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Prognostic validity of brainstem electric response audiometry in infants of a neonatal intensive care unit
A Durieux-Smith1, T W Picton, P Bernard
1Children's Hospital of Eastern Ontario, Ottawa, Canada.
Insights
Brainstem electric response audiometry (BERA) accurately predicted hearing status in 89% of infants tested. Discrepancies were mainly due to temporary conductive hearing losses, highlighting BERA
Area of Science:
- Audiology
- Neonatal Medicine
- Pediatric Hearing
Background:
- Neonatal intensive care unit (NICU) infants are at high risk for hearing impairment.
- Early detection of hearing loss is crucial for timely intervention and better outcomes.
Purpose of the Study:
- To compare the predictive accuracy of Brainstem Electric Response Audiometry (BERA) in NICU infants with pure-tone audiometry (PTA) results at 3 years of age.
- To identify discrepancies between BERA and PTA and analyze their causes.
Main Methods:
- Prospective study comparing BERA in infancy with PTA at 3 years.
- Included 333 NICU infants with complete follow-up data from an initial cohort of 600.
- Analyzed prediction accuracy and causes of discrepancies.
Main Results:
- BERA accurately predicted hearing status in 89% of children at 3 years.
- Discrepancies (9%) were primarily related to transient conductive hearing losses.
- Two cases of false-positive sensorineural hearing loss and six false-negative cases were noted.
Conclusions:
- BERA is a reliable tool for predicting hearing status in NICU infants.
- Transient conductive hearing loss can cause temporary discrepancies.
- Regular follow-up is essential for accurate long-term hearing assessment in high-risk infants.
Abstract:
This study compared the results of brainstem electric response audiometry (BERA) in infants of a neonatal intensive care unit to those obtained on the same children with pure-tone audiometry at 3 years of age. Six hundred children were initially tested in infancy, and complete follow-up information was obtained on 333. In 297 (89%) the BERA results accurately predicted the hearing status at the age of 3 years. Twenty-nine (9%) of the discrepancies were related to conductive hearing losses: 17 patients with a conductive hearing loss in the first few months of life had normal hearing at 3 years, and 12 patients normal in infancy had a conductive loss at 3 years. Two patients evaluated as a sensorineural hearing loss by BERA had normal hearing. These may have been due to a conductive loss. Six patients assessed as normal by BERA had significant hearing losses at the age of 3 years. Five of these had normal hearing at one frequency between 1,000 and 4,000 Hz. The sixth may have developed a sensorineural hearing loss after birth.