Correlation Analysis and Comparison of Adult CE-Chirp ABR Response Threshold and Pure Tone Hearing Threshold / 法医学杂志

Objective To study the application of CE-Chirp in the evaluation of hearing impairment in forensic medicine by testing the auditory brainstem response(ABR)in adults using CE-Chirp to ana-lyze the relationship between the V-wave response threshold of CE-Chirp ABR test and the pure tone hearing threshold.Methods Subjects(aged 20-77 with a total of 100 ears)who underwent CE-Chirp ABR test in Changzhou De'an Hospital from January 2018 to June 2019 were selected to obtain the V-wave response threshold,and pure tone air conduction hearing threshold tests were conducted at 0.5,1.0,2.0 and 4.0 kHz,respectively,to obtain pure tone listening threshold.The differences and statistical differences between the average pure tone hearing threshold and V-wave response threshold were compared in different hearing levels and different age groups.The correlation,differences and statistical differences between the two tests at each frequency were analyzed for all subjects.The lin-ear regression equation for estimating pure tone hearing threshold for all subjects CE-Chirp ABR V-wave response threshold was established,and the feasibility of the equation was tested.Results There was no statistical significance in the CE-Chirp ABR response threshold and pure tone hearing threshold dif-ference between different hearing level groups and different age groups(P>0.05).There was a good correlation between adult CE-Chirp ABR V-wave response threshold and pure tone hearing threshold with statistical significance(P<0.05),and linear regression analysis showed a significant linear correla-tion between the two(P<0.05).Conclusion The use of CE-Chirp ABR V-wave response threshold can be used to evaluate subjects'pure tone hearing threshold under certain conditions,and can be used as an audiological test method for forensic hearing impairment assessment.

Motor cortex stimulation for the treatment of trigeminal neuralgia after brainstem infarction:A case report / 中南大学学报(医学版)

Secondary trigeminal neuralgia after brainstem infarction is rare and rarely reported.A patient with secondary trigeminal neuralgia after brainstem infarction was admitted to the Department of Neurosurgery,Xiangya Hospital,Central South University.The patient was a 44 years old male who underwent motor cortex stimulation treatment after admission.The effect was satisfactory in the first week after surgery,but the effect was not satisfactory after one week.This disease is relatively rare and the choice of clinical treatment still requires long-term observation.

Normal Values of Ipsilateral and Contralateral Auditory Brainstem Responses Induced by Click in Normal Hearing Youth of Different Gender / 听力学及言语疾病杂志

Objective To study the characteristics of ipsilateral and contralateral ABRs in young adults with normal hearing,and the differences between the genders and recording sides(ipsilateral vs.contralateral).Methods Eighty-eight subjects(176 ears)aged 18 to 21 years old were recruited to perform ipsilateral and contralateral ABRs evoked by 70 dB nHL click.The mean and standard deviation of the latency of waves Ⅰ,Ⅲ,Ⅴ and the in-terpeak interval of Ⅰ-Ⅲ,Ⅲ-Ⅴ and Ⅰ-Ⅴ of ipsilateral,and waves Ⅲ,Ⅴ and the interpeak interval ABRs of Ⅲ-Ⅴof contralateral ABRs were calculated.The ANOVA was used to study the differences between the males and fe-males,and between ipsilateral and contralateral recordings.Results Males showed delayed peak and interpeak la-tency in waves Ⅲ,Ⅴ,Ⅰ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴ(F=13.13～60.82,P＜0.001).The peak and interpeak latency of waves Ⅲ,Ⅴ,Ⅲ-Ⅴ(F=22.43～76.18,P＜0.001)showed difference between ipsilateral and contralateral ABRs.The latency of ipsilateral ABRs in waves Ⅲ were delayed,but in other components were earlier.Conclusion This study established the normal values of ipsilateral and contralateral ABRs in young adults with normal hearing,and reported the gender and recording sides(ipsilateral vs.contralateral)differences in ABRs.

