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Luiz CBL, Gil D, Skarzynski PH, Skarżyńska MB, Sanfins MD, de Azevedo MF. The Auditory Steady-State Response and the Relationship between Electrophysiological and Behavioural Thresholds. Diagnostics (Basel) 2024; 14:1617. [PMID: 39125493 PMCID: PMC11311809 DOI: 10.3390/diagnostics14151617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/15/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND This study examined the relationship between behavioural thresholds as measured by pure tone audiometry and electrophysiological thresholds measured by the Auditory Steady-State Response (ASSR) in children with normal hearing and sensorineural hearing loss. MATERIALS AND METHODS After being assessed, 45 children of both sexes, ranging in age from 5 to 15, were split into four groups: 10 with moderate to moderately severe sensorineural hearing loss (G2M); 10 with steeply sloping sensorineural hearing loss (G2D); 10 with profound and severe sensorineural hearing loss (G2S); and 15 with normal hearing (G1). ASSR, tympanometry, acoustic reflex testing, pure tone audiometry, and speech audiometry (SRT and SDT) were performed. RESULTS The electrophysiological maximum in the group with normal hearing thresholds varied from 19 to 27 dB NA. The correlation in the group with moderate to moderately severe hearing loss was 0.42-0.74. The correlation in the steeply sloping hearing loss group was 0.68-0.94. The correlation in the group of people with profound and severe hearing loss was 0.59-0.86. The normal hearing group's mean differences in ASSR threshold and audiometric threshold ranged from -0.3 to 12 dB, in the moderate and moderately severe hearing loss group from -9 to 2 dB, in the steeply sloping hearing loss group from 1.4 to 7.5 dB, and in the severe and profound hearing loss group from -0.40 to 8.5 dB. CONCLUSION As expected, there was no strong relationship between behavioural and electrophysiological thresholds in the group with normal hearing. But in children with hearing loss, there was a strong correlation between electrophysiological and behavioural thresholds; this relationship was especially evident in children with severe and profound hearing loss and those with steeply sloping hearing loss.
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Affiliation(s)
- Cyntia Barbosa Laureano Luiz
- Department of Speech-Hearing-Language, Universidade Federal de São Paulo, São Paulo 04044-020, Brazil; (C.B.L.L.); (D.G.); (M.F.d.A.)
| | - Daniela Gil
- Department of Speech-Hearing-Language, Universidade Federal de São Paulo, São Paulo 04044-020, Brazil; (C.B.L.L.); (D.G.); (M.F.d.A.)
- Post-Graduate Program in Clinical Audiology, Instituto de Ensino e Pesquisa Albert Einstein, São Paulo 05652-000, Brazil
- Clinic of Audiology, Universidade Federal de São Paulo, São Paulo 04044-020, Brazil
| | - Piotr Henryk Skarzynski
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany, Poland;
- ENT Department, Maria Curie-Skłodowska University, 20-031 Lublin, Poland
- Center of Hearing and Speech Medincus, 05-830 Kajetany, Poland
- Department of Otolaryngology, Institute of Sensory Organs, 05-830 Warsaw, Poland
- Heart Failure and Cardiac Rehabilitation Department, Medical University of Warsaw, 02-091 Warsaw, Poland
- World Hearing Center, 05-830 Kajetany, Poland
| | - Magdalena Beata Skarżyńska
- Department of Pharmacotherapy and Pharmaceutical Care, Pharmaceutical Department, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Institute of Sensory Organs, 05-830 Kajetany, Poland
- Center of Hearing and Speech, 05-830 Nadarzyn, Poland
| | - Milaine Dominici Sanfins
- Department of Speech-Hearing-Language, Universidade Federal de São Paulo, São Paulo 04044-020, Brazil; (C.B.L.L.); (D.G.); (M.F.d.A.)
- Post-Graduate Program in Clinical Audiology, Instituto de Ensino e Pesquisa Albert Einstein, São Paulo 05652-000, Brazil
- Clinic of Audiology, Universidade Federal de São Paulo, São Paulo 04044-020, Brazil
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany, Poland;
| | - Marisa Frasson de Azevedo
- Department of Speech-Hearing-Language, Universidade Federal de São Paulo, São Paulo 04044-020, Brazil; (C.B.L.L.); (D.G.); (M.F.d.A.)
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Zhang VW, Hou S, Wong A, Flynn C, Oliver J, Weiss M, Milner S, Ching TYC. Audiological characteristics of children with congenital unilateral hearing loss: insights into Age of reliable behavioural audiogram acquisition and change of hearing loss. Front Pediatr 2023; 11:1279673. [PMID: 38027307 PMCID: PMC10663346 DOI: 10.3389/fped.2023.1279673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives The aims of this study were to report the audiological characteristics of children with congenital unilateral hearing loss (UHL), examine the age at which the first reliable behavioural audiograms can be obtained, and investigate hearing changes from diagnosis at birth to the first reliable behavioural audiogram. Method This study included a sample of 91 children who were diagnosed with UHL via newborn hearing screening and had reliable behavioural audiograms before 7 years of age. Information about diagnosis, audiological characteristics and etiology were extracted from clinical reports. Regression analysis was used to explore the potential reasons influencing the age at which first reliable behavioural audiograms were obtained. Correlation and ANOVA analyses were conducted to examine changes in hearing at octave frequencies between 0.5 and 4 kHz. The proportions of hearing loss change, as well as the clinical characteristics of children with and without progressive hearing loss, were described according to two adopted definitions: Definition 1: criterion (1): a decrease in 10 dB or greater at two or more adjacent frequencies between 0.5 and 4 kHz, or criterion (2): a decrease in 15 dB or greater at one octave frequency in the same frequency range. Definition 2: a change of ≥20 dB in the average of pure-tone thresholds at 0.5, 1, and 2 kHz. Results The study revealed that 48 children (52.7% of the sample of 91 children) had their first reliable behavioural audiogram by 3 years of age. The mean age at the first reliable behavioural audiogram was 3.0 years (SD 1.4; IQR: 1.8, 4.1). We found a significant association between children's behaviour and the presence or absence of ongoing middle ear issues in relation to the delay in obtaining a reliable behavioural audiogram. When comparing the hearing thresholds at diagnosis with the first reliable behavioural audiogram across different frequencies, it was observed that the majority of children experienced deterioration rather than improvement in the initial impaired ear at each frequency. Notably, there were more instances of hearing changes (either deterioration or improvement), in the 500 Hz and 1,000 Hz frequency ranges compared to the 2,000 Hz and 4,000 Hz ranges. Seventy-eight percent (n = 71) of children had hearing deterioration between the diagnosis and the first behavioural audiogram at one or more frequencies between 0.5 and 4 kHz, with a high proportion of them (52 out of the 71, 73.2%) developing severe to profound hearing loss. When using the averaged three frequency thresholds (i.e., definition 2), only 26.4% of children (n = 24) in the sample were identified as having hearing deterioration. Applying definition 2 therefore underestimates the proportion of children that experienced hearing changes. The study also reported diverse characteristics of children with or without hearing deterioration. Conclusion The finding that 78% of children diagnosed with UHL at birth had a decrease in hearing loss between the hearing levels at first diagnosis and their first behavioural audiogram highlights the importance of monitoring hearing threshold levels after diagnosis, so that appropriate intervention can be implemented in a timely manner. For clinical management, deterioration of 15 dB at one or more frequencies that does not recover warrants action.
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Affiliation(s)
- Vicky W. Zhang
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Sanna Hou
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
| | - Angela Wong
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
| | - Christopher Flynn
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Lutwyche centre, Hearing Australia, Brisbane, QLD, Australia
| | - Jane Oliver
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Upper Mt Gravatt centre, Hearing Australia, Brisbane, QLD, Australia
| | - Michelle Weiss
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Dandenong centre, Hearing Australia, Melbourne, VIC, Australia
| | - Stacey Milner
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- Cheltenham centre, Hearing Australia, Melbourne, VIC, Australia
| | - Teresa Y. C. Ching
- Audiological Science Department, National Acoustic Laboratories, Sydney, NSW, Australia
- NextSense Institute, Macquarie Park, Sydney, NSW, Australia
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, Australia
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Rance G, Carew P, Winata L, Sale P, Delatycki M, Sly D. Auditory neuropathy in mice and humans with Friedreich ataxia. Ann Clin Transl Neurol 2023; 10:953-963. [PMID: 37060174 PMCID: PMC10270266 DOI: 10.1002/acn3.51777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 04/16/2023] Open
Abstract
OBJECTIVE Recent studies have found that human Friedreich ataxia patients have dysfunction of transmission in the auditory neural pathways. Here, we characterize hearing deficits in a mouse model of Friedreich ataxia and compare these to a clinical population. METHODS Sixteen mice with a C57BL/6 background were evaluated. Eight were YG8Pook/J animals (Friedreich ataxia phenotype) and eight wild-type mice served as controls. Auditory function was assessed between ages 6 and 12 months using otoacoustic emissions and auditory steady-state responses. At study end, motor deficit was assessed using Rotorod testing and inner ear tissue was examined. Thirty-seven individuals with Friedreich ataxia underwent auditory steady-state evoked potential assessment and response amplitudes were compared with functional hearing ability (speech perception-in-noise) and disease status was measured by the Friedreich Ataxia Rating Scale. RESULTS The YG8Pook/J mice showed anatomic and functional abnormality. While otoacoustic emission responses from the cochlear hair cells were mildly affected, auditory steady-state responses showed exaggerated amplitude reductions as the animals aged with Friedreich ataxia mice showing a 50-60% decrease compared to controls who showed only a 20-25% reduction (F(2,94) = 17.90, p < 0.00). Furthermore, the YG8Pook/J mice had fewer surviving spiral ganglion neurons, indicating greater degeneration of the auditory nerve. Neuronal density was 20-25% lower depending on cochlear region (F(1, 30) = 45.02, p < 0.001). In human participants, auditory steady-state response amplitudes were correlated with both Consonant-Nucleus-Consonant word scores and Friedreich Ataxia Rating Scale score. INTERPRETATION This study found degenerative changes in auditory structure and function in YG8Pook/J mice, indicating that auditory measures in these animals may provide a model for testing Friedreich ataxia treatments. In addition, auditory steady-state response findings in a clinical population suggested that these scalp-recorded potentials may serve as an objective biomarker for disease progress in affected individuals.
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Affiliation(s)
- Gary Rance
- Department of Audiology and Speech PathologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Peter Carew
- Department of Audiology and Speech PathologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Leon Winata
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Phillip Sale
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Martin Delatycki
- Victorian Clinical Genetics Services, Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - David Sly
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
- Ear Science Institute AustraliaPerthWestern AustraliaAustralia
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Alamri Y, Jennings SG. Computational modeling of the human compound action potential. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:2376. [PMID: 37092943 PMCID: PMC10119875 DOI: 10.1121/10.0017863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/21/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
The auditory nerve (AN) compound action potential (CAP) is an important tool for assessing auditory disorders and monitoring the health of the auditory periphery during surgical procedures. The CAP has been mathematically conceptualized as the convolution of a unit response (UR) waveform with the firing rate of a population of AN fibers. Here, an approach for predicting experimentally recorded CAPs in humans is proposed, which involves the use of human-based computational models to simulate AN activity. CAPs elicited by clicks, chirps, and amplitude-modulated carriers were simulated and compared with empirically recorded CAPs from human subjects. In addition, narrowband CAPs derived from noise-masked clicks and tone bursts were simulated. Many morphological, temporal, and spectral aspects of human CAPs were captured by the simulations for all stimuli tested. These findings support the use of model simulations of the human CAP to refine existing human-based models of the auditory periphery, aid in the design and analysis of auditory experiments, and predict the effects of hearing loss, synaptopathy, and other auditory disorders on the human CAP.
