Analysis of auditory function using brainstem auditory evoked potentials and auditory steady state responses in infants with perinatal brain injury

Abstract

Abstract

Approximately 2–4 % of newborns with perinatal risk factors present hearing loss. The aim of this study was to analyse the auditory function in infants with perinatal brain injury (PBI). Brainstem auditory evoked potentials (BAEPs), auditory steady state responses (ASSRs), and tympanometry studies were carried out in 294 infants with PBI (586 ears, two infants had unilateral microtia-atresia). BAEPs were abnormal in 158 (27%) ears, ASSRs in 227 (39%), and tympanometry anomalies were present in 131 (22%) ears. When ASSR thresholds were compared with BAEPs, the assessment yielded 92% sensitivity and 68% specificity. When ASSR thresholds were compared with tympanometry results as an indicator of middle-ear pathology, the assessment gave 96% sensitivity and 77% specificity. When BAEP thresholds were compared with tympanometry results, sensitivity was 35% and specificity 95%. In conclusion, BAEPs are useful test for neonatal auditory screening; they identify with more accuracy sensorineural hearing losses. ASSRs are more pertinent for identifying conductive hearing loss associated with middle-ear pathology. The consistency and accuracy of these results could be considered in additional studies.

Sumario

Aproximadamente 2-4% de neonatos con factores de riesgo perinatales presentan pérdida auditiva. El objetivo de este estudio fue analizar la función auditiva de niños con daño cerebral perinatal (PBI). Se realizaron potenciales evocados auditivos de tallo cerebral (BAEPs) respuestas auditivas de estado estable (ASSRs) y timpanometrías en 294 niños con BPI (586 oídos; dos tenían microatresia unilateral). Los BAEPs fueron anormales en 158 (27%) de los oídos, las ASSRs en 227 (39%) y hubieron anomalías timpanométricas en 131 (22%) oídos. Cuando se compararon los umbrales de ASSR con BAEPs, la evaluación condujo a 92% de sensibilidad y 68% de especificidad. Al comparar umbrales de ASSR con timpanometrías como un indicador de patología del oído medio, la evaluación dio 96% de sensibilidad y 77% de especificidad. Cuando los umbrales BAEP se compararon con timpanometrías, la sensibilidad fue del 35% y la especificidad del 95%. En conclusión, los BAEPs son una prueba útil para el tamiz auditivo neonatal porque identifican con mayor precisión las pérdidas auditivas sensorineurales. Las ASSR son más pertinentes para identificar pérdidas conductivas asociadas con patología del oído medio. La consistencia y precisión de estos resultados podrá ser considerada para estudios adicionales.

Key Words:

• Perinatal brain injury
• Brainstem auditory evoked potentials
• Auditory steady state responses
• Otoacoustic emissions

Acknowledgements

This work was supported by UNAM, CONACyT, and PAPIIT-DGAPA IN205006-17 grants. We are grateful to Oscar González, David Ávila Acosta, Héctor Belmont, and Bruno Argueta for their invaluable assistance and Marcela Sánchez for her revision of the English version. Part of this study was presented at the XXVIIIth International Congress of Audiology, Innsbruck, Austria, September 6, 2006.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.