Auditory Brainstem Response Results Research Articles

Intraoperative Auditory Brainstem Response Results Predict Delayed Sensorineural Hearing Loss After Middle Cranial Fossa Resection of Vestibular Schwannoma.

To identify intraoperative neurophysiologic measures predictive of delayed progressive sensorineural hearing loss in the operative ear after a middle fossa approach (MCF) for resection of vestibular schwannoma (VS). Retrospective review. Academic, tertiary referral center. Subjects with vestibular schwannoma who underwent a MCF microsurgical resection of VS were analyzed for individuals whose hearing was initially preserved but subsequently developed progressive sensorineural hearing loss in the operative ear. Thirty-seven patients were identified for whom audiologic and neurophysiologic data was available. Intraoperative neurophysiologic changes will correlate with delayed sensorineural hearing loss in the operative ear. Audiometric evaluations, intraoperative electrocochleography (ECoG), and auditory brainstem response (ABR) measures. Twenty-five subjects experienced stable hearing or hearing loss in the operative ear comparable to the contralateral ear. Twelve subjects suffered a significant increase in the hearing asymmetry between ears. Deterioration in the amplitude of wave V of the ABR persisting at the close of tumor resection correlated with delayed sensorineural hearing loss in the operative ear (p 0.02, 5% mean improvement in the stable hearing group, versus a 14% decline with progressive asymmetry), but changes in ECoG or other auditory brainstem response parameters (p > 0.05) were not predictive. Persisting amplitude reduction of wave V of the intraoperative ABR best correlates with delayed progressive sensorineural hearing loss in the operative ear. Neither persistent changes in ECoG, other ABR parameters, nor transient changes, correlated with delayed progressive sensorineural hearing loss in the operative ear.

Perinatal factors influencing the neonatal hearing screening results

BackgroundPrevious studies have indicated that the majority of cases with “failed” results related to transient evoked otoacoustic emissions (OAE) test have the normal hearing. The present study aimed to assess the possible relationships between perinatal factors and the false-positive OAE results.MethodsA case-control study was carried out in an Iranian Hospital in 2020. Based on the OAE results on the first day of life, newborns were divided into 2 groups; Control group included subjects with “Pass” OAE results. Every neonate with “Fail” OAE result was referred for auditory brainstem response (ABR). Neonates with bilateral fail OAE but normal ABR results (false-positive OAE) were considered as the case group. All recorded data were analyzed to assess the possible correlations between maternal/neonatal factors and the false-positive OAE results.ResultsOne hundred and eighty-one neonates entered the study. Of all included neonates, 87 (48.1%) cases showed bilateral fail OAE and 94 (51.9%) subjects passed the OAE test. Normal ABR results (false-positive OAE) were observed in all cases with bilateral fail OAE. Comparisons of variables affecting the OAE results showed that of all perinatal factors, neonate’s sex (p = 0.046) and cesarean section (p = 0.003) were the only influencing factors that increased the risk of false-positive OAE results.ConclusionBased on the results, the cesarean section delivery and neonate’s male sex increased the risk of false-positive results related to OAE test. Implementing other screening tests such as ABR or Automated ABR as the initial screening test could be suggested for such cases.

Impact of Tinnitus Masking on Auditory Brainstem Response Results

Tinnitus- the perception of sound without external stimulation can also lead to disruption in the quality of life and has been over the years been benefitted by tinnitus masking. Hence this study to understand the effectiveness of tinnitus masking using the Auditory Brainstem Response (ABR) Test. The intention of this experimental research design is to determine whether tinnitus masking as treatment for tinnitus makes a significant difference in auditory evoked brainstem responses before and after masking for understanding the effectiveness of the treatment objectively and possible quantification of benefit measurement through ABR. 30 subjects with normal hearing and unilateral tinnitus were assessed using ABR before and after tinnitus masking. Data was collected and compared to evaluate pre-masking and post-masking values of Latency-Intensity function and Interpeak Latency differences. Data was analyzed using descriptive statistics, test of homogeneity of variances and Two-way ANOVA. Both latency-intensity functions and interpeak latency differences showed significant differences before and after tinnitus masking with significance values of Two-way ANOVA as .001, (Calculated at p < .05). Despite the patient's subjective feedback, objective proof of the patient's benefit is a necessity. Therefore, this study shows that ABR shows significant differences in patients treated with tinnitus masking. Further suggesting benefit quantification of tinnitus masking as a treatment to tinnitus suffering individuals and for further understanding the intricacies of changes in the central auditory pathway due to masking.

