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Weich, Tainara Milbradt, Tania Maria Tochetto, and Lilian Seligman. "Brain stem evoked response audiometry of former drug users." Brazilian Journal of Otorhinolaryngology 78, no. 5 (2012): 90–96. http://dx.doi.org/10.5935/1808-8694.20120014.
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Polisetti, Ravibabu, Sowmya Lanke, and Teja Vanipenta. "A study of hearing loss in infants using brain stem evoked response audiometry." International Journal of Otorhinolaryngology and Head and Neck Surgery 8, no. 10 (2022): 812. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20222440.
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<p class="abstract"><strong>Background:</strong> Hearing is necessary to learn languages and speech and to develop cognitive skills. Unfortunately, many children with severe hearing loss from birth are not diagnosed until 21/2-3 years. of age. Implementing high-risk neonatal screening, detecting hearing loss before 3 months, and intervention before 6 months will result in a better speech performance of neonates.</p><p class="abstract"><strong>Methods:</strong> Detailed history taking and general and ear, nose and throat (ENT) examination were done to rule out external ear and middle ear pathology. Brainstem evoked response audiometry (BERA) was done in a dust-free, sound-proof, airconditioned room. Feed was given 10–15 min before the procedure. Syrup pedichloryl 20 mg/kg was given to sedate the baby half an hour before the procedure. Intelligent hearing system BERA instrument was used. The study included a total of 60 infants. 30 were in the high-risk group and 30 were in the normal group. There were 14 males and 16 females in each group. </p><p class="abstract"><strong>Results:</strong> 21 infants had hearing loss out of the 30 infants in the high-risk group on initial screening. On doing a repeat BERA after 3 mins on the affected infants, 3 were detected to have normal hearing, i.e., 18 out of 30 infants were affected. All the infants in the normal or no risk factor group had normal hearing.</p><p class="abstract"><strong>Conclusions:</strong> The present study emphasizes the importance of using ABR as a screening tool for the detection of hearing impairment at an early stage which would have otherwise go unnoticed for about 2-3 years. Since it is an objective test, it is useful in the early identification of hearing loss.</p><p> </p>
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Rupa, V. "Dilemmas in auditory assessment of developmentally retarded children using behavioural observation audiometry and brain stem evoked response audiometry." Journal of Laryngology & Otology 109, no. 7 (1995): 605–9. http://dx.doi.org/10.1017/s002221510013083x.
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AbstractThe records of 94 consecutive developmentally retarded children with speech retardation and suspected hearing loss who underwent auditory assessment by both conventional behavioural observation audiometry (BOA) and brain stem evoked response audiometry (BERA) were analysed. In 54 children (57.4 percent) there was good agreement between the results of both techniques leading to a clearcut diagnosis. In 22 children a diagnosis was possible only by the results of BERA as the results of BOA were inconclusive. Of the remaining 18 children, two groups could be identified whose results posed a dilemma. Group 1 (n = 7) consisted of children whose BOA test results differed considerably from their BERA results. Group 2 (n = 11) consisted of children in whom there was no discernible response by BERA while the response by BOA was either inconsistent (n = 5) or not elicitable (n = 6). The specific strategies to be adopted for hearing assessment in these situations are discussed.
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Yousuf S, Praveen, and Chhaya Batham. "TYPE-2 DIABETES MELLITUS AND BRAIN STEM EVOKED RESPONSE AUDIOMETRY: A CASE CONTROL STUDY." Journal of Evolution of Medical and Dental Sciences 5, no. 08 (2016): 359–62. http://dx.doi.org/10.14260/jemds/2016/81.
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Senniappan, Shivakumar, and Gowri Paramasivam. "Evaluation of effect of brainstem evoked response audiometry in hyperlipidemic patients." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 11 (2020): 1971. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20204459.
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<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>
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Lau, S. K., W. I. Wei, J. S. T. Sham, D. T. K. Choy, and Y. Hui. "Early changes of auditory brain stem evoked response after radiotherapy for nasopharyngeal carcinoma—A prospective study." Journal of Laryngology & Otology 106, no. 10 (1992): 887–92. http://dx.doi.org/10.1017/s002221510012119x.
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AbstractA prospective study of the effect of radiotherapy for nasopharyngeal carcinoma on hearing was carried out on 49 patients who had pure tone, impedance audiometry and auditory brain stem evoked response (ABR) recordings before, immediately, three, six and 12 months after radiotherapy. Fourteen patients complained of intermittent tinnitus after radiotherapy. We found that 11 initially normal ears of nine patients developed a middle ear effusion, three to six months after radiotherapy. There was mixed sensorineural and conductive hearing impairment after radiotherapy. Persistent impairment of ABR was detected immediately after completion of radiotherapy. The waves I–III and I–V interpeak latency intervals were significantly prolonged one year after radiotherapy. The study shows that radiotherapy for nasopharyngeal carcinoma impairs hearing by acting on the middle ear, the cochlea and the brain stem auditory pathway.
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Holm, Godthelp, and Pauw. "Brain stem evoked response audiometry versus magnetic resonance imaging in the detection of CPA lesions." Clinical Otolaryngology and Allied Sciences 23, no. 4 (1998): 380. http://dx.doi.org/10.1046/j.1365-2273.1998.0165s.x.
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Mirajkar, Swapnil Chandrakant, and Surekha Rajadhyaksha. "Hearing Evaluation of Neonates with Hyperbilirubinemia by Otoacoustic Emissions and Brain Stem Evoked Response Audiometry." Journal of Nepal Paediatric Society 36, no. 3 (2017): 310–13. http://dx.doi.org/10.3126/jnps.v36i3.12155.
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Introduction: Neonatal hyperbilirubinemia is one of the most important factors affecting the auditory system and can cause sensorineural hearing loss. This study evaluated the hearing status in neonates with hyperbilirubinemia and results obtained from Otoacoustic emissions (OAE) and Brain stem evoked response audiometry (BERA) analysis were compared with each other’s.Material and Methods:This study was performed on fifty eligible term neonates with hyperbilirubinemia requiring either phototherapy or exchange transfusion or both. Hearing analysis was done by OAE and BERA.Results: Out of fifty eligible neonates, twenty one (42%) had hearing impairment as per OAE analysis, eight (16%) had hearing impairment; two (4%) neonate had inconclusive hearing analysis as per BERA analysis. Out of twenty one neonates having hearing impairment by OAE only five had hearing impairment as per BERA analysis. While the eight neonates who had hearing impairment by BERA analysis, five had hearing impairment by OAE.Conclusion: The study showed hearing impairment by OAE analysis in 42% neonates while the BERA analysis showed hearing impairment in 16 % neonates. The increased level of Serum bilirubin has not shown the increase in percentage of hearing impairment.J Nepal Paediatr Soc 2016;36(3):310-313
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Adelman, Cahtia, Nejama Linder, and Haya Levi. "Auditory Nerve and Brain Stem Evoked Response Thresholds in Infants Treated with Gentamicin as Neonates." Annals of Otology, Rhinology & Laryngology 98, no. 4 (1989): 283–86. http://dx.doi.org/10.1177/000348948909800409.
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Thirty-two infants (18 full-term and 14 premature) who had been treated with gentamicin as neonates were examined to ascertain whether this drug induced hearing loss, even of low severity. Objective thresholds to clicks were obtained using auditory nerve and brain stem evoked responses. In addition, behavioral audiometry was performed. Serum concentrations before and after gentamicin treatment were at therapeutic levels. All infants were examined at least 1 1/4 months after cessation of therapy. Normal thresholds were obtained in all ears, with the exception of two with demonstrable middle ear effusion. It appears that gentamicin in therapeutic doses and serum concentrations, in the absence of renal insufficiency, does not cause hearing loss in neonates.
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Shepherd, R. K., and G. M. Clark. "Effect of High Electrical Stimulus Intensities on the Auditory Nerve Using Brain Stem Response Audiometry." Annals of Otology, Rhinology & Laryngology 96, no. 1_suppl (1987): 50–53. http://dx.doi.org/10.1177/00034894870960s123.