The Characteristics of Auditory Brainstem Response Waveform in Autistic Children with Normal Hearing / 听力学及言语疾病杂志

Objective To investigate the effect of auditory brainstem response(ABR)in clinical detection and severity assessment of autism spectrum disorder(ASD)in children with normal hearing.Methods ① A total of 55 autistic children(110 ears)with normal hearing and 55 children(110 ears)with typical development(TD)who did not differ in sex composition ratio and average monthly age were divided into four sub-groups according to age:≤24 months group(22 ears),25～36 months group(40 ears),37～48 months group(28 ears)and＞48 months group(20 ears).The ABR latencies and interpeak latencies were compared between ASD children and age-matched TD children.② ASD children were graded by severity according to the Diagnostic and Statistical Manual of Mental Dis-orders(DSM-V),and the correlations between the ABR latencies and interpeak latencies in autistic children with normal hearing and the severity grading were studied.Results ① No statistically significant differences in ABR wave latencies and interpeak latencies were found in autistic children with normal hearing under 24 months of age compared to age-matched TD children(P＞0.05).② Compared with children with TD,autistic children with nor-mal hearing at 25～36 months of age had significantly longer wave Ⅲ latencies and the interpeak latencies of Ⅰ-Ⅲ andⅠ-Ⅴ;the significantly longer wave Ⅲ,Ⅴ latencies,the interpeak latencies of Ⅰ-Ⅲ,Ⅲ-Ⅴ and Ⅰ-Ⅴ in autistic chil-dren with normal hearing at 37～48 months of age.Autistic children with normal hearing in the＞48 months group had significantly longer wave Ⅴ latencies and interpeak latencies of Ⅲ-Ⅴ,Ⅰ-Ⅴ than age-matched TD children(P＜0.05).③ The higher the ASD severity grading the longer the wave Ⅲ and V latencies and the longer interpeak latencies of Ⅰ-Ⅲ,Ⅲ-Ⅴ,and Ⅰ-Ⅴ(P＜0.05).Conclusion Differences in the level of auditory brainstem pathway de-velopment emerged at 25 months of age,and autistic children with normal hearing had significantly lower levels of auditory brainstem development than age-matched TD children.There were correlations between the latencies and interpeak latencies of ABR in autistic children with normal hearing and the severity grading.

Digital characteristics of brainstem morphology and age-related development in young children / 中国组织工程研究

BACKGROUND:Previous brain studies have mostly focused on adults and fetuses,and the developmental characteristics of young children's brainstems have rarely been studied. OBJECTIVE:To observe the brainstem development characteristics of healthy young children and to explore the age-related differences and their correlation with sex. METHODS:From January 2019 to April 2022,a retrospective study of 3.0T MRI images of 174 children aged 2 to 6 years in the Affiliated Hospital of Inner Mongolia Medical University was conducted,and the median sagittal diameter,area and angle of the brainstem(including midbrain,pons and medulla oblongata)were measured. RESULTS AND CONCLUSION:There is an age-related increase in the anterior and posterior diameters of the midbrain,pons and medulla oblongata in the 2-5 years old group as well as in the longitudinal diameter and area of the midbrain,pons and medulla oblongata in the 2-6 years old group.Except for the longitudinal diameter of the medulla oblongata,all others show a positive correlation with age(r>0,P<0.05).In the 2-3 years old group and 4-5 years old group,the children are in the rapid growth and development stage,and these two age groups can be used as the key observation indicators for the development of young children.The anterior-posterior diameter,longitudinal diameter,area of the pons and total brainstem area are strongly correlated with age,which can be used as the key observation indicators for the brainstem development in young children.

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.

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.