Comparison of Pre-treatment and Post-treatment Auditory Brainstem Response Results in Children with Serous Otitis

Introduction: The present study aimed to investigate the effect of middle ear effusion on the ABR test through a comparison of clinical auditory brainstem response (ABR) results in pre-treatment and post-treatment in patients diagnosed with otitis media with effusion (OME). Materials and Methods: This retrospective study included 42 children aged 3 months-12 months, who failed the otoacoustic emissions (OAE) test in the hearing screening program and were diagnosed with serous otitis. Results: Following treatment of the patients, the right ears of 76.9% of patients and the left ears of 69.04% of patients passed the distortion product otoacoustic emissions test. In the OAE tests post-treatment, in 23.8% of patients, the right ear, and 30.95% patients, the left ear was negative, and a decrease was seen in the hearing thresholds in clinical ABR. The latencies of the ABR 1st and 3rd waves were observed to be significantly prolonged pre-treatment compared to post-treatment in all patients. Conclusion: The appropriate intervention in the early stage eliminates or reduces the negative effects of hearing loss. To avoid a very long follow-up period of infants diagnosed with serous otitis media in the first years of life, prompt treatment should be applied to patients who have not responded to medical treatment, and if the thresholds after treatment are above normal values, a hearing aid should be applied as soon as possible and family therapy should be provided.

Brainstem hyperintensity in patients with vestibular schwannoma is associated with labyrinth signal on magnetic resonance imaging but not vestibulocochlear tests.

Focal hyperintensity in the dorsal brainstem (HDB) has been described in large cerebellopontine angle tumours and is thought to represent vestibular nuclei degeneration, but its functional significance has not been thoroughly investigated. Our aim was to analyse its relationship to imaging characteristics of the tumour and inner-ear structures and to vestibulocochlear functional tests. We retrospectively reviewed 54 patients with a histological diagnosis of vestibular schwannoma (VS). Magnetic resonance imaging tumour characteristics (size, cystic composition and distance from the cochlear aperture), signal intensity ratio of the cochlea and vestibule in fluid-attenuated inversion recovery (FLAIR) and fast imaging employing steady-state acquisition (FIESTA)/fast spin-echo imaging with variable flip angles (CUBE) and vestibulocochlear function tests (audiometry, auditory brainstem response (ABR) and video head impulse testing (vHIT)) were obtained. Statistical analyses were performed to evaluate their relation to focal HDB. Focal HDB was found in 22% of VS. It was significantly associated with large (p < 0.001) and cystic (p = 0.004) tumours and also with tumours located further from the cochlear aperture (p = 0.039). The signal intensity ratio of the cochlea on FLAIR was higher in patients with HDB (p < 0.014), but this difference was not observed in FIESTA/CUBE (p = 0.981). Audiometry, ABR and vHIT results did not significantly differ in patients with HDB, but ABR results were worse in patients with higher cochlear signal intensity on FLAIR sequences (p = 0.026). Focal HDB in patients with VS was associated with increased signal intensity ratio of the cochlea on FLAIR in patients with VS but not directly to the results of vestibulocochlear function tests.

The Protective Effect of Nigella sativa Oil against Experimentally Induced Cisplatin Ototoxicity: An Animal Study.

The objective of this study was to investigate the potential protective effect of Nigella sativa oil (NSO) against cis-diamminedichloroplatinum or cisplatin (CDDP)-induced ototoxicity. Twenty-four Wistar albino rats were randomly and equally divided into four groups. Groups 1 and 2 were given a total of 15 mg/kg CDDP intraperitoneally, which was divided equally into three doses on days 1, 3, and 5. Group 2 was treated via gavage feeding with 15 ml NSO that was divided into five doses on days 1, 3, 5, 7, and 9. Groups 3 and 4 received only 15 ml of NSO and 15 ml of 0.9% saline solution, respectively, which were orally administered and divided into five doses on days 1, 3, 5, 7, and 9. Baseline high-frequency (8, 12, 16, and 32 kHz) auditory brainstem response (ABR) measurements were collected in all the groups before the medical administrations and were repeated on the 14th day before sacrifice. Afterward, a histopathological evaluation of the cochlea was performed. There was a significant difference in the histopathological changes between group 1 and the other groups (p<0.01). Changes in the spiral ganglion cells, the stria vascularis, and the external ciliated cells were significantly different between groups 1 and 2 (p=0.019, 0.039, and 0.045, respectively). The ABR results revealed significant differences in the 16 and 32 kHz measurements between groups 1 and 2 (p=0.013 and p<0.01, respectively). According to the results, NSO may have a protective effect on cochlear function against the disruptive effects of CDDP in rats.

