The use of melatonin for auditory brainstem response audiometry in children with comorbidities
Caroline Struijk1,2, Nicolien van der Poel3, Isabel Blommaerts3
1Department of Orthopedic Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium. Struijk.caroline@gmail.com.
Insights
Melatonin effectively aids auditory brainstem response (ABR) testing in children, including those with comorbidities. This study found high success rates and no adverse events, making it a feasible option for pediatric hearing assessments.
Area of Science:
- Pediatric Audiology
- Pharmacology
Background:
- Auditory brainstem response (ABR) audiometry is crucial for assessing hearing in infants and children.
- Children with comorbidities or developmental delays may present challenges during ABR testing due to difficulties with cooperation and prolonged immobility.
- Melatonin, a sleep-regulating hormone, has been explored for its potential to facilitate medical procedures requiring sedation or sleep in pediatric populations.
Purpose of the Study:
- To evaluate the efficacy and feasibility of using melatonin to facilitate auditory brainstem response (ABR) audiometry in young children.
- To assess the impact of melatonin on sleep-onset latency, sleep duration, and adverse events during ABR investigations.
- To determine if melatonin is effective for ABR testing in children with and without comorbidities.
Main Methods:
- A prospective study involving 131 children undergoing click-induced ABR tests between January 2018 and August 2020.
- Melatonin was administered post-electrode placement, with dosages of 5 mg for children under 6 years and 10 mg for those 6 years or older.
- Study success was defined by the completion of binaural ABR testing.
Main Results:
- 87% of all ABR investigations were successfully completed.
- 70% of the children had comorbidities, such as neurodevelopmental disorders or developmental delays, with equal distribution between successful and failed groups.
- Mean sleep duration was 38 minutes, and mean sleep-onset latency was 28 minutes, with no documented adverse events.
Conclusions:
- Melatonin is an effective and feasible option for facilitating ABR examinations in both infants and children, irrespective of comorbidities.
- The use of melatonin allows for sequential hearing loss monitoring in at-risk children.
- Optimal outcomes depend on clear caregiver instructions and audiologist expertise.
Purpose:
In this study, the efficacy and feasibility of melatonin in young children with and without comorbidities, undergoing auditory brainstem response audiometry (ABR) was evaluated. The aim of this study was primarily to evaluate the use of melatonin for ABR investigations in children with comorbidities. Second, the efficacy of melatonin was evaluated based on several factors like sleep-onset latency, sleep duration, frequency of awakenings as well as adverse events.
Methods:
Click-induced ABR tests were performed at the outpatient clinic between January, 2018 and August, 2020. Investigations were considered successful when binaural testing was completed. A dose of melatonin depending on age, 5 mg for children younger than 6 years and 10 mg if older than 6 years, was administered after placement of electrodes.
Results:
131 children were included in this study. 87% of all ABR investigations were performed successfully. Comorbidities such as neurodevelopmental disorders or developmental delays were present in 70% of all children. There was no significant difference in age (p = 0.36) or gender (p = 0.97) between the success and failed group. In addition, comorbidities were equally distributed between both groups. Mean sleep duration was 38 (SD 21) min and sleep-onset latency was 28 (SD 20) min No adverse events were documented.
Conclusion:
Melatonin is effective for ABR examinations in infants and children with and without comorbidities. Furthermore, it allows for sequential testing in those at risk for progressive hearing loss. Clear instructions to caregivers and expertise of audiologists are a prerequisite for optimal outcomes.