Wave V threshold among children with delayed speech and language, using brainstem evoked response audiometry – A cross-sectional study

Background: Brainstem Evoked Response Audiometry (BERA) is an objective test for audiometric assessment of children. As deprived linguistic skill is often associated with auditory impairment in initial years of life; early diagnosis and interventions are much needed. Aim and Objective: To detect Wave V, in the lowest intensity, as it is a reliable parameter to assess BERA threshold for hearing among different age group of children. Materials and Methods: This cross-sectional study included 250 children (n = 250) with impaired speech and 120 normal children. The case population was divided into four groups according to age – Group 1 (<1 year); Group 2 (1–3 years); Group3 (3–6 years); and Group 4 (6–12 years). Wave V threshold was determined by BERA (measure brainstem auditory evoked potential). Cases were also divided into two categories depending on unilateral or bilateral involvement of ear. Mean threshold of each group was compared with corresponding control group of similar age. The test of significance used was Mann–Whitney U-test. Intragroup comparison was done by Kruskal–Wallis test. Results: In Group 1, 91.7%; Group 2, 100%; Group 3; 88.6%, and Group 4; 85% of children were suffering from bilateral hearing loss. In all the groups, mean threshold was statistically significantly increased in comparison with control group. In intragroup comparison, there was no statistically significant difference of threshold among all the groups of cases in both of the ears. Conclusions: This study identified increased wave V threshold in children with impaired speech of all four groups. Thereby, it indicates the necessity of BERA as screening method.

Limiar Diferencial de mascaramento e potencial evocado auditivo de tronco encefálico em adultos normo-ouvintes com zumbido / Masking Level Difference and Auditory Brainstem ResponseIn Normal Hearing Adults With Tinnitus / Umbral de enmascaramiento diferencial y potencial evocado auditivo del tronco encefálico en adultos con audición normal y tinnitus

Introdução: O zumbido é uma ilusão auditiva consciente, uma sensação sonora não relacionada com uma fonte externa de estimulação. Objetivos: Caracterizar a Acufenometria, Limiar Diferencial de Mascaramento, o questionário de qualidade de vida Inventário de Desvantagem do Zumbido e Potencial Auditivo de Tronco Encefálico em adultos normo-ouvintes com zumbido, com a finalidade de comparar seus achados. Método: Vinte indivíduos do sexo feminino e masculino, entre 20 e 60 anos de idade, normo-ouvintes com queixa de zumbido, foram submetidos ao Acufenometria, Limiar Diferencial de Mascaramento, Inventário de Desvantagem do Zumbido e Potencial Evocado Auditivo de Tronco Encefálico. Resultados: AAcufenometriarevelou que o pitch médio foi de 4,3 KHz à orelha direita e 4,6 KHz à orelha esquerda. O loudness médio foi de 21,7 dBNS à orelha direita e 23,5 dBNS à orelha esquerda. O Limiar Diferencial de Mascaramento médio mostrou-se alterado. O Inventário de Desvantagem do Zumbido médio correspondeu à classificação de grau leve. O Potencial Evocado Auditivo de Tronco Encefálico apresentou parâmetros dentro da normalidade bilateralmente. Conclusão: Constatou-se que adultos normo-ouvintes com queixa de zumbido apresentam zumbido de pitch agudo bilateral com discreto impacto na qualidade de vida, condução adequada das vias auditivas até o tronco encefálico e comprometimento na identificação de sons na presença de ruído, demonstrando que o zumbido pode ter repercussões nas habilidades auditivas centrais. (AU)

Introduction: Tinnitus is a conscious auditory illusion, a sound perception unrelated to any external stimulus source. Objectives: To characterize the Acuphenometry, Masking Level Difference, the quality of life questionnaire Tinnitus Handicap Inventory and Auditory Brainstem Response in normal hearing adults with tinnitus, with the purpose of comparing the findings. Method: Twenty female and male individuals, between 20 and 60 years of age, normal hearing with complaints of tinnitus, underwent Acuphenometry, Masking Level Difference, Tinnitus Handicap Inventory and Auditory Brainstem Response. Results: The Acuphenometry showed the average pitch was 4.3 KHz to the right ear and 4.6 KHz to the left ear. The average loudness was 21.7 dBSL to the right ear and 23.5 dBs to the left ear. The average Masking Level Difference was altered. The average Tinnitus Handicap Inventory corresponded to the classification of mild grade. Auditory Brainstem Response showed parameters within normal range bilaterally. Conclusion: It was found that normal hearing adults with tinnitus complaints have bilateral acute pitch tinnitus with a slight impact on quality of life, appropriate conduction of auditory pathways to the brainstem and impaired identification of sounds in the presence of noise, demonstrating that tinnitus can have repercussions on central auditory skills. (AU)

