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Raised ABR threshold after suction aspiration of glue from the middle ear: three case studies
J D Mason1, S M Mason, K P Gibbin
1Department of Otolaryngology, University Hospital, Nottingham, UK.
Insights
Fluid aspiration during myringotomy may cause temporary threshold shifts in children
Area of Science:
- Pediatric Audiology
- Otolaryngology
Background:
- Auditory Brainstem Response (ABR) is a key diagnostic tool for assessing hearing in children.
- Myringotomy with grommet insertion is a common procedure for middle ear effusions.
Observation:
- 13 children (25 ears) underwent ABR testing under general anesthesia.
- 14 ears had fluid aspirated and grommets inserted before ABR.
- 11 ears had dry myringotomies or no myringotomy prior to ABR.
Findings:
- 43% of ears (6/14) with fluid aspiration showed a temporary threshold shift of ≥15 dB post-procedure.
- No temporary threshold shifts were observed in ears without fluid aspiration (p = 0.034).
Implications:
- Unexpected high ABR thresholds following middle ear fluid aspiration require cautious interpretation.
- This finding highlights a potential transient impact of otologic procedures on ABR results.
Abstract:
Between 1991 and 1993, 13 children (25 hearing ears) underwent recordings of the auditory brain stem response (ABR) under a general anaesthetic. The anaesthetic technique was similar for each child. Fourteen of these ears had fluid aspirated after myringotomy with insertion of grommets prior to the auditory brain stem response investigation. On subsequent hearing assessment six of these 14 ears (43 per cent) showed clear evidence of a threshold shift of 15 dB or greater. Eleven ears had either dry myringotomies or did not have a myringotomy prior to ABR and none of these showed evidence of a temporary threshold shift. Using Fisher's Exact probability test this difference is significant (p = 0.034). We feel it is important to report these observations so that unexpected high ABR thresholds following aspiration of glue are interpreted with caution.