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Acoustic reflex testing in infants and young children can be performed under general anesthesia when cooperation is difficult. Certain anesthetics allow for reliable reflex elicitation, aiding in hearing loss assessment.
Area of Science:
- Audiology
- Anesthesiology
- Pediatric Medicine
Background:
- Infants and young children often struggle to cooperate with impedance measurements.
- General anesthesia presents a potential solution for conducting acoustic reflex examinations in challenging pediatric cases.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of acoustic reflex testing under general anesthesia in pediatric patients.
- To determine the impact of various anesthetic agents on stapedius reflex measurements.
- To explore the clinical applications of this method in diagnosing hearing impairments and related conditions in children.
Main Methods:
- Acoustic reflex examinations were conducted on pediatric patients under general anesthesia.
- The effects of different anesthetic agents (Tiobutabarbital, Propanidid, Diazepam, Ketamin-hydrochlorid, Alphaxalone-alphadolone acetate) on reflex response were investigated.
- Stapedius reflex threshold and amplitude were measured and analyzed.
Main Results:
- No reflex response was observed with Tiobutabarbital, Propanidid, and Diazepam.
- Acoustic reflexes could be elicited under Ketamin-hydrochlorid and Alphaxalone-alphadolone acetate narcosis.
- The reflex threshold remained stable, while the amplitude of muscle contraction slightly increased with effective anesthetics.
Conclusions:
- General anesthesia is a viable option for acoustic reflex testing in non-cooperative pediatric populations.
- Specific anesthetic agents are suitable for this procedure, preserving reflex integrity.
- This technique aids in assessing hearing loss in children with cleft palate, excluding neuromuscular disorders, and evaluating hearing in speech-delayed children.
Abstract:
Infant and small children are not always able to cooperate in impedance measurements. For this reason it was decided, -in special cases, -to perform acoustic reflex examination under general anaesthesia. The first report on stapedius reflex and general anaesthesia was published by Mink et al. in 1981. Under the effect of Tiobutabarbital, Propanidid and Diazepam there is no reflex response. Acoustic reflex can be elicited with Ketamin-hydrochlorid and Alphaxalone-alphadolone acetate narcosis. The reflex threshold remains unchanged and the amplitude of muscle contraction is somewhat increased. The method was used: 1. to assess the type and degree of hearing loss in children with cleft palate and/or lip prior to surgery. 2. to exclude neuromuscular disorders with indication of pharyngoplasties. 3. to quantify hearing level in children--mostly multiply handicapped--with retarded speech development. The results of Behavioral Observation and Impedance Audiometry are discussed and evaluated.