Analysis of Click and Swept-Tone Auditory Brainstem Response Results for Moderate and Severe Sensorineural Hearing Loss

Introduction: Auditory brainstem response (ABR) is one of the commonly used methods in clinical settings to evaluate the hearing sensitivity and auditory function. The current ABR measurement usually adopts click sound as the stimuli. However, there may be partial ABR amplitude attenuation due to the delay characteristics of the cochlear traveling wave along the basilar membrane. To solve that problem, a swept-tone method was proposed, in which the show-up time of different frequency components was adjusted to compensate the delay characteristics of the cochlear basilar membrane; therefore, different ABR subcomponents of different frequencies were synchronized. Methods: The normal hearing group, moderate sensorineural hearing loss group, and severe sensorineural hearing loss group underwent click ABR and swept-tone ABR with different stimulus intensities. The latencies and amplitudes of waves I, III, and V in 2 detections were recorded. Results: It was found that the latency of each of the recorded I, III, and V waves detected by swept-tone ABR was shorter than that by click ABR in both the control group and experimental groups. In addition, the amplitude of each of the recorded I, III, and V waves, except V waves under 60 dB nHL in the moderate sensorineural hearing loss group, detected by swept-tone ABR was larger than that by click ABR. The results also showed that the swept-tone ABR could measure the visible V waves at lower stimulus levels in the severe sensorineural hearing loss group. Conclusion: Swept-tone improves the ABR waveforms and helps to obtain more accurate threshold to some extent. Therefore, the proposed swept-tone ABR may provide a new solution for better morphology of ABR waveform, which can help to make more accurate diagnosis about the hearing functionality in the clinic.

Post-exposure effect of music through personal listening device (PLD) on speech perception in noise test in young adults

Introduction: Tinnitus is often perceived temporarily after noise exposure, usually disappearing within a few hours. However, a significant number of young people perceive permanent tinnitus which is the most frequent symptom following exposure to noise via PLDs.Objective: To evaluate the effect of music exposure through (PLD) with and without tinnitus on results of EHFA, TEOAEs, ABR and SPIN tests in normal hearing young adults.Patients and Methods: Sixty normal hearing young adults were included in this study, fifteen as a control group and forty-five PLDs users as study group, the study group were subdivided according to the presence of tinnitus into two subgroups. All subjects were submitted to basic audiological evaluation (pure tone audiometry, speech audiometry and immittancemetry), Extended high frequency audiometry (EHFA), transient evoked otoacoustic emissions (TEOAEs), auditory brainstem response (ABR) and speech perception in noise (SPIN) test.Results: There were statistically significant differences in extended high frequency audiometry (HFA) at different frequencies among study and control groups. There were statistically significant differences in transient evoked otoacoustic emission test (TEOAEs) response among control and study groups. There were no statistically significant differences in absolute and inter-peak latencies of low and high repetition rate ABR among control and studied groups. There were statistically significant differences in speech perception in noise test (SPIN) among the control and study groups.Conclusion: : exposure to recreational noise due to excessive PLDs usage cause elevated EHFA thresholds, decreased TEOAEs amplitudes and decreased SPIN scores despite normal conventional PTA thresholds.

