Using click-evoked auditory brainstem response thresholds in infants to estimate the corresponding pure-tone
Tsun-Min Lu1, Fang-Wei Wu2, Hsiuwen Chang3
1Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan.
Insights
Click-evoked auditory brainstem response (ABR) testing in infants can reliably estimate behavioral pure-tone audiometry (PTA) thresholds in children. This method aids in early hearing aid fitting and auditory rehabilitation for infants with congenital hearing loss.
Area of Science:
- Audiology
- Pediatric Medicine
- Neuroscience
Background:
- Newborn hearing screening programs are crucial for early detection of hearing loss.
- Accurate hearing threshold assessment in infants is vital for timely intervention.
- Behavioral pure-tone audiometry (PTA) is the gold standard but challenging in infants.
Purpose of the Study:
- To evaluate the accuracy of estimating children's behavioral PTA thresholds from infant click-evoked auditory brainstem response (ABR) thresholds.
- To assess the utility of ABR in predicting hearing outcomes in early childhood.
- To inform audiological management strategies for infants identified through universal newborn hearing screening (UNHS).
Main Methods:
- Retrospective review of data from a UNHS program in Taiwan.
- Analysis of 186 ears from 104 infants with regular follow-up.
- Correlation and linear regression analyses to compare infant click-evoked ABR and child PTA thresholds.
Main Results:
- A strong correlation (r=0.76) was found between click-evoked ABR and behavioral PTA thresholds at 1-4 kHz and 2-4 kHz.
- Behavioral PTA thresholds were accurately estimated from click-evoked ABR in 57% and 58% of children at these frequencies.
- Click-evoked ABR provides a reliable estimation for specific frequency ranges.
Conclusions:
- Click-evoked ABR is a valuable tool for cautiously estimating behavioral PTA thresholds in children.
- Combining click-evoked ABR with frequency-specific tone-burst ABR is recommended for precise hearing aid fitting and auditory rehabilitation in infants.
- Early and accurate hearing assessment using ABR facilitates better outcomes for congenitally deaf infants.
Objective:
To examine whether behavioral pure-tone audiometry (PTA) thresholds in children can be accurately estimated from the corresponding infants' click-evoked auditory brainstem response (ABR) thresholds through a retrospective review of data from a universal newborn hearing screening (UNHS) program in Taiwan.
Method:
According to medical records from Mackay Memorial Hospital, Taipei Hospital District, 45,450 newborns received hearing screening during January 1999-December 2011. Among these newborns, 104 (82, both ears; 22, one ear; total, 186 ears) received regular follow-up and were recruited as subjects. The relationship between infant click-evoked ABR thresholds and the corresponding child PTA thresholds was determined through Pearson correlation coefficient and linear regression analyses.
Results:
The correlation coefficient between click-evoked ABR thresholds and behavioral PTA thresholds at the average of frequencies of 1-4 and 2-4 kHz was 0.76 and 0.76, respectively. Linear regression analysis showed that behavioral audiometry thresholds at the average of frequencies of 1-4 and 2-4 kHz were accurately estimated from click-evoked ABR thresholds in 57% and 58% children, respectively.
Conclusion:
Click-evoked ABR testing is a reliable tool to cautiously estimate behavioral PTA thresholds at the average of frequencies of 1-4 and 2-4 kHz. For accurately performing hearing aid fitting and auditory rehabilitation in congenitally deaf infants, a combination of frequency-specific tone-burst ABR and click-evoked ABR should be used.
