ABSTRACT
OBJECTIVES: This study aims to compare the electrical auditory brainstem response (EABR) following cochlear implant (CI) surgery in pediatric subjects with cochlear malformation and a normal cochlea, in order to assess the sensitivity of EABR and to evaluate the surgery outcome. MATERIALS AND METHODS: A total of 26 pediatric subjects who were deaf and scheduled for CI surgery were enrolled into this case control study. Group A (n=20) included subjects with a normo-conformed cochlea. Group B (n=6) included subjects with cochlear malformation. Subjects were evaluated with EABR immediately (T0) and 6 months (T1) post-CI surgery. The EABR Waves III and V average amplitude and latency were compared across time, separately for each group, and across groups, separately for each time. RESULTS: Auditory brainstem response (ABR) could only be recorded in Group A. We were able to record EABR from all subjects at T0 and T1, and waves III and V were present in all the recorded signals. There were no statistically significant differences between T0 and T1 in EABR Waves III and V in terms of average amplitude and latency in neither group. When comparing Groups A and B, the only statistically significant difference was the average amplitude of wave V, both at T0 and T1. CONCLUSION: EABR is a valid tool to measure the auditory nerve integrity after CI surgery in patients with a normal and malformed cochlea, as shown by its ability to measure waves III and V when ABR is absent. The EABR testing should be performed before and after CI surgery, and EABR should be used as a measure of outcome, especially in patients with a malformed cochlea.
Subject(s)
Cochlea/abnormalities , Cochlear Implants , Evoked Potentials, Auditory, Brain Stem/physiology , Case-Control Studies , Child, Preschool , Cochlea/surgery , Cochlear Nerve/physiology , Deafness/physiopathology , Deafness/surgery , Female , Humans , Infant , Magnetic Resonance Imaging , Male , Otoacoustic Emissions, Spontaneous/physiology , Postoperative Complications/physiopathology , Reaction Time/physiology , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: An elective investigation into the early diagnosis of deafness in children under the age of 4-5 years is performed using auditory evoked potentials of auditory brainstem responses (ABRs). In case of pediatric patients, the major difficulty includes being examined during spontaneous sleep, which is complicated to obtain, especially in the age range of 12 to 72 months. Recently, melatonin has been used as a "sleep inducer" in diagnostic tests with positive results. Our aim was to evaluate the use of melatonin and of a solution containing melatonin, tryptophan, and vitamin B6 as an inducer of spontaneous sleep on repeated ABR analyses as well as to evaluate the reduction in analyses with sedative drugs in case of uncooperative patients. MATERIALS AND METHODS: In total, 748 children aged between 12 and 48 months were included in the study and divided into three groups: A: placebo (n=235), B: melatonin (n=246), and C: melatonin, tryptophan, and vitamin B6 (n=267). RESULTS: In groups B and C, in addition to physiological awakening, we observed a significant reduction in the number of repeated analyses as well as drug regimen usage. CONCLUSION: This study confirms the strategic role of melatonin as an inducer of spontaneous sleep. However, above all, it suggests that the administration of a solution containing melatonin, tryptophan, and vitamin B6 significantly reduces the number of repeated ABR examinations as well as the percentage of repeated analysis performed using sedative drugs compared to both the control group and the melatonin-only group.
