CC BY 4.0 · Int Arch Otorhinolaryngol 2024; 28(02): e294-e300
DOI: 10.1055/s-0043-1776727
Original Research

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

1   Human Communication and Health Graduate Program, Faculty of Humanities and Health Sciences, Pontifícia Universidade Católica de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil
,
2   Department of Otorhinolaryngology and Phoniatrics, Centro Audição na Criança, Pontifícia Universidade Católica de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil
,
3   Department of Theories and Methods of Speech Language Pathology and Audiology and Physiotherapy, Faculty of Humanities and Health Sciences, Pontifícia Universidade Católica de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil
› Author Affiliations
Funding Dr. Ormundo D. S. reported receiving support for the present work from the National Council for Scientific and Technological Development (CNPq, in the Portuguese acronym).

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.

Authorship

Ormundo D. S.: Method design, data acquisition, data analysis, paper writing, review, and editing; Fávero M. L. and Lewis, D. R.: Method design, data analysis, intellectual contributions to discussion, paper review, and corrections.




Publication History

Received: 12 March 2023

Accepted: 30 July 2023

Article published online:
24 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Lewis DR, Marone SA, Mendes BC, Cruz OL, Nóbrega Md. Multiprofessional committee on auditory health: COMUSA. Rev Bras Otorrinolaringol (Engl Ed) 2010; 76 (01) 121-128
  • 2 The Joint Committee on Infant Hearing. Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. J Early Hear Detect Interv 2019; 4 (02) 1-44
  • 3 Sabo DL. The audiologic assessment of the young pediatric patient: the clinic. Trends Amplif 1999; 4 (02) 51-60
  • 4 Sininger YS. Audiologic assessment in infants. Curr Opin Otolaryngol Head Neck Surg 2003; 11 (05) 378-382
  • 5 Hall III JW. Crosscheck Principle in Pediatric Audiology Today: A 40-Year Perspective. J Audiol Otol 2016; 20 (02) 59-67
  • 6 Sininger YS, Abdala C, Cone-Wesson B. Auditory threshold sensitivity of the human neonate as measured by the auditory brainstem response. Hear Res 1997; 104 (1-2): 27-38
  • 7 Stapells DR. Threshold Estimation by the Tone-Evoked Auditory Brainstem Response: A Literature Meta-Analysis. J Speech Lang Pathol Audiol 2000; 24 (02) 74-83
  • 8 Ribeiro FM, Carvallo RM. Tone-evoked ABR in full-term and preterm neonates with normal hearing. Int J Audiol 2008; 47 (01) 21-29
  • 9 Vander Werff KR, Prieve BA, Georgantas LM. Infant air and bone conduction tone burst auditory brain stem responses for classification of hearing loss and the relationship to behavioral thresholds. Ear Hear 2009; 30 (03) 350-368
  • 10 Almeida MG, Rodrigues GRI, Lewis D. Frequency-specific Auditory Brainstem Response in infants with normal hearing Auditory evoked potentials. Rev CEFAC 2011; 13 (03) 489-495
  • 11 Ramos N, Lewis DR. Air and bone conduction tone burst auditory Brainstem response in normal hearing neonates. Rev CEFAC 2014; 16 (03) 757-767
  • 12 McCreery RW, Kaminski J, Beauchaine K, Lenzen N, Simms K, Gorga MP. The impact of degree of hearing loss on auditory brainstem response predictions of behavioral thresholds. Ear Hear 2015; 36 (03) 309-319
  • 13 Shore SE, Nuttall AL. High-synchrony cochlear compound action potentials evoked by rising frequency-swept tone bursts. J Acoust Soc Am 1985; 78 (04) 1286-1295
  • 14 Dau T, Wegner O, Mellert V, Kollmeier B. Auditory brainstem responses with optimized chirp signals compensating basilar-membrane dispersion. J Acoust Soc Am 2000; 107 (03) 1530-1540