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The response of the auditory nerve to acute intracochlear electrical stimulation using charge-balanced biphasic current pulses was monitored using electrically evoked auditory brain stem responses (EABRs). Stimulation at moderate charge densities (64 μC cm−2 geom/phase; 0.8 mA, 200 μs/phase) for periods of up to 12 hours produced only minimal short-term changes in the EABR. Stimulation at a high charge density (144 μC cm−2 geom/phase; 1.8 mA, 200 μs/phase) resulted in permanent reductions in the EABR for high stimulus rates (> 200 pulses per second [pps]) or long stimulus durations (12 hours). At lower stimulus rates and durations, recovery to prestimulus levels was slow but complete. The mechanisms underlying these temporary and permanent reductions in the EABR are probably caused by neural adaptation and more long-term metabolic effects. These findings have implications for the design of speech-processing strategies using high stimulus rates.
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Valame, Deepa A., and Preeti Nandapurkar. "Audiovestibular Test Battery Approach in Patients with Vertigo." An International Journal of Otorhinolaryngology Clinics 4, no. 1 (2012): 5–16. http://dx.doi.org/10.5005/jp-journals-10003-1083.
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ABSTRACT All audiological tests are site-of-lesion tests and are used as a part of a test battery. Pure tone audiometry gives estimate of peripheral hearing status. Speech audiometry, acoustic reflex testing and auditory brain stem response differentiate cochlear and retrocochlear sites of lesion. Addition of cervical vestibular evoked myogenic potentials (VEMP) and ocular VEMP to this battery can further differentiate between saccular vs utricular lesions and between lesions of inferior vs superior vestibular nerve. Overall, this battery of tests provides useful insights into the otoneurological diagnosis of vertigo. Few case examples are cited to elucidate the utility of audiovestibular test battery. How to cite this article Valame DA, Nandapurkar P. Audiovestibular Test Battery Approach in Patients with Vertigo. Int J Otorhinolaryngol Clin 2012;4(1):5-16.
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Goswami, Deepika, Saurabh Srivastava, Anuja Bhargava, et al. "Role of Brainstem Evoked Response Audiometry in Evaluating Sensorineural Hearing Loss in Diabetic Patients." Bengal Journal of Otolaryngology and Head Neck Surgery 29, no. 2 (2021): 182–88. http://dx.doi.org/10.47210/bjohns.2021.v29i2.481.
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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.
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Shah, Hemal, Pramod Kharadi, Krunal Patel, Sushil Jha, and Abhishek Kumar Singh. "Correlation between brainstem evoked response audiometry with other audiological tests in different types of hearing loss." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 5 (2020): 839. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20201672.
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<p class="abstract"><strong>Background:</strong> Brainstem evoked response audiometry (BERA) is most specific and sensitive test for brain stem dysfunction. It is most important objective method for evaluating peripheral auditory system in neonates, infants, sedated and comatose patients and other person who doesn’t understand the language. Objective of the study was to evaluate correlation BERA with other audiological tests in different types of hearing loss as well as to study variations of wave forms in different types of hearing loss.</p><p class="abstract"><strong>Methods:</strong> Patients underwent a complete ENT check up to rule out any actively discharging gears, wax, infection or any middle ear problems. Different audiometric tests: pure tone audiometry (PTA), distortion product otoacoustic emissions, auditory steady-state response (ASSR) and BERA were applied to the patients. </p><p class="abstract"><strong>Results:</strong> The majority of the patients (32 cases) belonged to the age group of 0-5 years. Maximum cases were of sensorineural hearing loss (60%). ASSR was highly sensitive (85.1%) for estimation of hearing threshold and specificity was 100% (p&lt;0.001). BERA was also highly significant for estimation of hearing threshold (sensitivity: 83%; specificity: 92.3%; p value &lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> BERA has high degree of accuracy in detecting hearing threshold as an objective test but not as much accurate as ASSR. It is more valuable in terms of identification of site and size of the lesion in auditory pathway and identification for the type of the deafness.</p>
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Munjal, Manish, Karanpreet Singh, Parth Chopra, et al. "Correlation between serum electrolyte levels and brain stem evoked response audiometry in chronic renal failure: a pilot study." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 11 (2020): 2050. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20204630.
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<p class="abstract"><strong>Background:</strong> The effect of electrolyte imbalance on hearing thresholds and its objective manifestation, as delayed latencies or inter-peak intervals in evoked response audiometry is studied.</p><p class="abstract"><strong>Methods:</strong> The present prospective study was undertaken in a period of one and a half years, to analyze the audiological profile in patients of chronic renal failure and renal allograft recipients. 60 patients were randomly selected from the out- patient and indoor services of nephrology, urology and oto-rhino-laryngology, Dayanand Medical College and Hospital, Ludhiana. Brain stem evoked response audiometry was performed and the latencies were tabulated. </p><p class="abstract"><strong>Results:</strong> A significant delay in the absolute latency of wave V was noted in hyponatremic patients of CRF on comparison with patients of CRF having a normal serum Na<sup>+</sup> levels. The I-V interpeak interval was also seen to be significantly delayed on comparison. A statistically significant delayed I-III inter-peak latency was also observed in hypernatremic patients in comparison to patients having a serum Na<sup>+</sup> level in the normal range. No significance of serum creatinine levels and wave latencies was noted on comparison between the three categories of patients of CRF as categorized by their serum creatinine levels.</p><p class="abstract"><strong>Conclusions:</strong> There is a definite deterioration of the audiological function in patients of chronic kidney disease, and some reversal of these abnormalities following a successful renal transplantation; indirectly pointing towards uremic milieu being the culprit.</p>
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Patil, Mallikarjun, Prakash Handi, K. R. Prasenkumar, and Kranti Gouripur. "Objective screening of hearing impairment using brainstem evoked response audiometry in children below 5 years of age and assessing the high risk factors." International Journal of Otorhinolaryngology and Head and Neck Surgery 4, no. 4 (2018): 923. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20182475.
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<p class="abstract"><strong>Background:</strong> Hearing impairment is a common disability in children. This study is to evaluate the common high risk factors for hearing loss in our locality and to estimate hearing threshold by brain stem evoked response audiometry.</p><p class="abstract"><strong>Methods:</strong> 100 children under five years were subjected to brainstem evoked response audiometry. Wave V morphology was studied and hearing threshold estimated. The high risk factor(s) were analysed and degree of hearing impairment assessed. </p><p class="abstract"><strong>Results:</strong> 38 children were found to have hearing impairment. Most of the children had bilateral hearing impairment. Of them 30 children (79%) had profound hearing loss. Consanguineous marriage was the most common risk factor.</p><p class="abstract"><strong>Conclusions:</strong> Since consanguinity is the most common risk factor, health education and genetic counselling will help to decrease the incidence of autosomal recessive nonsyndromic deafness. Improvement in immunization for rubella can decrease the hearing impairment due to these infections. Due to availability of medical facilities hearing impairment due to perinatal factors have decreased.</p>
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Singh, Vishwambhar, Utkarsh Agrawal, Ashvanee Kr Chaudhary, and Mukesh Ranjan. "Study of Variation and Latency of Wave V of Brain Stem Evoked Response Audiometry in North Central India." Indian Journal of Otolaryngology and Head & Neck Surgery 71, S2 (2018): 1408–11. http://dx.doi.org/10.1007/s12070-018-1484-3.
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Barnea, G., J. Attias, S. Gold, and A. Shahar. "Tinnitus with Normal Hearing Sensitivity: Extended High-Frequency Audiometry and Auditory-Nerve Brain-Stem-Evoked Responses." International Journal of Audiology 29, no. 1 (1990): 36–45. http://dx.doi.org/10.3109/00206099009081644.
