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Abnormal positive potentials in round window electrocochleography.

S J O'Leary¹, T E Mitchell, W P Gibson

¹Department of Otolaryngology, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.

The American Journal of Otology

|November 15, 2000

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An abnormal positive potential (APP) on round window electrocochleograms (RW ECochG) in children may indicate severe hearing loss. Half of affected children required non-auditory communication strategies for development.

Area of Science:

Pediatric audiology
Neurophysiology
Otolaryngology

Background:

Severe to profound hearing loss in children presents diagnostic challenges.
Round window electrocochleography (RW ECochG) is a tool for auditory threshold estimation.
Atypical waveforms may offer further diagnostic insights.

Purpose of the Study:

To describe an abnormal positive potential (APP) waveform on RW ECochG in children.
To correlate the occurrence of APP with clinical history and auditory outcomes.

Main Methods:

Prospective identification and retrospective analysis of clinical data for children undergoing RW ECochG.
Analysis included audiograms, auditory outcomes, and clinical history.
Focus on children under 110 months with suspected severe to profound hearing loss.

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Main Results:

APP was observed in 34 children, most pronounced with clicks and 8-kHz tones.
APP click thresholds averaged 70 dB HL; brainstem evoked potentials showed abnormalities.
Clinical factors like prematurity, kernicterus, or hypoxia were frequently associated with APP.

Conclusions:

APP thresholds were lower than neural or behavioral thresholds.
Children with APP require close follow-up due to a high likelihood of needing non-auditory communication strategies.