantes evaluados entre los años 2016 y 2018, mediante el contraste empírico con las técnicas descriptivas de distribución de frecuencias de variables, y las pruebas inferenciales chi cuadrado y análisis de varianza (ANOVA). Resultados: en cuanto a la edad al momento del examen, el 71 % de la muestra tenía entre 0 y 3 días. Su desempeño a través del tiempo y la extensión a distintos centros de salud ha sido satisfactorio, así mismo, la cantidad de infantes valorados ha sido hasta del 98 % de la población. Conclusiones: el programa TANU es eficaz en la mayoría de aspectos analizados, destaca la identificación de factores de riesgo y la detección temprana de afecciones auditivas, sin embargo, se proponen mejoras en relación con el manejo de la información.

Abstract Introduction: Hearing screening is a detection method, its objective is to provide an early intervention that allows reducing the negative consequences of an eventual hearing impairment, in the integral development of the infant. Costa Rica has implemented a universal neonatal hearing screening program in the public health system, where the hearing of every child born in the country is examined before the first month of life. Although multiple benefits have been perceived, it is important to demonstrate with scientific evidence if it accomplishes its objectives. Methodology: the effectiveness of the Universal Newborn Hearing Screening Program in Costa Rica was analyzed, based on the information recorded from 37,656 children evaluated since 2016 to 2018, through empirical contrast using both descriptive techniques: frequency distribution of variables, as well as the use of inferential tests: chi square and analysis of variance (ANOVA). Results: 71 % of the sample was between 0 and 3 days old at the moment of being examined. Its performance over time and extension to different health centers has been satisfactory, likewise, the number of infants evaluated has been up to 98 % of the population. Conclusions: the TANU program is effective in most of the aspects analyzed, the identification of risk factors and the early detection of hearing disorders are outstanding, however, improvements are proposed in relation to the handling of information.

Inhibiting DNA methylation alleviates cisplatin-induced hearing loss by decreasing oxidative stress-induced mitochondria-dependent apoptosis via the LRP1-PI3K/AKT pathway

Cisplatin-related ototoxicity is a critical side effect of chemotherapy and can lead to irreversible hearing loss. This study aimed to assess the potential effect of the DNA methyltransferase (DNMT) inhibitor RG108 on cisplatin-induced ototoxicity. Immunohistochemistry, apoptosis assay, and auditory brainstem response (ABR) were employed to determine the impacts of RG108 on cisplatin-induced injury in murine hair cells (HCs) and spiral ganglion neurons (SGNs). Rhodamine 123 and TMRM were utilized for mitochondrial membrane potential (MMP) assessment. Reactive oxygen species (ROS) amounts were evaluated by Cellrox green and Mitosox-red probes. Mitochondrial respiratory function evaluation was performed by determining oxygen consumption rates (OCRs). The results showed that RG108 can markedly reduce cisplatin induced damage in HCs and SGNs, and alleviate apoptotic rate by protecting mitochondrial function through preventing ROS accumulation. Furthermore, RG108 upregulated BCL-2 and downregulated APAF1, BAX, and BAD in HEI-OC1 cells, and triggered the PI3K/AKT pathway. Decreased expression of low-density lipoprotein receptor-related protein 1 (LRP1) and high methylation of the LRP1 promoter were observed after cisplatin treatment. RG108 treatment can increase LRP1 expression and decrease LRP1 promoter methylation. In conclusion, RG108 might represent a new potential agent for preventing hearing loss induced by cisplatin via activating the LRP1-PI3K/AKT pathway.

Esketamine may be an ideal substitute for ketamine during cochlear function measurement

The mixture of ketamine and xylazine is widely used for the auditory brainstem response (ABR) measurement. Esketamine is twice as potent as ketamine. Our objective was to assess the influence of esketamine in mice undergoing cochlear function measurement including ABR and distortion product otoacoustic emission (DPOAE) measurement. C57Bl/6J mice were treated with an equivalent dose of analgesia and received either a single intraperitoneal (ip) injection of 100 mg/kg ketamine and 25 mg/kg xylazine or 50 mg/kg esketamine and 25 mg/kg xylazine. Hearing thresholds, peak latencies of waves I and V, and DPOAE thresholds were recorded. Time to loss of righting and time to regain righting were also assessed. We found that hearing thresholds, the peak latencies of waves I and V, and DPOAE thresholds were similar between the two groups (all P>0.05). Time to regain righting was significantly shorter in the esketamine group (P<0.001) than in the ketamine group. We concluded that when using equivalent doses of analgesia, esketamine may be an ideal substitute for ketamine during cochlear function test.