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Suligavi, Shashidhar S., and Shradha S. Pawar. "Study of brain stem evoked audiometry in children under 10 years of age: a case series study." International Journal of Otorhinolaryngology and Head and Neck Surgery 5, no. 4 (2019): 1071. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20192732.
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<p class="abstract"><strong>Background:</strong> Brainstem evoked response audiometry (BERA) is a diagnostic tool which can be used to assess the early hearing loss and planning rehabilitative procedures. It is noninvasive and can be performed in uncooperative children.</p><p class="abstract"><strong>Methods:</strong> To evaluate the hearing threshold and find the incidence of hearing loss in infants and children under 10 years of age. </p><p class="abstract"><strong>Results:</strong> Totally, 55 patients under 10 years of age were included in the study. 15 children had normal hearing (27.27%) and 40 (72.72 %) were found to have sensorineural hearing loss. Amongst 40, 19 (47.5%) children were found in the age group of 1-5years. 14 (35%) were found to have profound hearing loss, 15 (37.5%) had severe, 8(20%) had moderate, 3 (7.5%) had mild hearing loss.</p><p><strong>Conclusions:</strong> Newborn screening is mandatory to identify hearing loss in the prelinguistic period to reduce the burden of handicap in the community. BERA should be carried out as a routine procedure to detect hearing impairment in high risk children and rehabilitative measures should be started as early as possible.</p>
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Ishimaru, Tadashi, Takaki Miwa, Takefumi Shimada, and Mitsuru Furukawa. "Electrically Stimulated Olfactory Evoked Potential in Olfactory Disturbance." Annals of Otology, Rhinology & Laryngology 111, no. 6 (2002): 518–22. http://dx.doi.org/10.1177/000348940211100607.
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Olfactory evoked potential is considered a useful method of electrophysiological olfactometry for the diagnosis of olfactory disturbance. However, electrophysiological olfactometry is not as widely used as electrophysiological audiometry, such as the auditory brain stem response, because odor stimulation is difficult to perform. In contrast, electrical pulse stimulation is easy to perform, and its evoked potential is also easily recorded by the averaging method. We recorded olfactory evoked potentials from the scalp produced by electrical stimulation on the olfactory mucosa and investigated the relationship between this electrical olfactory evoked potential (EOEP) and the results of Toyoda and Takagi's perfumist's strip method (T&T) olfactometry, which is a standard Japanese means of psychophysical olfactometry. In EOEP-detectable cases, the detection and cognitive thresholds of T&T olfactometry were 1.32 ± 1.99 (mean ± SD; n = 10) and 3.02 ± 1.64 (n = 10), respectively. But in the undetectable cases, the thresholds were 4.67 ± 2.03 (n = 8; 5.8 means off the scale) and 5.80 ± 0.00 (n = 8), respectively. The differences between the T&T thresholds of EOEP-detectable and -undetectable cases were significant. We concluded that EOEP is suitable for electrophysiological olfactometry.
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Jha, Indira, MD Kabir Alam, Chandan Kumar, Niska Sinha, and Tarun Kumar. "High-Frequency Hearing Loss Amongst Smart Mobile Phone Users: A Case–Control Study." Annals of African Medicine 23, no. 4 (2024): 684–87. http://dx.doi.org/10.4103/aam.aam_93_24.
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Background: In past 20 years, there is increase in mobile phone users from 12.4 million to about 5.6 billion i.e 70 % of the world’s population.[1] Electromagnetic radiations emitted from mobile phone damages inner ear, cochlea and outer hair cells of inner ear and auditory pathway (AP).[2] Materials and Methods: Case control study. Group 1, N=30 subjects, using mobile smart phones since past 1-5 years and exposure time more than 2 hours per day. Group II included 30 subjects, using mobile smart phones for more than 5 years and exposure time more than 2 hours per day. Headache, tinnitus, or sensations of burning around phone-using were excluded. Brainstem auditory evoked potential (BAEP) done. Student Unpaired t test was used for analysis and chisquare test. Results: Mean ± SD of absolute latencies (AL) of Brainstem evoked response auditory. (BERA) waves III, V and all interpeak latencies at 80 dB and 4,6,8 KHz in group 2 were delayed and significant as compared to group 1. All parameters were highly significant at 8KHz as compared to 4KHz in group 2. Conclusion: Brain stem evoked response audiometry (BERA) detects hearing loss in smart mobile phone using subjects at higher frequencies i.e at 8 KHz early. Hence central neural axis involvement can be detected early by BERA.
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Nageris, Ben I., and Aaron Popovtzer. "Acoustic Neuroma in Patients with Completely Resolved Sudden Hearing Loss." Annals of Otology, Rhinology & Laryngology 112, no. 5 (2003): 395–97. http://dx.doi.org/10.1177/000348940311200501.
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Approximately 30% of patients with sudden hearing loss show complete recovery. Researchers have long questioned whether extensive evaluation is necessary in these cases. Recently, however, with the increasing widespread application of magnetic resonance imaging, a higher rate than expected of acoustic neuromas has been detected in patients with sudden hearing loss. Two studies have suggested that affected patients may even partially regain hearing. The aim of the present clinical study was to determine whether acoustic neuroma–induced hearing loss may be associated with full recovery. The files of 67 patients evaluated for sudden hearing loss at Rabin Medical Center from 1989 to 2000 were reviewed. All patients underwent pure tone audiometry, acoustic reflex tests, and auditory brain stem evoked response tests. Hearing evaluation was followed by magnetic resonance imaging scan and, 1 month later, a second hearing test. Findings were compared between patients with and without evidence of tumor on imaging, and between patients with tumor with and without full recovery. Twenty-four patients (36%) had a diagnosis of acoustic tumor, of whom 4 (16.7%) recovered hearing after 1 month. All 4 tumors were intracanalicular. Two of these patients had low-tone hearing loss, and 2 had flat curves; 3 had a pathological auditory brain stem evoked response. Of the 43 patients without tumors, 26 (60%) showed complete resolution of the hearing loss. We conclude that complete recovery of hearing loss does not exclude acoustic tumor, and these patients therefore require full evaluation. The reason for the recovery remains unclear.
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Khera, Daisy, Saurabh Agarwal, Prawin Kumar, and Kuldeep Singh. "Case of oculo-auriculo-vertebral spectrum: rare clinical features." BMJ Case Reports 14, no. 3 (2021): e234181. http://dx.doi.org/10.1136/bcr-2019-234181.
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A 2-month-old boy presented to us with bilateral microtia, left lower motor neuron facial palsy, micrognathia, hemivertebra, bifid rib, bifid thumb and absent/hypoplastic right-sided depressor anguli oris. He had bilateral external auditory canal atresia, although response to loud sound was present. Brain stem evoked response audiometry (BERA) was advised at 3 months of age. Karyotype was normal. We diagnosed him as a case of oculo-auriculo-vertebral spectrum. Child was discharged on request by the family with the plan for bone-anchored hearing aid after BERA and plan for pinna and ear canal reconstruction at a later age but child did not come for any follow-up visit. On telephonic enquiry, it was found that he is thriving well but has developmental delay including speech delay. We conclude that children presenting with external ear abnormalities should be screened for multiple congenital anomalies so that a multidisciplinary approach to management can be planned.
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N P, Prasanth, Dr Ravanan M P, and Deepak Raj P V. "A Study on Diagnosis of Auditory Neuropathy Spectrum Disorder in Adults and Comparison of Its Management with Hearing Aids Versus Cochlear Implantation." International Journal of Health Sciences and Research 12, no. 9 (2022): 258–63. http://dx.doi.org/10.52403/ijhsr.20220933.
