Evoked response audiometry and tomography - complementary procedures for the assessment of the deaf infant

Evoked response audiometry and tomography of the ear both provide highly objective means of assessing certain types of deafness, but both require a general anaesthetic when used to investigate very young children. The use of evoked response audiometry (in particular electrocochleography and brain stem evoked response audiometry) and tomography as combined procedures using the same general anaesthetic is discussed in relation to 15 patients. Their ages ranged from 1 year 3 months to 16 years. All 15 had electrophysiological abnormalities in one or both ears. Abnormalities of the middle and/or inner ear were demonstrated by tomography in 12 patients and in 3 the tomography was normal. In 10 cases both procedures suggested severe or almost total deafness in one or both ears. The demonstration of an anatomical abnormality can be very important in future management with particular reference to surgical reconstructions and the potential development of cerebrospinal fluid fistula.