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Brainstem auditory evoked potentials in young children before and after tympanostomy tube placement
M J Owen1, K Norcross-Nechay, V M Howie
1Department of Pediatrics, University of Texas Medical Branch, Galveston 77550.
Insights
Tympanostomy tube placement significantly improves hearing function in infants with otitis media with effusion (OME). Brainstem auditory evoked potentials (BAEP) confirmed reduced hearing loss after tube insertion, aiding diagnosis in young children.
Area of Science:
- Pediatric Otolaryngology
- Neuroscience
- Audiology
Background:
- Otitis media with effusion (OME) is common in infants and young children, often causing hearing loss.
- Accurate hearing assessment in this age group can be challenging with traditional behavioral audiometry.
- Brainstem Auditory Evoked Potentials (BAEP) offer an objective method for evaluating auditory function.
Purpose of the Study:
- To assess the immediate and short-term effects of tympanostomy tube placement on hearing function in infants and young children with OME.
- To evaluate the utility of BAEP in estimating hearing loss in young children with OME.
- To investigate changes in brainstem auditory pathway transmission following OME treatment.
Main Methods:
- Brainstem Auditory Evoked Potentials (BAEP) were recorded in young children (mean age 22 months) with OME undergoing tympanostomy tube insertion.
- Hearing loss was estimated using peak V latency-intensity curves before and immediately after tube placement.
- BAEP were also assessed at 3 weeks to 18 months post-insertion to evaluate short-term effects.
- A control group of healthy infants with normal audiometry was included for comparison.
Main Results:
- Immediate post-tympanostomy tube placement, mean hearing loss decreased significantly from 22 dB to 11 dB in ears with effusion (P < 0.0001).
- Ears without effusion at myringotomy showed minimal hearing loss (8 dB) that did not significantly change after tube insertion.
- Short-term follow-up showed mean hearing loss of 3 dB for dry tubes and 31 dB for ears with otorrhea.
- BAEP demonstrated prolonged peak latencies in ears with effusion, which improved significantly after tube placement.
Conclusions:
- Tympanostomy tube placement effectively improves hearing function in young children with OME.
- BAEP is a valuable tool for estimating hearing loss in infants and young children with OME, especially when behavioral audiometry is difficult.
- The study highlights the utility of BAEP in detecting auditory pathway changes in very young children with a history of OME.
Abstract:
To evaluate the effect of tympanostomy tube placement upon the hearing function of infants and young children, brainstem auditory evoked potentials (BAEP) were recorded in a group of young children (mean age 22 mos) receiving this treatment for otitis media with effusion (OME). For comparison, a group of healthy infants with normal behavioral audiometry were also tested with BAEP. Hearing loss was estimated for each ear using peak V latency-intensity curves. To evaluate the immediate effect of tube placement, 98 ears in 52 children were tested immediately before and after tube insertion. The 63 ears with effusion had prolonged peak latencies that decreased significantly (P < 0.001) immediately after tube placement and a mean hearing loss estimate of 22 dB that improved significantly (P < 0.0001) to 11 dB immediately after tube insertion. The 35 ears without effusion at myringotomy had a mean hearing loss estimate of 8 dB that did not change significantly after tube insertion. To evaluate the short-term effect of tube presence, 39 ears in 25 children were tested 3 weeks to 18 months after tube insertion. The 28 ears with dry tubes had a mean hearing loss estimate of 3 dB, and the 11 ears with otorrhea had a mean hearing loss estimate of 31 dB. The magnitude of mean hearing loss estimates in these young children with OME and the improvement in hearing function with tube placement is similar to that reported in older children studied with BAEP and audiometry. The study groups with a history of otitis media that had resolved by the time of testing had isolated prolongation of mean III-V interpeak latencies compared to normals (P < 0.01). These studies show that BAEP techniques are useful in estimating hearing loss in children with OME who are difficult to test by behavioral audiometry and show changes in rostral brainstem transmission in very young children with a history of OME.