Correlation between brainstem evoked response audiometry with other audiological tests in different types of hearing loss

Hemal Shah; Pramod Kharadi; Krunal Patel; Sushil Jha; Abhishek Kumar Singh

doi:10.18203/issn.2454-5929.ijohns20201672

Authors

Hemal Shah Department of ENT and Head and Neck Surgery, Care Institute of Medical Sciences (CIMS), Ahmedabad, Gujarat, India
Pramod Kharadi Department of ENT, GMERS Medical College and Hospital, Vadnagar, Gujarat, India
Krunal Patel Consultant ENT Surgeon, Swari ENT Hospital, Ahmedabad, Gujarat, India
Sushil Jha Department of ENT, Govt. Medical College, Bhavnagar, Gujarat, India
Abhishek Kumar Singh Consultant ENT Surgeon, Dr. Singh ENT Hospital, Deoria, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20201672

Keywords:

Correlation, Brainstem evoked response audiometry, Audiological tests, Hearing loss

Abstract

Background: Brainstem evoked response audiometry (BERA) is most specific and sensitive test for brain stem dysfunction. It is most important objective method for evaluating peripheral auditory system in neonates, infants, sedated and comatose patients and other person who doesn’t understand the language. Objective of the study was to evaluate correlation BERA with other audiological tests in different types of hearing loss as well as to study variations of wave forms in different types of hearing loss.

Methods: Patients underwent a complete ENT check up to rule out any actively discharging gears, wax, infection or any middle ear problems. Different audiometric tests: pure tone audiometry (PTA), distortion product otoacoustic emissions, auditory steady-state response (ASSR) and BERA were applied to the patients.

Results: The majority of the patients (32 cases) belonged to the age group of 0-5 years. Maximum cases were of sensorineural hearing loss (60%). ASSR was highly sensitive (85.1%) for estimation of hearing threshold and specificity was 100% (p<0.001). BERA was also highly significant for estimation of hearing threshold (sensitivity: 83%; specificity: 92.3%; p value <0.001).

Conclusions: BERA has high degree of accuracy in detecting hearing threshold as an objective test but not as much accurate as ASSR. It is more valuable in terms of identification of site and size of the lesion in auditory pathway and identification for the type of the deafness.

Metrics

Metrics Loading ...

References

Zahnert T. The differential diagnosis of hearing loss. Dtsch Arztebl Int. 2011;108(25):433-43.

Rance G. Auditory neuropathy/dys-synchrony and its perceptual consequences. Trends Amplif. 2005;9(1):1-43.

National Research Council (US) Committee on Disability Determination for Individuals with Hearing Impairments; Dobie RA, Van Hemel S, editors. Hearing Loss: Determining Eligibility for Social Security Benefits. Washington (DC): National Academies Press (US); 2004. 2, Basics of Sound, the Ear, and Hearing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207834/. Last accessed on 12 December 2019.

Gil D, Iorio MC. Formal auditory training in adult hearing aid users. Clinics (Sao Paulo). 2010;65(2):165-74.

Hoth S, Baljic I. Current audiological diagnostics. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2017;16:9.

Jewett DL, Romano MN, Williston JS. Human auditory evoked potentials: possible brain stem components detected on the scalp. Science. 1970;167(3924):1517-8.

Xie L, Wang M, Liao T, Tan S, Sun K, Li H, et al. The characterization of auditory brainstem response (ABR) waveforms: A study in tree shrews (Tupaia belangeri). J Otol. 2018;13(3):85-91.

Verhulst S, Jagadeesh A, Mauermann M, Ernst F. Individual Differences in Auditory Brainstem Response Wave Characteristics: Relations to Different Aspects of Peripheral Hearing Loss. Trends Hear. 2016;20:2331216516672186.

Yilmaz MS, Guven M, Cesur S, Oguz H. The auditory brainstem responses in patients with unilateral cochlear hearing loss. Indian J Otolaryngol Head Neck Surg. 2013;65(3):203-9.

Soni A, Kanaujia SK, Kaushik S. Brainstem Evoked Response Audiometry (BERA) in Neonates with Hyperbillirubinemia. Indian J Otolaryngol Head Neck Surg. 2016;68(3):334-8.

Kochhar A, Hildebrand MS, Smith RJ. Clinical aspects of hereditary hearing loss. Genet Med. 2007;9(7):393-408.

