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Auditory brainstem response audiometry in congenitally hypothyroid children under early replacement therapy
Insights
Congenital hypothyroidism in children treated with thyroid hormone therapy shows a significant incidence of auditory brainstem response abnormalities. These findings suggest potential peripheral and central auditory pathway impacts in affected children.
Area of Science:
- Pediatric Endocrinology
- Neuroscience
- Audiology
Background:
- Congenital hypothyroidism (CH) is a condition requiring lifelong thyroid hormone replacement.
- Auditory function in children with CH, even when treated, requires thorough investigation.
- Thyroid hormones play a crucial role in auditory system development and function.
Purpose of the Study:
- To evaluate auditory pathway function in children with CH using auditory brainstem response (ABR) audiometry.
- To identify the incidence and nature of ABR abnormalities in treated CH patients.
- To explore potential correlations between ABR findings and treatment parameters.
Main Methods:
- Auditory brainstem response (ABR) audiometry was performed on 34 children with CH (ages 5-12) undergoing thyroid hormone therapy.
- A control group of 24 age- and sex-matched children was included for comparison.
- ABR parameters, including wave I latencies and I-V interpeak latencies, were analyzed.
Main Results:
- 20% of CH children exhibited prolonged wave I latencies, suggesting peripheral auditory impairment.
- 10 CH children (29%) showed shortened I-V interpeak latencies, indicating central auditory pathway alterations.
- No significant correlation was found between ABR abnormalities and L-thyroxine levels, bone age, or developmental quotients.
Conclusions:
- Treated children with congenital hypothyroidism demonstrate a notable prevalence of auditory brainstem response abnormalities.
- These findings highlight the potential for subclinical auditory pathway dysfunction in CH, even with treatment.
- Further research is warranted to understand the long-term implications and underlying mechanisms of these auditory changes.
Abstract:
Using auditory brainstem response audiometry, we evaluated 34 congenital hypothyroidism children under thyroid hormone therapy and 24 age- and sex-matched controls between 5 and 12 yr of age. Two main auditory brainstem response abnormalities were encountered: first, prolonged wave I latencies, secondary to a peripheral impairment, were found in seven congenital hypothyroidism children (20%): three of these showed signs of serious otitis media, unilaterally in two and bilaterally in the other, at the time of the evaluation. Second, shortened I-V interpeak latencies were observed in 10 children (29%). No correlation was found between the interpeak latencies and the L-thyroxine serum values at the time of the test or just prior to treatment initiation. Also, there was no correlation with estimated bone age at treatment initiation or with the Griffiths global mental development quotients assessed at 5 yr of age. These preliminary results suggest a significant incidence of auditory brainstem response abnormalities in treated hypothyroid children.