Forward masking and cognitive-language skills in children as a function of literacy stage

ABSTRACT Purpose: to investigate the relation between forward masking and cognitive-language skills in children as a function of literacy stage. Methods: twenty-seven children registered in literacy stage at public schools, aged from 6 to 9 years old, with no learning difficulties or audiological problems reported, participated in this study. Frequency Following Responses were registered in two test conditions: 1) /da/ alone; 2) /da/ presented 4 milliseconds after a speech noise. Two language protocols were applied: a cognitive-linguistic skills protocol and a phonological awareness one. Results: forward masking was evident in Frequency Following Responses of all children regardless of literacy stage. Frequency Following Responses latencies in both testing conditions showed no difference among participants' age. Cognitive-language skills scores were below those expected for all children, with significant improvement noticed as a function of age. No correlation between language performance and forward masking was found. Conclusion: there was no relation between forward masking and cognitive-language skills in children, as a function of literacy stage.

Comparison of ASSR, ABR and 40 Hz AERP Response Thresholds at Different Frequencies and Their Forensic Applications / 法医学杂志

OBJECTIVES@#To explore the relationship between the frequency characteristics and response threshold of auditory steady-state response (ASSR), auditory brainstem response (ABR) and 40 Hz auditory event related potential (40 Hz AERP), and their application values in forensic medicine.@*METHODS@#Thirty volunteers with normal hearing (60 ears) were selected to perform pure tone audiometry (PTA) threshold and ASSR, ABR and 40 Hz AERP response threshold tests in the standard sound insulation shielding room, and the results were statistically analyzed by SPSS 22.0 software.@*RESULTS@#At 0.5 kHz and 1.0 kHz frequencies, the correlation between 40 Hz AERP response threshold and PTA threshold was good, which was better than that of ASSR and ABR response threshold. At 2.0 kHz and 4.0 kHz frequencies, the correlation between ASSR and ABR response thresholds and PTA threshold was good, which was better than that of 40 Hz AERP response threshold.@*CONCLUSIONS@#To evaluate the hearing at 0.5 kHz and 1.0 kHz frequencies, it is recommended to use 40 Hz AERP and ASSR to comprehensively assess the PTA threshold of the subjects. To evaluate the hearing at 2.0 kHz and 4.0 kHz frequencies, ABR and ASSR are recommended to assess the PTA threshold of subjects comprehensively. The combination of ASSR, ABR and 40 Hz AERP can improve the accuracy of hearing function evaluation.

A study of effect of aminoglycoside therapy on auditory brainstem evoked responses in preterm and term neonates

Background: Aminoglycosides are widely used drugs in neonates with associated ototoxic side effects, that can be diagnosed with auditory brainstem evoked responses, which is the recommended screening technique in neonatal intensive care unit infants.  This study was conducted to evaluate the effect of aminoglycoside therapy on auditory brainstem evoked responses in term and preterm neonates.Methods: A cross-sectional case control study. Two groups of 26 term and 22 preterm neonates who received aminoglycosides, with no other known risk factors for ototoxicity, were compared with suitable matched control group of 10 neonates in each. ABER was done after at least 5 days of aminoglycoside therapy and results were compared to suitable matched controls.Results: Mean latency of wave I in term neonates at 90 dB and 60 dB and mean interwave latencies of I-V waves in preterm neonates at 30 dB was higher in study group and statistically significant. No statistically significant difference in any of ABER parameters was observed in any group, at all other intensities.Conclusions: Wave I latency was prolonged in study group of term neonates at two intensities which indicates effect of aminoglycoside therapy on distal portion of acoustic nerve. But as there were no such findings at other intensities in term study group and in preterm study group and moreover no other ABER abnormalities were observed, it was concluded that the aminoglycoside therapy has low potential for ototoxicity. Authors support the ABER screening for early detection of hearing abnormalities, and recommend study on larger group of neonates and meta-analysis for final conclusion for evidence-based recommendations to use aminoglycosides in neonates, in view of audiometric and neurological abnormalities.

