Frequency-specific auditory brainstem response testing with age-appropriate sedation

Levit, Yael; Mandel, Dror; Matot, Idit

doi:10.1016/j.ijporl.2018.02.028

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…However, CMV-positive neonates comprised a very small portion (1.9%) of the entire population of infants who failed the OAE hearing screening. It should be noted that according to our protocol, infants are tested for cCMV after failing their second OAE test regardless of the automated ABR screening test result [11, 12].…”

Section: Resultsmentioning

confidence: 99%

“…All the audiological evaluations were performed with ABR testing with frequency-specific 500–4,000 Hz chirp stimuli (using Eclipse by Interacoustics, Denmark). For the detailed protocols, see our earlier publications [11, 12]. All infants diagnosed with cCMV were referred to the hearing clinic at our medical center and scheduled for an audiological evaluation with ABR testing before the age of 3 weeks.…”

Section: Methodsmentioning

confidence: 99%

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Assessment of Risk Indicators for Targeted Cytomegalovirus Screening in Neonates

Levit¹,

Dym²,

Yochpaz³

et al. 2020

Neonatology

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Background: In the absence of universal screening for congenital cytomegalovirus (cCMV) infection, the aim of this study was to assess the outcomes of a targeted screening protocol based on maternal and neonatal risk indicators. Methods: The medical records of 2,623 neonates born in our maternal hospital between June 2016 and December 2018 and screened for cCMV infection were reviewed. Among those of the included neonates, the records of 380 CMV-negative and 19 CMV-positive neonates were randomly assigned to obtain additional comparative data. Results: During the study period, a total of 63 neonates were identified as positive for cCMV, comprising 0.2% of the total birth cohort (63/28,982) and 2.4% of all neonates screened for cCMV (63/2,623). The comparative data analysis showed that suspected or confirmed CMV infection during pregnancy, maternal age, and maternal diabetes mellitus were found to be significantly associated with a positive cCMV diagnosis. Although symmetric small for gestational age and hearing screening failure contributed to the detection of some of the CMV-positive infants, these factors were not specific to this group. The results of the logistic regression model showed that the only factor that was significantly associated with an increased risk for a cCMV diagnosis was maternal serology suspected of CMV infection during pregnancy, with a regression coefficient estimate of 2.657 (adjusted p < 0.001). Conclusions: A targeted neonatal screening protocol based on multiple maternal and neonatal risk indicators is feasible but provides limited information. Our study emphasizes the importance of universal neonatal screening for the detection of neonates with cCMV.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Assessment of Risk Indicators for Targeted Cytomegalovirus Screening in Neonates

Levit¹,

Dym²,

Yochpaz³

et al. 2020

Neonatology

Self Cite

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“…However, it is difficult to consistently reach an adequate level of sleep in the clinical setting with older children. 1,3 Performing diagnostic ABRs under general anesthesia is only recommended if a child is unable to achieve a sufficient natural sleep state, due to the increased cost and risks associated with sedation. 4 Nevertheless, age-appropriate sedation permits accurate characterization of HL type, degree, and configuration.…”

Section: Introductionmentioning

confidence: 99%

“…4 Nevertheless, age-appropriate sedation permits accurate characterization of HL type, degree, and configuration. 3 Current Early Hearing Detection and Intervention (EHDI) guidelines recommend hearing screening by 1 month of age, diagnosis of HL by 3 months of age, and enrollment in early intervention by 6 months of age. Recently, the Joint Committee on Infant Hearing has recommended decreasing to a 1-2-3 timeline to intervention.…”

Section: Introductionmentioning

confidence: 99%

Confirmatory Auditory Brainstem Responses Testing Results in Discordant Outcomes: Implications for Timely Care

et al. 2023

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ObjectivesThe purpose of this study is to evaluate for discrepancies in diagnostic auditory brainstem responses (ABR) between Children's National Hospital (CNH), a pediatric medical center, and outside facilities (OSF) that referred patients to CNH for confirmatory evaluation. Such discrepancies impact early hearing detection and intervention (EHDI) timelines.MethodsA retrospective chart review was conducted from an internal database of patients who underwent diagnostic ABR from 2017 to 2021. Only patients with ABR results from both CNH and OSF were analyzed. Demographic data, external and internal test results, and intervention data were obtained. Hearing loss (HL) severity was graded on a scale of 0 to 8, where 0 indicated normal hearing and 8 indicated profound. Each ear was analyzed separately.ResultsForty‐nine patients met the inclusion criteria, and each ear was evaluated separately. Median HL severity was 1.0 [0.0, 4.3] at CNH compared to 3.0 [1.8, 6] at OSF (p = 0.004). Forty‐seven ears (48.0%) showed lower severity at CNH. Twenty‐seven patients (55%) received hearing amplification devices. The median age at time of hearing intervention was 220 days.ConclusionOur results showed statistical significance in the median severity of HL between CNH and OSF. A substantial proportion (70%) of children in our dataset who received amplification via cochlear implant or hearing aids were shown to have discrepancies in ABR findings from CNH and OSF. These findings have implications with regards to the appropriate usage of health care resources and maintaining EDHI timelines.Level of Evidence4 (Retrospective Cohort Study) Laryngoscope, 2023

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“…Auditory brainstem response (ABR) is a crucial screening test for hearing loss in children, representing the gold standard for objective hearing evaluation in infants and toddlers [ 1 ]. ABR testing require in children the administration of a safe and stable sedative drug to avoid artifacts; in fact, babies cannot be calm enough to allow the test or unable to sleep, while children cannot be cooperative as in case of subjects with behavioural or developmental disabilities [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Sedation with Intranasal Dexmedetomidine in the Pediatric Population for Auditory Brainstem Response Testing: Review of the Existing Literature

et al. 2022

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Background: Intranasal dexmedetomidine (IN DEX) is a relatively new sedative agent with supporting evidence on its efficacy and safety, which can be used for procedural sedation in children, and could have a major role in auditory brainstem response testing, especially in the case of non-cooperative children. The goal of this systematic review is to assess the role of IN DEX in ABR testing, evaluating the reported protocol, potential, and limits. Methods: We performed a comprehensive search strategy on PubMed, Scopus, and Google Scholar, including studies in English on the pediatric population, without time restrictions. Results: Six articles, published between 2016 and 2021, were included in the systematic review. Sedation effectiveness was high across the studies, except for one study; 3 μg/kg was the dosing most often used. A comparison group was present in three studies, with oral chloral hydrate as the drug of comparison. Adverse effects were rarely reported. Conclusion: This systematic review showed how IN DEX can represent an adequate sedative for children undergoing ABR testing; larger and more rigorous trials are warranted in order to recommend its systematic utilization.

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Frequency-specific auditory brainstem response testing with age-appropriate sedation

Cited by 9 publications

References 33 publications

Assessment of Risk Indicators for Targeted Cytomegalovirus Screening in Neonates

Assessment of Risk Indicators for Targeted Cytomegalovirus Screening in Neonates

Confirmatory Auditory Brainstem Responses Testing Results in Discordant Outcomes: Implications for Timely Care

Sedation with Intranasal Dexmedetomidine in the Pediatric Population for Auditory Brainstem Response Testing: Review of the Existing Literature

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