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Updated: Aug 7, 2026
Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
[Hearing evaluation in chronic renal failure children]
Agata Hajduk1, Grazyna Lisowska, Grzegorz Namysłowski
1Katedra i Oddział Kliniczny Laryngologii w Zabrzu, Sl AM w Katowicach.
Insights
Children with chronic renal failure (CRF) show reduced hearing organ activity, specifically in the inner ear, as measured by distortion product otoacoustic emissions (DPOAEs). Auditory brainstem responses (ABR) showed no significant differences in these young patients.
Area of Science:
- Otoacoustic Emissions
- Auditory Evoked Potentials
- Nephrology
Background:
- Chronic renal failure (CRF) is associated with systemic complications, including neurological and otological issues.
- Early detection of hearing impairment in pediatric CRF patients is crucial for timely intervention.
- Objective hearing assessment methods are valuable for evaluating auditory function in children.
Purpose of the Study:
- To objectively assess inner ear function in children with CRF using distortion product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABR).
- To identify the specific part of the auditory system affected by CRF.
- To determine optimal ipsilateral stimulation parameters for clinical DPOAE testing in this population.
Main Methods:
- Hearing acuity was evaluated in 22 CRF children and 18 healthy controls using pure tone audiometry and tympanometry.
- Objective hearing assessment included DPOAEs with varying stimulus levels and ABR using click stimuli.
- DPOAEs measured responses to two simultaneous pure tones (f1, f2) analyzing the 2f1-f2 emission.
- ABR evaluated wave latencies and inter-wave intervals.
Main Results:
- CRF children exhibited significantly lower mean DPOAE amplitudes across all measured frequencies compared to healthy children.
- No significant differences were observed in ABR results between CRF children and controls.
- Specific DPOAE stimulus parameters (L1=65/L2=60, L1=63/L2=55, L1=59/L2=45 dB SPL) were identified as most optimal for clinical use.
Conclusions:
- Pediatric CRF is associated with subclinical cochlear dysfunction, detectable by DPOAEs.
- DPOAEs are sensitive to inner ear changes in CRF, while ABR may not reveal early auditory pathway alterations.
- Optimized DPOAE protocols can aid in the early detection of otological complications in children with CRF.
Unlabelled:
Chronic renal failure (CRF) causes a lot of systemic side-effects, among them: neurological and otological complications. In present study hearing evaluation was made in young patients, using distortion product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABR).
The Aim Of Study:
(1) objective assessment of hearing organ activity in CRF children, (2) localization of hearing organ part involved in CRF, (3) establishing best parameters of ipsilateral stimulation in DPOAEs for clinical use.
Materials And Methods:
Hearing acuity was assessed in 22 CRF children ranging in age from 9 to 17 years and 18 healthy children ranging in age from 10 to 18 years. At first pure tone audiometry and tympanometry were evaluate. Only patients with normal middle ear condition and hearing threshold better than 30 dB HL were put forward further investigations. Objective assessment of hearing condition included: (1) DPOAEs using DP-gram format. Two simultaneous pure-tone signals (primaries) were presented to the ear at two different frequencies (f1 and f2, where f2 > f1) and the 2f1-f2 were analyzed. Five pairs of non equal level and L2 were used L1 and L2: panel A1: L1 = 65 and L2 = 60 dB SPL, panel A2: L1 = 63 and L2 = 55 dB SPL, panel A3: L1 = 59 and L2 = 45 dB SPL, panel A4: L1 = 55 and L2 = 35 dB SPL, panel A5: L1 = 51 and L2 = 25 dB SPL; (2) ABR investigation using click stimulus, at 90 dB nHL level. Wave I, III, V latencies and intervals I-III, III-V, I-V were evaluated. Our results reviled significantly lower mean DPOAEs amplitudes in CRF children when compare to healthy children, at all frequencies measured. No differences in ABR evaluation were observed. Most optimal DPOAEs parameters in clinical use seem to be panel A1, A2 and A3 of level L1 and L2.
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