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PubMed1980

Clinical use of brainstem evoked response audiometry.

The preceeding cases were selected to illustrate the contribution of BER audiometry in threshold testing for infants and malingerers, diagnosis of VIIIth nerve tumors, and identification of brainstem lesions. We feel, however, that these represent only the fundamental applications of BER and that a whole new diagnostic dimension wil evolve. The day only limitations of which the authors are aware in the use of brainstem evoked response is that a patient with a high tone sensorineural hearing loss may have abnormal wave forms or, if the high tone loss is severe, the waves may be totally absent. Brainstem evoked responses are unaffected by anesthesia and drugs. The patient does have to be relatively quiet during the test; this can be accomplished with sedation, if necessary.

Adult↗
PubMed1977

Acoustic tumor detection with brain stem electric response audiometry.

Tumors that press on the audiotry nerve can cause a latency increase that is detectable from the scalp by electric response audiometry (BERA). The response delay is best seen by comparing the Jewett wave V, or P5, latencies for the two ears. This interaural latency difference is normally less than 0.2 msec, but was 0.4 msec or greater for 35 acoustic tumor cases and for seven of ten other temporal bone tumors. Acoustic tumor size can be estimated from the amount of latency delay.

Audiometry↗
PubMed1977

Diagnostic speech audiometry.

The scope of speech audiometry can be expanded to provide useful diagnostic information. Comparison of performance vs intensity (Pl) functions for both phonemically balanced (PB) words and synthetic sentence identification (SSl) yields pattersn useful in differentiating among peripheral and central sites of auditory disorder.

Adolescent↗
PubMed1977

Békésy audiometry and tone and reflex decay tests in diabetics.

The responses of nine diabetics (without substantial hearing loss) to Békésy audiometry and tone and reflex decay tests at 250, 1,000, 4,000 and 8,000 Hz were determined. Excessive tone decay was found at 8,000 Hz in two subjects. This was found to be significant when compared with a normal group of 19 subjects tested at this frequency. Two diabetics had a 25 to 30-dB separation of the Békésy tracing at 8,000 Hz. All other findings were normal. It was concluded that excessive adaptation at threshold is to be expected at 8,000 Hz in diabetic subjects.

Adolescent↗
PubMed1977

Diagnosis of hearing loss in infancy by electric response audiometry.

The assessment of hearing by electric response audiometry (ERA) in 88 children under the age of 3 years was compared with the final assessment of hearing by other means made six months to four years later. A reliable decision was available in 78 patients. The ERA was correct in 64 patients (72.7%) and was incorrect in 14 (15.9%). In ten patients (11.4%), the reliability could not be determined. The incidence of errors was much greater in the 23 children who were given pentobarbital (39%) than it was in 55 not given this drug (9%). All of the errors associated with pentobarbital were the incorrect diagnosis of a loss of hearing. Three of the five errors in patients not given pentobarbital were the false diagnosis of a hearing loss in infants recovering from meningitis.

Audiometry↗
PubMed1978

Response detection in respiration audiometry.

The respiration of ten adults with normal hearing was monitored to determine how well changes in respiration could be detected after auditory stimulation. Three judges used two methods of response scoring. The first was without knowledge of signal presentation, and the second was with knowledge of signal presentation. Judges detected the presence of respiratory responses not only during signal presentations (hits) but also during silent intervals (false alarms). Hits and false alarms co-varied in a manner predicted by the theory of signal detectability. A low false alarm rate could be purchased only at the expense of a low hit rate. The implications of this finding for the clinical efficacy of respiration audiometry are considered.

Acoustic Stimulation↗
PubMed1979

Brain stem evoked response audiometry in newborn hearing screening.

Brain stem evoked response audiometry (BERA) has been used as an auditory screening procedure in three groups of newborn infants. Group 1 consisted of 220 normal-term infants who were tested within 72 hours of birth; no hearing abnormalities were uncovered (386 ears), and their threshold responses (for clicks) lay between a 10- and 20-dB hearing level (re: adult). Group 2 consisted of 75 newborns who were treated in an intensive care unit for one to 14 weeks; four were found to have severe sensorineural hearing loss (seven ears) at the time of discharge. Group 3 consisted of a group of 325 infants, 1 year or older, who had previously been discharged from the same intensive care unit; of these infants, an additional four showed severe sensorineural hearing loss. All abnormalities that were identified by BERA were subsequently confirmed by conventional audiometric measures. The estimate of an incidence of severe hearing loss in one of 50 infants who required intensive care in the neonatal period calls for careful testing of this population.

Audiometry↗
PubMed1979

Brainstem audiometry in neurotologic diagnosis.

Brainstem electric response audiometry (BERA) has been found to be a valuable adjunct to the neurotologic diagnosis. Ninety-eight percent of patients with surgically confirmed acoustic neuromas has positive BERA findings. We report six cases that illustrate the value of this technique in examining patients with suspected retrocochlear lesions.

