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[Brain stem audiometry and unconventional audiometry in small children--a comparison with pure-tone audiometry
1Audiologisk afdeling, Bispebjerg Hospital, København.
Insights
Auditory brain-stem responses (ABR) accurately estimate hearing thresholds in infants and children. This reliable audiology tool is valuable for difficult-to-test pediatric patients.
Area of Science:
- Pediatric Audiology
- Neuroscience
- Hearing Science
Background:
- Infants and children, especially those at high risk, often present challenges for standard hearing assessments.
- Accurate hearing threshold determination is crucial for early intervention and development.
Purpose of the Study:
- To evaluate the reliability of auditory brain-stem responses (ABR) in estimating hearing thresholds in young children.
- To compare ABR results with pure tone audiometry in a pediatric cohort.
Main Methods:
- Auditory brain-stem responses (ABR) were conducted on 71 high-risk or difficult-to-test infants and children.
- A subset of 41 children underwent pure tone audiometry approximately 2.5 years later for follow-up comparison.
- Behavioral audiometry was also analyzed in 28 children.
Main Results:
- A significant correlation (Kendall tau C = 0.59) was found between ABR and pure tone audiometry thresholds at 2 kHz.
- ABR correctly estimated hearing thresholds within +/- 20 dB HL for 81% of children compared to pure tone audiometry.
- False negative rates were 2% for ABR vs. pure tone audiometry, and 21% for behavioral audiometry vs. pure tone audiometry.
- False positive rates were 17% for ABR vs. pure tone audiometry, and 50% for behavioral audiometry vs. pure tone audiometry.
Conclusions:
- Auditory brain-stem responses (ABR) are a reliable and valuable tool for estimating hearing thresholds in pediatric populations who cannot cooperate with traditional audiometric tests.
- ABR provides a more valid estimation of hearing compared to behavioral audiometry in young children.
- ABR is a crucial diagnostic procedure in pediatric audiology for accurate hearing assessment.
Abstract:
Auditory brain-stem responses (ABR) was performed in the determination of hearing threshold in 71 infants and children born 1980-1985, all belonging to high risk groups or difficult-to-test children (median age 17 months, range 2-80). In a follow up study, 41 of the children were tested with pure tone audiometry approximately 2 1/2 years later. A significant correlation was revealed between the threshold obtained by ABR and the pure tone threshold at 2 kHz (Kendall tau C = 0.59, p less than 0.00005). Compared to pure tone audiometry, the threshold had been estimated correctly by ABR in 81% of the patients (+/- 20 dB HL), in 2% the threshold had been estimated to be more than 20 dB better (false negative), while 17% had the threshold estimated more than 20 dB worse (false positive). The median difference between the thresholds obtained was -10 dB HL, the 25% percentile -20 dB HL and the 75% percentile 0 dB HL. In 28 children, behavioural audiometry and pure tone audiometry could be analyzed. 21% were false negative and 50% false positive. The result of the study indicates that ABR is a reliable testing procedure in the estimation of hearing thresholds in children who cannot cooperate sufficiently for pure tone audiometry. ABR gives a more valid estimation of the hearing than behavioural audiometry and is therefore a most valuable testing procedure in paediatric audiology.