Brainstem auditory evoked potential combined with high resolution cranial base CT can optimize the diagnosis of auditory nerve injury.

PURPOSE: Auditory nerve injury is one of the most common nerve injury complications of skull base fractures. However, there is currently a lack of auxiliary examination methods for its direct diagnosis. The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury. METHODS: Through retrospectively analyzing the results of brainstem auditory evoked potential (BAEP) and high-resolution CT (HRCT) in 37 patients with hearing impairment following trauma from January 1, 2018 to July 31, 2020, the role of the two inspection methods in the diagnosis of auditory nerve injury was studied. Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma; while exclusion criteria were: (1) severe patient with a Glasgow coma scale score ≤5 because these patients were classified as severe head injury and admitted to the intensive care unit, (2) patient in the subacute stage admitted 72 h after trauma, and (3) patient with prior hearing impairment before trauma. According to Goodman's classification of hearing impairment, the patients were divided into low/medium/severe injury groups. In addition, patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results. The positive rates of BEAP for each group were observed, and the results were analyzed by Chi-square test (p < 0.05, regarded as statistical difference). RESULTS: A total of 37 patients were included, including 21 males and 16 females. All of them were hospitalized patients with GCS score of 6-15 at the time of admission. The BAEP positive rate in the medium and severe injury group was 100%, which was significantly higher than that in the low injury group (27.27%) (p < 0.01). The rate of BEAP positivity was significantly higher in the HRCT-positive group (20/30, 66.7%) than in the HRCT-negative group (1/7, 14.3%) (p < 0.05). Twenty patients (54.05%) were both positive for BEAP and HRCT test, and considered to have auditory nerve damage. Six patients (16.22%) were both negative for BEAP and HRCT test, and 10 patients (27.03%) were BAEP-negative but HRCT-positive: all the 16 patients were considered as non-neurological injury. The rest 1 case (2.70%) was BAEP-positive but HRCT-negative, which we speculate may have auditory nerve concussion. CONCLUSION: By way of BAEP combining with skull base HRCT, we may improve the accuracy of the diagnosis of auditory nerve injury. Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.

Diagnostic accuracy of intraoperative brainstem auditory evoked potential for predicting hearing loss after vestibular schwannoma surgery.

Objective: This meta-analysis evaluated the diagnostic value of intraoperative brainstem auditory evoked potential (BAEP) for predicting post-operative hearing loss. Methods: Research articles in MEDLINE, Embase, and Cochrane Library databases were searched and selected up to 20 January 2022, and data were extracted following a standard procedure. A diagnostic accuracy test meta-analysis was performed using a mixed-effect binary regression model. Results: A total of 693 patients from 15 studies were extracted. The change in intraoperative BAEP showed high sensitivity (0.95) but low specificity (0.37), with an area under the curve of 0.83. Diagnostic accuracy of the loss of potentials showed high sensitivity (0.82) and specificity (0.79). The area under the curve was 0.88. No factor was found to account for the heterogeneity of the results according to the meta-regression and subgroup analyses (all P-values > 0.05). Conclusions: Our results showed that the loss of BAEP has meaningful value for predicting hearing loss after vestibular schwannoma surgery. The change in BAEP is also important for its high sensitivity during hearing preservation surgery.

Brainstem auditory evoked potential combined with high resolution cranial base CT can optimize the diagnosis of auditory nerve injury / 中华创伤杂志(英文版)

PURPOSE@#Auditory nerve injury is one of the most common nerve injury complications of skull base fractures. However, there is currently a lack of auxiliary examination methods for its direct diagnosis. The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.@*METHODS@#Through retrospectively analyzing the results of brainstem auditory evoked potential (BAEP) and high-resolution CT (HRCT) in 37 patients with hearing impairment following trauma from January 1, 2018 to July 31, 2020, the role of the two inspection methods in the diagnosis of auditory nerve injury was studied. Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma; while exclusion criteria were: (1) severe patient with a Glasgow coma scale score ≤5 because these patients were classified as severe head injury and admitted to the intensive care unit, (2) patient in the subacute stage admitted 72 h after trauma, and (3) patient with prior hearing impairment before trauma. According to Goodman's classification of hearing impairment, the patients were divided into low/medium/severe injury groups. In addition, patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results. The positive rates of BEAP for each group were observed, and the results were analyzed by Chi-square test (p < 0.05, regarded as statistical difference).@*RESULTS@#A total of 37 patients were included, including 21 males and 16 females. All of them were hospitalized patients with GCS score of 6-15 at the time of admission. The BAEP positive rate in the medium and severe injury group was 100%, which was significantly higher than that in the low injury group (27.27%) (p < 0.01). The rate of BEAP positivity was significantly higher in the HRCT-positive group (20/30, 66.7%) than in the HRCT-negative group (1/7, 14.3%) (p < 0.05). Twenty patients (54.05%) were both positive for BEAP and HRCT test, and considered to have auditory nerve damage. Six patients (16.22%) were both negative for BEAP and HRCT test, and 10 patients (27.03%) were BAEP-negative but HRCT-positive: all the 16 patients were considered as non-neurological injury. The rest 1 case (2.70%) was BAEP-positive but HRCT-negative, which we speculate may have auditory nerve concussion.@*CONCLUSION@#By way of BAEP combining with skull base HRCT, we may improve the accuracy of the diagnosis of auditory nerve injury. Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.

Brainstem evoked potential in newly diagnosed patients of subclinical hypothyroidism.

