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Hearing assessment of at-risk infants. Current status of audiometry in young infants.

This study reports hearing status of a consecutive series of infants who had required neonatal intensive care. A relatively high percentage of infants demonstrated hearing impairment. Results are discussed in terms of their implications for the pediatrician who often serves a "case manager" role for families. An underlying assumption is that pediatricians are better equipped to advise parents and make referral decisions if they have an awareness of the current audiologic assessment strategies for infants and young children. The strengths and limitations of the currently employed methodologies are defined and discussed.

Audiometry↗

The reliability of Békésy sweep audiometry recording and effects of the earphone position.

The hearing thresholds of subjects with hearing impairment of different severity were tested several times. The reliability of the hearing threshold measurements were analysed and compared to the inter-aural variations, the learning effects, the degree of noise-induced hearing impairment and the application of the earphones. The main factor determining the reliability of the hearing threshold is the application of the conventional earphone. A preliminary test-retest with the earphone adapted to an ear speculum for sound transmission to the external ear canal suggests that the precision of the Békésy sweep hearing threshold measurement can obviously be increased in the frequency range of 2 to 8 kHz.

Adult↗

High frequency audiometry in facial paralysis.

High frequency (10-21 kHz) hearing thresholds were measured in 54 patients with Bell's palsy. In 25 (46%) of the patients the high frequency hearing was worse in the affected side, and in 16 (30%) better. The differences in the mean threshold between the two ears varied from 17.1 to 3.8 dB, being statistically significant at half of the frequencies measured. The findings support the idea that facial palsy is one manifestation of a lesion which extends beyond the VIIth cranial nerve.

Audiometry↗

Electric response audiometry in infants and preschool children. Long-term control of the results.

Two hundred and four infants and preschool children (mean age 2 years and 7 months +/- 9 months) with auditory impairment according to ABR and ECochG data, and 33 subjected to SVR were followed up for periods ranging from 1 year to 4 years and 6 months until a reliable conventional pure tone audiogram was obtained. One hundred and fifty-one children had conductive hearing loss, 75 sensorineural, 7 had ABR indicating disorders of the central auditory pathways, 5 were normal. Hit, false positive and false negative rates resulted as follows: 58.62%, 17.24% and 24.14% for SVR: 98.37%, 1.63% and 0% for ABR; 99.15%, 0.85% and 0% for ECochG. In the group with sensorineural hearing loss, 75% of the children gave ECochG detectable responses at 90 dB nHL, against 51.5% with ABR. With 1 kHz tonebursts, 64% of the tested subjects gave threshold responses to ECochG and 12% to ABR. The best strategy for children who failed the behavioral hearing tests, or in whom these tests were not applicable, was that based on ABR and middle ear impedance measures, complemented, when necessary, by ECochG.

Audiometry, Evoked Response↗