Application of otoacoustic emissions and brainstem evoked response audiometry in newborn hearing screening

<p class="abstract"><strong>Background: </strong>Newborn hearing screening was conducted in a tertiary care hospital in a step by step manner using otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA) and details were recorded.</p><p class="abstract"><strong>Methods:</strong> A prospective institutional based study was conducted. All the newborns born in the hospital over a period of 18 months from December 2018 to May 2020 were considered in the study. Healthy newborns were screened bedside within 24 hours of delivery and NICU (Neonatal Intensive Care Unit) babies were screened in the NICU. Handheld OAE apparatus was used as the initial screening tool. A total of 3 OAEs were done for babies with a “refer” result in the OAEs, which were done 1 month apart. Babies with a “refer” in the third OAE were subjected for BERA.</p><p class="abstract"><strong>Results:</strong> A total of 14226 babies were screened at 24-48 hours of birth. Among them, 13,069 babies passed the first OAE screening in both ears. Remaining babies were referred for further follow-up. After subsequent follow-ups and successive testing, 11 babies were found to have hearing loss, which was diagnosed within 4-5 months of the child’s birth.</p><p class="abstract"><strong>Conclusions: </strong>Universal newborn hearing screening is the need of the day. OAE is an effective screening tool for newborn hearing loss. When complemented by BERA, majority of congenitally deaf babies can be diagnosed at a very early age. This helps in early intervention.</p>

Comparative study of brainstem evoked response audiometry in diabetic patients and non-diabetic subjects to assess the involvement of central auditory pathway

<p><strong>Background: </strong>Diabetes mellitus (DM) which is prevalent in world is associated with sensorineural hearing loss. Brainstem evoked response audiometry (BERA) is a simple, non-invasive procedure to detect early impairment of acoustic nerve and auditory pathway. The present study is under taken to evaluate the impact of DM on BERA parameters. Aim of the study was to compare the BERA of diabetic patients to those of age and gender matched controls to assess the involvement of central auditory pathway.</p><p><strong>Methods</strong>: A cross sectional study was conducted on 35 diabetic patients, aged 35 to 55 years, who were on treatment for at least 2 years, and 35 age and sex matched control participants, were subjected for BERA at 70,80 and 90 dB. The waveforms, absolute latency of wave I, wave III, wave V and interwave/ inter peak latency of I-III, III-V and I-V were analyzed with respect to both groups.</p><p><strong>Results</strong>: The absolute latency of wave III and wave V, interpeak/ interwave latency of I-III, interpeak/ interwave latency of I-V, III-V and absolute latency of wave V were highly significant at corresponding tested stimuli in the diabetic group compared to the control group.</p><p><strong>Conclusions</strong>: Early involvement of central auditory pathway in diabetic patients, can be detected with fair accuracy with auditory evoked potential studies; if done on a regular basis warrants meticulous glycemic control and prevents further damage.</p>

Role of Brainstem Evoked Response Audiometry in Evaluating Sensorineural Hearing Loss in Diabetic Patients

Introduction Diabetes has become a global epidemic. Hearing loss has been long associated with diabetes. Brainstem Evoked Response Audiometry (BERA) is an objective, non-invasive, electro diagnostic test that not only evaluates the functional integrity of the subcortical auditory pathway but also provides topo-diagnosis of hearing loss. This study aims to identify the role BERA in detecting hearing loss early in diabetic patients.Materials and Methods In this study a total of 210 patients were taken and subjected to blood glucose levels followed by PTA were divided into two groups. Group I (n=105) consisted of diabetic patients with sensorineural hearing loss (SNHL) and Group II (n=105) had age and sex matched non-diabetics with SNHL. All the patients were evaluated with BERA.Results All the patients were subjected to Brain Stem Evoked Response Audiometry (BERA). Absolute latency of Wave I, III, V, I-III, III-V and I-V were assessed for both the ears. In both ear Absolute latency were significantly higher in diabetics as compared to non-diabetic patientsConclusion The findings of present study showed that the severity of hearing loss was significantly higher in diabetic patients as compared to non-diabetic controls. Level of glycemic control showed a possible link with severity of hearing loss.