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This study was done at two super specialty hospitals with the purpose of identifying the best diagnostic methods and management options for Auditory Neuropathy Spectrum Disorders (ANSD) in adults. In the management part, we compared the benefits of hearing aids versus cochlear implantation in adult subjects with ANSD. This study was conducted between August 2014 and July 2020. Out of a large number of patients who came to the department, 30 patients who were willing for the study and fulfilled the criteria of ANSD were taken as subjects. Average age of the subjects was 29 years. Specific risk factors which are common in infantile ANSDs were not seen in adult subjects. Pure tone audiometry showed sensory neural hearing loss varying from mild to profound in severity and varying configurations. The word discrimination scores varied from 0% to 70%. Ipsilateral and contralateral Acoustic reflexes were absent in both ears. Brain stem evoked responses showed absent/abnormal peaks at maximum stimulus presentation levels. Cochlear microphonics was present in 80% of individuals and DPOAEs were present in 70% of individuals. Only 30% showed benefit after hearing aid use. 4 individuals underwent cochlear implantation and they showed improvement in hearing threshold, speech discrimination, and reception skills. Thus benefits of hearing aid are limited in late onset ANSDs but they show considerable benefit with cochlear implantation. Audiological investigations such as PTA, Speech audiometry, Immittance Audiometry, OAE & ABR plays the key role in diagnosis of ANSD. A large sample size study and long term follow up is needed to assess the exact outcome of various management options in adults with ANSD. Key words: ANSD - Auditory Neuropathy Spectrum Disorder, DPOAE – Distortion Product Otoacoustic emissions OAE – Oto Acoustic Emissions. ABR - Auditory brainstem response, PTA- Pure Tone Audiometry cochlear microphonics, hearing aids, speech discrimination, cochlear implantation SNHL – Sensory Neural Hearing Loss ANSI – American National Standards Institute
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Hyde, Martyn, Noriaki Matsumoto, Peter Alberti, and Yao-Li Li. "Auditory Evoked Potentials in Audiometric Assessment of Compensation and Medicolegal Patients." Annals of Otology, Rhinology & Laryngology 95, no. 5 (1986): 514–19. http://dx.doi.org/10.1177/000348948609500514.
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The clinical utility of auditory evoked potentials for validation of the pure tone audiogram in adult compensation claimants and medicolegal patients is examined. Large sample comparisons of evoked potential and conventional pure tone thresholds showed that the slow vertex response can estimate true hearing levels within 10 dB in almost all patients. Given adequate tester skills, it is the tool of choice, and it merits more widespread implementation. Properly used, it can improve and abbreviate the assessment battery for detection and quantification of nonorganic hearing loss. The 40-Hz middle latency response is useful as a secondary tool, but at present, cochlear nerve and brain stem potentials have limited audiometric value in this population.
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C, Sathyaki D. "A clinico-epidemiological study of hearing loss in adult patients presenting to a tertiary healthcare center in India." MedPulse - International Journal of ENT 19, no. 3 (2021): 18–20. http://dx.doi.org/10.26611/10161932.
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Background: The objectives of the study are: 1. To determine the profile of patients presenting with hearing loss. 2. To determine the causes of hearing loss in adult patients of various age groups. The cases for the study comprised of adult patients aged >/=20years, presenting to the ENT Out-patient Department with complaint of hearing loss. Detailed history thorough ENT examination including Examination of the ear, nose and throat with Bull’s eye lamp, Otoscopic/Otomicroscopic/Otoendoscopic examination with photo-documentation of the ear status when required, tuning fork tests, and a battery of audiological tests including pure-tone audiometry, impedance audiometry and Brain-stem Evoked Response audiometry (when required) were conducted and the reports of the same were enclosed with the Pro forma of the patients. Results and Discussion: Hearing loss is more common in old age and more male patients presented with hearing loss. The most common symptom seen with hearing loss was tinnitus which was commonly ringing type and this was commonly seen in older patients associated with sensori-neural hearing loss. The most common type of hearing loss was sensori-neural hearing loss seen more commonly in older patients and associated with tinnitus. The definitive diagnosis for patients with sensori-neural hearing loss was difficult to specify with the most common diagnosis being presbyacusis, followed by noise induced hearing loss. The second common diagnosis was Chronic Otitis Media(COM).
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Oliveira, Anna Caroline Silva de, Simone Fiuza Regaçone, and Ana Claudia Figueiredo Frizzo. "Middle latency auditory evoked potential in child population." Journal of Human Growth and Development 26, no. 3 (2016): 368. http://dx.doi.org/10.7322/jhgd.122905.
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Introduction: The middle-latency auditory evoked potential is used to evaluate any abnormality that might impair the central auditory pathways, which are situated between the brain stem and the primary auditory cortex. Objective: To analyse the middle-latency auditory evoked potentials in children. Methods: This is a descriptive and cross-sectional study. Pure-tone audiometry was performed, and if no change was detected, Biologic’s portable Evoked Potential System (EP) was used to measure auditory evoked potentials. The identification of the responses was performed using electrodes positioned at C3 and C4 (left and right hemispheres) in reference to ears A1 and A2 (left and right earlobe). These were ipsilaterally and contralaterally paired and landed at Fpz (forehead), in two steps, with alternating stimulation of the right and left ears. Results: In this study, there was 100% detectability of the Na, Pa, and Nb components and interamplitude Na–Pa. This study compared different electrode leads, and there was no significant difference between the different electrode positions studied for the right and left ears in the studied population. Conclusion: It was concluded that the examination of middle-latency evoked potential is steady and feasible for the studied age group regardless of electrode position.
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Karmacharya, Sameer, Bikash Lal Shrestha, Abha Kiran K.C., Aakash Pradhan, Ayushi Shrestha, and Saroj Babu Ghimire. "Comparative study of Automated Auditory Brainstem Response (AABR) and Brainstem Evoked Response Audiometry (BERA) for Hearing Loss Detection in High Risk Infants delivered in Dhulikhel Hospital." Janaki Medical College Journal of Medical Science 11, no. 1 (2023): 6–11. http://dx.doi.org/10.3126/jmcjms.v11i1.56845.
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Background & Objective: Brainstem evoked response audiometry (BERA) is most specific and sensitive test for brain stem dysfunction. It is most important objective method for evaluating peripheral auditory system in neonates, infants, sedated and comatose patients and other person who doesn’t understand the language. Objective of the study was to evaluate correlation BERA with other audiological tests in different types of hearing loss. Material and Methods: This was a hospital based retrospective observational analytic study that used a cross-sectional approach. The sampling used was consecutive sampling until the minimum size fulfilled from 1st September 2021 to 30th September 2022. All high-risk infants aged 0–3 months who suffer from asphyxia, sepsis, LBW, premature, and hyperbilirubinemia, the baby was stable and transportable, the patient’s parents were willing to participate were taken. Results: Out of 46 high risk infants of 0 - 3 months, male:female ratio of 1.7:1 with mean age of 31 days, the most common high risk factor was low birth weight and hyperbilirubinemia i.e 23(50%). 64% of infants were pass in AABR 2nd test in comparison to 71% pass in BERA test. Conclusion: There was no difference between AABR and BERA results for HL detection in high-risk infants at NICU.
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K., Latha, Vidhya A., Abiramasundari R., and Viji Devanand. "A study of auditory brainstem response in vitiligo patients." Biomedicine 43, no. 02 (2023): 630–33. http://dx.doi.org/10.51248/.v43i02.2049.
