A positive wave at 8 ms (P8) and modified auditory brainstem responses measurement in auditory neuropathy spectrum disorder

Use of Socioeconomic Demographic Data in Studies on Pediatric Unilateral Hearing Loss: A Scoping Review

OBJECTIVES

Social determinants of health (SDOH) (healthcare access and quality, education access and quality, socioeconomic status, social and cultural context, neighborhood and built environment) ( Healthy People 2030 ) have been shown to impact a wide range of health-related outcomes and access to care. Given the medical and nonmedical costs associated with children with unilateral hearing loss (UHL), the varied insurance coverage for hearing healthcare services, and the differences in hearing aid utilization rates between children of different sociodemographic classes, the sociodemographic information of children with UHL enrolled in research studies should be collected to ensure the generalizability of hearing healthcare interventions. Therefore, the objective of this scoping review is to assess the reporting of SDOH data for participants in studies of pediatric UHL and its comparison to population trends.

DESIGN

Two searches of published literature were conducted by a qualified medical librarian. Two reviewers then evaluated all candidate articles. Study inclusion parameters were from 2010 to present, peer-reviewed studies with prospective study design, and participant population including children (age 0 to 18 years old) with UHL.

RESULTS

Two literature searches using PubMed Medline and Embase found 442 and 3058 studies each for review. After abstract and paper review, 87 studies were included in final qualitative review, with 22 of these studies reporting race distribution of participants, 15 reporting insurance status or family income, and 12 reporting the maternal education level.

CONCLUSIONS

Sociodemographic data are not commonly reported in research studies of children with UHL. In reported samples, research participants are more likely to have private insurance and higher family income compared with overall population distribution. These demographic biases may affect the generalizability of study results to all children with UHL. Further evaluation is warranted to evaluate whether participant recruitment affects outcomes that reflect the overall population.

Chirp-Evoked Auditory Brainstem Response in Children: A Review

PURPOSE

The aim of this study was to assess the use of the chirp stimulus to record auditory brainstem responses in the pediatric population via a traditional review.

METHOD

An electronic search of the literature and a hand search of the literature were conducted. Studies that utilized chirp stimuli within the pediatric population that met all of the inclusion criteria were included in this review. Qualitative synthesis and interpretation of the data were completed.

RESULTS

Seven studies that met the inclusion criteria were included in the review. Chirp stimuli produce auditory brainstem response (ABR) waveform amplitudes in children similar to those in adults when presented at moderate to low frequency levels. Latency data from chirp stimuli are not consistent when stimulus presentation rates are altered. Test-retest reliability when using the chirp stimulus was found to be good, as were sensitivity and specificity of chirp-evoked ABRs utilized in a newborn hearing screening protocol.

CONCLUSION

Reviewed studies indicated that when presented at 60 dB nHL or lower, broadband chirp-generated ABRs have larger amplitudes than click-generated ABRs in children with normal hearing. Utilization of chirp stimuli decreases test time because waveforms are easier to detect with increased synchronization. Further research should focus on correlating chirp thresholds with behavioral hearing thresholds. Given the variance of results in these select studies, future research should also evaluate latency findings and focus on developing normative data for infants with hearing impairment and normal hearing.

Auditory dyssynchrony or auditory neuropathy: understanding the pathophysiology and exploring methods of treatment

OBJECTIVE

To review the literature on auditory dyssynchrony (AD) or neuropathy which is characterized by absent auditory brainstem responses, normal otoacoustic emissions, and word discrimination disproportional to the pure tone audiogram.

RESULTS

Several papers attempt to estimate the prevalence of AD that seems to range between 0.23 and 2% in infants "at risk" for hearing impairment and it is considered to be responsible for approximately 8% of newly diagnosed cases of hearing loss in children per year. The prevalence gets even higher, reaching 10% in children with permanent hearing loss. It seems that AD is not a single disease but a spectrum of pathologies that affect the auditory pathway at the level of the inner hair cells, the synapses, or the auditory nerve. Many predisposing or contribution factors have been reported, including prematurity, hyperbilirubinemia, hypoxia, low-birth weight, immunological conditions, infectious diseases, etc. Before proposing any method of management, parents should be informed about the variation among patients and the changes that may appear in some children's audition over time. Sigh language, speech and language therapy, hearing-aids, and cochlear implantation have been used in the treatment of AD. In general, AD is rather refractory to conventional amplification and cochlear implantation has been found an effective method of management in young implanted children with severe/profound deafness and AD. However, the situation is more complicated and challenging in milder hearing losses.

CONCLUSION

The selected and proposed 30 related articles published in the International Journal of Pediatric Otorhinolaryngology aim to stimulate the related research in order to further explore the etiology, pathophysiology, and management of AD.