Characterization of Shared Patient Factors in Children Who Have Undergone Sedated Auditory Brainstem Response
Harold Brooks Lampkin1, Sydney Mitchell1, Lauren Kate Storm1
1Department of Otolaryngology-Head and Neck Surgery, University of Mississippi Medical Center, Jackson.
Insights
This study analyzed children undergoing sedated auditory brainstem response (ABR) testing. Many children, even those passing newborn hearing screening, required further assessment, highlighting the need for timely diagnosis and efficient sedation practices.
Area of Science:
- Pediatric Audiology
- Neuroscience
- Otolaryngology
Background:
- Early detection of hearing loss in children is crucial for development.
- Sedated Auditory Brainstem Response (ABR) is a key diagnostic tool for pediatric hearing assessment.
- Understanding patient characteristics aids in optimizing ABR procedures.
Purpose of the Study:
- To characterize patient demographics and risk factors of children undergoing sedated ABR.
- To identify factors influencing the need for sedated ABR in pediatric populations.
- To evaluate the diagnostic yield of sedated ABR in children with varying newborn hearing screen results.
Main Methods:
- Retrospective chart review of children under 18 undergoing sedated ABR.
- Data collection included demographics, family history, newborn hearing screen status, and risk factors.
- Analysis of data stored using Research Electronic Data Capture (REDCap).
Main Results:
- Mean age of children undergoing sedated ABR was 23.12 months.
- Half of the children passed newborn hearing screening, yet required sedated ABR.
- Children referred in newborn screening were younger at sedated ABR (16.10 months) than those who passed (30.57 months).
- Significant proportions of children with sensorineural, mixed, or conductive hearing loss were identified via sedated ABR.
- 60% of sedated ABRs were performed concurrently with another procedure.
Conclusions:
- Vigilance in pediatric hearing assessment is essential to prevent diagnostic delays.
- Sedated ABR is valuable for children who pass or refer newborn hearing screening.
- Performing sedated ABR during other procedures can minimize repeat sedation events.
Purpose:
This study aims to characterize patient characteristics of children undergoing sedated auditory brainstem response (ABR) at a tertiary-level medical center.
Method:
A retrospective chart review analyzed children, under 18 years of age, who underwent sedated ABR evaluation in an operating room at a single tertiary academic center from January 1, 2013, to January 1, 2023. The following information was collected: sex, age, family history of hearing loss, newborn hearing screen status, and presence or absence of known risk factors for childhood hearing loss (neurodegenerative disorders, syndromes, congenital cytomegalovirus infection, other congenital infections, craniofacial anomalies, Apgar score at 5 min, neonatal intensive care unit stay of > 5 days, ototoxic medication treatment, low birth weight, assisted ventilation, and history of outer or middle ear pathology). Data were collected and stored using Research Electronic Data Capture software.
Results:
The mean age of children undergoing sedated hearing assessment was 23.12 months. Roughly half the children who underwent sedated testing passed newborn hearing screening, while the other half referred. Findings show statistically significant difference in age of children undergoing sedated assessment that passed (30.57 months) versus referred (16.10 months) newborn hearing screening. While majority of children who passed newborn hearing screening were found to have normal hearing with sedated evaluation, 24% had sensorineural or mixed hearing loss and 18% conductive hearing loss. Findings showed a higher proportion of children subsequently identified with conductive hearing loss had sedated assessment completed in conjunction with another procedure. Overall, nearly 60% of children undergoing sedated ABR had another procedure in conjunction.
Conclusions:
This study highlights the need for continued vigilance in hearing assessments to prevent delays in diagnosis. Both children who passed and referred newborn hearing screening subsequently underwent sedated ABR testing. We recommend whenever possible, children needing sedated hearing assessment do so in conjunction with another procedure to limit the need for multiple sedation events.
