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Hearing threshold assessment post grommet insertion. Is it reliable?

H Griffiths1, D James, R Davis

  • 1Department of ENT, Russells Hall Hospital, Dudley, UK. huwgriffiths@mac.com

The Journal of Laryngology and Otology
|December 14, 2006
PubMed
Summary

Auditory Brainstem Response (ABR) may inaccurately overestimate hearing thresholds immediately after grommet insertion. Temporary threshold shift is a likely cause of this ABR inaccuracy in pediatric audiology.

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Area of Science:

  • Pediatric Audiology
  • Otolaryngology
  • Hearing Science

Background:

  • Grommet insertion is a common procedure for otitis media with effusion.
  • Accurate hearing threshold assessment is crucial for monitoring treatment efficacy.
  • Auditory Brainstem Response (ABR) is a key audiological test.

Purpose of the Study:

  • To evaluate the accuracy of Auditory Brainstem Response (ABR) for hearing threshold measurement immediately following tympanostomy tube insertion.
  • To compare ABR results with Transient Evoked Otoacoustic Emissions (TEOAE) and findings at a later review.

Main Methods:

  • Ten children (20 ears) underwent ABR and TEOAE testing pre-operatively, immediately post-operatively under anesthesia, and at a six-week follow-up without anesthesia.
  • Hearing thresholds (dB) and TEOAE presence were recorded by senior audiologists.

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Main Results:

  • Post-operative ABR showed elevated thresholds compared to pre-operative assessments in 11 ears.
  • Significant threshold shifts (≥15 dB) were observed in seven ears immediately after grommet insertion.
  • ABR overestimation of hearing thresholds was noted, with a significant intra-subject variation (p<0.001).

Conclusions:

  • Auditory Brainstem Response (ABR) may be inaccurate when performed immediately after grommet insertion, potentially overestimating hearing thresholds.
  • Temporary threshold shift is hypothesized as the mechanism for ABR inaccuracy in the immediate post-operative period.
  • Six-week follow-up assessments provided more reliable hearing threshold data.