The association between age-related sensorineural hearing loss and saccular dysfunction in the elderly

Introduction: Presbycusis or age-related sensorineural hearing loss (ARSNHL) is a complex disorder that results in a slow deterioration in auditory function. A considerable high number of these presbycusis or ARSNHL patients also suffer from dizziness and related vestibular symptoms. Although auditory and vestibular systems are distinct, they work just alike. Hence, there is a great relation among their functions. Once one is stimulated, the other suffers changes as well. Methodology: Participants in this study comprised forty adult patients (60–75 years) divided into two groups: control group with normal hearing and without any vestibular symptoms or diagnosed vestibular diseases and study group with mild-to-moderately severe sensorineural hearing loss with or without dizziness in the form of a sense of imbalance during walking or a sense of rotation of the surrounding, especially on sitting or standing from lying position. All patients in this study were without any history of noise exposure in their life. The audiological status was measured with pure-tone audiometry and auditory brainstem response (ABR). The vestibular system was assessed using videonystagmography test battery and cervical vestibular-evoked myogenic potential (cVEMP). Timed up and go test was used as a quick screening tool for detecting balance problems. ABR and cVEMP results of the groups were calculated and compared. Results: The absolute peak latencies of ABR wave I, III, and V were prolonged in the study group than that in the control group. Vestibular-evoked myogenic potential results showed that P13 and N23 latencies were prolonged and P13–N23 amplitude was decreased in the study group when compared to the control group. Conclusion: Thoughtful examination of the vestibular system, in conjunction with auditory functions in elderly persons, is recommended. This may help discover their subclinical vestibular problem and guide physicians to design a suitable treatment plan that helps in decreasing the risk of falls for aged persons.

The efficacy of statins as otoprotective agents: A systematic review.

This systematic review examined current literature, summarised research findings and identified research gaps regarding the efficacy of statins on audiological outcomes. Systematic search of electronic databases and grey literature was performed. Eligibility criteria were the study of a statin drug with report of audiological outcomes such as hearing, tinnitus or balance in either human or animal studies. Data extraction and quality assessment were performed by two independently researchers. The characteristics of the study and research findings were collated and summarised. A narrative synthesis was conducted. Meta-analysis was not possible due to heterogeneity of the included studies. Analysis of searches yielded 17 studies meeting the criteria. Included studies had variable drug type and dosage, outcome measures and associated inner ear conditions. Most animal experiments showed promising audiological outcomes after statin treatment, demonstrated by the results of auditory brainstem response, distortion product otoacoustic emissions and inner ear histology. However, no clear effect can be discerned in human trials due to the mixed results, and heterogeneity in research methodology and quality. Audiological outcomes were not always correlated with cholesterol levels. Statins remain a potential candidate as otoprotective agents which warrant further investigation.

Is auditory brainstem response a prognostic factor in patients with sudden sensorineural hearing loss?

Background: Serum thyroid hormone levels are closely related to the normal functioning of the cochlea. However, the relationship between initial auditory brainstem response (ABR) results and levels of thyroid hormone remained unclear until we adopted ABR as a prognostic factor in Idiopathic sudden sensorineural hearing loss (ISSNHL) patients.Objective: This investigation aimed to elucidate the association between ABR and outcomes in patients with ISSNHL.Material and methods: Thirty-three patients presenting with unilateral ISSNHL underwent blood sampling and ABR tests on the day of admission. The mean latencies of the ABR results were compared among the groups which were classified by ISSNHL outcome, based on Siegel’s criteria. The association between the ABR results and the thyroid hormone serum levels (TSH, T3, and free T4) were assessed.Results: The overall successful recovery rate was 60.6% (n = 20). The mean latencies of all the ABR parameters were not significantly different between the different treatment outcome groups (Mann–Whitney U test). Wave V latency, III–V interval and I–V interval were negatively associated with T3 serum levels.Conclusion: The results indicate that clinical caution should be exercised when conducting ABR tests without assessing thyroid hormone levels.

Correlation between Auditory Brainstem Response Characteristics and Hearing Recovery in Sudden Deafness