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Introduction and Aim: Vitiligo is a hypomelanotic, idiopathic disease influencing entire pigmentary system which includes stria vascularis of internal ear described by depigmented patches in the skin because of absence of melanin and functioning melanocytes in the epidermis. The aim of this study was to assess the audiological irregularities by assessing the brain stem auditory evoked potential in vitiligo patients and comparing with the healthy controls. Materials and Methods: Forty clinically confirmed vitiligo patients of 20 to 40 years of both genders, with or without therapy were enlisted from the Dermatology and cosmetology outpatient clinics, Government Stanley Hospital. Forty controls with similar ages and genders were chosen. The Neuro perfect Medicaid polyrite instrument was used in recording Brainstem Evoked Reaction Audiometry (BERA) in both vitiligo individuals and controls. Inter-Peak Latencies (IPL) and Absolute Wave Latencies (AWL)were measured and analysed by using SPSS version 17. Student's independent 't' test was done for comparing the groups. Results: AWL and IPL of the two ears were measured and both were compared in the study and control groups. In the left ear, AWL III of study subjects had a significant increase 3.34+0.16 than that of controls 3.27+0.19; IPL I-III also significantly increased in the study subjects 1.91+0.16 than the controls 1.77+0.17. In the right ear, AWL III of study subjects had a significant increase 3.18+0.17 than the controls 3.06+0.15; IPL I-III also significantly increased in the study subjects 1.79+0.17 than the controls 1.64+0.16. Conclusion: BERA findings were abnormal in clinically asymptomatic research subjects, suggesting that this test should be included in the routine follow-up of vitiligo patients to detect audiological subclinical involvement.
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J, Maina, Rati Santhakumar, Manoj V.C., and Mridula Vellore. "Screening for Hearing Impairment in High-Risk Neonates in a Tertiary Care Centre in Central Kerala." Journal of Evidence Based Medicine and Healthcare 7, no. 49 (2020): 2959–63. http://dx.doi.org/10.18410/jebmh/2020/605.
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BACKGROUND Hearing loss is a chronic condition, and many cases can be detected in the neonatal period. Recognizing it early is of crucial importance as early auditory rehabilitation would help in child’s comprehensive development. We wanted to assess the prevalence of hearing impairment among high risk newborns admitted to inborn unit of tertiary care centre in Central Kerala and screen for the associated risk factors in these newborns. METHODS Thousand consecutive inborn neonates from Neonatal ICU, Department of Paediatrics, tertiary care centre in Thrissur, Kerala, detected as high risk by Joint Committee on Infant Hearing (JCIH) criteria were enrolled for the study from December 2011 to November 2012 after the approval by Institute’s Ethics Review Board. Risk factor assessment was done before enrolment. A qualified audiologist conducted the test on babies in soundproof chamber. DPOAEs (Distortion Product Otoacoustic Emissions) were used for initial testing after checking ears for debris. Those who failed in the first test were asked to come for a retest after 2 weeks. Those who failed in the retest were asked to report for Brainstem Evoked Response Audiometry (BERA). Those who were diagnosed as having hearing impairment were advised auditory rehabilitation as well as auditory verbal therapy. RESULTS Of the 1000 eligible neonates born in our hospital during the study period (December 2011 to November 2012) 69 were lost to follow up. Among the remaining 931 babies the frequency of hearing impairment was 0.8 %. Among the 931 neonates, 130 had absent response with the first OAE test contributing to 13.9 %. Twenty-one neonates had absent response to second OAE test out of 130 contributing to 16.1 %. The failure rate for second test is 2.2 % of the total population of 931 newborns. Eight of the 21 neonates who were subjected to BERA had severe hearing loss. The prevalence of hearing impairment was 8 per 1000. CONCLUSIONS The prevalence (percentage) of hearing impairment by two staged screening protocol is 0.8 %. Risk factors which were present in these babies were prematurity, low birth weight, low Apgar score, history of exanthematous fever in mother, neonatal jaundice, ototoxic medication history, craniofacial anomalies, and family history of deafness, meningitis and mechanical ventilation. KEYWORDS Otoacoustic Emissions, Brain Stem Evoked Response Audiometry, Risk Factors, Hearing Impairment, Neonates
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Savonius, Okko, Irmeli Roine, Saeed Alassiri, et al. "867. Upregulated Matrix Metalloproteinase-2 Relates to Milder Hearing Impairment in Bacterial Meningitis." Open Forum Infectious Diseases 5, suppl_1 (2018): S23. http://dx.doi.org/10.1093/ofid/ofy209.052.
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Abstract Background Hearing impairment is a well-recognized sequela caused by bacterial meningitis, but the underlying pathophysiology remains largely unknown. Matrix metalloproteinase-2 (MMP-2) is known to affect neuronal cell damage and survival in different diseases of the brain. We investigated whether levels of MMP-2 in the cerebrospinal fluid (CSF) relate to the extent of hearing impairment in children with bacterial meningitis. Methods Clinical data of 179 children were obtained from a previous clinical trial examining the adjuvant treatment of bacterial meningitis in Latin America in 1996–2003. At discharge or shortly thereafter, the ability to hear was measured with brain stem evoked response audiometry or traditional pure tone audiometry. Levels of CSF MMP-2 on admission (CSF1, n = 161) and 12–24 hours later (CSF2, n = 133) were assessed by zymography. The combined results for the detected pro-form and active MMP-2 were compared with the audiological outcome of the patients. Results MMP-2 was detected in half of both the CSF1 and CSF2 samples. The median densitometric values with interquartile ranges (IQRs) were 0.04 (IQR 0.00–0.29) for CSF1 and 0.00 (IQR 0.00–0.33) for CSF2. Detectable MMP-2 associated with milder hearing impairment in CSF1 (P = 0.05), but not in CSF2 (P = 0.1). Patients who were deaf at discharge had lower levels of MMP-2 in both samples (CSF1, P = 0.05; CSF2, P = 0.04), compared with patients who were not deaf. A MMP-2 level over the 75th percentile in CSF1 predicted lower odds of any audiological sequelae (odds ratio 0.30, 95% confidence interval 0.14–0.68, P = 0.004). Conclusion The upregulation of MMP-2 in the CSF associated with a better audiological outcome in children with bacterial meningitis. The results suggest that MMP-2 might play a protective role in the development of hearing sequelae due to bacterial meningitis. Disclosures All authors: No reported disclosures.
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Mihail, R. Clifford, Joseph Fishburne, Joanne M. Crowley, John E. Reinwall, Brian E. Walden, and Joan T. Zajtchuk. "The Tricyclic Trimipramine in the Treatment of Subjective Tinnitus." Annals of Otology, Rhinology & Laryngology 97, no. 2 (1988): 120–23. http://dx.doi.org/10.1177/000348948809700204.
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We examined 26 consecutive patients with subjective tinnitus. All subjects were treated with the tricyclic antidepressant trimipramine in a double-blind study, each subject acting as his own control. All subjects were evaluated with pure tone audiometry, site of lesion testing, and auditory brain stem evoked response. The tinnitus assessment consisted of frequency and intensity matching, the determination of masking levels, and a subjective evaluation of severity. Plasma levels of trimipramine were monitored at regular intervals, and the Zung and Millon inventories were administered at the beginning and end of each study period. Nineteen subjects completed the study. Within the trimipramine group, one reported complete disappearance of his tinnitus, eight reported improvement, three no change, and seven that tinnitus was worse. Within the placebo group, eight reported improvement, seven no change, and four that tinnitus was worse. The natural history of tinnitus is such that what has been observed may reflect the evolution of the disease itself, rather than the effect of treatment. We feel that while tricyclics may not have been shown to be effective, the placebo effect played a significant role in the results obtained.
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Telian, Steven A., and Paul R. Kileny. "Usefulness of 1000 Hz Tone-Burst-Evoked Responses in the Diagnosis of Acoustic Neuroma." Otolaryngology–Head and Neck Surgery 101, no. 4 (1989): 466–71. http://dx.doi.org/10.1177/019459988910100410.
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The auditory brain stem response (ABR) has become widely recognized as a sensitive and cost-effective screening modality in neuro-otologic diagnosis. However, the audiometric characteristics of the test ear may obscure the interpretation of the click-evoked ABR, particularly in the face of high-frequency hearing loss. It is often unclear whether latency delays or absent responses are attributable to retrocochlear disease or simply to the magnitude of the patient's hearing loss. The acoustic click stimulus commonly used in ABR testing activates predominantly the basilar membrane in the 2000 to 4000 Hz range. Because many cochlear and retrocochlear processes are associated mainly with hearing loss in this range, we have found it helpful in selected cases to use 1000 Hz tone-burst stimuli to circumvent the effects of elevated hearing thresholds on the ABR. In this article, our experience with the use of 1000 Hz nonlinearly gated tonebursts in 17 patients with acoustic neuroma is presented.