Introducción: El tinnitus es una ilusión auditiva consciente, una sensación de sonido no relacionada con una fuente externa de estimulación. Objetivos: Caracterizar la coincidencia de tono y volumen, el umbral de enmascaramiento diferencial, el inventario de minusvalía para acúfenos y el potencial auditivo del tronco encefálico en adultos normoyentes con acúfenos, con el fin de comparar sus hallazgos. Método:Veinte sujetos masculinos y femeninos, con edades entre 20 y 60 años, audición normal con tinnitus, fueron sometidos a acúfenos, Umbral de Enmascaramiento Diferencial, Inventario de Desventajas de Tinnitus y Potenciales Evocados Auditivos del Tronco Encefalico. Resultados: La combinación de tono y volumen reveló que el tono promedio era de 4,3 KHz en el oído derecho y de 4,6 KHz en el oído izquierdo. Mientras que el volumen medio fue de 21,7 dBNS para el oído derecho y de 23,5 dBNS para el oído izquierdo. Se modificó el umbral diferencial de enmascaramiento promedio. El Inventario de Desventajas de Tinnitus promedio correspondió a la clasificación de grado leve. El Potenciales Evocados Auditivos del Tronco Encefalico presentó parámetros dentro del rango normal bilateralmente. Conclusión:Se encontró que los adultos normooyentes con quejas de tinnitus presentan tinnitus de tono alto bilateral con leve impacto en la calidad de vida, conducción adecuada de las vías auditivas al tronco encefálico y deterioro en la identificación de sonidos en presencia de ruido, demostrando que Tinnitus puede tener repercusiones en las habilidades auditivas centrales. (AU)

Potenciais evocados auditivos de tronco encefálico em indivíduos com doença de Parkinson: revisão de literatura / Brainstem auditory evoked potentials in individuals with Parkinson's disease: literature review

Objetivo: investigar a integridade da via auditiva por meio do Potencial Evocado Auditivo de Tronco Encefálico (PEATE) em indivíduos com Doença de Parkinson (DP) por meio de uma revisão integrativa da literatura. Métodos: foram utilizadas as bases de dados Embase, Google acadêmico, Scielo, bem como o portal eletrônico completo da Biblioteca Virtual da Saúde, com os seguintes descritores: DP (Parkinson Disease ou Parkinsonian Disorders) e PEATE (Evoked Potentials, Auditory, Brain Stem ou Evoked Potentials, Auditory). Foram selecionados artigos nacionais e internacionais, sem limitação de ano ou idioma. Os estudos foram descritos e analisados qualitativamente e quantitativamente quanto à latência absoluta e à amplitude das ondas I, III e V, e quanto aos interpicos I-III, III-V e I-V. Resultados: após exclusão dos títulos repetidos, 420 artigos foram encontrados, sendo que 17 atenderam aos critérios de inclusão. Nos resultados do PEATE, estudos descreveram o aumento da latência de todas as ondas, principalmente das ondas III e V e, também, aumento dos interpicos I-V e III-V. Conclusão: indivíduos com DP apresentam neurodegeneração das vias auditivas centrais com diminuição na velocidade de transmissão neural do estímulo acústico.

Purpose: investigate the integrity of the auditory pathway through the Brainstem Auditory Evoked Potential (BAEP) in individuals with Parkinson's Disease (PD) through an integrative literature review. Methods: Embase, Academic Google, Scielo databases were used, as well as the complete electronic portal of the Virtual Health Library, with the following descriptors: PD (Parkinson Disease or Parkinsonian Disorders) and BAEP (Evoked Potentials, Auditory, Brain Stem or Evoked Potentials, Auditory). National and international articles were selected, without limitation of year or language. The studies were described and analyzed qualitatively and quantitatively regarding the absolute latency and amplitude of waves I, III and V, and regarding the interpeaks I-III, III-V and I-V. Results: After excluding repeated titles, 420 articles were found, however only 17 met the inclusion criteria. In the ABR results, studies described the increase in latency of all waves, especially waves III and V, and also an increase in interpeaks I-V and III-V. Conclusion: individuals with PD present neurodegeneration of the central auditory pathways with a decrease in the neural transmission speed of the acoustic stimulus.

