Objective Assessment of Hearing in Children: Update on Procedures and Protocols

2011 ◽  
Vol 21 (2) ◽  
pp. 50-58
Author(s):  
James W. Hall ◽  
Anuradha R. Bantwal
Keyword(s):  
Psychosocial Development ◽  
Otoacoustic Emissions ◽  
Objective Assessment ◽  
Behavioral Assessment ◽  
Auditory Brainstem ◽  
Test Battery ◽  
Auditory Evoked Responses ◽  
Brainstem Response ◽  
Assessment Techniques ◽  
Pediatric Populations

Early identification and diagnosis of hearing loss in infants and young children is the first step toward appropriate and effective intervention and is critical for optimal communicative and psychosocial development. Limitations of behavioral assessment techniques in pediatric populations necessitate the use of an objective test battery to enable complete and accurate assessment of auditory function. Since the introduction of the cross-check principle 35 years ago, the pediatric diagnostic test battery has expanded to include, in addition to behavioral audiometry, acoustic immittance measures, otoacoustic emissions, and multiple auditory evoked responses (auditory brainstem response, auditory steady state response, and electrocochleography). We offer a concise description of a modern evidence-based audiological test battery that permits early and accurate diagnosis of auditory dysfunction.

Clinical Application of Otoacoustic Emissions: What do we Know about Factors Influencing Measurement and Analysis?

1994 ◽  
Vol 110 (1) ◽  
pp. 22-38 ◽  
Author(s):  
James W. Hall ◽  
Jane E. Baer ◽  
Patricia A. Chase ◽  
Mitchell K. Schwaber
Keyword(s):  
Otoacoustic Emissions ◽  
Large Scale ◽  
Auditory Brainstem ◽  
Distortion Product ◽  
Clinical Investigations ◽  
Gender And Age ◽  
Measurement And Analysis ◽  
The Everyday ◽  
Brainstem Response ◽  
Clinical Environments

Three electrophysiologic audiologic procedures-aural immittance measurement, auditory brainstem response (ABR), and otoacoustic emissions (OAE) — were first described in the 1970's. Immittance measurement and ABR have contributed importantly for years to the assessment of auditory function in children and adults, whereas OAEs have not yet been incorporated into the everyday audiology test battery. In this article, we argue that the transition from OAE measurement by hearing scientists in laboratory settings to routine application by audiologists in the clinic will be greatly facilitated by (1) comprehensive, large-scale studies of the effects of subject characteristics, such as gender and age (from infancy to advancing adulthood), on both transient evoked (TEOAE) and distortion product (DPOAE) otoacoustic emissions; (2) clinical investigations of TEOAE and DPOAE in sizeable patient populations with specific neurotologic diagnoses; (3) guidelines for OAE test protocols in clinical environments; and (4) clear criteria for OAE analysis in clinical populations.

scholarly journals Auditory pathway maturational study in small for gestational age preterm infants

CoDAS ◽  
2014 ◽  
Vol 26 (4) ◽  
pp. 286-293 ◽  
Author(s):  
Rosanna Giaffredo Angrisani ◽  
Edna Maria Albuquerque Diniz ◽  
Ruth Guinsburg ◽  
Alexandre Archanjo Ferraro ◽  
Marisa Frasson de Azevedo ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Otoacoustic Emissions ◽  
Newborn Infants ◽  
Tone Burst ◽  
Auditory Pathway ◽  
Auditory Brainstem ◽  
Cross Sectional ◽  
Brainstem Response

PURPOSE: To follow up the maturation of the auditory pathway in preterm infants small for gestational age (SGA), through the study of absolute and interpeak latencies of auditory brainstem response (ABR) in the first six months of age.METHODS: This multicentric prospective cross-sectional and longitudinal study assessed 76 newborn infants, 35 SGA and 41 appropriate for gestational age (AGA), born between 33 and 36 weeks in the first evaluation. The ABR was carried out in three moments (neonatal period, three months and six months). Twenty-nine SGA and 33 AGA (62 infants), between 51 and 54 weeks (corrected age), returned for the second evaluation. In the third evaluation, 49 infants (23 SGA and 26 AGA), with age range from 63 to 65 weeks (corrected age), were assessed. The bilateral presence of Transient Evoked Otoacoustic Emissions and normal tympanogram were inclusion criteria.RESULTS: It was found interaural symmetry in both groups. The comparison between the two groups throughout the three periods studied showed no significant differences in the ABR parameters, except for the latencies of wave III in the period between three and six months. As for the maturation with tone burst 0.5 and 1 kHz, it was found that the groups did not differ.CONCLUSION: The findings suggest that, in the premature infants, the maturational process of the auditory pathway occurs in a similar rate for SGA and AGA. These results also suggest that prematurity is a more relevant factor for the maturation of the auditory pathway than birth weight.

Normative Sweep Frequency Impedance Measures in Healthy Neonates

2014 ◽  
Vol 25 (04) ◽  
pp. 343-354 ◽  
Author(s):  
Venkatesh Aithal ◽  
Joseph Kei ◽  
Carlie Driscoll ◽  
Andrew Swanston ◽  
Katrina Roberts ◽  
...  
Keyword(s):  
Middle Ear ◽  
Otoacoustic Emissions ◽  
Static Pressure ◽  
Auditory Brainstem ◽  
Ear Canal ◽  
Sweep Frequency ◽  
Tone Frequency ◽  
Automated Auditory Brainstem Response ◽  
Brainstem Response ◽  
Stapedial Reflex