TO STUDY THE INCIDENCE OF SENSORINEURAL HEARING LOSS POST MENINGITIS IN NEONATES

Background:Post meningitis hearing impairment is an important public health problem. Neonatal meningitis is an important cause of mortality and morbidity in neonates in future life. An important consequence is hearing loss. Hearing plays a basic and important role in language, speech and intellectual development. Late detection causes irreversible stunting of the language development potential of the child. Early detection and intervention would help to maximize linguistic competence and literacy development for children who are deaf or hard of hearing. The study of brainstem evoked response audiometry provides an opportunity to evaluate the functional integrity of auditory pathway from inner ear to upper brainstem. Aim:This study was conducted to determine the incidence of sensorineural hearing loss following meningitis in neonates. Material and Methods:The present study was conducted in the Department of Pediatrics, Government Medical College Srinagar. All the patients,Term neonates with CSF culture proven bacterial meningitis. , were referred to the Department of ENT, SMHS Hospital Srinagar, of the institution for thorough ENT checkup, to exclude any ear pathology and BERA (Brainstem Evoked Response Audiometry). Results:In our study total number of cases were 87. Majority of our studied children i.e. 47 (54%) were < days of age whereas 40 (46%) children were 8-28 days of aged. The mean age of our study patients was 15.7+3.71.Out of 87 patients in our study, male predominance was observed with 55.2% males versus 44.8% females with a male to female ratio of 1.2:1. Hearing loss was observed in 11 (12.6%) of our study children.Bilateral hearing loss was seen in 5 of the 11 children (5.7%) while as unilateral hearing loss was observed in 6 of the 11 children (6.9%). Out of a total of 11 (12.6%) patients who had hearing loss, 6 (6.9%) were having mild hearing loss, followed by 3 (3.4%) children with profound hearing loss while as moderate and severe hearing loss was observed in 1 (1.1%) patients each. Conclusion: Hearing loss is not a rare complication asociated with meningitis in neonates, early detection and appropriate treatment is needed to prevent language , speech and intellecual damage.

Karakteristik Pasien yang Menjalani Pemeriksaan Brainstem Evoked Response Audiometry (BERA) di RSUP Dr. Kariadi Semarang

Introduction: Brainstem Evoked Response Audiometry (BERA) is an auditory electrophysiological examination to objectively and non-invasively assess the integrity of the central auditory system. BERA examination is proposed to be carried out on every newborn as a standard examination to identify early hearing loss in newborns. The incidence of congenital deafness between 4-6 babies in 1000 live births in developing countries. Purpose: This study aimed to determine the characteristics of patients undergoing BERA examination including age, gender, hearing threshold values, risk factors, and the spread of events in the Central Java region. Methods: This was a retrospective descriptive study utilizing medical records of patients undergoing BERA examination conducted at the hospital. Dr. Kariadi Semarang from January 2016 - December 2016. There were 515 patients who underwent BERA examination from 35 districts and cities in Central Java. Most patients undergoing BERA examination came from the city of Semarang. Results: Most patients underwent BERA examination aged 0-3 years, with the most frequent risk factors being febrile seizures and profound was found to be the highest results. Discussion: The incidence of hearing loss in children 0-3 years with a hearing threshold of more than 86 dB was the highest incidence in Semarang within 2016. Conclusion: BERA examination has not been able to reach other areas around Central Java.

Evaluation of effect of brainstem evoked response audiometry in hyperlipidemic patients

<p class="abstract"><strong>Background:</strong> Brain stem evoked response audiometry (BERA) is a useful objective assessment of hearing. The major advantage of this procedure is its ability to test even infants in whom conventional audiometry may not be useful. This investigation can be used as a screening test for deafness at high risk. This study is to correlate changes in brainstem evoked response audiometry parameters concerning lipid profile.</p><p class="abstract"><strong>Methods:</strong> The study was conducted between January 2019 to June 2020 on 50 patients attending ENT OPD in Vinayaka Mission’s Kirupanandha Variyar Medical College and Hospital, Salem. All patients with auditory and/or vestibular complaints were seen at the otorhinolaryngology OPD and underwent an otorhinolaryngological examination, audiological studies (pure tone audiometry) and an electrophysiological assessment BERA. </p><p class="abstract"><strong>Results:</strong> The results of BERA was considered. A total of 5 waveforms and 3 interpeak latency waves were calculated. It was recorded from both the ears. There was a significant increase in the values of absolute waves II, III, IV, and V and interpeak latency wave values I-II and I-V.</p><p class="abstract"><strong>Conclusions:</strong> Early identification of hyperlipidemic patients is useful in preventing disease progression and associated morbidity and mortality. BERA is a non-invasive method which can help us to detect central auditory pathway dysfunction at early stages in hyperlipidemic patients even before the patient's experience symptomatic hearing loss.</p>