Monitoring of the auditory pathway maturation after early intervention during the first year of life in infants with sensorineural hearing loss

F Matin,A Lesinski-Schiedat,S Haumann,W Roßberg,D Mitovska,T Lenarz

doi:10.1007/s00405-020-06498-3

F Matin, A Lesinski-Schiedat + Show 4 more

Open Access

https://doi.org/10.1007/s00405-020-06498-3

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Abstract

PurposeThe objective of this study was to investigate the auditory pathway maturation monitored by auditory brainstem responses (ABR) in infants with hearing loss during the first year of life. ABR were used to estimate hearing thresholds and the effect of early intervention strategies using hearing aids (HA).MethodsClick-evoked ABRs were measured in 102 infants aged from 0 to 12 months to determine their individual auditory threshold. Early therapy intervention was recommended before 12 months of age and analyzed. To evaluate the effect of hearing amplification on auditory maturation, different subgroups of infants with moderate hearing loss were analyzed and the auditory pathway maturation was determined based on IPL I–V shortening.ResultsOverall, 110 ears (54.0% of 204 ears) with mild to profound HL showed threshold changes of 10 dB up to 60 dB in the follow-up ABR testing. HA were prescribed at the age of 3.8 ± 3.9 months. Cochlear implantation (CI) was performed in cases of repeated profound HL at the age of 9.9 months ± 4.5 months. A significant shortening of IPL I–V in all subgroups of infants (with and without risk factors) who received HA was shown and assumed auditory pathway maturation.ConclusionAn early intervention using optimally fitted HA influenced auditory pathway maturation and may lead to improvements of hearing thresholds during the first year of life in infants. This study underscores the importance of not only providing HAs to infants, but also controlling for hearing threshold changes ensuring that HAs provide the optimal level of intervention or CI is indicated.

Highlights

Severe to profound bilateral sensorineural hearing loss (SNHL) is present in 1 to 3 out of 1000 newborns and 2 to 4 out of 100 infants who require neonatal intensive care (American Academy of Pediatrics 1999) [1,2,3]
We further looked at infants with identified risk factors with moderate HL provided with hearing aids (HA) and separated them from infants fitted with HA without risk factors to identify if risk factors possibly affect auditory maturation
In children with a diagnosed SNHL, auditory maturation is delayed and the maturation delay can be influenced by other risk factors [27,28,29]

Summary

Introduction

Severe to profound bilateral sensorineural hearing loss (SNHL) is present in 1 to 3 out of 1000 newborns and 2 to 4 out of 100 infants who require neonatal intensive care (American Academy of Pediatrics 1999) [1,2,3]. To avoid significant delay of speech and language acquisition as well as auditory maturation followed by undetected congenital hearing loss (HL), an early identification and intervention is required [4]. The ability to obtain reliable behavioral responses in infants is useful clinically [12]. The click-evoked ABR provides reliable estimates of the behavioral pure-tone thresholds in the frequency range 2–4 kilohertz (kHz). Using special fitting and stimulus configurations, more frequency-specific responses down to 1 kHz can be evoked [11, 16]

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