  • 15 Fobel O, Dau T. Searching for the optimal stimulus eliciting auditory brainstem responses in humans. J Acoust Soc Am 2004; 116 (4 Pt 1): 2213-2222
  • 16 Elberling C, Don M, Cebulla M, Stürzebecher E. Auditory steady-state responses to chirp stimuli based on cochlear traveling wave delay. J Acoust Soc Am 2007; 122 (05) 2772-2785
  • 17 Elberling C, Cebulla M, Stürzebecher E. Simultaneous multiple stimulation of the auditory steadystate response (ASSR). Auditory signal processing in hearing-impaired listeners. 1st International Symposium on Auditory and Audiological Research (ISAAR 2007). T. Dau, J. M. Buchholz, J. M. Harte, T. U. Christiansen (Eds.). ISBN: 87–990013–1-4. Print: Centertryk A/S.
  • 18 Elberling C, Don M. Auditory brainstem responses to a chirp stimulus designed from derived-band latencies in normal-hearing subjects. J Acoust Soc Am 2008; 124 (05) 3022-3037
  • 19 Rodrigues GR, Ramos N, Lewis DR. Comparing auditory brainstem responses (ABRs) to toneburst and narrow band CE-chirp in young infants. Int J Pediatr Otorhinolaryngol 2013; 77 (09) 1555-1560
  • 20 Ferm I, Lightfoot G, Stevens J. Comparison of ABR response amplitude, test time, and estimation of hearing threshold using frequency specific chirp and tone pip stimuli in newborns. Int J Audiol 2013; 52 (06) 419-423
  • 21 Ferm I, Lightfoot G. Further comparisons of ABR response amplitudes, test time, and estimation of hearing threshold using frequency-specific chirp and tone pip stimuli in newborns: Findings at 0.5 and 2 kHz. Int J Audiol 2015; 54 (10) 745-750
  • 22 Elberling C, Callø J, Don M. Evaluating auditory brainstem responses to different chirp stimuli at three levels of stimulation. J Acoust Soc Am 2010; 128 (01) 215-223
  • 23 Elberling C, Don M. A direct approach for the design of chirp stimuli used for the recording of auditory brainstem responses. J Acoust Soc Am 2010; 128 (05) 2955-2964
  • 24 Kristensen SG, Elberling C. Auditory brainstem responses to level-specific chirps in normal-hearing adults. J Am Acad Audiol 2012; 23 (09) 712-721
  • 25 Cargnelutti M, Cóser PL, Biaggio EPV. LS CE-Chirp® vs. Click in the neuroaudiological diagnosis by ABR. Rev Bras Otorrinolaringol (Engl Ed) 2017; 83 (03) 313-317
  • 26 British Society of Audiology, Recommended Procedure Tympanometry. https://www.thebsa.org.uk/wp-content/uploads/2013/04/OD104-35-Recommended-Procedure-Tympanometry-.pdf/ 2013 , (Accessed 02 April, 2020).
  • 27 British Society of Audiology. Recommended Procedure Auditory Brainstem Response (ABR) Testing in Babies. https://www.thebsa.org.uk/wpcontent/uploads/2019/06/OD104-81-Recommended-Procedure-for-ABR-Testing-in-Babies.pdf/ 2019 , (accessed 01 May, 2020).
  • 28 Don M, Elberling C. Use of quantitative measures of auditory brain-stem response peak amplitude and residual background noise in the decision to stop averaging. J Acoust Soc Am 1996; 99 (01) 491-499
  • 29 Elberling C, Don M. Quality estimation of averaged auditory brainstem responses. Scand Audiol 1984; 13 (03) 187-197
  • 30 Békésy G. Experiments in Hearing, McGraw-Hill,. New York: 1960
  • 31 Northern JL, Downs MP. Audição na Infância. 5ª ed.. Guanabara Koogan; Rio de Janeiro: 2005
  • 32 Liu W, Atturo F, Aldaya R. et al. Macromolecular organization and fine structure of the human basilar membrane - RELEVANCE for cochlear implantation. Cell Tissue Res 2015; 360 (02) 245-262
  • 33 Cobb KM, Stuart A. Neonate Auditory Brainstem Responses to CE-Chirp and CE-Chirp Octave Band Stimuli I: Versus Click and Tone Burst Stimuli. Ear Hear 2016; 37 (06) 710-723
  • 34 Findlen UM, Schuller ND. Audiologic Clinical Practice Patterns: Infant Assessment. J Early Hear Detect Interv 2020; 5 (01) 28-46