White EJ, Hutka SA, Williams LJ, Moreno S. Learning, neural plasticity and sensitive periods: implications for language acquisition, music training and transfer across the lifespan. Front Syst Neurosci. 2013;7:90.

Meltzer NE, Ryugo DK. Projections from auditory cortex to cochlear nucleus: A comparative analysis of rat and mouse. Anat Rec A Discov Mol Cell Evol Biol. 2006;288(4):397-408.

Jorgensen LE, Benson EA, Creery MRW. Conventional Amplification for Children and Adults with Severe-to-Profound Hearing Loss. Semin Hear. 2018;39(4):364-76.

World Report on Disability 2011. Geneva: World Health Organization; 2011. Available at: https://www.ncbi.nlm.nih.gov/books/NBK304079/. Accessed on 23 December 2019.

Ptok M. Early detection of hearing impairment in newborns and infants. Dtsch Arztebl Int. 2011;108(25):426-31.

Beyea JA, Mullen MKP, Harris MS, Houston DM, Martin JM, Bolster VA, et al. Cochlear Implants in Adults: Effects of Age and Duration of Deafness on Speech Recognition. Otol Neurotol. 2016;37(9):1238-45.

Seldran F, Gallego S, Micheyl C, Veuillet E, Truy E, Van TH. Relationship between age of hearing-loss onset, hearing-loss duration, and speech recognition in individuals with severe-to-profound high-frequency hearing loss. J Assoc Res Otolaryngol. 2011;12(4):519-34.

Pfingst BE, Bowling SA, Colesa DJ, Garadat SN, Raphael Y, Shibata SB, et al. Cochlear infrastructure for electrical hearing. Hear Res. 2011;281(1-2):65-73.

Johnson DD. Communication characteristics of a young deaf adult population: techniques for evaluating their communication skills. Am Ann Deaf. 1976;121(4):409-24.

Turner JS. The Ear and Auditory System. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 126. Available at: https://www.ncbi. nlm.nih.gov/books/NBK231/. Accessed on 28 December 2019.

Eggermont JJ. The inadequacy of click-evoked auditory brainstem responses in audiological applications. Ann N Y Acad Sci. 1982;388:707-9.

Minovi A, Dazert S. Diseases of the middle ear in childhood. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2014;13:11.

Friedrich BS, Wulke C. Classification and diagnosis of ear malformations. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2007;6:5.

Korver AM, Smith RJ, Camp VG, Schleiss MR, Glindzicz BMA, Lustig LR, et al. Congenital hearing loss. Nat Rev Dis Primers. 2017;3:16094.

Greene J, Dhahir AMA. Acoustic Neuroma (Vestibular Schwannoma) (Updated 16 December 2019). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available at: https://www.ncbi.nlm.nih.gov/books/ NBK470177/. Accessed on 12 January 2020.

Bauch CD, Olsen WO, Harner SG. Auditory brain-stem response and acoustic reflex test. Arch Otolaryngol. 1983;109(8):522-5.

Musiek FE, Pinheiro ML. Frequency patterns in cochlear, brainstem, and cerebral lesions. Audiology. 1987;26(2):79-88.

Verma NP, Lynn GE. Auditory evoked responses in multiple sclerosis. Wave I abnormality. Arch Otolaryngol. 1985;111(1):22-4.

Lemay JF, Herbert AR, Dewey DM, Innes AM. A rational approach to the child with mental retardation for the paediatrician. Paediatr Child Health. 2003;8(6):345-56.

Lee S, Jeon ES, Cho HH. Auditory Evoked Potential Inconsistency in Sudden Unilateral Hearing Loss with Multiple Sclerosis. J Int Adv Otol. 2019;15(1):160-4.

Holenweg A, Kompis M. Non-organic hearing loss: new and confirmed findings. Eur Arch Otorhinolaryngol. 2010;267(8):1213-9.

Read AP, Newton VE. Waardenburg syndrome. J Med Genet. 1997;34(8):656-65.

Koca TT. Apert syndrome: A case report and review of the literature. North Clin Istanb. 2016;3(2):135-9.

Vander WKR, Brown CJ, Gienapp BA, Schmidt Clay KM. Comparison of auditory steady-state response and auditory brainstem response thresholds in children. J Am Acad Audiol. 2002;13(5):227-35.