BACKGROUND: Hypothyroidism is known to be associated with impairment of hearing. The hearing impairment may be conductive, sensorineural, or mixed. AIMS: The aim is to assess the auditory pathway by brainstem auditory evoked potentials (BAEPs) in newly diagnosed patients of subclinical hypothyroidism and healthy sex- and age-matched controls. MATERIALS AND METHODS: The study included 25 healthy sex- and age-matched controls (Group I) and 25 patients of newly diagnosed subclinical hypothyroidism (Group II). The recording was taken by using RMS EMG EP MK2 equipment. The unpaired Student's t-test was used and a P value <0.05 was considered significant. RESULTS: Wave V of right ear BAEP in group II was prolonged (6 ± 0.62 ms) compared to group I (5.49 ± 0.26 ms), and wave V of left ear BAEP in group II was prolonged (5.84 ± 0.57 ms) compared to group I (5.47 ± 0.35 ms). There was no significant coefficient of correlation between wave V and inter-peak latency (IPL) I-V compared to thyroid-stimulating hormone (TSH) levels of both the ears. CONCLUSION: The prolongation of wave V in BAEPs of both ears suggests that the central auditory pathway is affected significantly in subclinical hypothyroid patients.

The Role of Brainstem Auditory Evoked Potential in the Diagnosis of Cerebral Concussion / 医学研究杂志

Objective To observe the change of brainstem auditory evoked potential(BAEP)of cerebral concussion patients.Methods The results of BAEP of 60 patients with cerebral concussion were analyzed and were compared with the results of CT test.Results Among the results of 60 cases of cerebral concussion,the abnormal rate of BAEP was 83%;the abnormal rate of CT test results was 21%.Conclusion BAEP is of great value in the early diagnosis of cerebral concussion and in the efficient evaluation of the function of brain stem.

Effects of Early Intervention on Functional Outcome and NGF in Brain of Rats with Brain Damage / 中国心理卫生杂志

Objective: To explore the effects of early intervention on functional outcome and the repair mechanisms in rats with hypoxic-ischemic brain damage (HIBD). Methods: A HIBD rat model was established by ligating either uterine vessel of one pregnant horn. The way of intervention was the neonatal handling and enriched environment. One trial passive avoidance response, brainstem auditory evoked potential (BAEP) and NGF levels in the brain were used as assessment index. Results:(1) In the one trial passive avoidance response test, the medial step-through latency (STL) of intervention group (n=18) was much longer than that of non-intervention group (n=15) (P

Determination of Follow-up Time of Abnormal Brainstem Auditory Evoked Potential in Infancy

OBJECTIVE: To determine optimal follow-up time of BAEP for the infants with abnormal BAEP at the initial screening test. METHOD: Control group consisted of 85 infants with normal BAEP and experimental group consisted of 41 infants with abnormal BAEP at the first examination but normalized on regular follow-up examinations. Gestational age (correctional age), intrauterine period, birth weight, delivery method, presence of perinatal asphyxia, Apgar score after 1 minute, the highest serum bilirubin level, and the results of cranial ultrasonography were recorded. The above parameters, peak and interpeak latencies of BAEP were compared between both groups. RESULTS: Lower correctional age at the first BAEP, shorter intrauterine period, and lower birth weight were noted in experimental group (p<0.001). The average correctional age when BAEP had normalized in experimental group was 45.0+/-5.8 weeks, which was much later than 40.2+/-2.8 weeks in control group (p<0.001). 90.2% of infants among experimental group revealed normalized BAEP within 48 weeks, and 95.1% within 51 weeks according to correctional age, or within 12 weeks after initial examination. CONCLUSION: We recommend that BAEP should be rechecked after 48 weeks by correctional age for the high risk infants who were abnormal with initial screening BAEP.

The Findings of Brainstem Auditory Evoked Pontential(BAEP) and Somatosensory Evoked Potential(SSEP) in Head Injury

There were 84 cases of brainstem auditory evoked potential(BAEP) and 90 cases of somatosensory evoked potential(SSEP) from the 124 cases of head injury. The studies were performed within the first three days after head injury in most cases and after ten days in emergency operative cases. The results of BAEP and SSEP studies recorded from 67 normal volunteers were used as a control group. The latency, amplitude and wave pattern of the evoked potential were examined and a peak or interpeak latency were considered abnormal when it exceeded the corresponding mean(2SD found in the control group. The wave patterns were arranged in BAEP as grade I:all waves were normal; grade II: waves I, II, III were abnormal;grade III:waves IV, V, VI were abnormal;grade IV:all waves were abnormal. In SSEP as grade I:all waves were normal;grade II:N13 wave was abnormal;grade III:N19wave was abnormal;grade IV:all waves were abnormal. The abnormal findings by percentage were:47.6% in latency of BAEP, 68.9% in latency of SSEP, 49.4% in wave pattern of BAEP and 87.8% in wave pattern of SSEP. The BAEP was superior to SSEP in correlation to clinical parameters including GCS, duration of coma, basal cisterns in initial brain CT scan and Glasgow outcome scale(GOS). As a BAEP criterion, the wave V latency and the BCT(III-V interpeak latency) and as a SSEP criterion, the central conduction time(N19-N13) were more correlated to duration of coma and GOS. The appearance of the basal cisterns on initial brain CT is significantly correlated with wave V and BCT of BAEP only. Grade I and II were reliable predictors of a good prognosis. Therefore, we concluded that BAEP and SSEP are adjunctively diagnostic tests for determining the outcome of head injuried patients.