Differential diagnostics, severe versus profound hearing loss in infants and toddlers using ASSR ‘‘ CE-Chirp’’
Journal Title: Polski Przegląd Otorynolaryngologiczny - Year 2013, Vol 2, Issue 4
Abstract
[b]Introduction: [/b]One of the most difficult tasks in pediatric audiology is to assess the precisely hearing level of the child in the first months of life. It is rather impossible to acquire frequency specific responses precisely in hard of hearing infants using tone bursts or clicks. But the distinction between severe and profound hearing loss is clearly meaningful and significant with regard to aural rehabilitation and selection of powerful hearing aids versus cochlear implants. In recent years, the ‘‘CE-Chirp’’ stimuli have been introduced in the ‘‘Interacoustics’’ ASSR system to maintain a larger quantity of hair cells in the response, thus making the response more robust and easier to detect. Input compensation of ‘‘CE-Chirp’’ allows low frequency acoustics segments to initiate before high frequencies, causing sequential frequencies to reach their destinations along the basilar membrane at the same time. Clinical testing involving subjects with normal hearing demonstrates that the Chirp ABR is 1.5–2.0 times larger than the corresponding click ABR. But there is a lack of research that shows convincing advantages of chirps in testing hard of hearing infants. Aim: The aim of the study has been to assess hearing levels with ASSR ‘‘CE-Chirp’’ in children who have no, or residual response in the first year of life. [b]Materials and methods: [/b]Eleven children were included in the study. These patients had no, or residual response between the ages of 3 and 6 months, in click and tone bursts ABR. Eight infants were referred for cochlear implantation. In the ages between 12 and 18 months we tested these hearings using Interacoustics ASSR ‘‘CE-Chirp’’. [b]Results: [/b]Six patients of the tested group were recognized as severely hard of hearing (mean 60–80 dB nHl), three as profoundly hard of hearing (90 dB nHl). In two children we did not find any response. Conclusions: The ABR tone bursts and click tests can overestimate hearing loss in the first six months of life We can evaluate the quantity of hearing more exactly in infants and toddlers, with ASSR ‘‘CE-Chirp’’.
Authors and Affiliations
Przemysław Śpiewak, Jerzy Adamek, Beata Śpiewak
Keywords
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