Monitoramento eletrofisiológico do sistema auditivo central em crianças nascidas pequenas para a idade gestacional / Electrophysiological follow-up of the central auditory system in children born small for gestational age

RESUMO Objetivo Monitorar o sistema auditivo central de crianças nascidas pequenas para a idade gestacional, por meio da avaliação eletrofisiológica da audição, para verificar a ocorrência de eventuais disfunções neurais nesse sistema. Métodos Estudo longitudinal, cuja casuística foi composta por 23 crianças distribuídas em quatro grupos: 1) grupo de quatro crianças nascidas pequenas para a idade gestacional e a termo; 2) grupo de sete crianças nascidas pequenas para a idade gestacional e pré-termo; 3) grupo de quatro crianças nascidas com peso adequado para a idade gestacional e a termo; 4) grupo de oito crianças nascidas adequadas para a idade gestacional e pré-termo, cuja idade ao final da pesquisa foi de 3 anos (variação entre 34 e 39 meses). O critério de inclusão foi presença bilateral de emissões otoacústicas transientes. Todas as crianças foram submetidas ao potencial evocado auditivo de tronco encefálico ao nascimento, aos 6 meses e aos 3 anos de idade e à pesquisa do potencial evocado auditivo de longa latência aos 3 anos. Resultados crianças nascidas pequenas para a idade gestacional e a termo tiveram maior ocorrência de alterações, em relação aos demais grupos, com aumento da latência das ondas III e V e interpicos I-III e I-V. Todas apresentaram resultados normais no potencial evocado auditivo de longa latência. Conclusão Crianças nascidas pequenas para a idade gestacional e a termo apresentam disfunções na condução neural no tronco encefálico e devem ser consideradas de risco para alterações do desenvolvimento das habilidades auditivas necessárias para garantir qualidade de processamento da informação acústica.

ABSTRACT Purpose To follow up the central auditory system of children born small for gestational age, through electrophysiological evaluation of hearing, in order to verify the occurrence of possible neural dysfunctions in this system. Methods A longitudinal study was carried out with 23 children divided into four groups: Term-born group, subdivided into small for gestational age (four children) and four children born with appropriate weight for gestational age, whose age at the end of the research was three years old. Preterm group subdivided into small for gestational age (seven children), and appropriate for gestational age (eight children), whose corrected age, at the end of the research was three years old. All children were subjected to assessment of auditory brainstem auditory evoked potentials at birth, at six months and at three years of age, and Long-Latency Auditory Evoked Potential at three years. Results children born at term and small for gestational age had a higher occurrence of hearing alterations in relation to the other groups, with increased latency of waves III and V and interpeaks I-III and I-V. All children presented normal evaluation in the Long-Latency Auditory Evoked Potential. Conclusion Children born term and small for gestational age present dysfunctions in neural conduction in the brainstem and should be considered at risk for alterations in the development of the auditory skills that are necessary to guarantee quality of acoustic information processing.

Frequency Characteristics of AEPs in Normal Young Adults and Comparison of Their Response Threshold and Pure Tone Audiometry Threshold / 法医学杂志

Objective The tests of three types of auditory evoked potentials （AEPs） were performed on normal young adults, to understand the frequency characteristics of different testing methods and the relationship between response threshold and pure tone audiometry threshold of different methods, and to discuss the forensic value of 3 types of AEPs to evaluate hearing function. Methods Twenty normal young adults were selected, their standard pure tone audiometry threshold, short-term pure tone audiometry threshold and the response threshold of 3 types of AEPs （tone burst-auditory brainstem response, 40 Hz auditory event-related potential and slow vertex response） at 0.5 kHz, 1.0 kHz, 2.0 kHz and 4.0 kHz were recorded. The relationship between the response threshold and standard pure tone audiometry threshold, short-term pure tone audiometry threshold of 3 types of AEPs at different frequencies as well as the differences between different types of AEPs were analyzed. Results The short-term pure tone audiometry threshold was higher than the standard pure tone audiometry threshold at each frequency. The response threshold and standard pure tone audiometry threshold of the 3 types of AEPs all had a certain correlation, and the response threshold of the 3 types of AEPs was higher than short-term pure tone audiometry threshold and standard pure tone audiometry threshold at each frequency. The differences in the differences between the response threshold and standard pure tone audiometry threshold of the 3 types of AEPs at different frequencies had statistical significance. Linear regression mathematical models were established to infer the standard pure tone audiometry threshold （hearing level） from response threshold （sound pressure level） of 3 types of AEPs of normal young adults. Conclusion When using response threshold of different types of AEPs to estimate pure tone audiometry threshold, conversion and correction are needed. Combined use of different types of AEPs could improve the accuracy of hearing function evaluation.

