[Analyses of audiological examination in children without auditory brainstem response]

Area of Science:

• Pediatric Audiology
• Neuroscience
• Otolaryngology

Background:

• Severe and profound sensorineural deafness in children presents diagnostic challenges.
• Auditory Brainstem Response (ABR) testing, specifically wave V detection, is a standard but may not capture all residual hearing.
• Objective audiological assessments are vital for comprehensive hearing evaluations in pediatric populations.

Purpose of the Study:

• To investigate residual hearing in children with severe to profound sensorineural deafness where wave V was absent in ABR testing.
• To highlight the importance of a comprehensive battery of objective audiological tests.
• To explore the diagnostic utility of cochlear microphonic potentials (CMs) in specific cases.

Main Methods:

• A cohort of 252 children (72 days to 4 years) with sensorineural deafness underwent a full suite of objective audiological tests.
• Tests included Distortion Product Otoacoustic Emissions (DPOAEs), tympanometry, ABR, 40 Hz Auditory Event Related Potential (40 HzAERP), and Auditory Steady-State Responses (ASSRs).
• Data analysis was performed using SPSS 16.0 to correlate findings.

Main Results:

• 88.1% of ears (444/504) demonstrated residual hearing across various frequencies.
• Responses were not detected in 40 HzAERP and ASSR testing in 11.9% of ears (60/504).
• Cochlear microphonic potentials (CMs) were identified in 14.3% of patients (38/252 ears).

Conclusions:

• A comprehensive battery of objective audiological tests is superior for investigating residual hearing in children.
• CMs can aid in diagnosing Auditory Neuropathy in infants with absent OAEs and ABR.
• These findings underscore the need for multi-faceted audiological assessment in pediatric hearing loss.