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Affiliation(s)
- Yousef Alamri
- Department of Biomedical Engineering, The University of Utah, 390 South, 1530 East, BEHS 1201, Salt Lake City, Utah 84112, USA
| | - Skyler G Jennings
- Department of Communication Sciences and Disorders, The University of Utah, 390 South, 1530 East, BEHS 1201, Salt Lake City, Utah 84112, USA
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Easwar V, Purcell D, Wright T. Predicting Hearing aid Benefit Using Speech-Evoked Envelope Following Responses in Children With Hearing Loss. Trends Hear 2023; 27:23312165231151468. [PMID: 36946195 PMCID: PMC10034298 DOI: 10.1177/23312165231151468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 12/24/2022] [Accepted: 12/30/2022] [Indexed: 03/23/2023] Open
Abstract
Electroencephalography could serve as an objective tool to evaluate hearing aid benefit in infants who are developmentally unable to participate in hearing tests. We investigated whether speech-evoked envelope following responses (EFRs), a type of electroencephalography-based measure, could predict improved audibility with the use of a hearing aid in children with mild-to-severe permanent, mainly sensorineural, hearing loss. In 18 children, EFRs were elicited by six male-spoken band-limited phonemic stimuli--the first formants of /u/ and /i/, the second and higher formants of /u/ and /i/, and the fricatives /s/ and /∫/--presented together as /su∫i/. EFRs were recorded between the vertex and nape, when /su∫i/ was presented at 55, 65, and 75 dB SPL using insert earphones in unaided conditions and individually fit hearing aids in aided conditions. EFR amplitude and detectability improved with the use of a hearing aid, and the degree of improvement in EFR amplitude was dependent on the extent of change in behavioral thresholds between unaided and aided conditions. EFR detectability was primarily influenced by audibility; higher sensation level stimuli had an increased probability of detection. Overall EFR sensitivity in predicting audibility was significantly higher in aided (82.1%) than unaided conditions (66.5%) and did not vary as a function of stimulus or frequency. EFR specificity in ascertaining inaudibility was 90.8%. Aided improvement in EFR detectability was a significant predictor of hearing aid-facilitated change in speech discrimination accuracy. Results suggest that speech-evoked EFRs could be a useful objective tool in predicting hearing aid benefit in children with hearing loss.
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Affiliation(s)
- Vijayalakshmi Easwar
- Department of Communication Sciences and Disorders & Waisman
Center, University of
Wisconsin–Madison, Madison, USA
- National
Acoustic Laboratories, Macquarie
University, Sydney, New South Wales, Australia
| | - David Purcell
- School of Communication Sciences and Disorders,
Western
University, London, Canada
- National Centre for Audiology, Western
University, London, Canada
| | - Trevor Wright
- Department of Communication Sciences and Disorders & Waisman
Center, University of
Wisconsin–Madison, Madison, USA
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Cabrera L, Lau BK. The development of auditory temporal processing during the first year of life. HEARING, BALANCE AND COMMUNICATION 2022; 20:155-165. [PMID: 36111124 PMCID: PMC9473293 DOI: 10.1080/21695717.2022.2029092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objectives The processing of auditory temporal information is important for the extraction of voice pitch, linguistic information, as well as the overall temporal structure of speech. However, many aspects of its early development remain poorly understood. This paper reviews the development of auditory temporal processing during the first year of life when infants are acquiring their native language. Methods First, potential mechanisms of neural immaturity are discussed in the context of neurophysiological studies. Next, what is known about infant auditory capabilities is considered with a focus on psychophysical studies involving non-speech stimuli to investigate the perception of temporal fine structure and envelope cues. This is followed by a review of studies involving speech stimuli, including those that present vocoded signals as a method of degrading the spectro-temporal information available to infant listeners. Results/Conclusion This review suggests that temporal resolution may be well developed in the first postnatal months, but that the ability to use and process the temporal information in an efficient way along the entire auditory pathway is longer to develop. Those findings have crucial implications for the development of language abilities, especially for infants with hearing impairment who are using cochlear implants.
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Affiliation(s)
- Laurianne Cabrera
- Université de Paris, INCC UMR 8002, CNRS, 45 rue des saints-pères, F-75006 Paris, France
| | - Bonnie K Lau
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, 1701 NE Columbia Rd, Box 257923, Seattle, WA 98195
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Cardon G, Sharma A. Cortical Neurophysiologic Correlates of Auditory Threshold in Adults and Children With Normal Hearing and Auditory Neuropathy Spectrum Disorder. Am J Audiol 2021; 30:28-42. [PMID: 33264574 DOI: 10.1044/2020_aja-20-00062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Auditory threshold estimation using the auditory brainstem response or auditory steady state response is limited in some populations (e.g., individuals with auditory neuropathy spectrum disorder [ANSD] or those who have difficulty remaining still during testing and cannot tolerate general anesthetic). However, cortical auditory evoked potentials (CAEPs) can be recorded in many such patients and have been employed in threshold approximation. Thus, we studied CAEP estimates of auditory thresholds in participants with normal hearing, sensorineural hearing loss, and ANSD. Method We recorded CAEPs at varying intensity levels to speech (i.e., /ba/) and tones (i.e., 1 kHz) to estimate auditory thresholds in normal-hearing adults (n = 10) and children (n = 10) and case studies of children with sensorineural hearing loss and ANSD. Results Results showed a pattern of CAEP amplitude decrease and latency increase as stimulus intensities declined until waveform components disappeared near auditory threshold levels. Overall, CAEP thresholds were within 10 dB HL of behavioral thresholds for both stimuli. Conclusions The above findings suggest that CAEPs may be clinically useful in estimating auditory threshold in populations for whom such a method does not currently exist. Physiologic threshold estimation in difficult-to-test clinical populations could lead to earlier intervention and improved outcomes.
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Affiliation(s)
- Garrett Cardon
- Department of Communication Disorders, Brigham Young University, Provo, UT
| | - Anu Sharma
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder
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Kaveh R, Doong J, Zhou A, Schwendeman C, Gopalan K, Burghardt FL, Arias AC, Maharbiz MM, Muller R. Wireless User-Generic Ear EEG. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2020; 14:727-737. [PMID: 32746342 DOI: 10.1109/tbcas.2020.3001265] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In the past few years it has been demonstrated that electroencephalography (EEG) can be recorded from inside the ear (in-ear EEG). To open the door to low-profile earpieces as wearable brain-computer interfaces (BCIs), this work presents a practical in-ear EEG device based on multiple dry electrodes, a user-generic design, and a lightweight wireless interface for streaming data and device programming. The earpiece is designed for improved ear canal contact across a wide population of users and is fabricated in a low-cost and scalable manufacturing process based on standard techniques such as vacuum forming, plasma-treatment, and spray coating. A 2.5 × 2.5 cm2 wireless recording module is designed to record and stream data wirelessly to a host computer. Performance was evaluated on three human subjects over three months and compared with clinical-grade wet scalp EEG recordings. Recordings of spontaneous and evoked physiological signals, eye-blinks, alpha rhythm, and the auditory steady-state response (ASSR), are presented. This is the first wireless in-ear EEG to our knowledge to incorporate a dry multielectrode, user-generic design. The user-generic ear EEG recorded a mean alpha modulation of 2.17, outperforming the state-of-the-art in dry electrode in-ear EEG systems.
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An integrative approach for pediatric auditory neuropathy spectrum disorders: revisiting etiologies and exploring the prognostic utility of auditory steady-state response. Sci Rep 2020; 10:9816. [PMID: 32555439 PMCID: PMC7299968 DOI: 10.1038/s41598-020-66877-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/12/2020] [Indexed: 11/22/2022] Open
Abstract
Auditory neuropathy is an important entity in childhood sensorineural hearing loss. Due to diverse etiologies and clinical features, the management is often challenging. This study used an integrative patient-history, audiologic, genetic, and imaging-based approach to investigate the etiologies and audiologic features of 101 children with auditory neuropathy. Etiologically, 48 (47.5%), 16 (15.8%), 11 (10.9%), and 26 (25.7%) children were categorized as having acquired, genetic, cochlear nerve deficiency-related, and indefinite auditory neuropathy, respectively. The most common causes of acquired and genetic auditory neuropathy were prematurity and OTOF mutations, respectively. Patients with acquired auditory neuropathy presented hearing loss earlier (odds ratio, 10.2; 95% confidence interval, 2.2–47.4), whereas patients with genetic auditory neuropathy had higher presence rate of distortion product otoacoustic emissions (odds ratio, 10.7; 95% confidence interval, 1.3–85.4). In patients with different etiologies or pathological sites, moderate to strong correlations (Pearson’s r = 0.51–0.83) were observed between behavioral thresholds and auditory steady-state response thresholds. In conclusion, comprehensive assessments can provide etiological clues in ~75% of the children with auditory neuropathy. Different etiologies are associated with different audiologic features, and auditory steady-state responses might serve as an objective measure for estimating behavioral thresholds.
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Ehrmann-Müller D, Shehata-Dieler W, Alzoubi A, Hagen R, Cebulla M. Using ASSR with narrow-band chirps to evaluate hearing in children and adults. Eur Arch Otorhinolaryngol 2020; 278:49-56. [PMID: 32449020 DOI: 10.1007/s00405-020-06053-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE All studies concerning the reliability and threshold prediction of auditory steady-state responses (ASSR) focused on a particular group of patients. The present article evaluates the use of narrow-band, chirp-evoked ASSR for testing hearing in adults and children of all ages and with different types of hearing loss, as well as normal hearing. The aims are: to determine whether there are possible influencing factors, mainly the degree of hearing loss; and to validate the clinical value of using ASSR with chirp-stimuli. METHODS This is a retrospective study of 667 patients who had been diagnosed with and treated for hearing loss at our tertiary referral center. The following results were compared: ASSR to pure tone audiometry (PTA); click-ABRs to PTA; and click-ABRs to ASSR. We then calculated mean, median and standard deviation. A regression analysis was used to examine the correlation between: ASSR and click-ABRs; "estimated" audiogram and PTA; click-ABRs and PTA; and ASSR and PTA. RESULTS We found significant correlations at all frequencies when comparing ASSR to click-ABRs, click-ABRs to PTA, and ASSR to PTA. Concerning the degree of hearing loss, there were significant differences between the patients with normal hearing and those with moderate-to-profound hearing loss. CONCLUSION ASSR with narrow-band chirps are a reliable tool for estimating hearing thresholds in children and adults with all kinds of hearing loss. We have demonstrated that threshold differences between PTA and ASSR are negligible in the clinical routine. The "estimated" ASSR audiogram is a good approach for communicating ASSR results to the average user.