The Effects of Riluzole on Cisplatin-induced Ototoxicity

Abstract Introduction Riluzole (2-amino-6-trifluoromethoxy benzothiazole) is known as a neuroprotective, antioxidant, antiapoptotic agent. It may have beneficial effects on neuronal cell death due to cisplatin-induced ototoxicity. Objective To evaluate the effect of riluzole on cisplatin-induced ototoxicity in guinea pigs. Methods Twenty-four guinea pigs, studied in three groups, underwent auditory brainstem response evaluation using click and 8 kHz tone burst stimuli. Subsequently, 5 mg/kg of cisplatin were administered to all animals for 3 days intraperitoneally (i.p.) to induce ototoxicity. Half an hour prior to cisplatin, groups 1, 2 and 3 received 2 ml of saline i.p., 6 mg/kg of riluzole hydrochloride i.p., and 8 mg/kg of riluzole hydrochloride i.p., respectively, for 3 days. The auditory brainstem responses were repeated 24 hours after the last drug administration. The cochleae were analyzed by transmission electron microscopy (TEM). Results After drug administiration, for 8,000 Hz stimulus, group 1 had significantly higher threshold shifts when compared with groups 2 (p < 0.05) and 3 (p < 0.05), and there was no significant difference in threshold shifts between groups 2 and 3 (p > 0.05). Transmission electron microscopy findings demonstrated the protective effect of riluzole on the hair cells and the stria vascularis, especially in the group treated with 8 mg/kg of riluzole hydrochloride. Conclusion We can say that riluzolemay have a protective effect on cisplatin- induced ototoxicity. However, additional studies are needed to confirm these results and the mechanisms of action of riluzole.

Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing / Comparação entre o uso de hidrato de cloral e propofol-quetamina como formas de sedação para exames de potenciais evocados auditivos de tronco encefálico

Abstract Introduction: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. Objective: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. Methods: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study. Drugs doses, adverse effects, sedation times, and the effectiveness of the sedative regimens were reviewed. Results: 73 patients underwent oral chloral hydrate sedation, while 117 received propofol-ketamine sedation. 12% of the patients in the chloral hydrate group failed to achieve desired sedation level. The average procedure, recovery and total nursing times were significantly lower in the propofol-ketamine group. Propofol-ketamine group experienced higher incidence of transient hypoxemia. Conclusion: Both sedation regimens can be successfully used for sedating children undergoing auditory brainstem response testing. While deep sedation using propofol-ketamine regimen offers more efficiency than moderate sedation using chloral hydrate, it does carry a higher incidence of transient hypoxemia, which warrants the use of a highly skilled team trained in pediatric cardio-respiratory monitoring and airway management.

Resumo Introdução: O uso de testes diagnósticos de potencial evocado auditivo de tronco encefálico sob sedação é atualmente o padrão-ouro em lactentes e crianças pequenas que não têm desenvolvimento suficiente para realizar o exame. Objetivo: O objetivo do estudo foi comparar a sedação de crianças submetidas a testes de potencial evocado auditivo de tronco encefálico com propofol-quetamina e com hidrato de cloral por via oral. Método: Pacientes entre 4 meses e 6 anos de idade que necessitaram de sedação para a realização do potencial evocado auditivo de tronco encefálico foram incluídos nesse estudo retrospectivo. Foram revisadas as doses dos medicamentos, os efeitos adversos, os tempos de sedação e a eficácia das formas de sedação. Resultados: 73 pacientes foram submetidos à sedação oral com hidrato de cloral, enquanto 117 receberam sedação com propofol-quetamina; 12% dos pacientes do grupo hidrato de cloral não alcançaram o nível desejado de sedação. Os tempos médios de procedimento, recuperação e o tempo total de cuidados de enfermagem foram significativamente menores no grupo propofol-quetamina, entretanto este grupo experimentou maior incidência de hipoxemia transitória. Conclusão: Ambos os regimes de sedação podem ser utilizados com sucesso para sedar crianças para realização do exame de potencial evocado de tronco encefálico. Embora a sedação profunda com propofol e quetamina ofereça mais eficiência do que a sedação moderada com hidrato de cloral, ela apresenta maior incidência de hipoxemia transitória, o que requer uma equipe altamente qualificada, treinada em monitoramento cardiorrespiratório pediátrico e manejo de vias aéreas.

