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Threshold changes of ABR results in toddlers and children
Julia Louza1, Daniel Polterauer1, Natalie Wittlinger1
1Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ludwig-Maximilians-University Munich.
Insights
Repeated auditory brainstem response (ABR) tests reveal frequent changes in young children's hearing thresholds, with many showing improvement. These findings highlight the need for multiple ABR measurements to accurately assess hearing in children.
Area of Science:
- Pediatric audiology
- Neuroscience
- Otolaryngology
Background:
- Auditory brainstem response (ABR) is crucial for diagnosing hearing loss in young children.
- Previous research indicates hearing thresholds can fluctuate post-diagnosis, showing both deterioration and improvement.
Purpose of the Study:
- To evaluate longitudinal changes in auditory thresholds measured by ABR in young children.
- To determine the frequency and magnitude of hearing threshold shifts over time.
Main Methods:
- Retrospective analysis of 459 ABR measurements from 116 children (aged 0-3 years) between 2010-2014.
- Auditory thresholds assessed using click and/or NB-chirp stimuli under natural sleep or anesthesia.
- Frequency of threshold differences ≥10dB between repeated measurements was analyzed.
Main Results:
- Significant hearing threshold improvement (≥10dB) observed in 35% of right ears and 38% of left ears.
- Over 20dB improvement noted in 27 cases; threshold deterioration occurred in 10-12% of ears.
- Hearing thresholds remained stable in only half of the children across repeated measurements, with an average interval of 5 months.
Conclusions:
- Repeated ABR measurements frequently detect changes in auditory thresholds in young children.
- Multiple ABR assessments are essential for accurate diagnosis and management of hearing impairment.
- Auditory threshold fluctuations must be considered when providing hearing aid solutions.
Introduction:
Auditory brainstem response (ABR) is a clinically established method to identify the hearing threshold in young children and is regularly performed after hearing screening has failed. Some studies have shown that, after the first diagnosis of hearing impairment in ABR, further development takes place in a spectrum between progression of hearing loss and, surprisingly, hearing improvement.
Objective:
The aim of this study is to evaluate changes over time of auditory thresholds measured by ABR among young children.
Material And Methods:
For this retrospective study, 459 auditory brainstem measurements were performed and analyzed between 2010 and 2014. Hearing loss was detected and assessed according to national guidelines. 104 right ears and 101 left ears of 116 children aged between 0 and 3 years with multiple ABR measurements were included. The auditory threshold was identified using click and/or NB-chirp-stimuli in natural sleep or in general anesthesia. The frequency of differences of at least more than 10dB between the measurements was identified.
Results:
In 37 (35%) measurements of right ears and 38 (38%) of left ears there was an improvement of the auditory threshold of more than 10dB; in 27 of those measurements more than 20dB improvement was found. Deterioration was seen in 12% of the right ears and 10% of the left ears. Only half of the children had stable hearing thresholds in repeated measurements. The time between the measurements was on average 5 months (0 to 31 months).
Conclusion:
Hearing threshold changes are often seen in repeated ABR measurements. Therefore multiple measurements are necessary when ABR yields abnormal. Hearing threshold changes should be taken into account for hearing aid provision.
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