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Affiliation(s)
- Désirée Ehrmann-Müller
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
| | - Wafaa Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Amien Alzoubi
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Mario Cebulla
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
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Lemajić-Komazec S, Komazec Z, Buljčik Čupić M, Knežević S, Vajs O. COMPARISON OF HEARING THRESHOLD ESTIMATION USING AUDITORY STEADY STATE RESPONSES AND BRAINSTEM AUDITORY EVOKED POTENTIALS IN CHILDREN. Acta Clin Croat 2019; 58:701-708. [PMID: 32595255 PMCID: PMC7314306 DOI: 10.20471/acc.2019.58.04.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Current recommendations proposed by pediatric audiologists are to commence with hearing amplification in children aged 6 months and above, after previous determination of the type and degree of hearing impairment and audiometric configuration. The goal of this study was to compare results obtained by click-evoked auditory brainstem response (c-ABR) and auditory steady state response (ASSR) in a group of children. This study included 68 children with different degrees of hearing impairment evaluated by c-ABR and ASSR. It is well-known that the c-ABR threshold highly correlates with behavioral hearing level at 2 kHz. In our study, the correlation between the c-ABR and ASSR thresholds in the whole sample was 0.58, 0.73, 0.97, 0.96, 0.95, 0.97; in the group of children with c-ABR thresholds up to 40 dBHL, it was 0.42, 0.73, 0.86, 0.74, 0.81, 0.81; and in the group with c-ABR thresholds worse than 40 dBHL, it was 0.46, 0.56, 0.89, 0.83, 0.85, 0.89 at 0.5, 1, 2, 4, 1-4, 2-4 kHz, respectively. Individual differences between the c-ABR and ASSR thresholds in the whole sample were up to 95, 90, 20, 25 dB at 0.5, 1, 2, 4 kHz, respectively. Study results indicated that there was strong correlation between the c-ABR and ASSR thresholds at 2, 4, 1-4, 2-4 kHz. The ASSR can be used as a valuable clinical tool and an excellent complementary method which, along with other audiologic techniques, provides more accurate hearing threshold estimation at an early age in children.
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Affiliation(s)
| | - Zoran Komazec
- University of Novi Sad, Faculty of Medicine, Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina, Novi Sad, Vojvodina, Republic of Serbia
| | - Maja Buljčik Čupić
- University of Novi Sad, Faculty of Medicine, Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina, Novi Sad, Vojvodina, Republic of Serbia
| | - Saša Knežević
- University of Novi Sad, Faculty of Medicine, Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina, Novi Sad, Vojvodina, Republic of Serbia
| | - Oliver Vajs
- University of Novi Sad, Faculty of Medicine, Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina, Novi Sad, Vojvodina, Republic of Serbia
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12
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Discrepancies in Hearing Thresholds between Pure-Tone Audiometry and Auditory Steady-State Response in Non-Malingerers. Ear Hear 2019; 41:663-668. [PMID: 31567521 DOI: 10.1097/aud.0000000000000791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate discrepancies between pure-tone audiometry (PTA) and auditory steady state response (ASSR) tests in non-malingerers and investigate brain lesions that may explain the discrepancies, especially in cases where the PTA threshold was worse than the estimated ASSR threshold. DESIGN PTA, speech audiometry, auditory brainstem response, ASSR, and neuroimaging tests were carried out on individuals selected from 995 cases of hearing impairment. Among these, medical records of 25 subjects (19 males, 6 females; mean age = 46.5 ± 16.0 years) with significant discrepancy between PTA and estimated ASSR thresholds were analyzed retrospectively. To define acceptable levels of discrepancy in PTA and ASSR hearing thresholds, 56 patients (27 males, 29 females; mean age = 53.0 ± 13.6 years) were selected for the control group. Magnetic resonance images, magnetic resonance angiograms, and positron emission tomograms were reviewed to identify any neurologic abnormalities. RESULTS Pathologic brain lesions were found in 20 cases (80%) in the study group, all of which showed a significant discrepancy in hearing threshold between PTA and ASSR. Temporal lobe lesions were found in 14 cases (70%), frontal lobe lesions in 12 (60%), and thalamic lesions without the frontal or temporal lobe in 2 cases (10%). On repeated PTA and ASSR tests a few months later, the discrepancy between ASSR and behavioral hearing thresholds was reduced or resolved in 6 cases (85.7%). Temporal lobe lesions were found in all 3 cases in which the estimated ASSR threshold worsened with unchanged PTA threshold, and frontal lobe lesions were found in all 3 cases in which the PTA threshold improved but the estimated ASSR threshold was unchanged. No neurological lesions were found in 5 cases (20%) of patients with a discrepancy between ASSR and behavioral hearing thresholds. CONCLUSIONS Clinicians should not rely exclusively on ASSR, especially in cases of central nervous system including temporal, frontal lobe, or thalamus lesions. If no lesions are found in a neuroimaging study of a patient with a discrepancy between PTA thresholds and estimated ASSR thresholds, further functional studies of the brain may be needed. If clinicians encounter patients with a discrepancy between PTA thresholds and estimated ASSR thresholds, an evaluation of brain lesions and repeat audiologic tests are recommended in lieu of relying solely on ASSR.
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Abstract
Medical interventions to combat serious infection or malignancies carry significant morbidities, including ototoxicity. While these lifesaving drugs are often necessary to preserve life, the impact on quality of life for survivors is increasingly concerning for families and healthcare providers. Of primary importance for medical prescribers are appropriately sensitive ototoxicity grading scales and audiological monitoring protocols for surveillance for hearing loss. The intent of grading scales is to help communicate complicated audiological information to non-audiologist healthcare providers (such as oncologists) to help them make good decisions with regards to chemotherapy dosing. Appropriate audiological monitoring helps reduce the time delay between the adventitious onset of hearing loss and the diagnosis and intervention. Finally, pediatric ototoxicity grading and monitoring protocols help ensure timely access to adequate hearing habilitation, verification and validation of the management of permanent medication-induced hearing loss and tinnitus in children.
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Affiliation(s)
- Brian J Fligor
- Tobias and Battite, Inc., Boston, Massachusetts.,Lantos Technologies, Inc., Wilmington, Massachusetts.,Osborne College of Audiology, Salus University, Elkins Park, Pennsylvania
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14
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Aimoni C, Crema L, Savini S, Negossi L, Rosignoli M, Sacchetto L, Bianchini C, Ciorba A. Hearing threshold estimation by auditory steady state responses (ASSR) in children. ACTA ACUST UNITED AC 2019; 38:361-368. [PMID: 30197427 PMCID: PMC6146583 DOI: 10.14639/0392-100x-1463] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 08/03/2017] [Indexed: 11/23/2022]
Abstract
Hearing threshold identification in very young children is always problematic and challenging. Electrophysiological testing such as auditory brainstem responses (ABR) is still considered the most reliable technique for defining the hearing threshold. However, over recent years there has been increasing evidence to support the role of auditory steady-state response (ASSR). Retrospective study. Forty-two children, age range 3-189 months, were evaluated for a total of 83 ears. All patients were affected by sensorineural hearing loss (thresholds ≥ 40 dB HL according to a click-ABR assessment). All patients underwent ABRs, ASSR and pure tone audiometry (PTA), with the latter performed according to the child’s mental and physical development. Subjects were divided into two groups: A and B. The latter performed all hearing investigations at the same time as they were older than subjects in group A, and it was then possible to achieve electrophysiological and PTA tests in close temporal sequence. There was no significant difference between the threshold levels identified at the frequencies tested (0.25, 0.5, 1, 2 and 4 kHz), by PTA, ABR and ASSR between the two groups (Mann Whitney U test, p < 0.05). Moreover, for group A, there was no significant difference between the ASSR and ABR thresholds when the children were very young and the PTA thresholds subsequently identified at a later stage. Our results show that ASSR can be considered an effective procedure and a reliable test, particularly when predicting hearing threshold in very young children at lower frequencies (including 0.5 kHz).
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Affiliation(s)
- C Aimoni
- ENT & Audiology Department, University Hospital of Ferrara, Italy
| | - L Crema
- ENT & Audiology Department, University Hospital of Ferrara, Italy
| | - S Savini
- ENT & Audiology Department, University Hospital of Ferrara, Italy
| | - L Negossi
- ENT & Audiology Department, University Hospital of Ferrara, Italy
| | - M Rosignoli
- ENT & Audiology Department, University Hospital of Ferrara, Italy
| | - L Sacchetto
- ENT & Audiology Department, University Hospital of Ferrara, Italy
| | - C Bianchini
- ENT & Audiology Department, University Hospital of Ferrara, Italy
| | - A Ciorba
- ENT & Audiology Department, University Hospital of Ferrara, Italy
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Evaluation of Speed and Accuracy of Next-Generation Auditory Steady State Response and Auditory Brainstem Response Audiometry in Children With Normal Hearing and Hearing Loss. Ear Hear 2019; 39:1207-1223. [PMID: 29624540 DOI: 10.1097/aud.0000000000000580] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The first objective of this study was to compare the predicted audiometric thresholds obtained by auditory steady state response (ASSR) and auditory brainstem response (ABR) in infants and toddlers when both techniques use optimal stimuli and detection algorithms. This information will aid in determining the basis for large discrepancies in ABR and ASSR measures found in past studies. The hypothesis was that advancements in ASSR response detection would improve (lower) thresholds and decrease discrepancies between the thresholds produced by the two techniques. The second objective was to determine and compare test times required by the two techniques to predict thresholds for both ears at the 4 basic audiometric frequencies of 500, 1000, 2000, and 4000 Hz. DESIGN A multicenter clinical study was implemented at three university-based children's hospital audiology departments. Participants were 102 infants and toddlers referred to the centers for electrophysiologic testing for audiometric purposes. The test battery included wideband tympanometry, distortion-product otoacoustic emissions, and threshold measurements at four frequencies in both ears using ABR and ASSR (randomized) as implemented on the Interacoustics Eclipse systems with "Next-Generation" ASSR detection and FMP analysis for ABR. Both methods utilized narrow band CE-Chirp stimuli. Testers were trained on a specialized test battery designed to minimize test time for both techniques. Testing with both techniques was performed in one session. Thresholds were evaluated and confirmed by the first author and correction factors were applied. Test times were documented in system software. RESULTS Corrected thresholds for ABR and ASSR were compared by regression, by the Bland-Altman technique and by matched pairs t tests. Thresholds were significantly lower for ASSR than ABR. The ABR-ASSR discrepancy at 500 Hz was 14.39 dB, at 1000 Hz was 10.12 dB, at 2000 Hz was 3.73 dB, and at 4000 Hz was 3.67 dB. The average test time for ASSR of 19.93 min (for 8 thresholds) was found to be significantly lower (p < 0.001) than the ABR test time of 32.15 min. One half of the subjects were found to have normal hearing. ASSR thresholds plotted in dB nHL for normal-hearing children in this study were found to be the lowest yet described except for one study which used the same technology. CONCLUSIONS This study found a reversal of previous findings with up to 14 dB lower thresholds found when using the ASSR technique with "Next-Generation" detection as compared with ABR using an automated detection (FMP). The test time for an audiogram prediction was significantly lower when using ASSR than ABR but was excellent by clinical standards for both techniques. ASSRs improved threshold performance was attributed to advancements in response detection including utilization of information at multiple harmonics of the modulation frequency. The stimulation paradigm which utilized narrow band CE-Chirps also contributed to the low absolute levels of the thresholds in nHL found with both techniques.
