182. Early detection of hearing loss by means of brain stem auditory evoked potentials

An unusual case of unilateral delayed and progressive hearing loss following a microvascular decompression operation on cranial nerves V, VII, and VIII on the left side is reported. Preoperative and postoperative audiologic evaluation revealed a mild high-frequency hearing loss for both ears, normal thresholds for the acoustic middle ear reflex response, and normal brain stem auditory evoked potentials. Three years after this microvascular decompression procedure, the patient noticed slowly decreasing hearing in her left ear, and subsequent serial audiograms revealed a progressive sensorineural hearing loss and a decrease in her speech discrimination score. Brain stem auditory evoked potentials showed progressive changes. Because of the patient's increasing symptoms of vertigo and tinnitus in the left ear, reexploration of the eighth cranial nerve was performed 5½ years after the initial procedure. This second operation revealed reactive tissue around the eighth cranial nerve that was atrophic and yellow. We interpret the delayed and progressive hearing loss to be a result of reactive scar tissue and progressive atrophy of the auditory nerve.

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Monitoring Auditory Nerve Potentials during Operations in the Cerebellopontine Angle

Otolaryngology ◽

10.1177/019459988409200412 ◽

1984 ◽

Vol 92 (4) ◽

pp. 434-439 ◽

Cited By ~ 29

Author(s):

Aage R. Øller ◽

Peter J. Jannetta

Keyword(s):

Hearing Loss ◽

Evoked Potentials ◽

Brain Stem ◽

Microvascular Decompression ◽

Auditory Nerve ◽

Cerebellopontine Angle ◽

Auditory Evoked Potentials ◽

Cranial Nerves

Direct monitoring of auditory nerve potentials was performed in 19 patients undergoing retromastoid craniectomy and microvascular decompression of cranial nerves. In addition, brain stem auditory evoked potentials (BSEPs) were monitored in these patients. No patient suffered significant hearing loss. Direct monitoring of auditory nerve potentials complements the recording of BSEPs because the auditory nerve potentials can be visualized without averaging many responses. Therefore the effect of any intraoperative manipulation that is harmful to the auditory nerve can be detected instantaneously.

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Brain Stem Auditory Evoked Potentials in Jaundiced Gunn Rats

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948909800414 ◽

1989 ◽

Vol 98 (4) ◽

pp. 308-317 ◽

Cited By ~ 23

Author(s):

Steven M. Shapiro ◽

Kurt E. Hecox

Keyword(s):

Hearing Loss ◽

Evoked Potentials ◽

Brain Stem ◽

Auditory System ◽

Auditory Evoked Potentials ◽

Experimental Animals ◽

Bilirubin Encephalopathy ◽

Gunn Rats ◽

Auditory Dysfunction ◽

Bilirubin Toxicity

Bilirubin encephalopathy causes potentially preventable brain damage and hearing loss. The site of auditory dysfunction is controversial, despite pathologic studies showing damage to brain stem auditory nuclei in humans and experimental animals. We studied the effects of bilirubin toxicity on the auditory system of homozygous jaundiced Gunn rats by use of brain stem auditory evoked potentials. Small but statistically significant abnormalities were found for wave latencies, interwave intervals, and amplitudes.

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Auditory Nerve Compound Action Potentials and Brain Stem Auditory Evoked Potentials in Patients with Various Degrees of Hearing Loss

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949110000612 ◽

1991 ◽

Vol 100 (6) ◽

pp. 488-495 ◽

Cited By ~ 8

Author(s):

Aage R. Møller ◽

Peter J. Jannetta ◽

Margareta B. Møller ◽

Hae Dong Jho

Keyword(s):

Hearing Loss ◽

Evoked Potentials ◽

Brain Stem ◽

Auditory Nerve ◽

Action Potentials ◽

Auditory Evoked Potentials ◽

Compound Action Potentials ◽

Compound Action

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Brain Stem Auditory Evoked Potentials in Peripheral Acoustic Disorders

Clinical Neurophysiology ◽

10.1093/med/9780190259631.003.0051 ◽

2016 ◽

pp. 860-868

Author(s):

Christopher D. Bauch ◽

Wayne O. Olsen

Keyword(s):

Hearing Loss ◽

Evoked Potentials ◽

Brain Stem ◽

Auditory Evoked Potentials ◽

False Positive Rate ◽

Auditory Neuropathy ◽

Auditory Stimuli ◽

Positive Rate ◽

Cochlear Hearing Loss ◽

Conductive Hearing

Brain stem auditory evoked potentials (BAEPs) testing is a useful technique for the otoneurological assessment of patients with complaints of dizziness/imbalance, hearing loss, or tinnitus. The BAEP evaluation records neuroelectric potentials from cranial nerve (CN) VIII and the ascending brain stem pathways that are elicited as a response to brief auditory stimuli. BAEPs are performed in conjunction with audiology testing since conductive hearing losses as well as sensorineural disorders can affect BAEP waveform morphology and latencies. Overall sensitivity of BAEP is over 90% for patients with a CN VIII tumor, and the false-positive rate for patients having cochlear hearing loss is 12%. This chapter reviews BAEPs in the assessment of peripheral acoustic disordes and also discusses auditory neuropathy spectrum disorder and cochlear mocrophonic assessment as an additional electrophysiological method.

