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Auditory brainstem responses and clinical follow-up of high-risk infants
S J Kramer1, D R Vertes, M Condon
1Department of Otolaryngology, University of Texas Medical Branch, Galveston.
Insights
Auditory brainstem response (ABR) screening identified hearing impairments in high-risk infants. Infants failing ABR at 45 dB hearing level had severe sensorineural hearing loss, while those failing at 30 dB often had conductive disorders.
Area of Science:
- Audiology
- Neonatal Medicine
- Pediatric Healthcare
Background:
- Early detection of hearing loss in infants is crucial for developmental outcomes.
- High-risk infants in special care units require targeted audiological screening.
- Auditory brainstem response (ABR) is a standard method for assessing infant hearing.
Purpose of the Study:
- To evaluate the effectiveness of ABR screening in identifying hearing impairments in high-risk infants.
- To characterize the types and severity of hearing loss detected by ABR.
- To assess the incidence of severe hearing impairment in this population.
Main Methods:
- Auditory brainstem response (ABR) evaluations were conducted on 667 high-risk infants.
- Infants were categorized based on ABR results (pass, fail at 30 dB, fail at 45 dB).
- Follow-up otologic/audiologic assessments were scheduled at 1, 3, or 6 months post-initial ABR.
Main Results:
- 82% of high-risk infants passed the ABR screening.
- Severe sensorineural hearing impairment was exclusively found in infants failing at 45 dB HL, with an estimated incidence of 2.4%.
- Among infants failing at 30 dB HL, 80% showed conductive hearing disorders and 20% mild sensorineural hearing impairments upon follow-up.
Conclusions:
- ABR screening effectively identifies hearing impairments in high-risk infants.
- The severity of ABR failure (30 dB vs. 45 dB HL) correlates with the type and severity of hearing loss.
- Timely identification and intervention through ABR programs are vital for infants with hearing loss.
Abstract:
Auditory brainstem response (ABR) evaluations were performed on 667 high-risk infants from an infant special care unit. Of these infants, 82% passed the ABR. Those infants who failed the ABR were classified into two groups, those who failed at 30 dB hearing level and those who failed at 45 dB hearing level. All of the infants were encouraged to return for otologic/audiologic follow-up in 1, 3, or 6 months, depending on the initial ABR results. All of the infants with severe hearing impairments came from the group who failed at 45 dB hearing level. The incidence of severe sensorineural hearing impairment in this population was estimated to be 2.4%. For the group that failed at 30 dB hearing level, 80% of those who were abnormal at follow-up were considered to have conductive hearing disorders and 20% had mild sensorineural hearing impairments. In addition, infants enrolled in a parent-infant program for hearing impaired by 6 months of age were from the ABR program; however, several infants entered the parent-infant program at a relatively late age because they did not meet the high-risk criteria, they were from other hospitals, or they were not detected by the ABR program.