Analyses of audiological examination in children without auditory brainstem response / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate residual hearing of children severe and profound sensorineural deafness in whom wave V was not found in auditory brainstem response(ABR) testing, and to emphasize the importance of objective audiological tests.@*Methods@#Two hundred and fifty-two children who were admitted to the Second Affiliated Hospital of Zhengzhou University between January 2015 and April 2018, with an average age of 20 months from 72 days to 4 years, received a full battery of objective audiological tests consisting of distortion product otoacoustic emission(DPOAEs), tympanometry, auditory brainstem responses(ABRs), 40 Hz auditory event related potential(40 HzAERP) and auditory steady-state response(ASSRs).There were 159 males(318 ears) and 93 females(186 ears). Residual hearing obtained by 40 HzAERP、ASSR of 252 children with sensorineural deafness was studied in relation to the absence of wave V in click ABR. SPSS 16.0 software was used to analyze the data.@*Results@#Four hundred and forty-four ears of 504 ears have residual hearing of different degrees at different frequencies(88.1%),60 ears (11.9%) were found in whom responses was not found in 40 HzAERP、ASSR testing; Seventy-two ears(14.3%) in 38 patients were tested cochlear microphonic potentials (CMs).@*Conclusion@#In children hearing evaluations,a full battery of objective audiological tests could better investigate residual hearing; The CMs were tested could provide the Audiotery Neuropathy diagnosis in infants with OAEs and ABR absent.

Characteristics of auditory brainstom response and auditory steady state evoked responses in noise-induced hearing loss population / 中华劳动卫生职业病杂志

Objective@#To explore the characteristics of auditory steady state evoked responses (ASSR) and auditory brainstem response (ABR) in noise-induced hearing loss population and the relationship between the response threshold of corresponding frequency and pure tone audiometry (PTA) .@*Methods@#Noise-induced hearing loss patients who completed subjective and objective audiometry in our hospital from October 2014 to October 2018 were collected. The results of PTA, ABR, ASSR and the correlation between subjective and objective audiometry were discussed.@*Results@#A total of 381 ears of 193 patients were enrolled. The difference of 0.5, 1.0, 2.0 and 4.0 kHz between ASSR threshold and PTA was 5.9, 6.9, 11.8 and 1.8 dB, respectively. The correlation coefficients were 0.638, 0.680, 0.657 and 0.608. The difference of 1.0, 2.0, 3.0 and 4.0 kHz between ABR threshold and PTA was 44.2, 35.0, 19.0 and 2.0 dB. With the increase of frequency, the threshold difference between ABRt V wave and PTA decreased gradually.@*Conclusion@#ASSR and ABR response thresholds are valuable in subjective assessment on noise-induced hearing loss. The thresholds of ASSR and ABR at 4 kHz are close to those of PTA.

Effects of Residual Hearing on the Auditory Steady State Response for Cochlear Implantation in Children

BACKGROUND AND OBJECTIVES: We aim to explore the effects of residual auditory steady state response (ASSR) on cochlear implantation (CI) outcomes in children lacking auditory brainstem responses (ABRs). SUBJECTS AND METHODS: We retrospectively reviewed the data of child CI recipients lacking ABRs. All ears were divided into two groups: with residual ASSR and without ASSR. For each frequency, the T- and C-levels and the electrical dynamic ranges of postoperative 3-month and 1-year mappings were compared between the groups. To evaluate speech perception, patients who received simultaneous bilateral CIs were divided into two groups: group 1 exhibited responses at all frequencies in both ears; in group 2, at least one ear evidenced no response. The Categories of Auditory Perception (CAP) and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores were compared between the groups. RESULTS: We enrolled 16 patients. At 2 kHz, the postoperative 3-month and 1-year T-levels of patients with residual hearing were lower than those of hearing loss group (p=0.001, p=0.035). In residual hearing group, the ASSR threshold correlated positively with the postoperative 1-year T-level (p=0.012, R² =0.276) and C-level (p=0.002, R² =0.374). Of 10 simultaneous bilateral CI recipients, 5 exhibited ASSRs at all frequencies and the other 5 showed no response at ≥1 frequency. The latter had higher CAP scores at the postoperative 1-year (p=0.018). CONCLUSIONS: In children exhibiting hearing loss in ABR testing, residual hearing at 2 kHz ASSR correlated positively with the post-CI T-level. Those with ASSRs at all frequencies had significantly lower CAP scores at the postoperative 1year. CI should not be delayed when marginal residual hearing is evident in ASSR.