Effects of Hypoxic-Ischemic Encephalopathy and Whole-Body Hypothermia on Neonatal Auditory Function: A Pilot Study

Abstract

We assessed the effects of hypoxic-ischemic encephalopathy (HIE) and whole-body hypothermia therapy on auditory brain stem evoked responses (ABRs) and distortion product otoacoustic emissions (DPOAEs). We performed serial assessments of ABRs and DPOAEs in newborns with moderate or severe HIE, randomized to hypothermia (n = 4) or usual care (n = 5). Participants were five boys and four girls with mean gestational age (standard deviation) of 38.9 (1.8) weeks. During the first week of life, peripheral auditory function, as measured by the DPOAEs, was disrupted in all nine subjects. ABRs were delayed but central transmission was intact, suggesting a peripheral rather than a central neural insult. By 3 weeks of age, peripheral auditory function normalized. Hypothermia temporarily prolonged the ABR, more so for waves generated higher in the brain stem but the effects reversed quickly on rewarming. Neonatal audiometric testing is feasible, noninvasive, and capable of enhancing our understanding of the effects of HIE and hypothermia on auditory function.

Predictors of Long-Term Neurodevelopmental Outcome of Hypoxic-Ischemic Encephalopathy Treated with Therapeutic Hypothermia

“…A very small cohort of infants in this study underwent hypothermia. 86 Although EPs are useful complementary prognostic tools in challenging situations, lack of robust studies and consensus regarding their prognostic value has resulted in sparse use of the tools in clinical scenario. ►Table 3 summarizes the predictive value of different neurophysiological markers in HIE infants undergoing therapeutic hypothermia.…”

Otoacoustic Emissions for Outcome Prediction in Postanoxic Brain Injury

“…Otoacoustic emissions fulfill all criteria mentioned ( 1 , 2 ) but previous studies have only assessed their role in perinatal anoxic-ischemic injury ( 8 – 10 ) and intracranial hypertension ( 11 – 13 ). Our study is the first to assess the potential of otoacoustic emissions for prognostication of adult cardiac arrest survivors.…”

Radiologische Diagnostik bei Schwerhörigkeit im Kindesalter

“…Ein leichter bis mittelschwerer Sauerstoffmangel bei der Geburt kann zu einem vorübergehenden Hörverlust führen. Ein dauerhafter Hörverlust ist durch eine schwere hypoxische ischämische Enzephalopathie im Zusammenhang mit Infarkten möglich [8].…”