Choudhry Hannaan S, Povolotskiy Roman, Damji Shahin, Ying Yu-Lan M, Raia Nicole
Department of Otolaryngology-Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA.
Department of Otolaryngology-Head and Neck Surgery Boston University Chobanian and Avedisian School of Medicine Boston Massachusetts USA.
OTO Open. 2024 Dec 22;8(4):e70056. doi: 10.1002/oto2.70056. eCollection 2024 Oct-Dec.
Auditory brainstem response (ABR) is the gold standard to assess hearing loss in pediatric patients. Multiple widely accepted ABR protocols with varying parameters are accepted, difference in standards may lead to misdiagnosis or delay in diagnosis and treatment. This study investigates the quality of ABR testing in pediatric patients in addition to changes in diagnoses and management.
Retrospective chart review.
University Hospital, Rutgers New Jersey Medical School.
Retrospective chart review was conducted for all pediatric patients from 2012 to 2019 who had undergone prior outside ABR testing before presenting to our institution for hearing loss evaluation. The ABR tests were analyzed for completeness following the American Academy of Audiology (AAA), American Speech Language Hearing Association (ASHA), and The Joint Committee on Infant Hearing (JCIH) guidelines. Descriptive statistics on changes in patient diagnoses and interventions after repeat ABR were performed.
80 patients met inclusion criteria. The most common reasons for an incomplete ABR were inadequate components of testing including tone burst bone conduction (85.0%), polarity (82.5%), and tone burst air conduction (48.7%). 77 of the patients who presented required a repeat ABR. 37 repeated ABRs resulted in a change of diagnosis, the most common being from unspecified hearing loss to sensorineural hearing loss (10%). 23 cases had a change in ultimate management.
Incomplete ABR testing may result in misdiagnosis, delay in diagnosis and treatment. Identifying common reasons for incomplete ABR testing may aid Otolaryngologists develop a screening workflow to recognize patients requiring repeat testing.
听觉脑干反应（ABR）是评估儿科患者听力损失的金标准。目前有多个被广泛接受的ABR检测方案，其参数各不相同，标准差异可能导致误诊或诊断及治疗延误。本研究除了调查诊断和管理方面的变化外，还对儿科患者ABR检测的质量进行了调查。
回顾性病历审查。
罗格斯新泽西医学院大学医院。
对2012年至2019年期间所有在我院进行听力损失评估前曾在其他机构接受过ABR检测的儿科患者进行回顾性病历审查。按照美国听力学学会（AAA）、美国言语语言听力协会（ASHA）和婴儿听力联合委员会（JCIH）的指南，对ABR检测的完整性进行分析。对重复ABR检测后患者诊断和干预措施的变化进行描述性统计。
80例患者符合纳入标准。ABR检测不完整的最常见原因是检测组件不充分，包括短纯音骨传导（85.0%）、极性（82.5%）和短纯音气传导（48.7%）。前来就诊的77例患者需要重复进行ABR检测。37次重复ABR检测导致了诊断改变，最常见的是从未明确的听力损失变为感音神经性听力损失（10%）。23例患者的最终治疗方案发生了改变。
ABR检测不完整可能导致误诊、诊断及治疗延误。识别ABR检测不完整的常见原因可能有助于耳鼻喉科医生制定筛查流程，以识别需要重复检测的患者。
4级。