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Tabachnick AR, Toscano JC. Perceptual Encoding in Auditory Brainstem Responses: Effects of Stimulus Frequency. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2364-2375. [PMID: 30193361 DOI: 10.1044/2018_jslhr-h-17-0486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 05/09/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE A central question about auditory perception concerns how acoustic information is represented at different stages of processing. The auditory brainstem response (ABR) provides a potentially useful index of the earliest stages of this process. However, it is unclear how basic acoustic characteristics (e.g., differences in tones spanning a wide range of frequencies) are indexed by ABR components. This study addresses this by investigating how ABR amplitude and latency track stimulus frequency for tones ranging from 250 to 8000 Hz. METHOD In a repeated-measures experimental design, listeners were presented with brief tones (250, 500, 1000, 2000, 4000, and 8000 Hz) in random order while electroencephalography was recorded. ABR latencies and amplitudes for Wave V (6-9 ms) and in the time window following the Wave V peak (labeled as Wave VI; 9-12 ms) were measured. RESULTS Wave V latency decreased with increasing frequency, replicating previous work. In addition, Waves V and VI amplitudes tracked differences in tone frequency, with a nonlinear response from 250 to 8000 Hz and a clear log-linear response to tones from 500 to 8000 Hz. CONCLUSIONS Results demonstrate that the ABR provides a useful measure of early perceptual encoding for stimuli varying in frequency and that the tonotopic organization of the auditory system is preserved at this stage of processing for stimuli from 500 to 8000 Hz. Such a measure may serve as a useful clinical tool for evaluating a listener's ability to encode specific frequencies in sounds. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.6987422.
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Affiliation(s)
| | - Joseph C Toscano
- Department of Psychological and Brain Sciences, Villanova University, PA
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Garcia MV, Didoné DD, Testa JRG, Bruno RS, Azevedo MFD. Visual Reinforcement Audiometry and Steady-State Auditory Evoked Potential in infants with and without conductive impairment. REVISTA CEFAC 2018. [DOI: 10.1590/1982-0216201820312217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to compare the findings of minimum levels of answers through air and bone conductions between the Visual Reinforcement Audiometry and the Steady-State Auditory Evoked Potential in infants from six to twelve months, with and without conductive disorder. Methods: sixty children aged six to twelve months were evaluated, 30 presenting conductive disorder, and 30 not presenting it. Children with malformation in the external auditory meatus with neurological alteration and / or genetic syndrome were excluded, as well as patients with sensorineural or mixed hearing loss. The infants were subjected to Visual Reinforcement Audiometry and Steady-State Auditory Evoked Potential evaluation through air and bone conduction on the same day. The results of both assessments were compared and correlated. Results: in the comparison through air conduction, for the group without conductive disorder of the medium ear, the minimum levels of response for 500 and 1000Hz were lower (better thresholds) for Steady-State Auditory Evoked Potential in both ears, and through bone conduction were very similar in all frequencies. Concerning the infants that present conductive disorder, the responses through air conduction were better in all frequencies evaluated when obtained via Steady-State Auditory Evoked Potential test. Through bone conduction, the results were very similar for both groups. Conclusion: it was possible to compare the findings to the minimum levels of response through air and bone conductions between the Visual Reinforcement Audiometry and the Steady-State Auditory Evoked Potential, being that the comparison for bone conduction in both groups presents an equivalence in the results, being very similar. In addition, for the air conduction, in the control group, there was proximity of responses of some frequencies, while the values for the Steady-State Auditory Evoked Potential test were better than the behavioral responses in the conductive disorder group.
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Hoth S, Baljić I. Current audiological diagnostics. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2017; 16:Doc09. [PMID: 29279727 PMCID: PMC5738938 DOI: 10.3205/cto000148] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Today's audiological functional diagnostics is based on a variety of hearing tests, whose large number takes account of the variety of malfunctions of a complex sensory organ system and the necessity to examine it in a differentiated manner and at any age of life. The objective is to identify nature and origin of the hearing loss and to quantify its extent as far as necessary to dispose of the information needed to initiate the adequate medical (conservative or operational) treatment or the provision with technical hearing aids or prostheses. Moreover, audiometry provides the basis for the assessment of impairment and handicap as well as for the calculation of the degree of disability. In the present overview, the current state of the method inventory available for practical use is described, starting from basic diagnostics over to complex special techniques. The presentation is systematically grouped in subjective procedures, based on psychoacoustic exploration, and objective methods, based on physical measurements: preliminary hearing tests, pure tone threshold, suprathreshold processing of sound intensity, directional hearing, speech understanding in quiet and in noise, dichotic hearing, tympanogram, acoustic reflex, otoacoustic emissions and auditory evoked potentials. Apart from a few still existing gaps, this method inventory covers the whole spectrum of all clinically relevant functional deficits of the auditory system.
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Affiliation(s)
- Sebastian Hoth
- Functional Area of Audiology, Department of Otolaryngology, University of Heidelberg, Germany
| | - Izet Baljić
- Department of Otolaryngology, HELIOS Hospital of Erfurt, Germany
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Frank J, Baljić I, Hoth S, Eßer D, Guntinas-Lichius O. The accuracy of objective threshold determination at low frequencies: comparison of different auditory brainstem response (ABR) and auditory steady state response (ASSR) methods. Int J Audiol 2017; 56:337-345. [PMID: 28599607 DOI: 10.1080/14992027.2017.1281442] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The hearing threshold at 500 Hz was estimated using five methods which are suitable for the low frequency range: Low-Chirp BERA (LCBERA), Notched-noise BERA (NNBERA), Narrow band CE-Chirp BERA (NBCBERA) and Narrow band CE-Chirp ASSR (NBCASSR) (40/90 Hz). The slope of the discrimination function of each method was used for determination of the most efficient method. The threshold values were compared and the corresponding odds ratios (OR) were calculated. DESIGN All methods were applied to each subject. Stimulus levels were arranged individually. Response detection was carried out by visual inspection of the records in case of BERA and automatically in case of ASSR. Each individual series of recordings was converted to a dichotomous function indicating whether or not a response was discernible and a continuous method-specific discrimination function was constructed. This function was realised by a Boltzmann function whose slope in the inflection point serves as quality measure. Additionally, an OR evaluation was carried out in order to validate the significance of results. STUDY SAMPLE Twenty five normal hearing adults (aged 18-30 years) were tested. RESULTS LCBERA proved to have the highest reliability according to the slope of the Boltzmann function, the comparison of threshold values and OR. CONCLUSIONS The LCBERA is recommended for use in routine clinical practice.
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Affiliation(s)
- Jacqueline Frank
- a Department of Otorhinolaryngology , Jena University Hospital , Jena , Germany
| | - Izet Baljić
- b Department of Otorhinolaryngology , Helios Klinikum Erfurt , Erfurt , Germany , and
| | - Sebastian Hoth
- c Department of Otorhinolaryngology , University Hospital Heidelberg , Heidelberg , Germany
| | - Dirk Eßer
- b Department of Otorhinolaryngology , Helios Klinikum Erfurt , Erfurt , Germany , and
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François M, Dehan E, Carlevan M, Dumont H. Use of auditory steady-state responses in children and comparison with other electrophysiological and behavioral tests. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:331-335. [DOI: 10.1016/j.anorl.2016.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Michel F, Jørgensen KF. Comparison of threshold estimation in infants with hearing loss or normal hearing using auditory steady-state response evoked by narrow band CE-chirps and auditory brainstem response evoked by tone pips. Int J Audiol 2016; 56:99-105. [PMID: 27715342 DOI: 10.1080/14992027.2016.1234719] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this study is to compare air-conduction thresholds obtained with ASSR evoked by narrow band (NB) CE-chirps and ABR evoked by tone pips (tpABR) in infants with various degrees of hearing loss. DESIGN Thresholds were measured at 500, 1000, 2000 and 4000 Hz. Data on each participant were collected at the same day. STUDY SAMPLE Sixty-seven infants aged 4 d to 22 months (median age = 96 days), resulting in 57, 52, 87 and 56 ears for 500, 1000, 2000 and 4000 Hz, respectively. RESULTS Statistical analysis was performed for ears with hearing loss (HL) and showed a very strong correlation between tpABR and ASSR evoked by NB CE-chirps: 0.90 (n = 28), 0.90 (n = 28), 0.96 (n = 42) and 0.95 (n = 30) for 500, 1000, 2000 and 4000 Hz, respectively. At these frequencies, the mean difference between tpABR and ASSR was -3.6 dB (± 7.0), -5.2 dB (± 7.3), -3.9 dB (± 5.2) and -5.2 dB (± 4.7). Linear regression analysis indicated that the relationship was not influenced by the degree of hearing loss. CONCLUSION We propose that dB nHL to dB eHL correction values for ASSR evoked by NB CE-chirps should be 5 dB lower than values used for tpABR.
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Affiliation(s)
- Franck Michel
- Department of Otorhinolaryngology, Audiology Clinic, Aarhus University Hospital, Aarhus, Denmark
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Luiz CBL, Garcia MV, Azevedo MFD. Potencial evocado auditivo de estado estável em crianças e adolescentes. Codas 2016; 0:0. [DOI: 10.1590/2317-1782/20162015142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/01/2015] [Indexed: 11/21/2022] Open
Abstract
RESUMO Introdução A aplicabilidade do potencial evocado auditivo de estado estável tem crescido no diagnóstico audiológico. Objetivo Verificar a correlação entre os limiares eletrofisiológicos obtidos no Potencial Evocado Auditivo de Estado Estável e os limiares comportamentais obtidos na audiometria tonal liminar em crianças e adolescentes com audição normal e perda auditiva neurossensorial de grau moderado a moderadamente severo. Métodos Foram avaliados 25 indivíduos de ambos os sexos com idade entre 5 e 15 anos, distribuídos nos seguintes grupos: 15 indivíduos com audição normal e 10 indivíduos com perda auditiva neurossensorial de grau moderado a moderadamente severo. Os indivíduos foram submetidos a: audiometria tonal liminar, logoaudiometria, medidas de imitância acústica (timpanometria e pesquisa dos reflexos acústicos) e ao potencial evocado auditivo de estado estável. Resultados No grupo com audição normal, os limiares eletrofisiológicos máximos situaram-se entre 19 a 27 dBcgNA. No grupo com perda auditiva de grau moderado a moderadamente severo, a correlação encontrada foi de 0,42 a 0,74. As diferenças médias do limiar eletrofisiológico e o limiar comportamental situaram-se entre: –0,3 e 12 dB para o grupo de audição normal e de –9 e 2 dB no grupo com perda auditiva de grau moderado a moderadamente severo. Conclusão No grupo com audição normal não houve correlação entre os limiares eletrofisiológicos e comportamentais, em contrapartida foi encontrada correlação positiva no grupo com perda de grau moderado a moderadamente severo.
