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.

Applicability of Evoked Auditory Brainstem Responses with Complex Stimuli in Adults with Hearing Loss

Abstract Introduction The use of the speech-evoked auditory brainstem response (ABR) shows how the brainstem operates up to the subcortex in a more complexmanner than when the click-evoked ABR is used. Objective To study the applicability of the speech-evoked ABR in adults with hearing loss. Methods The sample was composed of a study group of 11 subjects, with ages ranging between 18 and 59 years, and auditory thresholds within normal standards, with loss of up to 65 dB at high frequencies or up to moderately severe symmetric sensorineural hearing loss. The sample underwent a basic audiological assessment, as well as speech-evoked ABR and click-evoked ABR, in which waves I, III and V, and V, A, C, D, E, F were respectively marked. The electrophysiological assessments were performed using the SmartEP device (Intelligent Hearing Systems, Miami, FL, US). Results For the speech-evoked ABR, the reference values were used in the identification and analysis of the study group. Those values found for the study group were: V = 8.56; A = 10.97; C = 21.33; D = 29.51; E = 37.93; F = 46.96; and O = 55.97. In the comparison between groups, the study group presented an increase in latency only in wave C. Conclusion The speech-evoked ABR can be performed in subjects with up to moderately severe hearing loss, and the test proved to be appropriate, because, unlike the click-evoked ABR, the former does not suffer influence of peripheral hearing loss.

Evaluation of Brainstem Auditory Evoked Response (BAER) in Parkinson’s Disease

Background: Parkinson’s disease (PD) is a progressive long-term, neurodegenerative disorder of central nervous system which mainly affects the motor system, caused by loss of dopaminergic neurons in the substantia nigra, but also in other dopaminergic and non-dopaminergic areas of the brain and mainly in the brainstem. Brainstem Auditory Evoked Response are routinely used in clinical practice to evaluate the function of the auditory nerve and auditory pathways in the brainstem. Objective: The aim of this study was to evaluate the Brainstem Auditory Evoked Response in patients with Parkinson’s disease. Methods30 subjects (18 males and 12females) with Parkinson’s disease. And same number of healthy age-matched subject control group was assessed. Age of Control Group was 61.2±11.6 & of Test Group 61.7±10.4. A complete & detailed neurological examination (CNS) were performed in all individuals clinically especially of motor system to evaluate the severity of the disease for the occurrence of Parkinson’s disease. Recordings of BAERs were performed with Neurostim Plus software of Medicaid Company, using 70 dB HL in the form of rarefaction clicks were used in each ear obtain good quality BAER recording. Results. The BAER results were interpreted for the latencies and Interpeak latencies. The result of this study shows that the waves II, III, IV, V and IPL III-V were significantly delayed. Conclusion. Parkinson’s disease population showed significant differences to Brainstem Auditory Evoked Response

Study of brainstem auditory evoked response in type 2 diabetes mellitus.

Background: Diabetes is a major cause of morbidity and among its complications neuropathies are the most common. Diabetes may alter both the central and peripheral nerve functions but the peripheral manifestations of diabetic neuropathy are more frequently discussed in the literature than the impairment of central nervous system. Objective: To study the Brainstem Auditory Evoked Response (BAER) in 30 type 2 diabetes mellitus patients and compared to age and sex matched 30 non diabetic group. Methods: 30 Type 2 diabetics and 30 age and sex matched control group were selected and subjected to BAER. Duration of latencies, interpeak latencies and amplitudes were recorded. Results: According to BAER report, Left side latencies III , both left and right IPL III – V , right side ampliude V decreased with p > 0.05 in type 2 DM compared to control group . Conclusion: The study showed bilateral changes in BAER report in type 2 DM. This indicates use of evoked potentials like BAER helps in evaluating central neuropathy in patients with type2 DM. Earlier diagnosis of central neuropathy is recommended for proper management.

Comparison between Pure Tone Audiometry and Auditory Steady-State Responses in Korean Children and Adult / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Assessing accurate audiometry might be an important index treating patients with hearing loss. So far there have been no studies on analysis of correlations between pure tone audiometry (PTA) and auditory steady-state response (ASSR) for children in Korea. We analyzed correlations between PTA and ASSR in order to investigate the usefulness of ASSR. SUBJECTS AND METHOD: Past medical records were retrieved from the patients who visited Department of Otolaryngology at Tertiary Referral Hospital from January 2012 to December 2012 and underwent the correlation study between ASSR and PTA with a correlation analysis of frequency. The participants over the age of 15 were classified into the adult group and those below in the children group. RESULTS: There was a statistically significant correlation between the average hearing threshold of ASSR and PTA (correlation coefficient=0.934). There was a strong correlation between children and adult group, too. With the frequency range of 500, 1000, 2000, and 4000 Hz, the correlation coefficients were 0.875, 0.896, 0.915, and 0.900, respectively. The degree of hearing loss was classified by using PTA follows: below 25 dB as normal; between 26-55 dB as moderate hearing loss; above 56 dB as severe hearing loss. Correlation coefficients for the above hearing ranges were 0.527, 0.670, and 0.744, respectively. Strong correlation was found between children and adult group, too. CONCLUSION: The comparison results between the average hearing threshold of ASSR and PTA indicated that the threshold of ASSR could well reflect the results of both children and adult group.