Background and Objectives Auditory brainstem response (ABR) can be utilized to verify the hearing threshold and determine the existence of retrocochlear pathology in sudden deafness. However, little is known about the significance of ABR characteristics as a prognostic factor in sudden deafness. The purpose of this study is to evaluate which characteristics of ABR is associated with the prognosis of sudden deafness. Subjects and Method We studied patients who were diagnosed with unilateral sudden deafness from January 2017 to May 2018. ABR results of click stimuli at 90 dB nHL were analyzed by the latency of wave I, III, and V. Results A total of 113 patients (55 men and 58 women) participated in the study. Hearing recovery was observed in 94 cases (83.2%). The absolute latency of wave I, III, and V was prolonged in the affected ears when compared with the unaffected ears. Hearing improvement was only correlated to the interaural latency delay of wave I (Pearson’s r=-0.278, p＜0.05). Prolonged interaural latency delay was noted from complete toward slight hearing recovery group. When the hearing outcome was evaluated by the interaural latency delay of wave I at 0.2 ms, the result of under 0.2 ms was significantly better than that over 0.2 ms and no visible wave I. Conclusion Prolonged interaural delay of wave I over 0.2 ms and no visible wave I in ABR showed worse hearing outcome in sudden deafness. This finding may provide ABR as a potential prognostic indicator in sudden deafness. Key words: Auditory ㆍ Evoked potentials ㆍ Latency

Examination and Comparison of Electrically Evoked Compound Action Potentials and Electrically Evoked Auditory Brainstem Response Results of Children with Cochlear Implantation without Inner Ear Anomaly.

To investigate the relationship between electrically evoked compound action potentials (ECAP) and electrically evoked auditory brainstem responses (EABR) in children with cochlear implants (CI) without inner ear anomalies. Sixteen children between the ages of two and six years who were CI users participated in the study. ECAP thresholds were recorded from one electrode in the basal, medial, and apical regions of the cochlear implant. EABRs were recorded from electrodes whose ECAP thresholds were determined. The latency-intensity functions, amplitude and morphological analyzes of the eIII and eV waves at 200 and 180 current unit (CU) excitation levels were performed. The data obtained were analyzed statistically. ECAP thresholds were found to be 171.5±11.38, 169.69±20.32 and 160.81±20.03 CU at the basal, medial and apical electrodes, respectively. EABR thresholds were also found to be 169.69±12.17, 165.62±16.41 and 160±15.49 CU in basal, medial and apical electrodes, respectively. There was a strong positive correlation between ECAP and EABR thresholds in apical, medial and basal electrodes (p<0.05). EABR threshold levels were not significantly different between basal, medial and apical region electrodes (p>0.05), and ECAP threshold values were significantly different between apical and basal region electrodes (p=0.002). When the significance values of EABR eV wave latencies were analyzed in terms of electrode region, the difference between basal and apical regions was found to be significant (p=0.03). Consistency was found between ECAP and EABR recordings. However, it was concluded that one could not be preferred over the other because the data quality of the two tests was different. In future studies, ECAP and EABR recordings may be recommended by selecting more electrodes for stimulation.

Auditory brainstem response in full-term neonates born to mothers with iron deficiency anemia: relation to disease severity

Background: Iron is crucial for fetal brain development; however, there are insufficient data regarding the effects of maternal iron deficiency anemia (IDA) on auditory neural maturation.Aim: We evaluated the effect of maternal IDA on auditory brainstem response (ABR) in full-term neonates.Methods: Out of 223 pregnant women, 50 were diagnosed as having IDA and 50 healthy mothers were enrolled as controls. ABR test was done for the studied neonates within 48 hours after birth and at 3 months.Results: We found that hemoglobin and iron profile were lower in neonates born to anemic mothers compared with controls. Of 100 neonates screened for ABR, 25 failed the test (all of them were born to anemic mothers). The majority of neonates who failed the screening ABR test (88%) had latent iron deficiency (cord blood ferritin 11–75 µg/L). After 3 months, 85 neonates underwent diagnostic ABR test which revealed significantly prolonged interpeak latencies I–III, III–V, and I–V among neonates born to IDA mothers compared with the control group. Within the IDA group, all interpeak latencies were more prolonged in neonates with latent iron deficiency and in those born to mothers with serum ferritin <15 µg/L. Logistic regression analysis showed that maternal hemoglobin and mean corpuscular volume could predict neonatal ABR results.Conclusions: IDA during late pregnancy adversely affects cord blood iron and hearing status. ABR results are closely related to the severity of maternal and neonatal iron status. Antenatal screening of pregnant mothers is needed to improve fetal iron status and prevent abnormal auditory maturation.