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Detection efficiency of auditory steady state evoked by modulated noise. Hear Res 2016; 339:125-31. [PMID: 27262450 DOI: 10.1016/j.heares.2016.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 05/23/2016] [Accepted: 05/26/2016] [Indexed: 11/21/2022]
Abstract
AIM This study aimed to investigate the efficiency of Magnitude Squared Coherence (MSC) and Spectral F test (SFT) for the detection of auditory steady state responses (ASSR) obtained by amplitude-modulated noises. MATERIAL AND METHODS Twenty individuals (12 women) without any history of neurological or audiological diseases, aged from 18 to 59 years (mean ± standard deviation = 26.45 ± 3.9 years), who provided written informed consent, participated in the study. The Audiostim system was used for stimulating and ASSR recording. The tested stimuli were amplitude-modulated Wide-band noise (WBN), Low-band noise (LBN), High-band noise (HBN), Two-band noise (TBN) between 77 and 110 Hz, applied in intensity levels of 55, 45, and 25 dB sound pressure level (SPL). MSC and SFT, two statistical-based detection techniques, were applied with a significance level of 5%. Detection times and rates were compared using the Friedman test and Tukey-Kramer as post hoc analysis. Also based on the stimulation parameters (stimuli types and intensity levels) and detection techniques (MSC or SFT), 16 different pass/fail protocols, for which the true negatives (TN) were calculated. RESULTS The median detection times ranged from 68 to 157s for 55 dB SPL, 68-99s for 45 dB SPL, and 84-118s for 25 dB SPL. No statistical difference was found between MSC and STF considering the median detection times (p > 0.05). The detection rates ranged from 100% to 55.6% in 55 dB SPL, 97.2%-38.9% in 45 dB SPL and 66.7%-8.3% in 25 dB SPL. Also for detection rates, no statistical difference was observed between MSC and STF (p > 0.05). True negatives (TN) above 90% were found for Protocols that employed WBN or HBN, at 55 dB SPL or that used WBN or HBN, at 45 dB SPL. For Protocols employing TBN, at 55 dB SPL or 45 dB SPL TN below 60% were found due to the low detection rates of stimuli that included low-band frequencies. CONCLUSION The stimuli that include high-frequency content showed higher detection rates (>90%) and lower detection times (<3 min). The noise composed by two bands applied separately (TBN) is not feasible for clinical applications since it requires prolonging the exam duration, and also led to a reduced percentage of true negatives. On the other hand, WBN and HBN achieved high detection performance and high TN and should be investigated to implement pass/fail protocol for hearing screening with clinical population. Finally, both WBN and HBN seemed to be indifferent to the employed technique (SFT or MSC), which can be seen as another advantage of ASSR employment.
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Paediatric diagnostic audiology testing in South Africa. Int J Pediatr Otorhinolaryngol 2016; 82:1-7. [PMID: 26857305 DOI: 10.1016/j.ijporl.2015.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 12/21/2015] [Accepted: 12/24/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION With the increased emphasis on the importance of early identification of paediatric hearing loss within developing countries such as South Africa and Nigeria there has been a recognition of the ethical obligation to ensure access to timely diagnostic and intervention services for children identified with hearing loss; regardless of their geographic or socioeconomic status. There are limited studies on diagnosis of paediatric hearing loss in a developing world context. OBJECTIVES The objective of this study was to determine processes used for diagnosis of paediatric hearing loss in South Africa, across the private and public healthcare sectors, and to profile the age of testing for each component of the diagnostic test battery. METHODS Diagnostic audiology testing data of 230 children enrolled in an early intervention programme was analysed to profile the reporting of diagnostic audiology testing as well as diagnostic audiology procedures employed. Results were analysed according to province as well as healthcare sector to compare diagnostic services across regions as well as healthcare sectors. RESULTS The differences in audiology practice and tests employed with paediatric clients across the regions of Gauteng, Kwazulu Natal and Western Cape indicates that services across regions and across the public and private sector are not equitable. Each region is equally unlikely to complete a full, comprehensive diagnostic evaluation on paediatric clients. The age of testing highlights the increased age of diagnosis of hearing loss. CONCLUSION Paediatric diagnostic audiology is a section of Early Hearing Detection and Intervention services that requires attention in terms of the appropriateness of procedures as well as equity of services. Further studies on diagnostic practice and resources in South Africa will provide information on factors that are preventing adherence to international best practice guidelines for paediatric diagnostic audiology.
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The impact of degree of hearing loss on auditory brainstem response predictions of behavioral thresholds. Ear Hear 2016; 36:309-19. [PMID: 25470369 DOI: 10.1097/aud.0000000000000120] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Diagnosis of hearing loss and prescription of amplification for infants and young children require accurate estimates of ear- and frequency-specific behavioral thresholds based on auditory brainstem response (ABR) measurements. Although the overall relationship between ABR and behavioral thresholds has been demonstrated, the agreement is imperfect, and the accuracy of predictions of behavioral threshold based on ABR may depend on degree of hearing loss. Behavioral thresholds are lower than ABR thresholds, at least in part due to differences in calibration interacting with the effects of temporal integration, which are manifest in behavioral measurements but not ABR measurements and depend on behavioral threshold. Listeners with sensory hearing loss exhibit reduced or absent temporal integration, which could impact the relationship between ABR and behavioral thresholds as degree of hearing loss increases. The present study evaluated the relationship between ABR and behavioral thresholds in infants and children over a range of hearing thresholds, and tested an approach for adjusting the correction factor based on degree of hearing loss as estimated by ABR measurements. DESIGN A retrospective review of clinical records was completed for 309 ears of 177 children with hearing thresholds ranging from normal to profound hearing loss and for whom both ABR and behavioral thresholds were available. Children were required to have the same middle ear status at both evaluations. The relationship between ABR and behavioral thresholds was examined. Factors that potentially could affect the relationship between ABR and behavioral thresholds were analyzed, including degree of hearing loss observed on the ABR, behavioral test method (visual reinforcement, conditioned play, or conventional audiometry), the length of time between ABR and behavioral assessments, and clinician-reported reliability of the behavioral assessment. Predictive accuracy of a correction factor based on the difference between ABR and behavioral thresholds as a function of ABR threshold was compared to the predictive accuracy achieved by two other correction approaches in current clinical use. RESULTS As expected, ABR threshold was a significant predictor of behavioral threshold. The agreement between ABR and behavioral thresholds varied as a function of degree of hearing loss. The test method, length of time between assessments, and reported reliability of the behavioral test results were not related to the differences between ABR and behavioral thresholds. A correction factor based on the linear relationship between the differences in ABR and behavioral thresholds as a function of ABR threshold resulted in more accurately predicted behavioral thresholds than other correction factors in clinical use. CONCLUSIONS ABR is a valid predictor of behavioral threshold in infants and children. A correction factor that accounts for the effect of degree of hearing loss on the differences between ABR and behavioral thresholds resulted in more accurate predictions of behavioral thresholds than methods that used a constant correction factor regardless of degree of hearing loss. These results are consistent with predictions based on previous research on temporal integration for listeners with hearing loss.
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J. 2014 CODEPEH Recommendations: Early Detection of Late Onset Deafness, Audiological Diagnosis, Hearing Aid Fitting and Early Intervention. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2016. [DOI: 10.1016/j.otoeng.2015.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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2014 CODEPEH recommendations: Early detection of late onset deafness, audiological diagnosis, hearing aid fitting and early intervention. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015; 67:45-53. [PMID: 26443498 DOI: 10.1016/j.otorri.2015.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 05/13/2015] [Accepted: 05/17/2015] [Indexed: 11/23/2022]
Abstract
The latest scientific literature considers early diagnosis of deafness as the key element to define the educational and inclusive prognosis of the deaf child, because it allows taking advantage of the critical period of development (0-4 years). Highly significant differences exist between deaf people who have been stimulated early and those who have received late or improper intervention. Early identification of late-onset disorders requires special attention and knowledge on the part of every childcare professional. Programs and additional actions beyond neonatal screening should be designed and planed to ensure that every child with a significant hearing loss is detected early. For this purpose, the CODEPEH would like to highlight the need for continuous monitoring of children's auditory health. Consequently, CODEPEH has drafted the recommendations included in the present document.
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Sardari S, Jafari Z, Haghani H, Talebi H. Hearing aid validation based on 40 Hz auditory steady-state response thresholds. Hear Res 2015; 330:134-41. [PMID: 26385486 DOI: 10.1016/j.heares.2015.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 08/30/2015] [Accepted: 09/08/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIM Aided thresholds can be used for prediction of success of hearing aids and to choose between hearing aids and cochlear implants. This study aimed to compare characteristics of aided and unaided auditory steady-state responses (ASSRs). METHODS A total of 30 moderate to profoundly hearing-impaired subjects participated in this study. The subjects underwent acoustic immittance, behavioral audiometry, and ASSR with the modulation rate of 40 Hz, first without a hearing aid and then with a hearing aid. Sixteen people with normal hearing and 17 people with severe hearing loss were included in biological calibration of the sound field. RESULTS There was a significant difference between unaided behavioral and ASSR thresholds in all test frequencies (mean difference of unaided behavioral ASSR thresholds: 6.19 dB; P = 0.02 at 500 Hz, P < 0.001 at 1000 and 2000 Hz, and P = 0.02 for 4000 Hz). There was also a significant difference between aided behavioral and ASSR thresholds at 1000 and 2000 Hz (P < 0.001) but not at 500 (P = 0.14) and 4000 (P = 0.23) Hz (mean difference of behavioral ASSR thresholds was 4.33 dB). Despite observing any unaided responses, aided thresholds could be recorded in some severe to profoundly hearing-impaired subjects. The number of recordable thresholds was directly related to speech clarity and speech-reading ability. Multi-frequency stimulation elevated the ASSR threshold, especially for the higher frequencies and in the aided condition. CONCLUSION Functional and ASSR gains show less difference than threshold data. Therefore, comparing gains instead of thresholds is more accurate for validation of hearing aids. The probability of success of hearing aids appears to be poor if ASSRs (especially aided ones) cannot be recorded. If special care is taken in the fitting of hearing aids and the testing conditions, aided ASSR testing could be a useful tool for validation of hearing aids and the cochlear implant decision-making process.
