Auditory Brainstem Responses in Children with Otitis Media with Effusion

Auditory brainstem responses (ABR) were recorded in 14 infants and toddlers and 12 school-age children with a previous history of recurrent otitis media with effusion (OME), or otoscopic and tympanometric evidence of persistent OME, or both. ABR tests were performed immediately before and after myringotomy and tympanostomy tube insertion in the younger subjects. For the school-age children, ABR tests were performed following otoscopy, tympanometry, and pure tone audiometry. The results demonstrate that the latency of both wave I and wave V of the ABR was sensitive (82% and 100%, respectively) to the presence of OME. Wave I also identified the absence of OME (specificity = 100%) whereas wave V did not (specificity = 25%). ABR latency was significantly decreased postoperatively in ears found to have OME, but not in ears found to have no OME. In the school-age subjects the ABR was used to predict the conductive hearing loss at 4000 Hz with less than a 20 dB error in virtually all subjects. The ABR latency delay was also found to be related to conductive hearing impairment at lower pure tone frequencies and to the average conductive loss at a variety of pure tone frequencies. Predictions of the presence of a conductive hearing loss from these relationships promise to be impressively accurate. The results suggest that the ABR can be a valuable tool for detecting the presence of conductive hearing impairment in infants and young children suspected to have OME and perhaps as an estimate of the degree of impairment.