Background: Diagnosing middle ear disorders in neonates is a challenging task for both audiologists and otolaryngologists. Although high-frequency (1000 Hz) tympanometry and acoustic stapedial reflex tests are useful in diagnosing middle ear problems in this age group, they do not provide information about the dynamics of the middle ear in terms of its resonance frequency (RF) and mobility. The sweep frequency impedance (SFI) test can provide this information, which may assist in the diagnosis of middle ear dysfunction in neonates. Purpose: This study aimed to investigate the feasibility of testing neonates using the SFI technique, establish normative SFI data for RF and mobility of the middle ear in terms of changes in sound pressure level (ΔSPL in dB), and describe the dynamics of the middle ear in healthy Australian neonates. Study Sample: A prospective sample of 100 neonates (58 males, 42 females) with a mean gestational age of 39.3 wk (SD = 1.3 wk; range = 38–42 wk), who passed all three tests, namely, automated auditory brainstem response, transient evoked otoacoustic emissions, and 1000 Hz tympanometry, were included in this study. Data Collection and Analysis: A SFI research prototype was used to collect the data. First, the SPL in the ear canal was measured as a probe-tone frequency was swept from 100–2000 Hz with the ear canal static pressure held constant at 200 daPa. Then, this measurement was repeated with the static pressure reduced in 50 daPa steps to –200 daPa. Additional measurement was also performed at the static pressure, where the peak of the 1000 Hz tympanogram occurred. A graph showing the variation of SPL against frequency at all static pressures was plotted. From this graph, the RF and ΔSPL at tympanometric peak pressure (TPP) were determined. Descriptive statistics and an analysis of variance (ANOVA) were applied to the RF and ΔSPL data with gender and ear as independent variables. Results: The results showed two resonance regions of the outer/middle ear with the high RF (mean = 1236 Hz; 90% range: 830–1518 Hz) being approximately equal to four times that of the low RF (mean = 287 Hz; 90% range = 209–420 Hz). The low RF was more easily identifiable than the high RF. The ΔSPL at the low RF (mean = 8.2 dB; 90% range = 3.4–13 dB) was greater than that at the high RF (mean = 5.0 dB; 90% range = 1.5–8.1 dB). There were no significant differences or interactions between genders and ears. Conclusion: The study showed that the SFI is a feasible test of middle ear function in neonates. The SFI results revealed two regions of resonance with the lower resonance (287 Hz) possibly related to the movements of the outer ear canal wall and higher resonance (1236 Hz) related to the resonance of the middle ear. The normative data developed in this study will be useful in evaluating outer and middle ear function in neonates.

Auditory steady state response in auditory neuropathy

2010 ◽  
Vol 124 (9) ◽  
pp. 950-956 ◽  
Author(s):  
A A Emara ◽  
T A Gabr
Keyword(s):  
Steady State ◽  
Auditory Brainstem Response ◽  
Otoacoustic Emissions ◽  
Hearing Threshold ◽  
Auditory Brainstem ◽  
Auditory Neuropathy ◽  
Steady State Response ◽  
State Response ◽  
Auditory Steady State Response ◽  
Brainstem Response

AbstractReview:Auditory neuropathy is a disorder characterised by preservation of outer hair cell function, with normal otoacoustic emissions and/or cochlear microphonics, but an absent or distorted auditory brainstem response.Purpose:This study aimed to objectively assess hearing thresholds in patients with auditory neuropathy, using the auditory steady state response.Materials and methods:Thirteen patients with auditory neuropathy and 15 normal hearing subjects were examined. Audiological evaluation included basic audiological tests, otoacoustic emissions, auditory brainstem response and auditory steady state response.Results:In the auditory neuropathy patients, the auditory brainstem response was absent in 11 patients, while the auditory steady state response was absent in only three.Conclusion:The auditory steady state response may serve as a valuable objective measure for assessing the hearing threshold across different frequencies in patients with auditory neuropathy. We recommend that auditory steady state response be used to complete the evaluation of patients with auditory neuropathy.

scholarly journals Protective effect of ethosuximide on hearing in NOD/LtJ mice via blockage of endogenous apoptosis

2020 ◽  
Vol 19 (2) ◽  
pp. 299-304
Author(s):  
Dejun Zhang ◽  
Guofang Guan ◽  
Yingyuan Guo ◽  
Yanru Hao ◽  
Fang Guo ◽  
...  
Keyword(s):  
Treatment Group ◽  
Protective Effect ◽  
Otoacoustic Emissions ◽  
Caspase 3 ◽  
Auditory Brainstem ◽  
New Drugs ◽  
Signal Frequency ◽  
Control Group ◽  
Distortion Product ◽  
Brainstem Response

Purpose: To determine the protective effect of ethosuximide on the hearing of NOD/LtJ mice, and the underlying mechanism of action. Methods: The mice were randomly assigned to control and treatment groups (20 mice per group). Mice in the treatment group were administered ethosuximide intraperitoneally at a dose of 200mg/kg body weight (bwt), while those in the control group received an equivalent dose of saline via the same route. Both groups were subjected to auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAE) tests, as well as determination of mRNA expressions of α1G, α1H, α1I, m-calpain, μ-calpain, and caspase-3. Results: At ages of 6 and 9 weeks, ABR values were significantly lower in the treatment group than those in the control group (p < 0.05). At age 3, 6 and 9 weeks, control group DPOAE values were much lower than those in the treatment group. However, at signal frequency of 35344 Hz, DPOAE value was significantly reduced in the treatment group (p < 0.05). There was significant down-regulation in mRNA expressions of α1G, α1H, α1I, m-calpain, μ-calpain and caspase-3, in the treatment group, when compared with the control group (p < 0.05). Conclusion: Ethosuximide delays mice hearing loss and protects their hearing via a mechanism involving blockage of endogenous apoptotic pathways. This mechanism may provide guidance in the search for suitable new drugs. Keywords: Ethosuximide, Endogenous apoptosis, Hearing, Protection

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