Brainstem Evoked Response Audiometry (BERA) in Neonates with Hyperbillirubinemia

Abstract

(1) To study the BERA changes in neonates with unconjugated hyperbilirubinemia. (2) To compare the BERA changes in the neonates with unconjugated hyperbilirubinemia before and after therapy. Thirty consecutive term appropriate for gestational age (AGA) neonates presenting to NICU with total serum bilirubin requiring intervention (using the American Academy of Pediatrics guidelines) were included in the study as cases and thirty normal term AGA neonates with uneventful peri-natal period and a maximum measured serum bilirubin \12 mg/ dl in case of term baby were included as controls after obtaining informed consent. Initial BERA was done within 3-24 h of hospitalization after obtaining informed consent from parents, at the time of discharge and at 3 month followup. Machine used for recording BERA was intelligent hearing system version 3.3. In our study out of the 30 cases 10 (33.3 %) cases were found to have BERA changes in the form of absent wave forms, raised threshold, prolonged latencies or prolonged inter peak latencies. In our study, it was observed that there was statistically significant correlation (p value \ 0.005) between increasing bilirubin level and BERA changes. Correlation of the findings of this study with previous few studies indicates that BERA can be used as a useful non invasive tool to determine auditory functions in the neonate especially changes of early bilirubin toxicity.

Brain stem auditory evoked potential response in neonates after recovery from hyperbilirubinemia: A neurophysiological approach to screening neuronal hearing loss

“…These findings are in line with the previous report indicating prolonged interwave interval in seven cases while the latencies of various waves had normalized in most cases. [21] In our study, the BERA waves I, III, and V were prolonged in cases than the control group. This might be either due to long-term effect of hyperbilirubinemia or the damaged auditory pathway was still in recovery process.…”

Hearing Assessment in Infants: A Retrospective Institutional Study

“…In the study done by Soni et al 6 showed that there is a high prevalence of hearing disability among the neonates who were diagnosed with hyper bilirubinemia with 10 of the 30 cases screened showing changes in BERA study.…”

Electrophysiological Threshold Evaluation in Infants with and Without Risk Indicators for Hearing Loss

“…Another interesting aspect to be explained is that the peripheral portion of the auditory system is developed between the fifth and sixth month of gestation and the structures of the central portion continue to form synaptic connections and improve their efficiency during the first two years of life, so the electrophysiological threshold and wave latency may change during this period [8,9]. In addition, variables such as: age, body temperature, middle ear effusion and hypoxic-ischemic lesions may cause transient changes in the test result [10][11][12]. Consequently, the preliminary findings of BAEP may not correspond to the final hearing status [1,6,7,13].…”