Electric response audiometry in young children before cochlear implantation: a short latency component
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Published on: January 23, 2017
1Medical Physics Department, Queen's Medical Centre, Nottingham, United Kingdom.
Insights
A short latency component (SLC) is present in some profoundly deaf children before cochlear implantation, particularly those with congenital deafness. This finding impacts auditory brain stem response (ABR) interpretation in pediatric audiology.
Area of Science:
- Pediatric Audiology
- Neurophysiology
- Auditory Evoked Potentials
Background:
- The auditory brain stem response (ABR) is crucial for assessing hearing in young children.
- A short latency component (SLC) has been observed in some profoundly deaf children during ABR testing.
- Understanding the origin and prevalence of the SLC is important for accurate diagnosis.
Purpose of the Study:
- To evaluate the incidence of the short latency component (SLC) in profoundly deaf young children.
- To investigate the relationship between the SLC and the etiology of deafness.
- To explore the potential origin of the SLC.
Main Methods:
- Auditory brain stem response (ABR) recordings were performed on 70 profoundly deaf children (ages 2-11) before cochlear implantation.
- Click and tone pip stimuli were used at high intensity levels (up to 105 dB nHL).
- The presence of the SLC at a latency of 3 msec was assessed.
Main Results:
- An SLC was observed in 18 out of 70 children (25.7%).
- The SLC was significantly more common in children with congenital deafness (48%) than in those deafened after meningitis (6%) (p < 0.001).
- The presence of the SLC was associated with younger age in congenitally deaf children (p < 0.01).
Conclusions:
- The ABR interpretation in profoundly deaf children should consider the potential presence of the SLC.
- The SLC may originate from stimulation of the vestibular system, possibly the vestibular nuclei.
- Damage to the vestibular labyrinth might explain the rarity of SLC in post-meningitis deafness.
Objective:
Evaluation of a short latency component (SLC) observed in profoundly deaf young children during recordings of the auditory brain stem response (ABR) before cochlear implantation.
Design:
Seventy young children (ages 2 to 11 yr) were investigated as part of their routine audiologic and diagnostic assessment, before cochlear implantation. The ABR was evoked using click stimuli and tone pips (500 Hz and 1 kHz) at intensity levels up to 105 dB nHL. The incidence of the SLC arising at a latency of 3 msec with high level click stimuli, in addition to residual ABR waves, was assessed.
Results:
An SLC was observed in a total of 18 of the 70 children investigated. It was present in 15 out of 31 congenitally deaf children (48%) compared with only 2 out of 33 children deafened after meningitis (6%). A chi-squared test employing a 2 x 2 contingency table shows that this dependency on etiology of deafness is highly statistically significant (p < 0.001). The presence of the SLC in the congenitally deaf children is related to age at the time of the Electric Response Audiometry test and is more likely to be observed in the younger child (p < 0.01).
Conclusions:
Interpretation of the ABR in profoundly deaf children should take into consideration the possible presence of the SLC. An evoked potential arising from stimulation of the vestibular system, particularly the vestibular nuclei, is proposed as a likely origin for this component. Damage to sensory cells in the vestibular portion of the labyrinth might explain why an SLC is seen rarely in cases of deafness after meningitis.