Brainstem auditory evoked potentials at high stimulation rates and posterior circulation ischemia / 中风与神经疾病杂志

@#Posterior circulation ischemia is an ischemic cerebrovascular disease frequently seen in clinical practice，which includes transient ischemic attack and cerebral infarction of the posterior circulation. The clinical manifestations of patients with posterior circulation infarction are complex and varied，and diagnosis is mainly based on clinical manifestations and imaging. Transient ischemic attacks in the posterior circulation have neither obvious positive signs nor typical imaging manifestations during the interictal period，making the diagnosis difficult. Brainstem auditory evoked potentials reflect the electrophysiological functioning of the auditory nerves and brainstem auditory conduction pathway. The use of brainstem auditory evoked potentials，especially brainstem auditory evoked potentials at high stimulation rates，in diagnosing posterior circulation ischemia expands and enriches diagnostic methods，which is of great significance for the early diagnosis of the disease. However，there are still many problems worth considering.

A case of MOG-IgG-associated brainstem encephalitis originating from hunt syndrome / 中风与神经疾病杂志

@#Objective To improve clinicians' understanding of myelin oligodendrocyte glycoprotein-immunoglobulin G （MOG-IgG）-associated isolated brainstem encephalitis. Methods The clinical data of one case of MOG-IgG-associated brainstem encephalitis with Hunt syndrome were collected and retrospectively analyzed， and the relevant literature was searched， summarized， and discussed. Results The patient was a 24-year-old female who was admitted to the hospital mainly for more than 20 days of dizziness and incomplete left eyelid closure. After admission， she frequently suffered from intractable nausea and vomiting. After completing the examinations of head magnetic resonance， lumbar puncture， and electroneurography， and finding of positive serum MOG-IgG， she was diagnosed as having MOG-IgG-associated brainstem encephalitis. She was given methylprednisolone pulse therapy. The patient's symptoms were significantly relieved and did not recur. Conclusion MOG-IgG-associated isolated brainstem encephalitis is relatively rare in clinic， and its clinical manifestations are diverse. In this case， the lesion is relatively limited， and the symptoms are mild. Missed diagnosis and misdiagnosis easily occur. This case can improve clinicians' understanding of this disease， and provide a theoretical basis for timely treatment and good prognosis.

Difference of clinical characteristics and risk factors between young patients and senior patients with spontaneous brainstem hemorrhage / 中风与神经疾病杂志

@#Objective This study aimed to analyze the difference of clinical characteristics and risk factors for poor outcome between young patients and senior patients with spontaneous brainstem hemorrhage. Methods This was a retrospective study.The patients with spontaneous brainstem hemorrhage who presented to the Nanjing Drum Tower Hospital from January 2013 to January 2021 were enrolled in this study.They were divided into two groups:Youth group (18-59 years old) and Senior group (60-90 years old).General information and clinical data were collected.Univariate analysis was used to compare the clinical characteristics of the two groups,and multivariate logistic regression was used to analyze the independent risk factors for poor prognosis. Results A total of 202 eligible patients were enrolled in this study,including 136 patients in the Youth group and 66 patients in the Senior group.Univariate analysis of the clinical data from the two groups demonstrated that the prevalence of poor outcome,the proportion of male patients,coma on admission,surgery operation,complicated pneumonia and the average NIHSS score,volume of hematoma,DBP,TG were significantly higher in the Youth group than the Senior group (P<0.05).The average GCS score was remarkably lower in the Youth group(P<0.05).Early coma,low GCS score,high NIHSS score,large volume of hematoma,poor glycemic control,complicated pneumonia and Acinetobacter baumannii infection were risk factors for poor prognosis of both group.Multivariate logistic regression showed that low GCS score was an independent predictor for poor prognosis of both group. Conclusion Young patients with spontaneous brainstem hemorrhage had worse prognosis than elderly patients.Avoiding or effective control of risk factors might ameliorate the final outcome.

