George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.
Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.
Int J Pediatr Otorhinolaryngol. 2024 Nov;186:112124. doi: 10.1016/j.ijporl.2024.112124. Epub 2024 Sep 29.
Auditory brainstem response (ABR) testing is the gold standard for diagnosis of hearing loss in children who cannot complete behavioral audiometry. Testing under general anesthesia is often recommended when natural sleep ABR and/or behavioral audiometry are unsuccessful. This study aims to determine which demographic and patient factors serve as barriers to receiving this diagnostic testing.
A retrospective chart review from an internal database of patients who underwent ABR testing under anesthesia from 2017 to 2023 was completed. Patient demographics, clinical diagnoses, dates of initial recommendation, and dates of testing were recorded.
A total of 395 patients met inclusion criteria, with a median time from initial evaluation to successful ABR under anesthesia of 5.1 months (range 0.1-209 months). This time was significantly higher in patients with public insurance compared to private insurance and in patients with the following medical complexities: cardiac disease, developmental delay, neurologic disease, eye disease, and genetic syndromes not associated with hearing loss. The interval was significantly shorter in patients with abnormal ear anatomy.
Patient factors, such as insurance type and certain medical diagnoses, may lead to delayed ABR testing under anesthesia and thus delayed diagnosis and management of hearing loss. This has implications for the timely care and treatment of children with hearing loss.
听觉脑干反应（ABR）测试是无法完成行为测听的儿童听力损失诊断的金标准。当自然睡眠 ABR 和/或行为测听不成功时，通常建议在全身麻醉下进行测试。本研究旨在确定哪些人口统计学和患者因素是接受这种诊断测试的障碍。
对 2017 年至 2023 年在全身麻醉下进行 ABR 测试的患者的内部数据库进行回顾性图表审查。记录患者的人口统计学、临床诊断、初次推荐日期和测试日期。
共有 395 名患者符合纳入标准，从初次评估到成功进行全身麻醉下 ABR 的中位时间为 5.1 个月（范围 0.1-209 个月）。与私人保险相比，公共保险的患者以及患有以下医疗复杂性的患者的时间明显更长：心脏病、发育迟缓、神经疾病、眼病和与听力损失无关的遗传综合征。在耳部解剖结构异常的患者中，间隔时间明显缩短。
患者因素，如保险类型和某些医疗诊断，可能导致全身麻醉下 ABR 测试延迟，从而导致听力损失的诊断和管理延迟。这对患有听力损失的儿童的及时护理和治疗有影响。