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Affiliation(s)
- Sara Sardari
- Department of Audiology, Faculty of Rehabilitation, Tehran University of Medical Sciences, Iran.
| | - Zahra Jafari
- Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Canadian Center for Behavioral Neuroscience (CCBN), Lethbridge University, Lethbridge, Alberta, Canada.
| | - Hamid Haghani
- Department of Statistics and Mathematics, Faculty of Management, Tehran University of Medical Sciences, Iran
| | - Hossain Talebi
- Department of Audiology, Faculty of Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
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Bakhos D, Vitaux H, Villeneuve A, Kim S, Lescanne E, Pigeon V, Aoustin JM, Bordure P, Galvin J. The effect of the transducers on paediatric thresholds estimated with auditory steady-state responses. Eur Arch Otorhinolaryngol 2015; 273:2019-26. [PMID: 26329899 DOI: 10.1007/s00405-015-3761-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/21/2015] [Indexed: 11/29/2022]
Abstract
The objective of this study was to investigate the usefulness of auditory steady-state responses (ASSRs) for estimating hearing thresholds in young children, compared with behavioural thresholds. The second objective was to investigate ASSR thresholds obtained with insert earphones versus supra-aural headphones to determine which transducer produces ASSR thresholds most similar to behavioural thresholds measured with supra-aural headphones. This retrospective study included 29 participants (58 ears): 12 children (24 ears) in the insert group and 17 children (34 ears) in the supra-aural group. No general anaesthesia was used. For both groups, there was a strong correlation between behavioural and ASSR thresholds, with a stronger correlation for the insert group. When behavioural thresholds are difficult to obtain, ASSR may be a useful objective measure that can be combined with other audiometric procedures to estimate hearing thresholds and to determine appropriate auditory rehabilitation approaches.
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Affiliation(s)
- D Bakhos
- Service d'ORL et Chirurgie Cervico-Faciale, CHRU de Tours, Tours, France. .,ENT Department, Université François-Rabelais de Tours, CHRU de Tours, UMR-S930, 2 Boulevard Tonnellé, 37000, Tours, France.
| | - H Vitaux
- Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Nantes, France
| | - A Villeneuve
- Service d'ORL et Chirurgie Cervico-Faciale, CHRU de Tours, Tours, France
| | - S Kim
- Service d'ORL et Chirurgie Cervico-Faciale, CHRU de Tours, Tours, France.,ENT Department, Université François-Rabelais de Tours, CHRU de Tours, UMR-S930, 2 Boulevard Tonnellé, 37000, Tours, France
| | - E Lescanne
- Service d'ORL et Chirurgie Cervico-Faciale, CHRU de Tours, Tours, France.,ENT Department, Université François-Rabelais de Tours, CHRU de Tours, UMR-S930, 2 Boulevard Tonnellé, 37000, Tours, France
| | - V Pigeon
- Service d'ORL et Chirurgie Cervico-Faciale, CHRU de Tours, Tours, France
| | - J M Aoustin
- Service d'ORL et Chirurgie Cervico-Faciale, CHRU de Tours, Tours, France
| | - P Bordure
- Service d'ORL et Chirurgie Cervico-Faciale, CHU de Nantes, Nantes, France.,Université de Nantes, CHU de Nantes, Nantes, France
| | - J Galvin
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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Farias VBD, Sleifer P, Pauletti LF, Krimberg CFD. Correlation of the findings of auditory steady-state evoked potential and of behavioral hearing assessment in infants with sensorineural hearing loss. Codas 2014; 26:226-30. [PMID: 25118919 DOI: 10.1590/2317-1782/201420140491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 05/16/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To correlate the findings of an open-field audiometry with the thresholds of steady-state auditory-evoked potentials (SSAEPs) found in infants of up to 6 months of age with sensorineural hearing loss. METHODS This study included 19 infants with sensorineural hearing loss (8 males and 11 females), with minimum age of 2 months and maximum age of 6 months. The SSAEPs were assessed at 500 and 2000 Hz, and the audiometry was performed in open field through observation of behavioral responses to sound stimuli, at the same frequencies. RESULTS We observed a significant correlation between the findings of both tests conducted at 500 and 2000 Hz, with p-values of 0.002 and 0.013, respectively. There was no statistical difference between ears (p=0.532) and genders (p=0.615). CONCLUSION We conclude that there was a significant correlation between the SSAEP thresholds and the findings of the open-field audiometry. Therefore, we can affirm that the SSAEPs are a viable examination, able to predict the degree and configuration of hearing loss in infants of up to 6 months of age, and that they can be included in the clinical routine of hearing assessments conducted in children.
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Affiliation(s)
| | - Pricila Sleifer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Parthasarathy A, Datta J, Torres JAL, Hopkins C, Bartlett EL. Age-related changes in the relationship between auditory brainstem responses and envelope-following responses. J Assoc Res Otolaryngol 2014; 15:649-61. [PMID: 24845405 PMCID: PMC4141432 DOI: 10.1007/s10162-014-0460-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 04/24/2014] [Indexed: 12/22/2022] Open
Abstract
Hearing thresholds and wave amplitudes measured using auditory brainstem responses (ABRs) to brief sounds are the predominantly used clinical measures to objectively assess auditory function. However, frequency-following responses (FFRs) to tonal carriers and to the modulation envelope (envelope-following responses or EFRs) to longer and spectro-temporally modulated stimuli are rapidly gaining prominence as a measure of complex sound processing in the brainstem and midbrain. In spite of numerous studies reporting changes in hearing thresholds, ABR wave amplitudes, and the FFRs and EFRs under neurodegenerative conditions, including aging, the relationships between these metrics are not clearly understood. In this study, the relationships between ABR thresholds, ABR wave amplitudes, and EFRs are explored in a rodent model of aging. ABRs to broadband click stimuli and EFRs to sinusoidally amplitude-modulated noise carriers were measured in young (3-6 months) and aged (22-25 months) Fischer-344 rats. ABR thresholds and amplitudes of the different waves as well as phase-locking amplitudes of EFRs were calculated. Age-related differences were observed in all these measures, primarily as increases in ABR thresholds and decreases in ABR wave amplitudes and EFR phase-locking capacity. There were no observed correlations between the ABR thresholds and the ABR wave amplitudes. Significant correlations between the EFR amplitudes and ABR wave amplitudes were observed across a range of modulation frequencies in the young. However, no such significant correlations were found in the aged. The aged click ABR amplitudes were found to be lower than would be predicted using a linear regression model of the young, suggesting altered gain mechanisms in the relationship between ABRs and FFRs with age. These results suggest that ABR thresholds, ABR wave amplitudes, and EFRs measure complementary aspects of overlapping neurophysiological processes and the relationships between these measurements changes asymmetrically with age. Hence, measuring all three metrics provides a more complete assessment of auditory function, especially under pathological conditions like aging.
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Affiliation(s)
- Aravindakshan Parthasarathy
- />Department of Biological Sciences and the Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, 47907 West Lafayette, IN USA
| | - Jyotishka Datta
- />Department of Statistics, Purdue University, West Lafayette, IN USA
| | | | - Charneka Hopkins
- />Department of Public Health, Western Illinois University, Macomb, IL USA
| | - Edward L. Bartlett
- />Department of Biological Sciences and the Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, 47907 West Lafayette, IN USA
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Garcia MV, Azevedo MFD, Biaggio EPV, Didoné DD, Testa JRG. Potencial evocado auditivo de estado estável por via aérea e via óssea em crianças de zero a seis meses sem e com comprometimento condutivo. REVISTA CEFAC 2014. [DOI: 10.1590/1982-021620140213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo verificar a viabilidade de pesquisar os níveis mínimos de resposta do Potencial Evocado Auditivo de Estado Estável por via aérea e via óssea em crianças do nascimento aos seis meses e mensurar o “gap” aéreo-ósseo de crianças com comprometimento condutivo. Métodos avaliadas 60 crianças, 30 com comprometimento condutivo e 30 sem, distribuídas em grupo controle e estudo. Foram realizadas medidas de imitância acústica, avaliação otorrinolaringológica e Potencial Evocado Auditivo de Estado Estável por via aérea e via óssea. O Potencial Evocado Auditivo de Estado Estável foi realizado por via aérea com fones de inserção e por via óssea com vibrador ósseo. Por via aérea as respostas foram pesquisadas em ambas as orelhas e por via óssea captadas somente da orelha esquerda. Resultados no grupo controle, houve predominância de curva do tipo “A”. No grupo estudo, de curvas tipo “B” e tipo “C”. Na avaliação otorrinolaringológica do grupo controle evidenciou-se normalidade da membrana timpanica. No grupo estudo, opacidade e retração. No Potencial Evocado Auditivo de Estado Estável do grupo controle por via aérea as respostas foram em torno de 17,2; 26,2; 22, 7 e 19,8dBNA nas frequências 500 a 4KHz e para via óssea entre 18,8 a 20dBNA. No grupo estudo por via aérea as respostas foram de 53; 56; 50,2 e 48dBNA e por via óssea de 25; 25; 20 e 20dBNA. Conclusão foi possível realizar a avaliação dos Potenciais Evocados Auditivos de Estado Estável por via aérea e via óssea em crianças até os seis meses e o “gap” aéreo-ósseo foi em torno de 20dB nas crianças com comprometimento condutivo.
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Mühler R, Rahne T, Mentzel K, Verhey JL. 40-Hz multiple auditory steady-state responses to narrow-band chirps in sedated and anaesthetized infants. Int J Pediatr Otorhinolaryngol 2014; 78:762-8. [PMID: 24613039 DOI: 10.1016/j.ijporl.2014.02.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 01/27/2014] [Accepted: 02/01/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The general consensus to date has been that a stimulus repetition rate of 40Hz is not appropriate for the recording of auditory steady-state responses (ASSR) in sedated or anaesthetized infants. The aim of this study was to investigate whether reliable 40-Hz ASSR thresholds can be obtained in sedated infants using narrow-band chirp stimuli in the clinical routine. METHODS 40-Hz auditory brainstem responses (ABR) and 40-Hz ASSR were recorded in 34 infants below the age of 48 months under sedation or under general anaesthesia. ABR were evoked by broad-band chirp stimuli with a flat amplitude spectrum. ASSR were recorded simultaneously from both ears with an adaptive multiple stimulus paradigm using four narrow-band chirps centred at 500, 1000, 2000 and 4000Hz. ABR and ASSR thresholds were evaluated to determine differences between the estimates from the two methods. RESULTS Despite of sedation and anaesthesia, large wave V amplitudes of the chirp evoked 40-Hz ABR were found at levels as low as 10dB above the individual ABR threshold. ASSR thresholds for stimulus repetition rates of 40Hz could be consistently estimated in all 34 infants. Thresholds estimated from the ASSR for the four frequencies of the narrow-band chirps and the threshold derived from the broad-band chirp ABR differ, on average by 3.7dB for the frequency range of 1000-2000Hz and 7.1dB for the frequency range from 2000 to 4000Hz. CONCLUSION In contrast to the general assumption that 40-Hz ASSR are not appropriate for threshold estimation in infants our results demonstrate that multiple ASSR with a stimulus repetition rate of 40Hz can be recorded in sedated and anaesthetized infants using narrow-band chirps. Threshold estimates obtained with 40-Hz ASSR are, on average, slightly higher than those obtained with chirp evoked ABR but allow for a frequency specific characterisation of the hearing ability.