Clinical study of microsurgical treatment of pontine hemorrhage with retrosigmoid approach from the cer-ebellopontine angle / 中国神经精神疾病杂志

Objective To explore the efficacy of the retrosigmoid sinus approach through the cerebellopontine angle in the treatment of pontine hemorrhage.Methods A retrospective analysis was performed on 108 patients with pontine hemorrhage in Kaifeng Central Hospital from January 2016 to June 2022.They were divided into two groups according to the treatment methods,the conservative treatment group and the craniotomy treatment group(transcerebellopontine angle sigmoid sinus posterior approach).There were 94 cases in the conservative treatment group and 14 cases in the surgical treatment group.First analysis was conducted to examined whether there are differences in gender,age,Glasgow Coma Score(GCS)on admission,bleeding volume,comorbidities and complications between the two groups.Additional analysis was performed to analyze modified Rankin(modified Rankin scale,mRS)score and mortality rate after three month follow-up in case there was no significant difference at first analysis.Results There were no statistical differences in gender,age,Glasgow Coma Score(GCS)on admission,bleeding volume,comorbidities and complications between the two groups.After 3 months of follow-up,49 patients died in the conservative treatment group and 3 patients in the craniotomy treatment group.The mortality rates of the two groups were 52.1％and 21.4％respectively(χ2=4.600,P<0.05)).There was a statistical difference in the mortality rate between the two groups,and the mortality rate of the craniotomy treatment group was significantly lower than that of the conservative group.The modified Rankin score was 4(3,5)in the conservative treatment group and 3(2,3)in the craniotomy group(Z=-2.994,P<0.01).The modified Rankin score in the craniotomy group was lower than that in conservative treatment group after 3 months.Conclusion Microsurgery through the cerebellopontine angle retrosigmoid sinus approach to treat pontine hemorrhage can significantly reduce patient mortality and improve prognosis and is an effective surgical treatment method.

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.

Effects of transcranial magnetic stimulation on the swallowing and brain-stem auditory evoked potentials of dysphagic stroke survivors / 中华物理医学与康复杂志

Objective:To observe any effects of contralateral repeated transcranial magnetic stimulation (rTMS) of the swallowing motor cortex on the swallowing and brainstem auditory evoked potentials (BAEPs) of stroke survivors with dysphagia.Methods:A total of 83 stroke survivors with dysphagia were randomly divided into an ipsilesional stimulation group ( n=22), a contralesional stimulation group ( n=21), a bilateral stimulation group ( n=20), and a control group ( n=20). In addition to their conventional dysphagia training, those in the three stimulation groups received 3Hz rTMS while the control group was given fake stimulation. The treatment was administered daily for 20 minutes, 6 days a week, for 5 consecutive weeks. Before and after the treatment, swallowing function was assessed videofluoroscopically and using the Dysphagia Outcome and Severity Scale (DOSS). The oral and pharyngeal stages of swallowing were evaluated using the videofluoroscopic dysphagia scale (VDS). Brain stem conduction was assessed using BAEPs. Results:After treatment the average DOSS scores of all 4 groups were significantly better than before the treatment. The average DOSS scores of the contralesional and bilateral sti-mulation groups were then significantly better than those of the other two groups. The sub-item and total VDS scores of all 4 groups had decreased significantly, but the average score of the bilateral stimulation group was significantly lower than the control group′s average. Ipsilesional stimulation significantly improved the VDS sub-item scores for the triggering of pharyngeal swallowing, laryngeal elevation, and pharyngeal transit time compared with the control group. In the contralesional stimulation group the average total score and the VDS sub-item scores for apraxia, premature bolus loss, oral transit times, the triggering of pharyngeal swallowing, vallecular residue, laryngeal elevation, coating on the pharyngeal wall, and pharyngeal transit time were significantly lower than those of the control group, on average. After the treatment the latencies of BAEP waves I, III and V and the I-III, III-V and I-V interpeak intervals had decreased significantly in all four groups, but the average latencies and intervals of the bilateral and contralesional groups were significantly shorter than those of the control group. The latencies and intervals of the bilateral stimulation group were then significantly shorter than those in the ipsilesional stimulation group on average. The average latency of wave V in the bilateral stimulation group (6.53±0.73ms) was significantly shorter than that in the contralesional stimulation group after the treatment.Conclusion:Bilateral rTMS over the swallowing motor cortex combined with conventional dysphagia training can significantly improve the swallowing of dysphagic stroke survivors.

