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The effect of hearing loss on ABR interpretation: use of a correction factor
M Z Cashman1, S G Stanton, C Sagle
1Department of Otolaryngology, University of Toronto, London, Ontario, Canada.
Insights
Abnormal auditory brainstem response (ABR) tests in patients with high-frequency hearing loss can complicate diagnoses. A correction factor improves accuracy but ABR is unreliable with severe hearing loss.
Area of Science:
- Audiology
- Neuroscience
- Otolaryngology
Background:
- Retrocochlear disorders present diagnostic challenges, often indicated by abnormal auditory brainstem responses (ABRs) alongside high-frequency hearing loss.
- Accurate interpretation of ABR results is crucial for effective clinical decision-making in audiology.
Purpose of the Study:
- To evaluate the impact of hearing loss, specifically at 4000 Hz, on the accuracy of auditory brainstem response (ABR) testing.
- To assess the effectiveness of the Selters and Brackmann correction factor in mitigating hearing loss-related inaccuracies in ABR results.
Main Methods:
- A retrospective analysis of 1539 patient ABR test results was conducted.
- False-positive and false-negative rates of ABR were calculated as a function of 4000 Hz hearing loss, both with and without the Selters and Brackmann correction factor.
Main Results:
- Without correction, ABR showed 25.0% false-positive and 2.9% false-negative rates for hearing loss >50 dB HL at 4000 Hz.
- With the correction factor, these rates decreased to 12.5% false-positive and 5.8% false-negative.
- ABR yielded abnormal results in 75% of non-tumor patients with >90 dB HL hearing loss at 4000 Hz.
Conclusions:
- The Selters and Brackmann correction factor offers some benefit but should be used with caution.
- Auditory brainstem response (ABR) testing is not recommended for patients with hearing loss exceeding 90 dB HL at 4000 Hz or 75 dB HL at 2000 Hz.
Abstract:
Patients suspected of retrocochlear disorders often have abnormal ABRs in the presence of high-frequency hearing loss, making clinical decisions difficult. In a retrospective study of the ABR test results of 1539 patients, the false-positive and false-negative rates for ABR are presented as a function of hearing loss at 4000 Hz, both before and after using Selters and Brackmann's correction factor for hearing loss. For patients with more than 50 db HL at 4000 Hz the false-positive and false-negative rates, uncorrected for hearing loss, were 25.0% and 2.9% respectively, and when the correction factor was used were 12.5% and 5.8%. When hearing loss at 4000 Hz was over 90 dB the ABR was abnormal in 75% of nontumor patients. Conclusions are that a correction factor for hearing loss is helpful with reservations, and that ABR is not a useful test when 4000 Hz hearing loss is greater than 90 dB HL and 2000 Hz is greater than 75 dB HL.