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Karkala, Venkat Nagender Reddy, Mounika Thopicharla, Jyothi Ramakrishna, and Rama Krishna Tirumala Bukkapatnam. "Early Detection of Hearing Impairment in Neonates - Screening by Otoacoustic Emission Test." Journal of Evidence Based Medicine and Healthcare 8, no. 07 (2021): 384–90. http://dx.doi.org/10.18410/jebmh/2021/75.
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BACKGROUND Approximately 3 per 1000 live births suffer from congenital hearing loss in India. If detected before the age of 6 months, their mental, social and intellectual growth can be restored by early intervention and rehabilitation. Their speech development and social integration depends highly on early detection of hearing loss, at least before the first birthday. We wanted to screen all new-borns for hearing and assess the incidence of hearing impairment in at risk and no risk cases by using otoacoustic emissions. We also wanted to evaluate the two-stage testing by OAE in screening programme. METHODS The present study was conducted from Feb. 1st 2013 to Jan. 31st 2015. A total of 849 infants have been studied of which 63 had high risk factors. RESULTS The overall incidence of hearing impairment was found to be 3.75 / 1000 births in no-risk group whereas 61.22 / 1000 were found in high risk group. CONCLUSIONS Early detection of hearing loss in infants by otoacoustic emission (OAE) is a reliable tool. It conforms with high precision when done with a two-stage protocol that reduces false apprehensions. KEYWORDS Neonatal Hearing Loss, Universal Screening, Otoacoustic Emissions, Brain Stem Evoked Response Audiometry (BSERA), OAE
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K., Srirangaprasad, Vinay Kumar V., and Pruthvi Raj S. "A study on efficacy of injection of intratympanic dexamethasone in treatment of sudden sensorineural hearing loss." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 3 (2020): 506. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20200625.
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<p class="abstract"><strong>Background:</strong> Sudden sensorineural hearing loss is a common otologic emergency which occurs due to various etiologies affecting the inner ear. Majority of treatment protocols are focussed on glucocorticoids either systemically or through intratympanic route due to their antioxidant and anti-inflammatory properties.</p><p class="abstract"><strong>Methods:</strong> This was a pre and post observational clinical study conducted in patients visiting Rajarajeswari medical college between December 2015 to December 2016 with a history of sudden hearing loss (30 patients). 6 of these patients presented with bilateral hearing loss, and we considered each ear as a separate case, giving us a total of 36 cases. A diagnosis of idiopathic sudden sensorineural hearing loss was made based on the patient’s history and audiological evaluation. All the patients were treated with 3 doses of Intratympanic injections of Dexamethasone (4 mg/ml), on alternate days. Pure tone audiometry (PTA) and brain stem evoked response audiometry (BERA) was done pre-treatment, at 1 and 6 months after treatment. </p><p class="abstract"><strong>Results:</strong> Mean age of our patients was 44.8. 80% of our patients were male. The average PTA gain, 1 month after treatment was 27.917 and 6 months after treatment was 29.639 with a p value of &lt;0.001, which correlated with BERA. At the end of 6 months after treatment, 15 cases had complete recovery (41.7%), 9 cases showed slight recovery (25%), 6 cases had marked recovery and 6 cases (16.7%) had no recovery.</p><p><strong>Conclusions:</strong> Intratympanic dexamethasone injections can be used as the first line of treatment with minimal side effects. </p>
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Sreedharan, Thulaseedharan, Nandakumar C.R, Sinumol Sukumaran, and Sheela Vasu. "Role of Two Stage Otoacoustic Emissions Test for Screening of Hearing Impairment in High Risk Neonates - A Prospective Observational Study." Journal of Evidence Based Medicine and Healthcare 7, no. 42 (2020): 2404–8. http://dx.doi.org/10.18410/jebmh/2020/498.
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BACKGROUND Hearing is one of the most important senses which constitutes the basis for acquiring language, communication, cognitive and psychosocial development. Hearing impairment in infants should be recognized as soon as possible after birth for early interventions. Hearing status of a newborn in this study is being assessed by two subsequent tests with Oto-Acoustic Emissions (OAE) followed by Brain stem Evoked Response Audiometry (BERA). We wanted to study the efficacy and role of two stage Otoacoustic Emission (OAE) test for screening high risk new-borns to detect hearing impairment. METHODS A prospective observational study was conducted from July 2014 to July 2017 at Govt. Medical College, Thrissur, Kerala. OAE screening was done in two stages for 500 high risk infants admitted in newborn intensive care unit (NBICU) during the study period. First OAE test was done on the day of admission and 2nd test was done after one month. All the infants underwent Brainstem Evoked Response Audiometry (BERA) test, a month after the second OAE test. Data was analysed for efficacy of the tests. RESULTS First OAE was passed by 290 babies i.e. 58 % whereas 210 babies (42 %) showed a result of ‘refer’ in both the ears. Second OAE tests were done after 1 month which showed a result of ‘pass’ by 460 babies (92 %) and a ’refer’ by 40 babies (8 %). All babies which underwent BERA 1 month after second OAE were included in the study; out of those babies, 10 babies showed impaired hearing and they were referred for further evaluation and intervention. In our study, OAE was 100 % sensitive in the first and second tests. Specificity of OAE was 59.1 % and 93.87 % in the first and second tests respectively. The study showed 2 % permanent congenital hearing impairment (PCHI). CONCLUSIONS OAE is an effective tool providing a quick, harmless and less expensive method for screening of hearing loss in infants, irrespective of comorbidities. No single test can detect all defects in the auditory pathway. As a primary option, a two-stage evaluation with OAE can easily detect infants who need further evaluation and early intervention. A two-stage screening with OAE will give a highly sensitive and reasonably specific test which can be easily implemented in all levels of the healthcare system. KEYWORDS High Risk Neonates, Hearing Impairment, OAE, BERA
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Ramanjaneyulu, J., S. Rajesh Kumar, V. Krishna Chaitanya, and A. Kusumanjali. "Oto acoustic emissions in early detection of sensorineural hearing loss in high-risk neonates." International Journal of Otorhinolaryngology and Head and Neck Surgery 7, no. 11 (2021): 1794. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20214233.
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<p><strong>Background: </strong>Early identification of congenital hearing loss and early intervention ameliorated many adverse consequences. This study was performed to observe effectiveness of otoacoustic emission in screening of hearing loss in high-risk babies.</p><p><strong>Methods: </strong>Prospective study on 45 high-risk newborns delivered during period of 2013-2014. Selective newborn hearing performed with oto acoustic emissions (OAE) and auditory brain stem responses (ABR), in high-risk infants aged below 7 days, 15 days, after 45 days and after 90 days.</p><p><strong>Results: </strong>Study population comprised of 45 high-risk newborns. In 1<sup>st</sup> level screening, 28 (62%) babies showed recordable OAE, 17 (38%) babies failed. In 2<sup>nd</sup> level screening 31 (81%) passed and 7 (19%) failed and death occurred in 7 infants. In 3<sup>rd</sup> level screening both OAE and brain stem evoked response audiometry (BERA), was performed in 38 cases and positivity was reported in 37 cases. 4<sup>th</sup> level screening was similar to 3<sup>rd</sup> level screening where 3 babies failed ABR test. In our study incidence of sensorineural hearing loss found to be 78.91% (3/38×1000) per 1000 high-risk babies. Auditory neuropathy was observed in 2 (4.4%) patients. Sensitivity and specificity of OAE was 100% and 33.3% respectively. In high-risk low birth weight neonates’ sensitivity and specificity was 66.7% and 50.0%.</p><p><strong>Conclusions: </strong>In high-risk babies, appropriate time for screening with OAE is around 60 days of age. OAE are useful diagnostic tool in evaluation of high-risk neonates for early detection of sensorineural hearing loss.</p>
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Qiu, William W., Fred J. Stucker, Shengguang S. Yin, and Louis W. Welsh. "Current Evaluation of Pseudohypacusis: Strategies and Classification." Annals of Otology, Rhinology & Laryngology 107, no. 8 (1998): 638–47. http://dx.doi.org/10.1177/000348949810700802.