Adult↗
PubMed1984

Multichannel infant reflex audiometry (MIRA) a new method for evaluating hearing in infants (preliminary results).

Multichannel infant reflex audiometry, applicable up to about 1 year of age, is based on the simultaneous registration of sucking and breathing activities and of eye movements together with marks which indicate the side, beginning, and end of the stimulus. Sucking and breathing are reduced or altered by suprathreshold stimuli. The threshold of responses is 20-40 dB lower than that obtained with behavioral tests and comparable in most cases with BERA thresholds.

Audiometry↗
PubMed1992

Intraoperative monitoring by transtympanic electrocochleography and brainstem electrical response audiometry in acoustic neuroma surgery.

The preservation of hearing is a major aim of contemporary temporal bone surgery. Our present findings demonstrate that intraoperative monitoring is a key method for attaining serviceable postoperative hearing after the removal of an acoustic neuroma. Both electrocochleography (ECoG) and brainstem electrical response audiometry were performed in 96 patients operated on for acoustic neuromas. The specificity of the different monitoring methods was affected by surgical manipulations in addition to such non-specific influences as CSF drainage, core body temperature and anesthesia. In the present study ECoG was found to be more reliable in assessing the intra- and postoperative course with respect to the preservation of cochlear function.

Audiometry, Evoked Response↗
PubMed1986

A method linking statistics and knowledge engineering for making medical consulting systems. A medical consulting system for electric response audiometry through auditory slow vertex response.

There are two methods of making medical consulting systems: the statistical method and the knowledge engineering method. Since both of these methods seem to be very different from each other, they have been recognized and applied separately. We contend, however, that a combination of statistics and knowledge engineering is a more effective and suitable way to create a medical consulting system than is the use of either method alone. In order to justify this contention, we created a medical consulting system, AUTSVR-V1.1, which detects auditory slow vertex responses (SVR) through observing and identifying background activities of the electroencephalogram (EEG) automatically during measurement of SVRs for the purpose of objective electric response audiometry (ERA), and compared it with AUTSVR-V1.0, which depends on statistics only.

Audiometry, Evoked Response↗
PubMed1985

Prognostic factors for postsurgical hearing and facial nerve function in cases of cerebellopontine angle-tumours. The meaning of brain stem evoked response audiometry (BERA).

Presurgical and postsurgical brain stem evoked response audiometry (BERA) examinations were done in patients with tumours of the posterior cranial fossa. A correlation exists between the extent of presurgical BERA-alterations and postsurgical hearing-power and facial nerve function. Small tumours (less than 1 cm) correlate generally with small BERA-alterations and show a good prognosis. Conservation of hearing in cases of larger tumours can only be expected when BERA-alterations are small. Prognosis is generally bad in cases of big tumours (greater than 3 cm). BERA-alterations on the contralateral side point to an additional brain stem compression which can normalize after surgery.

Audiometry↗
PubMed1993

Evoked otoacoustic emissions and pure tone threshold audiometry in patients receiving cisplatinum therapy.

Eight children and young adults with cancer were evaluated serially using pure tone audiometry as well as registration of click-evoked otoacoustic emissions (EOAE) 1 day prior to therapy as well as after various numbers of doses of cisplatinum. A reduction of EOAE-amplitudes following cisplatinum therapy was observed in all patients. This reduction tended to recover after the end of cisplatinum administration. Since EOAE are believed to result from cochlear bio-mechanical processes, the reduced emissions are interpreted as signs of cochlear dysfunction. We conclude, that EOAE testing may be a simple, non-invasive method that may detect early, transient functional impairment of hearing due to ototoxic agents such as cisplatinum, even in children. Further controlled trials are needed.

Acoustic Stimulation↗
PubMed1985

Progressive ototoxicity of neomycin monitored using derived brainstem response audiometry.

Progressive hearing loss following the systemic administration of neomycin was investigated using derived brainstem response audiometry. Cats were given three to five times the maximum recommended clinical dose of neomycin over a period of 10 days. Their hearing was monitored prior to and during the administration of the drug, and periodically following its completion. The results of this study showed that the induced hearing loss generally proceeded from high to low frequencies as an advancing lesion, with regions apical to the lesion functioning normally. Although considerable variability in response to the drug existed among animals, the evoked responses from both ears of each animal showed close bilateral symmetry during the deafening process. Furthermore, the present results highlight the long-term ongoing ototoxicity associated with neomycin, and the importance of monitoring high frequencies for initial signs of an aminoglycoside induced hearing loss.

Animals↗
PubMedDate not supplied

Mid-frequency hearing loss in rats following inhalation exposure to trichloroethylene: evidence from reflex modification audiometry.

