A cotton wick improves hearing in a patient with profound hearing loss

@#Dear Editor, The tympanic membrane and the ossicular chain contribute roughly 28 dB in hearing gain. In chronic suppurative otitis media, loss of tympanic membrane and lysis of the ossicular chain are significant causes of hearing loss.1 Through the years, hearing impairment has been augmented using various devices such as ear trumpets, carbon hearing aids, vacuum tube and transistor hearing aids, bone anchored hearing aids, and cochlear implants.2 This case report describes how a cotton wick was used to amplify sound.

Auditory steady state response (ASSR) frequency-specific thresholds with absent auditory brainstem response (click-ABR) test results among Filipino children

@#OBJECTIVE: Determine the frequency-specific thresholds of auditory steady state response (ASSR) of Filipino children with absent auditory brainstem response (click-ABR) results.METHODS: This is a cross-sectional study analyzing the frequency-specific thresholds of auditory steady state response (ASSR) of Filipino children with absent auditory brainstem response (click-ABR) results. The study population comprised of 99 pediatric patients referred for hearing assessment using electrophysiologic techniques at the Ear Unit of the Philippine General Hospital. The subjects underwent hearing threshold evaluation using both evoked-potential techniques (click ABR and ASSR) within a one-month period from January 2009 to March 2014. The ASSR results of patients with absent click-ABR were collected and analyzed.RESULTS: There were 99 patients who underwent both ABR and ASSR. Of the 65 patients with absent ABR thresholds results, 13 patients had unilateral absent ABR while 52 had bilateral absent ABR results. The data of hearing tests from the combined 117 ears with absent ABR hearing tests were collected. The proportion of children with ASSR thresholds with absent ABR per frequency were -500 Hz- 45/117 (38.5%); -1000 Hz- 76/117 (64.0%); -2000 Hz- 63/117 (53.8%); and -4000 Hz- 41/117 (35.0%). The proportion of children with ASSR thresholds with absent ABR per number of frequencies were: -4 frequencies- 19/117 (16.2%); -3 frequencies- 32/117 (27.4%); -2 frequencies- 22/117 (18.8%); and -1 frequency- 44/117 (37.6%)CONCLUSION: In the absence of click- ABR response, ASSR may provide information about the levels of severe to profound hearing loss among children. The criteria of selection of candidates for intervention (hearing aids or cochlear implantation) should include results from hearing evaluation not only from behavioral and ABR thresholds but also from ASSR thresholds. This may ensure that exclusion of some children with severe and profound hearing loss who may benefit from the intervention will be minimized.