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Affiliation(s)
- Roland Mühler
- Department of Experimental Audiology, Otto von Guericke University, Magdeburg, Germany.
| | - Torsten Rahne
- Department of Otorhinolaryngology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Katrin Mentzel
- Department of Experimental Audiology, Otto von Guericke University, Magdeburg, Germany
| | - Jesko L Verhey
- Department of Experimental Audiology, Otto von Guericke University, Magdeburg, Germany
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Oliveira LC, Alvarenga KDF, Araújo ES, Salgado MH, Costa Filho OA. Auditory Steady-State Response in the First Six Months of Life. AUDIOLOGY AND NEUROTOLOGY EXTRA 2014. [DOI: 10.1159/000356232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Stevens J, Boul A, Lear S, Parker G, Ashall-Kelly K, Gratton D. Predictive value of hearing assessment by the auditory brainstem response following universal newborn hearing screening. Int J Audiol 2013; 52:500-6. [PMID: 23617611 DOI: 10.3109/14992027.2013.776180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study set out to determine the accuracy with which tone pip ABR and click ABR, carried out in babies referred from universal newborn hearing screening, is able to predict the hearing outcome as determined by follow-up hearing tests. STUDY SAMPLE The cohort of babies studied were all babies referred for hearing assessment from the universal newborn hearing screen in Sheffield, UK for the period January 2002 to September 2007, who were found to have a significant hearing impairment. DESIGN The results of hearing assessment following referral from the newborn hearing screen were collected together with those of follow-up tests carried out up to an age when behavioural testing had established ear- and frequency-specific thresholds at 0.5, 1, 2 and 4 kHz. RESULTS The standard deviation of the difference between the follow up and the tone pip ABR thresholds was 10.5 dB for the 4-kHz tone pip, 16.8 dB for the 1-kHz tone pip, and ranged between 21.7 and 24.7 dB for click ABR. CONCLUSIONS The results of the study show that tone pip ABR following referral from newborn hearing screening has a similar accuracy to that reported in older subjects, and is a much better predictor compared to click ABR.
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Affiliation(s)
- John Stevens
- Department of Medical Physics and Clinical Engineering, Royal Hallamshire Hospital, Sheffield S10 2JF, UK. john.stevens@sheffi eld.ac.uk
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Vlastarakos PV. Profound deafness and the acquisition of spoken language in children. World J Clin Pediatr 2012; 1:24-8. [PMID: 25254164 PMCID: PMC4145645 DOI: 10.5409/wjcp.v1.i4.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 09/13/2012] [Accepted: 12/05/2012] [Indexed: 02/06/2023] Open
Abstract
Profound congenital sensorineural hearing loss (SNHL) is not so infrequent, affecting 1 to 2 of every 1000 newborns in western countries. Nevertheless, universal hearing screening programs have not been widely applied, although such programs are already established for metabolic diseases. The acquisition of spoken language is a time-dependent process, and some form linguistic input should be present before the first 6 mo of life for a child to become linguistically competent. Therefore, profoundly deaf children should be detected early, and referred timely for the process of auditory rehabilitation to be initiated. Hearing assessment methods should reflect the behavioural audiogram in an accurate manner. Additional disabilities also need to be taken into account. Profound congenital SNHL is managed by a multidisciplinary team. Affected infants should be bilaterally fitted with hearing aids, no later than 3 mo after birth. They should be monitored until the first year of age. If they are not progressing linguistically, cochlear implantation can be considered after thorough preoperative assessment. Prelingually deaf children develop significant speech perception and production abilities, and speech intelligibility over time, following cochlear implantation. Age at intervention and oral communication, are the most important determinants of outcomes. Realistic parental expectations are also essential. Cochlear implant programs deserve the strong support of community members, professional bodies, and political authorities in order to be successful, and maximize the future earnings of pediatric cochlear implantation for human societies.
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Affiliation(s)
- Petros V Vlastarakos
- Petros V Vlastarakos, Department of Otolaryngology, Lister Hospital, Stevenage SG1 4AB, United Kingdom
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Cardon G, Campbell J, Sharma A. Plasticity in the developing auditory cortex: evidence from children with sensorineural hearing loss and auditory neuropathy spectrum disorder. J Am Acad Audiol 2012; 23:396-411; quiz 495. [PMID: 22668761 DOI: 10.3766/jaaa.23.6.3] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The developing auditory cortex is highly plastic. As such, the cortex is both primed to mature normally and at risk for reorganizing abnormally, depending upon numerous factors that determine central maturation. From a clinical perspective, at least two major components of development can be manipulated: (1) input to the cortex and (2) the timing of cortical input. Children with sensorineural hearing loss (SNHL) and auditory neuropathy spectrum disorder (ANSD) have provided a model of early deprivation of sensory input to the cortex and demonstrated the resulting plasticity and development that can occur upon introduction of stimulation. In this article, we review several fundamental principles of cortical development and plasticity and discuss the clinical applications in children with SNHL and ANSD who receive intervention with hearing aids and/or cochlear implants.
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Affiliation(s)
- Garrett Cardon
- Speech, Language and Hearing Sciences Department, University of Colorado at Boulder, Boulder, CO 80309, USA
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François M, Teissier N, Barthod G, Nasra Y. Sedation for children 2 to 5 years of age undergoing auditory brainstem response and auditory steady state responses recordings. Int J Audiol 2011; 51:282-6. [DOI: 10.3109/14992027.2011.601469] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Prognostic validity of dichotic multiple frequencies auditory steady-state responses versus distortion product otoacoustic emissions in hearing screening of high risk neonates. Int J Pediatr Otorhinolaryngol 2011; 75:1109-16. [PMID: 21719120 DOI: 10.1016/j.ijporl.2011.05.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 05/27/2011] [Accepted: 05/30/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the validity of dichotic multiple frequencies auditory steady-state responses (ASSR) as a hearing screening technique versus using distortion product otoacoustic emissions (DPOAEs) among high-risk neonates. METHODS A cross sectional study was performed on 118 high-risk neonates by means of dichotic multiple frequencies ASSR and DPOAE for hearing screening. DPOAE results were used as the standard for hearing screening in parallel with ASSR. Dichotic multiple frequencies ASSR results were analyzed by means of F-value of less or greater than 0.05 criteria as a pass-fail for the responses. Dichotic multiple ASSR hearing screening technique was considered in two intensity levels at 40 and 70 dB HL. The ASSRs thresholds were measured in high risk neonates with and without hearing deficits as determined by DPOAES. The results of ASSR and DPOAE were compared to be gathered by contingency table in order to obtain sensitivity, specificity and other different statistical values. Average performing times for the tests were analyzed. RESULTS The specificity of dichotic multiple ASSR was 92.6%, 93.8% and the sensitivity was 71.6%, 62.2% at the 70 and 40 dB hearing levels, respectively. Mean ASSR thresholds for normal-hearing infants at an average corrected age of 6 days were 32.2 ± 12.2, 29.8 ± 10.2, 26.2 ± 11.4 and 30.4 ± 10.8 dB HL for 0.5, 1, 2 and 4 kHz, respectively. The average times for performing the tests were 18.7 and 32.9 min respectively. CONCLUSIONS ASSR with this special paradigm is a fairly desirable method for hearing screening of high-risk neonates. There is good concordance between ASSRs and DOPAEs results among high risk neonates referred for hearing screening. The sensitivity and specificity of this test is sufficient for hearing screening in high risk neonates. This test could be valuable for rapid confirmation of normal thresholds. As long as further research have not been conducted on ASSR, great caution should be made to interpret the results of ASSR as a hearing screening technique in young infants and also additional techniques such as the tone-evoked ABRs should be used to cross-check results. It's still too soon to recommend ASSRs as a standalone electrophysiologic measure of hearing thresholds in infants.
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The efficiency of the single- versus multiple-stimulus auditory steady state responses in infants. Ear Hear 2011; 32:349-57. [PMID: 21187750 DOI: 10.1097/aud.0b013e3181ff352c] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Multiple auditory steady state responses (ASSRs) will likely be included in the diagnostic test battery for estimating infant auditory thresholds in the near future; however, the effects of single- versus multiple-stimulus presentation in infants has never been investigated. In adults, there are no interactions (reduced amplitudes) between responses to multiple simultaneous stimuli presented at 60 dB SPL or lower. Maturational differences, however, may lead to greater interactions in infants; thus, it is unknown whether the single-stimulus technique or the multiple-stimulus technique is more efficient for testing infants. Two studies were carried out to address this issue. DESIGN All infants in study A participated in three stimulus conditions, which differed in the number of stimuli presented simultaneously. The monotic single (MS) condition consisted of 500, 1000, 2000, and 4000 Hz tones, which were presented singly to one ear. The monotic multiple (MM) condition was composed of four tones (500, 1000, 2000, and 4000 Hz) presented to one ear simultaneously. The dichotic multiple (DM) condition consisted of eight tones presented simultaneously to both ears (four tones to each ear). ASSR amplitudes were obtained from 15 normal infants (mean age: 23.1 wks) in response to multiple (MM, DM) and single (MS) air conduction amplitude-modulated (AM) tones (77 to 105 Hz modulation rates; 60 dB SPL). In study B, ASSR thresholds were determined for 500-Hz stimuli in the single- and DM-stimulus conditions (14 infants; mean age: 20.2 wks). RESULTS Mean single-stimulus ASSR amplitudes for 500, 1000, 2000, and 4000 Hz were 30, 39, 45 and 43 nV, respectively. Presentation of multiple AM tones (i.e., four octave-spaced frequencies) to one ear resulted in ASSR amplitudes that were 97%, 87%, 82%, and 70% (for 500, 1000, 2000, and 4000 Hz, respectively) of the single-stimulus ASSR amplitudes. Results for the dichotic presentation of eight AM tones show ASSR amplitudes that were 70%, 77%, 67%, and 67% relative to the MS condition. Although decreases in amplitude occurred using multiple stimuli in infants, the multiple ASSR remained more efficient than the single-stimulus ASSR (i.e., multiple-stimulus amplitudes were greater than single-stimulus amplitudes divided by √K, where K is the number of stimuli). Results from study B indicate that ASSR thresholds for 500 Hz presented in the DM condition were elevated 3 dB compared with that obtained in the 500-Hz single-stimulus condition. This statistically nonsignificant difference is within the range of acceptable test-retest variability and is thus not of clinical significance. CONCLUSIONS The amplitude reductions seen in the multiple-stimulus conditions in infants, not seen in adults, could be related to maturational differences in the ear canal, middle ear, cochlea, and/or brain stem. Because greater interactions occur in the DM-stimulus condition compared with the monotic multiple-stimulus condition and baseline single-stimulus condition, brain stem origins of these interactions are likely. Study B revealed statistically nonsignificant differences between threshold for 500 Hz when presented in the single- and DM-stimulus conditions. In summary, as with adults, multiple-stimulus presentation in infants is more efficient than single AM tones, at least for 60 dB SPL stimuli.