Endoscopic botulinum toxin injection combined with balloon dilatation for treatment of cricopharyngeal achalasia in patient with brainstem stroke / 中南大学学报(医学版)

OBJECTIVES@#At present, there are many reports about the treatment of cricopharyngeal achalasia by injecting botulinum toxin type A (BTX-A) into cricopharyngeal muscle guided by ultrasound, electromyography or CT in China, but there is no report about injecting BTX-A into cricopharyngeal muscle guided by endoscope. This study aims to evaluate the efficacy of endoscopic BTX-A injection combined with balloon dilatation in the treatment of cricopharyngeal achalasia after brainstem stroke, and to provide a better method for the treatment of dysphagia after brainstem stroke.@*METHODS@#From June to December 2022, 30 patients with cricopharyngeal achalasia due to brainstem stroke were selected from the Department of Rehabilitation Medicine, the First Hospital of Changsha. They were randomly assigned into a control group and a combined group, 15 patients in each group. Patients in both groups were treated with routine rehabilitation therapy, while patients in the control group were treated with balloon dilatation, and patients in the combined group were treated with balloon dilatation and BTX-A injection. Before treatment and after 2 weeks of treatment, the patients were examined by video fluoroscopic swallowing study, Penetration-aspiration Scale (PAS), Dysphagia Outcome Severity Scale (DOSS), and Functional Oral Intake Scale (FOIS) were used to assess the swallowing function.@*RESULTS@#In the combined group, 1 patient withdrew from the treatment because of personal reasons. Two weeks after treatment, the scores of DOSS, PAS, and FOIS in both groups were better than those before treatment (all P<0.01), and the combined group was better than the control group (all P<0.001). The effective rate was 85.7% in the combined group and 66.7% in the control group, with no significant difference between the 2 groups (P>0.05).@*CONCLUSIONS@#BTX-A injection combined with balloon dilatation is more effective than balloon dilatation alone in improving swallowing function and is worthy of clinical application.

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.

The effect of increase in blood glucose level on hearing loss

Abstract Objective: Previous studies have shown that hearing function is also vulnerable to the effects of diabetes mellitus which can be shown by brainstem auditory evoked potential and distortion product otoacoustic emission recordings. This study aimed to investigate the changes of brainstem auditory evoked potential and distortion product otoacoustic emission in hyperglycemia and whether there is a relationship between reactive oxygen substances production and hearing deterioration in the rat model. Methods: 25 streptozotocin induced diabetic rats were divided into three groups: control, high blood glucose, and diabetes mellitus. Brainstem auditory evoked potential and distortion product otoacoustic emission were recorded, and thiobarbituric acid reactive substances levels were measured in the brainstem tissue. Results: At 8 kHz, the latencies of I, II, III, IV, and V brainstem auditory evoked potential waves in high blood glucose and diabetes mellitus groups were elongated, at 16 kHz, only these wave latencies of the diabetes mellitus group were prolonged compared with the control group. A significant decrease was also found in distortion product otoacoustic emission amplitudes at 4, 6, 8, and 10 kHz in the high blood glucose and diabetes mellitus groups compared to the control group. There was a significant increase in thiobarbituric acid reactive substances values due to the increase in blood glucose levels in the high blood glucose and diabetes mellitus groups compared to the control group. Conclusion: These results suggested that high blood glucose levels may cause hearing impairment not only in the diabetic state but also in the period of hyperglycemia before the onset of manifest diabetes mellitus and reactive oxygen substances may play an important role in the pathophysiology of diabetes mellitus. We suggest that regulating high glucose levels even before the onset of manifest diabetes mellitus may prevent hazardous effects on hearing function. Level of evidence: Level 3.

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.