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Some cases of pseudohypacusis may involve medicolegal aspects and require a confirmed and quantitative diagnosis. These challenging cases must be identified, and then evaluated with basic audiologic and sophisticated electrophysiologic tests. Data on 64 patients with pseudohypacusis collected over a 4-year period are reported. A classification system was developed from an analysis of these cases and is presented for clinical evaluation and diagnosis. In many cases, conventional audiologic evaluation involving pure tone and speech audiometry may be adequate and sufficient for diagnosis. In more complex cases, evoked otoacoustic emissions (EOAEs) and auditory brain stem responses (ABRs) are needed for confirmation of peripheral auditory sensitivity. We found that EOAEs were the most rapid, economical, and objective method, and confirmed the diagnosis of hearing loss in 78.1 % of cases. Fifteen percent of subjects required ABRs to substantiate the diagnosis. The reliability of basic audiologic tests based on previous clinical investigations and data from the literature are discussed. We conclude that a thorough knowledge and understanding of pseudohypacusis is essential to verify the existence of pseudohypacusis, to determine its type, and to quantify the auditory thresholds.
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Stuart, Andrew, and Kristal N. Mills. "Late-Onset Unilateral Auditory Neuropathy/Dysynchrony: A Case Study." Journal of the American Academy of Audiology 20, no. 03 (2009): 172–79. http://dx.doi.org/10.3766/jaaa.20.3.3.
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Background: Auditory neuropathy/dysynchrony (AN/AD) typically develops early in life and is bilateral in nature. Purpose: Herein, we describe an unusual finding of late-onset unilateral AN/AD based on reported case history and audiometric findings. Research Design: A 64-year-old female presented with a complaint of a progressive unilateral hearing loss that had developed over the past two–three years. She underwent an extensive behavioral/electrophysiological test battery. Results: Magnetic resonance imaging was negative for internal auditory canal mass or lesion. A unilateral notched loss centered at 1000 Hz and other findings were consistent with late-onset unilateral AN/AD: observable bilateral otoacoustic emissions and cochlear microphonics, absent middle acoustic reflexes with stimulation on the affected side, abnormal auditory brain stem response on the affected side, and poorer speech recognition than would be predicted by the audiogram. Middle-latency and long-latency evoked responses were present bilaterally, although with lower amplitudes on the affected side.
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Pudar, Goran, Ljiljana Vlaski, Danka Filipovic, and Ilija Tanackov. "Functional hearing examinations in patients suffering from diabetes mellitus type 1 in regard to disease duration." Medical review 63, no. 5-6 (2010): 318–23. http://dx.doi.org/10.2298/mpns1006318p.
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Introduction. Problems of hearing disturbances in persons suffering from diabetes have been attracting great attention for many decades. Material and methods. In this study we examined the auditory function of 50 patients suffering from diabetes mellitus type 1 of different duration by analyzing results of pure-tone audiometry and brainstem audi?tory evoked potentials. The obtained results of measuring were compared to 30 healthy subjects from the corresponding age and gender group. The group of diabetic patients was divided according to the disease duration (I group 0-5 years; II group 6-10 years, III group over 10 years). Results and discussion. A statistically significant increase of sensorineural hearing loss was found in the diabetics according to the duration of their disease (I group = 14.09%, II group = 21.39%, III group = 104.89%). The results of the brain stem auditory evoked potentials, the significance threshold being p=0.05 between the controls and the diabetics at all levels of absolute latency of right and left sides, did not show significant differences in the mean values. In the case of interwave latencies, the diabetic patients were found to have a significant qualitative difference of intervals I-III and I-V on both ears in the sense of internal distribution of response. In cases of sensorineural hearing loss we found a significant connection with prolonged latencies of I wave on the right ear and of I and V waves on the left ear. In all probability, the cause of these results could be found in distinctive individuality of the organism reactions to the consequences of this disease (disturbance in the distal part of n. cochlearis). Conclusion. The results of research have shown the existence of a significant sensorineural hearing loss in the patients with diabetes mellitus type 1 in accordance to the disease duration. We also found qualitative changes of brainstem auditory evoked potentials in the diabetic patients in comparison to the controls as well as significant quantitative changes in regard to the presence of sensorineural hearing loss of the patients.
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Sabol, Z., F. Sabol, M. Kovač Šižgorić, et al. "Neurofibromatoses: II linical recommendations for the diagnosis, treatment and multidisciplinary monitoring of patients with neurofibromatosis type 2 and schwannomatosis." Paediatria Croatica 56, no. 2 (2012): 187–94. http://dx.doi.org/10.13112/pc.754.
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Neurofibromatosis type 2 is a neurocutaneous disease with an autosomal dominant pattern of inheritance. The NF2 gene is a tumor suppressor gene located on chromosome 22q12.1 and encodes the protein called merlin or schwannomin. Neurofibromatosis type 2 is characterized by the development of schwannomas of cranial nerves (usually bilateral involvement of the eighth nerve), spinal and peripheral nerves, multiple meningeomas, ependymomas, and ophthalmological changes (presenile cataract). The onset of neurofibromatosis type 2 symptoms occurs in the second and third decades of life. In about 10% and 18% of patients, they become evident at 10 and 15 years of age, respectively. There is currently good agreement on the criteria for the diagnosis of neurofibromatosis type 2 and follow-up protocols for neurofibromatosis type 2 affected/suspected and at risk subjects. Patients with neurofibromatosis type 2 should be periodically re-evaluated by a multidisciplinary medical team familiar with the disease. Longitudinal care includes the following: detailed medical history/genetic counseling/DNA analysis (at diagnosis), clinical assessment (dermatological, neurological, and ophthalmological (yearly); audiological tests with audiometry and brain stem auditory evoked response (BAER) (yearly); and brain and full spine magnetic resonance imaging (yearly). In first degree relatives of neurofibromatosis type 2 patients (at risk subjects), clinical monitoring includes the following: ophthalmological examination in the first two years of life (for asymptomatic congenital cataract); DNA analysis; clinical assessment (neurological, ophthalmological, and audiological) until the teens; and certainly brain and full spine magnetic resonance imaging at 15 and 30 years. If the results of these examinations are normal, follow-up can cease. The mainstay of treatment of NF2 complications is surgical removal of symptomatic tumors. Schwannomatosis is a third form of neurofibromatosis characterized by multiple schwannomas of cranial, spinal and peripheral nerves, but no bilateral vestibular schwannomas. The gene for schwannomatosis, called INI1/SMARCB1, is localized on chromosome 22 near the NF2 gene. In the pathogenesis of schwannomatosis, the most probable joint roles have INI1/SMACB1, NF2 gene, and other undetected genes. The disease begins to manifest itself clinically in young adulthood.
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Bhagya V, Manjushree R, and Brid S V. "Incidence of hearing impairment in at risk babies." Indian Journal of Clinical Anatomy and Physiology 8, no. 4 (2022): 293–97. http://dx.doi.org/10.18231/j.ijcap.2021.063.