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Ishida IM, Cuthbert BP, Stapells DR. Multiple auditory steady state response thresholds to bone conduction stimuli in adults with normal and elevated thresholds. Ear Hear 2011; 32:373-81. [PMID: 21206364 DOI: 10.1097/aud.0b013e318201c1e5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Auditory steady state responses (ASSRs) to multiple air conduction (AC) stimuli modulated at ∼80 Hz have been shown to provide reasonable estimates of the behavioral audiogram. To distinguish the type of hearing loss (i.e., conductive, sensorineural, or mixed), bone conduction (BC) results are necessary. There are few BC-ASSR data, especially for individuals with hearing loss. The present studies aimed to (1) determine multiple ASSR thresholds to BC stimuli in adults with normal hearing, masker-simulated hearing loss, and sensorineural hearing loss (SNHL) and (2) determine how well BC-ASSR distinguishes normal versus elevated thresholds to BC stimuli in adults with normal hearing or SNHL. DESIGN Multiple ASSR and behavioral thresholds for BC stimuli were determined in two studies. Study A assessed 16 normal-hearing adults with relatively flat threshold elevations produced by 50, 60, and 70 dB SPL AC masking noise, as well as no masking. Study B assessed 10 adults with normal hearing and 40 adults with SNHL. In both studies, the multiple (500 to 4000 Hz) ASSR stimuli were modulated between 77 and 101 Hz and varied in intensity from 0 to 50 dB HL in 10-dB steps. Stimuli were presented using a B71 bone oscillator held on the temporal bone by an elastic band while participants relaxed or slept. RESULTS Study A: Correlations (r) between behavioral and ASSR thresholds for all conditions combined were 0.77, 0.87, 0.90, and 0.87 for 500, 1000, 2000, and 4000 Hz, respectively. ASSR minus behavioral threshold difference scores for all frequencies combined for the no-masker, 50, 60, and 70 dB SPL masker conditions were 14.3 ± 9.2, 12.1 ± 10.4, 12.7 ± 7.7, and 11.4 ± 8.1 dB, respectively. Study B: The difference scores for 500, 1000, 2000, and 4000 Hz were, on average, 15.7 ± 12.3, 10.3 ± 10.7, 9.7 ± 10.3, and 5.7 ± 7.9 dB, respectively, with correlations of 0.73, 0.84, 0.87, and 0.94 for the normal-hearing and SNHL groups combined. The ASSR minus behavioral difference scores were significantly larger for 500 Hz and significantly smaller for 4000 Hz compared with 1000 and 2000 Hz. Across all frequencies, the BC-ASSR correctly classified 89% of thresholds as "normal" or "elevated" (92% correct for 1000, 2000, and 4000 Hz). CONCLUSIONS The threshold difference scores and correlations in individuals with SNHL are similar to those in normal listeners with simulated SNHL. These difference scores are also similar to those shown by previous studies for the AC-ASSR in individuals with SNHL, at least for 1000 to 4000 Hz. The BC-ASSR provides a reasonably good estimate of BC behavioral threshold in adults, especially between 1000 and 4000 Hz. Further research is required in infants with hearing loss.
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Affiliation(s)
- Ieda M Ishida
- School of Audiology and Speech Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
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Rodrigues GRI, Lewis DR. Auditory steady-state response in children with cochlear hearing loss. ACTA ACUST UNITED AC 2011; 22:37-42. [PMID: 20339806 DOI: 10.1590/s0104-56872010000100008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 02/01/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND auditory steady-state response (ASSR) is indicated as a promising technique in the assessment of the hearing status of children. AIM to investigate the level of agreement between the results of the ASSR and the visual reinforcement audiometry (VRA) in a group of children, thus examining the clinical applicability of this technique in hearing assessment of children. METHOD participants were 14 children with ages between 4 and 36 months (mean 16 months) with the diagnosis of cochlear hearing loss. The ASSR was recorded in the frequencies of 0.5, 1, 2 and 4kHz for multiple simultaneous stimulation and the results were compared with the visual reinforcement audiometry (VRA). RESULTS the intraclass correlation coefficients between ASSR and VRA were 0.90, 0.93, 0.93 and 0.89 respectively for the frequencies of 0.5, 1, 2 and 4kHz, indicating a strong correlation between the techniques. CONCLUSION the ASSR can provide accurate information to support the selection of hearing aids for children when it is not possible to perform the VRA.
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Mo L, Zhang F, Han D, Zhang L. Bone-conducted hearing assessment with 80-Hz multiple auditory steady-state responses to brief tones in adults with normal hearing. ORL J Otorhinolaryngol Relat Spec 2011; 73:253-9. [PMID: 21832862 DOI: 10.1159/000330040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 05/25/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate interactions (if any) in the bone-conduction auditory steady-state response (BC ASSR) between multiple brief tones presented simultaneously. METHODS 500-, 1,000-, 2,000-, and 4,000-Hz brief tones, repeated at a rate of 77-101 Hz, were presented using a B-71 vibrator. BC ASSR thresholds and amplitudes at 50 dB nHL were measured in two conditions where the stimulus was either presented alone or together with other stimuli. RESULTS Significantly larger amplitudes in the single-stimulus condition were found at 50 dB nHL. However, there was no significant threshold difference between single- and multiple-stimulus conditions. The BC ASSR thresholds (means ± SD) at 500, 1,000, 2,000, and 4,000 Hz were 96.7 ± 9.7, 75.3 ± 11.5, 65.6 ± 7.4, and 57.8 ± 7.2 dB re 1 μN ppe, respectively. CONCLUSION Interactions occurred in the multiple-stimulus condition at high presentation levels, but not at threshold levels. The results of the present study imply that BC ASSR thresholds to multiple brief-tone stimuli can be assessed at the same time, at least in normal-hearing adults.
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Affiliation(s)
- Lingyan Mo
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, PR China
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Evidence-Based Approach for Making Cochlear Implant Recommendations for Infants With Residual Hearing. Ear Hear 2011; 32:313-22. [DOI: 10.1097/aud.0b013e3182008b1c] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chou YF, Chen PR, Yu SH, Wen YH, Wu HP. Using multi-stimulus auditory steady state response to predict hearing thresholds in high-risk infants. Eur Arch Otorhinolaryngol 2011; 269:73-9. [PMID: 21512805 DOI: 10.1007/s00405-011-1604-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 04/06/2011] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to investigate whether multi-stimulus auditory steady-state responses were capable of estimating hearing thresholds in high-risk infants. A retrospective chart review study. Three tertiary referral centers. Infants born between January 2004 and December 2006 who met the criteria for risk factors of congenital hearing loss were enrolled in the study. While under sedation, the multi-stimulus auditory steady-state response was used to determine multi-channel auditory steady-state response thresholds for high-risk infants younger than 13 months. Conditioned play audiometry was then applied to these children at 23-48 months of age to obtain pure tone audiograms. Auditory steady-state response thresholds and pure tone thresholds were then compared. A total of 249 high-risk infants were enrolled in the study. 39 infants were lost during follow-up. The remaining 216 infants completed both examinations. The Pearson correlation coefficients (r) between the ASSR levels and pure tone thresholds were 0.88, 0.94, 0.94 and 0.97 at 500, 1,000, 2,000 and 4,000 Hz, respectively. The strength of the relationship between the auditory steady-state responses and pure tone thresholds increased with more severe degrees of hearing loss and higher frequencies. We conclude that initial multichannel ASSR thresholds measured under sedation are highly correlated with pure tone thresholds obtained 2 or 3 years later. ASSR can be used to predict the frequency-specific hearing thresholds of high-risk infants and can provide information for early hearing intervention.
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Affiliation(s)
- Yi-Fan Chou
- Department of Otolaryngology, Buddhist Tzuchi General Hospital, Taipei branch, Taipei, Taiwan
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Evaluating the Modulation Transfer Function of Auditory Steady State Responses in the 65 Hz to 120 Hz Range. Ear Hear 2010; 31:667-78. [DOI: 10.1097/aud.0b013e3181e0863b] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rodrigues GRI, Lewis DR. Threshold prediction in children with sensorioneural hearing loss using the auditory steady-state responses and tone-evoked auditory brain stem response. Int J Pediatr Otorhinolaryngol 2010; 74:540-6. [PMID: 20303185 DOI: 10.1016/j.ijporl.2010.02.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Revised: 02/12/2010] [Accepted: 02/15/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this study was to compare ASSRs to tone-evoked ABR and to behavioral thresholds obtained on follow-up audiometry at 500, 1000, 2000, and 4000 Hz in infants and young children. METHODS The study included 17 infants and young children ages between 2 months and 3 years old, with sensorineural hearing loss. The ASSRs thresholds were compared with the tone-evoked ABR thresholds, and with the behavioral thresholds obtained on follow-up audiometry. RESULTS The correlation of tone-evoked ABR and ASSRs thresholds at 500, 1000, 2000 and 4000 Hz was 0.91, 0.76, 0.81, 0.89, respectively. ASSRs and behavioral hearing thresholds obtained on follow-up were highly correlated, with Pearson r values exceeding 0.94 at each of the test frequencies. CONCLUSIONS Multiple ASSRs have strong correlations to tone-evoked ABR and to behavioral thresholds obtained during follow-up in hearing impaired infants and young children. These results might be useful in order to provide further evidence for the use of multiple ASSRs, as an alternative tool to tone-evoked ABR, although further data are still required.
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Affiliation(s)
- Gabriela Ribeiro Ivo Rodrigues
- Audiology and Speech Pathology Program, Catholic University of São Paulo, Hearing in Children Center, São Paulo, Brazil.
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Kim LS, Jeong SW, Lee YM, Kim JS. Cochlear implantation in children. Auris Nasus Larynx 2010; 37:6-17. [DOI: 10.1016/j.anl.2009.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 09/10/2009] [Accepted: 09/22/2009] [Indexed: 10/20/2022]
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Diagnostic challenges and safety considerations in cochlear implantation under the age of 12 months. Int J Pediatr Otorhinolaryngol 2010; 74:127-32. [PMID: 19939468 DOI: 10.1016/j.ijporl.2009.10.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Revised: 10/17/2009] [Accepted: 10/21/2009] [Indexed: 01/30/2023]
Abstract
AIM To review the current knowledge on cochlear implantation in infancy, regarding diagnostic, surgical and anesthetic challenges. STUDY-DESIGN Meta-analysis. EBM level: II. MATERIALS/METHODS Literature-review from Medline and database sources. Related books were also included. STUDY SELECTION Meta-analyses, prospective controlled studies, prospective/retrospective cohort studies, guidelines, review articles. DATA SYNTHESIS The diagnosis of profound hearing loss in infancy, although challenging, can be confirmed with acceptable certainty when objective measures (ABR, ASSR, OAEs) and behavioural assessments are combined in experienced centres. Reliable assessment of the prelexical domains of infant development is also important and feasible using appropriate evaluation techniques. Overall, 125 implanted infants were identified in the present meta-analysis; no major anesthetic complication was reported. The rate of surgical complications was found to be 8.8% (3.2% major complications) quite similar to the respective percentages in older implanted children (major complications ranging from 2.3% to 4.1%). CONCLUSION Assessment of hearing in infancy is feasible with adequate reliability. If parental expectations are realistic and hearing aid trial unsuccessful, cochlear implantation can be performed in otherwise healthy infants, provided that the attending pediatric anesthesiologist is considerably experienced and appropriate facilities of pediatric perioperative care are readily available. A number of concerns, with regard to anatomic constraints, existing co-morbidities or additional disorders, tuning difficulties, and special phases of the developing child should be also taken into account. The present meta-analysis did not find an increased rate of anesthetic or surgical complications in infant implantees, although long-term follow-up and large numbers are lacking.
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