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Intraoperative monitoring of brain-stem auditory evoked potentials

Journal of Neurosurgery ◽

10.3171/jns.1982.57.3.0341 ◽

1982 ◽

Vol 57 (3) ◽

pp. 341-348 ◽

Cited By ~ 103

Author(s):

Peter A. Raudzens ◽

Andrew G. Shetter

Keyword(s):

Evoked Potentials ◽

Brain Stem ◽

Auditory Evoked Potentials ◽

Neurological Deficits ◽

Additional Patient ◽

Content Type ◽

Intracranial Surgery ◽

Surgical Measures ◽

Evoked Potential Monitoring ◽

Operating Surgeon

✓ Intraoperative brain-stem auditory evoked potentials (BAEP's) were monitored in 46 patients undergoing intracranial surgery for a variety of pathological conditions to determine whether this technique was capable of providing useful information to the operating surgeon. Intraoperative BAEP's were unchanged throughout surgery in 34 patients (74%), and these individuals had no postoperative hearing deficits. Four patients (9%) developed an abrupt ipsilateral loss of all waveform components beyond Wave I and had postoperative evidence of a pronounced hearing loss in the affected ear. An additional patient demonstrated BAEP loss contralateral to the side of surgery, and this was associated with subsequent signs of severe brain-stem dysfunction. Seven patients (15%) developed intraoperative delays of BAEP waveform latency values, but maintained recognizable waveforms beyond Wave I. Postoperatively, their hearing was either normal or mildly impaired, and there were no indications of other brain-stem abnormalities. This group represents the individuals who may have been benefited by evoked potential monitoring, since corrective surgical measures were taken when latency delays were observed. Intraoperative BAEP's can be reliably and routinely recorded in an operating room environment. They provide a good predictor of postoperative auditory status, and may have prevented permanent neurological deficits in a small segment of patients by alerting the surgeon to potentially reversible abnormalities.

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Study of Short Latency Somatosensory and Brain Stem Auditory Evoked Potentials Patients with Acute Ischemic Stroke Involving Middle Cerebral Artery Territory

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0041-1727558 ◽

2021 ◽

Author(s):

Abhishek Miryala ◽

Mahendra Javali ◽

Anish Mehta ◽

Pradeep R. ◽

Purushottam Acharya ◽

...

Keyword(s):

Ischemic Stroke ◽

Evoked Potentials ◽

Middle Cerebral Artery ◽

Acute Ischemic Stroke ◽

Brain Stem ◽

Functional Outcome ◽

Cerebral Artery ◽

Negative Correlation ◽

Auditory Evoked Potentials ◽

Positive Correlation

Abstract Background The precise timings of evoked potentials in evaluating the functional outcome of stroke have remained indistinct. Few studies in the Indian context have studied the outcome of early prognosis of stroke utilizing evoked potentials. Objective The aim of this study was to determine somatosensory evoked potentials (SSEPs) and brain stem auditory evoked potentials (BAEPs), their timing and abnormalities in acute ischemic stroke involving the middle cerebral artery (MCA) territory and to correlate SSEP and BAEP with the functional outcome (National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS) and Barthel’s index) at 3 months. Methods MCA territory involved acute ischemic stroke patients (n = 30) presenting consecutively to the hospital within 3 days of symptoms onset were included. Details about clinical symptoms, neurological examination, treatment, NIHSS score, mRS scores were collected at the time of admission. All patients underwent imaging of the brain and were subjected to SSEP and BAEP on two occasions, first at 1 to 3 days and second at 4 to 7 days from the onset of stroke. At 3 months of follow-up, NIHSS, mRS, and Barthel’s index were recorded. Results P37 and N20 amplitude had a strong negative correlation (at 1–3 and 4–7 days) with NIHSS at admission, NIHSS at 3 months, mRS at admission, and mRS at 3 months and a significant positive correlation with Barthel’s index (p < 0.0001). BAEP wave V had a negative correlation (at 1–3 and 4–7 days) with NIHSS at admission, NIHSS at 3 months, mRS at admission, and mRS at 3 months and a positive correlation with Barthel’s index (p < 0.0001). Conclusion SSEP abnormalities recorded on days 4 to 7 from onset of stroke are more significant than those recorded within 1 to 3 days of onset of stroke; hence, the timing of 4 to 7 days after stroke onset can be considered as better for predicting functional outcome.

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