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Babies treated in neonatal intensive care are prone for hearing problems and with the decrease in infant mortality, babies who survive many perinatal risk factors are increasing. Deafness in 1st three years of life may impair the full development & maturation of auditory system & it is well known that deafness in infancy & childhood interferes with normal development of speech & language. To prevent this & to initiate rehabilitative procedure as early in life as possible a screening method to detect auditory disabilities in newborns is of great importance. Based on this background the present study determine to evaluate to know the incidence of hearing impairment in infants at risk.This is a prospective observational study conducted in JJM Medical College, Davanagere, Karnataka. A total 940 patients attended to JJM Medical College and Hospital and diagnosed with hearing impairment according to American Joint Committee statement on infant hearing screening (JCIH) criteria. All the patients under 2 years with history of high risk factors – pre–term, low birth weight, birth asphyxia, neonatal seizures, and hyperbilirubinemia were selected for the study. Those who failed in this test underwent repeated OAE after 6 weeks, followed by brain stem evoked response audiometry (BERA) if the second OAE was negative. Out of 940 high risk cases, 350 had profound hearing loss, 83 had severe hearing loss, 125 had moderate hearing impairment, 36 had mild hearing impairment &346 had normal hearing sensitivity. Out of 48 patients with normal hearing sensitivity, 53 patients were preterm, 166 had hyperbilirubinemia, 23 had neonatal convulsions, 68 birth asphyxia, 89 were of low birth weight. Out of 147 cases 31 patients had mild/moderate hearing impairment.Neonatal jaundice carries the highest risk of hearing impairment followed by birth asphyxia, neonatal convulsions and low birth weight.BERA is the tool which can confirm the normal sensitivity of hearing whenever required & is very useful in early detection of hearing loss and planning rehabilitative procedures.
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Yamashita, Toshiyuki, Mikio Yamaguchi, Humitoshi Tachibana, Masahiko Taniguchi, Hiroyuki Kanetake, and Yasuo Koike. "LARYNX-EVOKED BRAIN STEM RESPONSE." Koutou (THE LARYNX JAPAN) 3, no. 1 (1991): 1–3. http://dx.doi.org/10.5426/larynx1989.3.1_1.
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Anonsen, Cynthia K., M. Lauren Lalakea, and Maureen Hannley. "Laryngeal Brain Stem Evoked Response." Annals of Otology, Rhinology & Laryngology 98, no. 9 (1989): 677–83. http://dx.doi.org/10.1177/000348948909800904.
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Sensory stimuli to the larynx evoke a laryngeal adductor reflex mediated by the brain stem via superior and recurrent laryngeal nerves. Aberrant laryngeal reflexes have been proposed to explain a number of poorly understood disorders, including “reflex apnea,” idiopathic laryngospasm, and sudden infant death syndrome. The purpose of the present study was to evaluate far field brain stem recordings following stimulation of the superior laryngeal nerve to determine whether laryngeal brain stem response is a valid measure of laryngeal activity at the brain stem level. The nerve was stimulated electrically in adult cats, and the resultant laryngeal adductor response as well as far field brain stem activity was recorded. For the latter, six reproducible positive and five reproducible negative waves were obtained via posterior pharyngeal (+) and posterior cervical (−) recording electrodes. Response threshold and latencies were measured and evaluated as a function of stimulus parameters. Wave latencies corresponded closely to those reported in prior near and far field evoked response recordings.
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WOODSON, G. E. "Laryngeal Brain-Stem-Evoked Response." Archives of Otolaryngology - Head and Neck Surgery 115, no. 11 (1989): 1279–81. http://dx.doi.org/10.1001/archotol.1989.01860350013004.
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Bhandari, Vineet, Anil Narang, S. B. S. Mann, M. Raghunathan, and O. N. Bhakoo. "Brain stem electric response audiometry in neonates with hyperbilirubinemia." Indian Journal of Pediatrics 60, no. 3 (1993): 409–13. http://dx.doi.org/10.1007/bf02751203.
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Yamashita, Toshiyuki. "Larynx-evoked Brain Stem Response on Human." Koutou (THE LARYNX JAPAN) 2, no. 2 (1990): 130–35. http://dx.doi.org/10.5426/larynx1989.2.2_130.
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J. B. Ashraf Al and J. Rose Priyadharshini. "Brain Stem Evoked Auditory Response In Hypertension." Indian Journal of Public Health Research & Development 15, no. 4 (2024): 160–67. http://dx.doi.org/10.37506/a62cyb54.
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Aim: To Assess the involvement of Peripheral and Central Brainstem Auditory Pathways in Hypertension Patients Materials & Methods: Eligibility Criteria for Hypertension Patients in the Study: BP > 140/90 mmHg, as per JNC 7 Guidelines, and Under Control with Antihypertensive Medications. Subjects with Acute Illness were excluded. Informed Written Consent Acquisition. Informed Written Consent Acquisition in the Study was made to Ensure Ethical Participation. Exclusion Criteria and Instrumentation in the Study: Patients with associated diseases (e.g., Diabetes Mellitus, Ischemic Heart Disease, Cerebrovascular Disease) or auditory abnormalities were excluded. Medicaid Neuroperfect plus Instrument was utilized, and electrodes were placed following the 10-20 international system of EEG electrode placement. The parameters include: Absolute latency of all the waves from I to V Interpeak latency I-III, I-V and III-V Result: The results of the study indicate that the Absolute Latency of Wave I in the hypertensive group showed a statistically significant prolongation, with a P value of 0.0001. This suggests that there is a notable delay in the auditory nerve response in these individuals compared to the control group. The statistically significant prolongation observed in the latency values of Waves I, V, Inter-peak latency I-V, and Inter-peak latency III-V highlights the impact of hypertension on auditory function and warrants further investigation for a better understanding of the underlying mechanisms. Conclusion: These findings indicate that there are measurable delays in the auditory nerve responses and the conduction of auditory signals along the brainstem pathways in individuals with hypertension. Further research in this area may help to better understand the underlying mechanisms and potentially explore novel approaches for managing auditory abnormalities in hypertensive patients.
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Darling, Rieko M., and Lloyd L. Price. "Loudness and Auditory Brain Stem Evoked Response." Ear and Hearing 11, no. 4 (1990): 289–95. http://dx.doi.org/10.1097/00003446-199008000-00006.
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Gunduz, B., Y. A. Bayazit, F. Celenk, et al. "Absence of contralateral suppression of transiently evoked otoacoustic emissions in fibromyalgia syndrome." Journal of Laryngology & Otology 122, no. 10 (2008): 1047–51. http://dx.doi.org/10.1017/s0022215107001569.
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AbstractObjective:To assess contralateral suppression of transiently evoked otoacoustic emissions in patients with fibromyalgia syndrome and normal hearing.Methods:Twenty-four female patients with fibromyalgia syndrome and 24 healthy female controls with normal hearing were assessed using pure tone audiometry and transiently evoked otoacoustic emissions.Results:All patients with fibromyalgia syndrome and all controls had normal hearing on pure tone audiometry. In the patients with fibromyalgia syndrome, the mean transiently evoked otoacoustic emission amplitude was 15.5 ± 4.8 dB. The mean transiently evoked otoacoustic emission amplitudes after contralateral suppression was 15.5 ± 4.9 dB. There was no statistically significant difference between the transiently evoked otoacoustic emission amplitudes measured before and after contralateral suppression (p > 0.05). In the controls, the mean transiently evoked otoacoustic emission amplitude was 12 ± 5 dB. The mean transiently evoked otoacoustic emission amplitudes after contralateral suppression was 11 ± 4.7 dB. There was a statistically significant decrease in transiently evoked otoacoustic emission amplitudes after contralateral suppression (p < 0.01).Conclusion:The mechanisms related to contralateral suppression of transiently evoked otoacoustic emissions seem dysfunctional in fibromyalgia syndrome. This dysfunction may be at the brain stem level, where the medial superior olivary complex is located, or at the synapses of medial superior olivary complex fibres with the outer hair cells in the cochlea. Demonstration of lack of contralateral suppression of transiently evoked otoacoustic emissions can be used as a diagnostic tool in patients with fibromyalgia syndrome.
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KAVIANI, M., and A. H. JAFARY. "Auditory brain-stem response audiometry in patients with Bell's palsy." Clinical Otolaryngology 20, no. 2 (1995): 135–38. http://dx.doi.org/10.1111/j.1365-2273.1995.tb00030.x.
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