Critical appraisal of appropriate method for early detection of hearing impairment in newborns in a tertiary care centre

Background: Hearing plays a vital role in developmental of a child. Hearing loss not only affects the speech and language development of a child but also affects the social, emotional and intellectual development. Hearing is important in the first 2 years of life as this is the critical period for language acquisition. Thereby early detection and intervention for hearing loss is recommended. However, there are no standard protocols for newborn hearing screening. Hence, this study is undertaken to evaluate the appropriate protocol for early detection of hearing impairment in newborns and to ascertain the sensitivity and specificity of Distortion Product Oto-acoustic Emission (DPOAE) and Auditory Brainstem Response (ABR).Methods: A prospective study was conducted in the Department of Paediatrics and Department of Audiology and Speech Pathology in SRM Medical College Hospital and Research Centre. A total of 122 neonates were screened for hearing loss using both DPOAE and ABR before discharge from the hospital. A rescreening with ABR after 1 month was done for those infants who had hearing loss at the initial screening.Results: The study revealed that 16.4% of infants had hearing loss. The referral rate of DPOAE was 54.1% and ABR was 16.4%. ABR had higher passing rates when compared to DPOAE. In a combined screening with both DPOAE and ABR, 17 (13.9%) babies had failed DPOAE with abnormal hearing in ABR (True positives), 49 (40.2%) babies failed DPOAE but had normal hearing in ABR (False positives), 3 (2.5%) babies passed DPOAE but had hearing loss in ABR (False negatives) and 53 (43.4%) babies passed DPOAE and had normal hearing in ABR (True negatives). The association between the results of DPOAE and ABR was statistically significant (0.002). Auditory neuropathy was detected in 3 out of 122 neonates. All these 3 babies belonged to high-risk population. The prevalence of auditory neuropathy is 2.5% which is much lower when compared to other studies. The sensitivity and specificity of DPOAE is 85% and 51.9% respectively. The sensitivity and specificity of ABR was 100%.Conclusions: Present study concludes that the use of combination protocol using both DPOAE and ABR identifies babies with auditory neuropathy spectrum disorder and also ensures high sensitivity and acceptable specificity. Thus, helps in early identification and intervention of congenital hearing loss.

Audiometric Profiles in Patients With Normal Hearing and Bilateral or Unilateral Tinnitus

Patients with subjective nonpulsatile tinnitus and a normal conventional audiogram have more objective audiologic evidence of hidden hearing loss and deafferentation-related pathology than patients without tinnitus. The aim of this study was to assess the epidemiologic characteristics and audiologic profiles, including auditory brainstem response (ABR), distortion product otoacoustic emission, and threshold-equalizing noise test results, in patients with tinnitus and a normal audiogram. The test results for 20 patients complaining of nonpulsatile chronic tinnitus were compared with those of 91 subjects with normal hearing and no tinnitus. Patients with unilateral tinnitus had higher tinnitus handicap inventory scores than those with bilateral tinnitus (p < 0.05). Threshold-equalizing noise tests were normal in all study participants. In patients with unilateral tinnitus, the ABR and distortion product otoacoustic emission test results were similar to those of controls. In contrast, patients with bilateral tinnitus showed a shortening of latency in wave III of the ABR on the right (p = 0.047) and in wave V on the left (p = 0.024). Logistic regression analysis revealed that enhanced wave III/I (p = 0.018) and V/I (p = 0.012) ratios on the left and poorer pure-tone average on the right were significant risk factors for bilateral tinnitus. The mechanism involved in the development of tinnitus may depend on its laterality. Bilateral tinnitus may be associated with hyperactivity at the level of the cochlear nucleus whereas a higher-order cortical area may be involved in unilateral tinnitus.

Gender differences in binaural speech-evoked auditory brainstem response: are they clinically significant?