Correlação dos achados do PEATE-FE e da avaliação comportamental em crianças com deficiência auditiva / Correlation between frequency-specific auditory brainstem responses and behavioral hearing assessment in children with hearing loss

OBJETIVO: analisar e correlacionar os achados dos Potenciais Evocados Auditivos de Tronco Encefáico por Frequência Específica e da avaliação comportamental, por Via aérea e Via óssea, em crianças com perda auditiva sensorioneural ou mista. MÉTODO: a casuística foi composta por dez crianças com até três anos de idade, diagnosticadas com perda auditiva sensorioneural. Foram realizados os PEATE-FE nas frequências de 0.5, 1, 2 e 4 kHz e a audiometria comportamental nas mesmas frequências, tanto por via aérea como por via óssea. Os resultados dos dois procedimentos foram correlacionados afim de verificar se o PEATE-FE é capaz de predizer o status auditivo de crianças com deficiência auditiva. RESULTADOS: os resultados mostraram forte correlação entre os dois procedimento nas quatro frequências estudadas por via aérea; já na via óssea, foi encontrada forte correlação nas frequências de 0.5, 1 e 2 kHz e moderada em 4 kHz. CONCLUSÃO: os PEATE-FE estimaram a audição com forte precisão quando comparados à audiometria comportamental. Desta forma, a aplicação dos PEATE-FE possibilita a estimativa da audição até que possam ser determinados, com segurança, os limiares comportamentais na população estudada.

PURPOSE: analyze and correlate the findings of the frequency specific auditory brainstem response and behavioral assessment by air and bone conduction in children with sensorineural hearing loss or mixed hearing loss. METHOD: the sample was composed of ten children up to three years old, diagnosed with sensorineural hearing loss. We conducted the FS-ABR in the frequencies of 0.5, 1, 2 and 4 kHz and behavioral audiometry in the same frequencies, by air and bone conduction. The results of both procedures were correlated in order to verify if the FS-ABR is able to predict auditory status of children with hearing impairment. RESULTS: it was observed a strong correlation between the two procedures in the four frequencies studied by air conduction; for bone conduction, found a strong correlation was found in the frequencies of 0.5, 1 and 2 kHz and a moderate correlation at 4 kHz. CONCLUSION: FS-ABR estimated the hearing with strong accuracy when compared to behavioral audiometry. Thus, the application of FS-ABR enables the estimation of hearing status until they can be determined by behavioral hearing tests in the population studied.

Effect of Hyperbilirubinemia on the Brainstem Auditory Evoked Response in Newborn Piglets

PURPOSE: We sought to know the effect of hyperbilirubinemia on brainstem auditory evoked response in newborn piglets. METHODS: To achieve the concentration of bilirubin above 20 mg/dL, we injected a bolus of 50 mg/kg of bilirubin intravenously over 30 minutes, followed by 30-40 mg/kg/ hr of bilirubin continuous intravenous infusion to 10 newborn piglets. Brainstem auditory evoked responses were obtained from these piglets at baseline, 1 hour, 2 hours, 3 hours and 4 hours after the exposure to hyperbilirubinemia. RESULTS: The mean amplitude of wave V was 0.33+/-0.03 microV at baseline, 0.32+/-0.04 microV at 1 hour, 0.33+/-0.05 microV at 2 hours, 0.23+/-0.04 microV at 3 hours and 0.26+/-0.05 microV at 4 hours of experiment and began to decrease after 3 hours of the exposure to hyperbilirubinemia. The latency of wave III was 4.06+/-0.08 ms at baseline, 3.95+/-0.09 ms at 1 hour, 4.05+/-0.10 ms at 2 hours, 4.05+/-0.09 ms at 3 hours, 4.12+/-0.11 ms at 4 hours of experiment and began to increase after 1 hour of the exposure to hyperbilirubinemia. CONCLUSION: Hyperbilirubinemia decreased the amplitude of wave V and increased the latency of wave III of brainstem auditory evoked responses in newborn piglets.

Comparison of Brainstem Auditory Evoked Response in Normal Infants, Male and Female, Right and Left Ear

PURPOSE: Brainstem auditory evoked response(BAER) is used as screening test for hearing disorders, damages of the central nervous system and congenital anomalies. We studied the difference values according to gender and stimulation sites in normal full-term infants. METHODS: We performed BAER in 38 male and 28 female normal full-term infants, delivered in the Gil Medical Center, Gachen Medical School, from March to July 1996, aged one to seven days. Amplitude I, V, V/I and latency I, III, V and interpeak latency(IPL) I-III, III-V, I-V were measured at 90, 60, 45, 30 dB. Data were analyzed between both sex and between both ears with Student t-test. RESULTS: There were no significant difference in male and female group with the same side's stimulation. At 90 dB, amplitude I of left ear stimulation was significantly higher than right in male and female. Amplitude V/I of right ear stimulation was significantly higher than left ear stimulation in total only. At 90 dB, latency I of right was significantly longer than left in male and female. Latency III of right was longer significantly in total only. IPL I-III, I-V was significantly longer in left than right in male and total. At 60 dB intensity, all data except latency I in total, showed no significant difference. CONCLUSIONS: Interpreting BAER, stimulation site and intensity should be considered. and further studies will be needed for the evaluation of the difference between left and right ear.