Application Of Chirp-induced Auditory Brainstem Response In Hearing Loss Assessment In Otitis Media With Effusion Children

Objective Otitis media with effusion is a common disease that causes hearing loss in children,and the hearing loss mainly seen in the low frequency region.Currently,click sound is the most widely used stimulation sound in clinic,but it has certain limitations.Its main test range is 2000-4000Hz medium and high frequency hearing.Therefore,in recent years,a new type of stimulating sound ABR,namely Chirp-ABR,has gradually been applied to clinical audiology tests.The characteristics of Chirp stimulus sound signal are that low-frequency sounds are emitted early and high-frequency sounds are emitted late.It overcomes the traveling wave delay caused by the special anatomy of the cochlea and can cause more nerve fibers to discharge at the same time.And its waveform amplitude is significantly increased,the threshold is more convenient to judge,and the detection time is shorter.This method is recently applied,however,the hearing assessment of children with abnormal hearing needs to be further explored.Previous studies have suggested that Chirp-ABR has advantages in assessing low-frequency hearing loss.In this study,we intend to compare the clinical value of Chirp-ABR on children’s hearing loss caused by secretory otitis media by comparing the detecting effect of Chirp-ABR and click-ABR.Methods Auditory brainstem response examinations are conducted in a national acoustic standard soundproof shielded room.Children with secretory otitis media diagnosed in Dongguan Neonatal Hearing Impairment Diagnosis and Treatment Center through otoscope and acoustic immittance examination were enrolled,and the Danish International Hearing Eclipse EP25 evoked potential instrument was used for Chirp-ABR and click-ABR tests under sedation.The latency of waves Ⅰ,Ⅲ,and Ⅴdetected by Chirp-ABR and click-ABR for children with different hearing loss levels and different types of hearing loss were recorded,as well as the threshold and amplitude of wave V,and the intervals between waves Ⅰ-Ⅲ,Ⅲ-Ⅴ and Ⅳ.The latency,wave interval and reaction threshold of Chirp-ABR and click-ABR were compared by self-paired t-test.Result At 80dBnHL stimulus intensity,42 cases(55 ears)of children with secretory otitis media had Chirp-ABR wave Ⅰ and Ⅲ latency longer than click-ABR;Chirp-ABR Ⅰ-Ⅲ and Ⅲ-Ⅴ wave intervals were shorter than click-ABR,but the difference was not statistically significant(P>0.05).Chirp-ABR wave V response threshold is lower than and click-ABR,although the difference is not statistically significant(P>0.05).In response to the threshold stimulus sound intensity,the Ⅴlatency of Chirp-ABR wave was longer than that of click-ABR(P<0.05).Conclusions The Chirp-ABR waveform is well differentiated,and the wave Ⅴamplitude is high,which may benefit for threshold identification;when receiving 80dB nHLstimulating sound intensity,the latency of Chirp-ABR waves Ⅰ,Ⅲ,and Ⅴis prolonged in children with secretory otitis media,compared with that of click-ABR.The incubation period of wave V is prolonged at the response threshold intensity;there is no significant difference in the response threshold between Chirp-ABR and click-ABR in children with secretory otitis media.Chirp-ABR can be applied to objective hearing threshold assessment in children with mild to moderate conductive hearing loss and otitis media with effusion,worthy of clinical promotion.