IntroductionBinaurally evoked auditory evoked potentials have good diagnostic values when testing subjects with central auditory deficits. The literature on speech-evoked auditory brainstem response evoked by binaural stimulation is in fact limited. Gender disparities in speech-evoked auditory brainstem response results have been consistently noted but the magnitude of gender difference has not been reported. ObjectiveThe present study aimed to compare the magnitude of gender difference in speech-evoked auditory brainstem response results between monaural and binaural stimulations. MethodsA total of 34 healthy Asian adults aged 19–30 years participated in this comparative study. Eighteen of them were females (mean age=23.6±2.3 years) and the remaining sixteen were males (mean age=22.0±2.3 years). For each subject, speech-evoked auditory brainstem response was recorded with the synthesized syllable /da/ presented monaurally and binaurally. ResultsWhile latencies were not affected (p>0.05), the binaural stimulation produced statistically higher speech-evoked auditory brainstem response amplitudes than the monaural stimulation (p<0.05). As revealed by large effect sizes (d>0.80), substantive gender differences were noted in most of speech-evoked auditory brainstem response peaks for both stimulation modes. ConclusionThe magnitude of gender difference between the two stimulation modes revealed some distinct patterns. Based on these clinically significant results, gender-specific normative data are highly recommended when using speech-evoked auditory brainstem response for clinical and future applications. The preliminary normative data provided in the present study can serve as the reference for future studies on this test among Asian adults.

The relationship between presbycusis and vestibular activity

Introduction Presbycusis or age-related sensorineural hearing loss (SNHL) is a complex disorder that results in a slow deterioration in auditory function. A considerably high number of these patients with presbycusis or age-related SNHL also experience dizziness and related vestibular symptoms. Although auditory and vestibular systems are distinct, they work just alike. So, there is a great relation among their functions. Once one is stimulated, the other experiences changes as well. Participants and methods This study comprised 40 adult patients (50–75 years) without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with auditory brainstem response (ABR). The vestibular system was assessed using videonystagmography test battery, sensory organization test, and vestibular evoked myogenic potential (VEMP). ‘Get up and go’ test was used as a quick screening tool for detecting balance problems. Patients were divided into two groups: a study group (patients with SNHL) and a control group (patients without SNHL). ABR and VEMP results of the groups were calculated and compared. Results Absolute peak latencies of ABR waves I, III, and V were prolonged in the study group than the control group (P Conclusion Thorough full examination of the vestibular system, in conjunction with auditory functions in elderly persons, is recommended. This may help to discover their subclinical vestibular problem and guide physicians to design a suitable treatment plan that helps in decreasing risk of falls for aged persons.

Unraveling the Mystery of Auditory Brainstem Response Corrections: The Need for Universal Standards.

The auditory brainstem response (ABR) is used to estimate behavioral hearing thresholds in infants and difficult-to-test populations. Differences between the toneburst ABR and behavioral thresholds exist making the correspondence between the two measures less than perfect. Some authors have suggested that corrections be applied to ABR thresholds to account for these differences. However, because there is no agreed upon universal standard, confusion regarding the use of corrections exists. The primary purpose of this article is to review the reasoning behind and use of corrections when the toneburst ABR is employed to estimate behavioral hearing thresholds. We also discuss other considerations that all audiologists should be aware of when obtaining and reporting ABR test results. A review of the purpose and use of corrections reveals no consensus as to whether they should be applied or which should be used. Additionally, when ABR results are adjusted, there is no agreement as to whether additional corrections for hearing loss or the age of the client are necessary. This lack of consensus can be confusing for all individuals working with hearing-impaired children and their families. Toneburst ABR thresholds do not perfectly align with behavioral hearing thresholds. Universal protocols for the use of corrections are needed. Additionally, evidence-based procedures must be employed to obtain valid ABRs that will accurately estimate hearing thresholds.

The Effect of Methylphenidate on the Hearing of Children with Attention Deficit Hyperactivity Disorder.

Introduction There has been a sudden idiopathic hearing loss case presented after methylphenidate treatment in a child with attention deficit hyperactivity disorder (ADHD). Objective This study was performed to reveal the probable ototoxic side effects of methylphenidate use in patients with ADHD. Methods Thirty pediatric patients with ADHD were included in the study. Pure tone audiometry, speech discrimination scores, waves I, III, V absolute latencies and waves I-III, I-V, III-V interpeak latencies at the 80 dB nHL intensity after click stimulus auditory brainstem response (ABR) results were compared before and 3 months after methylphenidate treatment. Results There were no statistically significant difference between pretreatment and posttreatment pure tone and speech audiometry findings and ABR results (p > 0.05 for all parameters). Conclusion Methylphenidate can be regarded as a safe drug regarding ototoxic side effects. Additional studies with a larger sample size and longer follow-up may be needed.