Audiogram Estimation by Auditory Brainstem Response with NB CE-Chirp LS stimulus in Normal Hearing Infants

Ormundo, Diego da Silva; Fávero, Mariana Lopes; Lewis, Doris Ruthy

doi:10.1055/s-0043-1776727

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Sumário

Original Research • Int Arch Otorhinolaryngol 28 (2) • 2024 • https://doi.org/10.1055/s-0043-1776727 copy

Audiogram Estimation by Auditory Brainstem Response with NB CE-Chirp LS stimulus in Normal Hearing Infants

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

NB CE-Chirp LS was developed to improve the audiogram estimation by auditory brainstem response (ABR) thresholds during audiological assessment of infants and difficult to test children. However, before we know how the stimulus behaves in several types of hearing loss, it is important we know how the stimulus behaves in normal hearing infants.

Objective

To describe ABR thresholds with NB CE-Chirp LS stimulus for 500, 1,000, 2,000, and 4,000 Hz, as well as the amplitude and absolute latency for ABR thresholds.

Methods

Auditory brainstem response thresholds were evaluated with the Eclipse EP25 system. NB CE-Chirp LS was presented using an ER-3A insert earphone. EEG filter was 30 Hz high-pass and 1,500 Hz low-pass. The ABR threshold was defined as the lowest intensity capable of clearly evoke wave V, accompanied by an absent response 5 dB below.

Results

Eighteen normal hearing infants were evaluated. The mean and standard deviation (SD) of the ABR threshold (dB nHL) were: 23.8 (±4.2); 14.4 (±5.7); 6.0 (±5.0); and 7.0 (±5.9). The mean and SD of the absolute latency (ms) were: 8.86 (±1.12); 9.21 (±0.95); 9.44 (±0.78); and 9.64 (±0.52). The mean amplitude (nV) and SD were: 0.123 (±0.035); 0.127 (±0.039); 0.141 (±0.052); and 0.105 (±0.028), respectively, for 500, 1,000, 2,000 and 4,000 Hz.

Conclusion

Auditory brainstem response threshold with NB CE-Chirp LS reaches low levels, in special for high frequencies. It provides absolute latencies similar between frequencies with robust amplitude. The results obtained brings to the examiner more confidence in the results registered.

Keywords
electrophysiology; auditory brainstem response; infants; hearing tests

Frequencies (Hz)	Ears	N	Mean	SD	p-value
500	R	9	26.1	4.2	< 0.001
	L	8	21.3	2.3	< 0.001
	Total	17	23.8	4.2
1,000	R	10	15.5	6.0	0.079
	L	8	13.1	5.3	0.079
	Total	18	14.4	5.7
2,000	R	10	6.5	3.4	0.104
	L	10	5.5	6.4	0.104
	Total	20	6.0	5.0
4,000	R	10	7.5	5.4	0.095
	L	10	6.5	6.7	0.095
	Total	20	7.0	5.9

Ear	Mean ABR Thresholds for Frequencies	Mean Difference	Standard Error	95% Confidence Interval	p-value
Right	1,000 - 500	- 11.76	2.72	(- 19.37–- 4.15)	0.002
	2,000–1,000	- 7.6	2.58	(- 14.83–- 0.38)	0.037
	4,000–2,000	- 0.4	2.58	(- 7.62–6.83)	0.999
Left	1,000 - 500	- 10	2.78	(- 17.87–- 2.13)	0.010
	2,000–1,000	- 6.97	2.56	(- 14.22–0.29)	0.062
	4,000–2,000	- 0.67	2.31	(- 7.20–5.87)	0.991

Frequencies (Hz)	Ears	N	Mean	SD	p-value
500	R	9	8.81	0.67	0.228
	L	8	8.93	1.53	0.228
	Total	17	8.86	1.12
1,000	R	10	9.23	1.00	0.400
	L	8	9.19	0.95	0.400
	Total	18	9.21	0.95
2,000	R	10	9.38	0.73	0.315
	L	9	9.52	0.88	0.315
	Total	19	9.44	0.78
4,000	R	10	9.44	0.44	< 0.001
	L	10	9.83	0.54	< 0.001
	Total	20	9.64	0.52

Frequencies (Hz)	Ears	N	Mean	SD	p-value
500	R	9	0.123	0.021	0.171
	L	8	0.124	0.048	0.171
	Total	17	0.123	0.035
1,000	R	10	0.120	0.033	0.122
	L	8	0.136	0.045	0.122
	Total	18	0.127	0.039
2,000	R	10	0.142	0.063	0.563
	L	10	0.139	0.042	0.563
	Total	20	0.141	0.052
4,000	R	10	0.115	0.028	0.002
	L	10	0.095	0.026	0.002
	Total	20	0.105	0.028

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[1] Address for correspondence Diego da Silva Ormundo, Audiologist MSc, Human Communication and Health Graduate Program, Faculty of Humanities and Health Sciences, Pontifical Catholic University of São Paulo, PUC-SP, São Paulo, SP, Brazil (e-mail: diegosilvaormundo@gmail.com).