Application of Auditory Brainstem Response in the Hearing Loss and Prognosis Research on Neonatal Hypoxic Ischemic Encephalopathy_Chinese Journal of Evidence-Based Medicine

Authors：

 JIANG Zhou , ZHAO Lili , SONG Wei

Department of Neonatology, Chengdu Women and Children Central Hospital, Chengdu 610091, China;

Corresponding author：

JIANG Zhou, Email: 13881803949@163.com

Keywords：

Neonate; Hypoxic ischemic encephalopathy (HIE); Auditory brainstem response (ABR); Prognosis; Hearing threshold

DOI：

10.7507/1672-2531.20130145

Video：

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Objective 　Application of auditory brainstem response (ABR) in the study on the relationship of neonates with hypoxic-ischemic encephalopathy (HIE) and the children with hearing loss and auxiliary determine the prognosis of encephalopathy.
Methods 　We prospectively selected neonates diagnosed as HIE in the department of neonatology of the Chengdu Women and Children Central Hospital from January, 2006 to June, 2008. Neonatal ABR was tested and the prognosis of neonates were observed through 3-year followed up in order to analyze the relationship between HIE severity and the severity of hearing handicap and the relationship between the severity of hearing handicap and prognosis. Statistical analysis was performed using SPSS 18.0. χ2 test was used to compare the rate between groups.
Results 　40 cases involving 80 ears were included, of which 33 cases accomplished the 3-year follow-up for prognosis. The results showed that, 86.3% HIE neonates had hearing handicap (mainly mild hearing loss, 40.0%). Medium-severe HIE groups had more serious hearing handicap than Mild HIE group with a statistical significance (continuity correction χ2=7.383, P=0.007). ABR results showed that, mild HIE is mainly manifested as I wave PL prolonged or poorly differentiated, accounting for 78.1%; medium - severe HIE are mainly manifested as III and V wave PL prolonged central segment abnormalities, accounting for 95.8%; the hearing threshold no more than 60 dB group had better prognosis than the hearing threshold more than 60 dB group prognosis (Fisher exact probability P=0.001).
Conclusion 　ABR reflects that HIE severity and was positively related to the severity of hearing handicap. The more serious hearing loss in neonates is, the worse prognosis the neonates have. ABR can be used to assist the assessment of the prognosis of neonatal HIE.

Citation： JIANG Zhou,ZHAO Lili,SONG Wei. Application of Auditory Brainstem Response in the Hearing Loss and Prognosis Research on Neonatal Hypoxic Ischemic Encephalopathy. Chinese Journal of Evidence-Based Medicine, 2013, 13(7): 807-809. doi: 10.7507/1672-2531.20130145 Copy

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10.	湛月娥, 王丹, 许蔓春, 等. 脑干听觉诱发电位在新生儿缺氧缺血性脑病中的应用价值.中国现代神经疾病杂志, 2006, 6(4): 271-274.

1. Dickey EJ, Long SN, Hunt RW. Hypoxic ischemic encephalopathy-what can we learn from humans? J Vet Intern Med, 2011, 25(6): 1231-1240.
2. Jiang ZD, Shao XM, Wilkinson AR. Brainstem auditory-evoked responses in full-term newborn infants with temporary low Apgar score. Acta Otolaryngol, 2005, 125(2): 163-168.
3. Romero G, Méndez I, Tello A, et al. Auditory brainstem responses as a clinical evaluation tool in children after perinatal encephalopathy. Int J Pediatr Otorhinolaryngol, 2008, 72(2): 193-201.
4. 金汉珍, 黄德珉, 关希吉. 实用新生儿学. 第3版. 北京: 人民卫生出版社, 2003: 767-770.
5. Meyer C, Witte J, Hildmann A, et al. Neonatal screening of hearing disorders in infants at risk: incidence, risk factors, and follow-up. Pediatrics, 1999, 104(4): 900-904.
6. Park MS, Lee JH. Diagnostic potential of distortion product otoacoustic emissions in severe or profound sensorineural hearing loss. Acta Otolaryngol (Stockh), 1998, 118(4): 496-500.
7. 潘映辐. 临床诱发电位学. 第2版. 北京: 人民卫生出版社, 2002: 643-646.
8. Stone JL, Calderon-Arnulphi M, Watson KS, et al. Brainstem auditory evoked potentials-a review and modified studies in healthy subjects. J Clin Neurophysiol, 2009, 26(3): 167-175.
9. Petrova LD. Brainstem auditory evoked potentials. Am J Electroneurodiagnostic Technol, 2009, 49(4): 317-332.
10. 湛月娥, 王丹, 许蔓春, 等. 脑干听觉诱发电位在新生儿缺氧缺血性脑病中的应用价值.中国现代神经疾病杂志, 2006, 6(4): 271-274.

Chinese Journal of Evidence-Based Medicine

Application of Auditory Brainstem Response in the Hearing Loss and Prognosis Research on Neonatal Hypoxic Ischemic Encephalopathy

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