The present experiments were undertaken to characterize the hearing loss associated with 1,1,2-trichloroethylene (TCE) exposure. Adult male Long-Evans (LE) rats were exposed to TCE via inhalation (whole body) for 6 h/day for 5 days. The concentration-effect function (0-4000 ppm) was determined 3 weeks post-exposure. Animals were tested for auditory thresholds to 4, 8, 16, 24, 32, and 40-kHz tones using reflex modification audiometry. In a separate experiment, the time course of effects was determined by monitoring 16-kHz thresholds prior to, 1 h following each of the 5 exposure days, and 5 days, 1, 2, 4, 8, and 12 weeks post-exposure. At 14 weeks, these same animals were tested for thresholds to 0.5, 1, 2, 4, 8, 16, 24, 32, and 40-kHz tones. Results indicate elevated thresholds (hearing loss) for the 4000 ppm group at 8 and 16 kHz of approximately 18 and 30 dB, respectively. Time-course data demonstrated a rapid onset, a 20-dB loss at 16 kHz after the fifth exposure day, and a 40-dB loss by 2 weeks that persisted up to 14 weeks post-exposure. These data demonstrate an atypical and persistent, mid-frequency hearing loss in rats following inhalation exposure to TCE.

Administration, Inhalation↗
PubMed2004

Correlation of CT analysis and audiometry in Japanese otosclerosis.

OBJECTIVE: To determine the extent of audiometric correlation with CT findings. METHODS: Forty-four patients (82 ears) with surgically confirmed otosclerosis underwent preoperative CT examination. Based on the computed tomography (CT) findings, the ears were classified into five groups as follows: Group A, the group with no pathological CT findings; Group B1, the group with demineralization localized in the region of the fissula antefenestram; Group B2, the group with demineralization extending towards the cochleariform process from the anterior region of the oval window; Group B3, the group with extensive demineralization surrounding the cochlea; and Group C, the group with thick anterior and posterior calcified plaques. RESULTS: There were 32 ears (39.0%) in Group A, 21 ears (25.6%) in Group B1, 16 ears (19.5%) in Group B2, 7 ears (8.5%) in Group B3, and 6 ears (7.3%) in Group C. The mean bone conduction levels were greater in the order of the extent of demineralization: Groups A, B1-B3 suggesting positive relationship between the cochlear function and the degree of labyrhinthine otosclerosis. CONCLUSION: A good correlation between the preoperative CT findings and audiometry findings suggests that CT with a slice intervals between 0.5 and 1mm could provide useful informations in assuming the extent of otosclerosis in the inner ear.

Adolescent↗
PubMed2004

Behavioral audiometry: protocols for measuring hearing thresholds in babies aged 4-18 months.

OBJECTIVE: This paper provides the first report in English of original behavioral audiometry protocols for measuring hearing thresholds in very young children, including the multiply handicapped. METHODS: Based on reactions to one or two well-calibrated acoustic stimulations delivered in the sound field, the protocol first involves the use of a vibrator to measure hearing levels by bone conduction. This measurement technique, which is not affected by middle ear infections, is the key diagnostic step. Moreover, in profoundly hearing loss children, it triggers reactions through vibratory stimulation and sets the scene for the conditioning of responses. Next, hearing levels are assessed by air conduction with the aid of headphones, in order to measure hearing levels in each ear as early as possible. A unique set-up is used to facilitate the emergence of reliable "surprise reactions", which may be interpreted by a sole examiner. Classical visual reinforcement is replaced by a highly interactive, dynamic and playful exchange between child and examiner, which gives meaning to the perception of stimuli and heralds the learning of hearing. RESULTS: The results concern 105 babies suffering from bilateral sensorineural hearing loss and aged 4-18 months at the first behavioral test. Group 1 comprised 91 babies with no other handicap, in whom full bilateral air conduction was obtained in 82.4% before 12 months and in 98.9% before 18 months. In this group, air conduction in each ear was obtained in 47.0% before 12 months and in 70.3% before 18 months. In Group 2, which included 14 multiply handicapped babies, full bilateral air conduction was obtained in 37.5% before 12 months and in 78.6% before 18 months. Air conduction in both ears was obtained in 28.6% before 18 months. CONCLUSION: The protocols described make it possible, in a minimum number of sessions, to measure hearing thresholds early over the whole range of hearing frequencies, even in multiply handicapped babies and those suffering from developmental retardation.

Acoustic Impedance Tests↗
PubMed1985

Hearing assessment in developmentally impaired infants: classical conditioning as a supplement to brainstem-evoked response audiometry (BERA).

The brainstem-evoked response audiometry (BERA) is probably the most common approach to hearing assessment in high-risk and developmentally handicapped infants. It is usually suggested, however, that BERA should not be the sole assessment method. In an attempt to determine an effective supplement to BERA, the present study evaluated a classical conditioning procedure with developmentally impaired babies. Within this procedure, different tones served as conditioned stimuli while an air-puff was used as the unconditioned stimulus. Results indicate that this procedure could be successfully applied with almost all of the babies.

Audiometry, Evoked Response↗