Barriers to auditory brainstem response testing under anesthesia

Authors

Alexandra E. Tunkel, George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.
Anisa Benbourenane, George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.
Hengameh K. Behzadpour, Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.
Md Sohel Rana, Department of Surgery, Children's National Hospital, Washington, DC, USA.
Tracey Ambrose, Division of Hearing and Speech, Children's National Hospital, Washington, DC, USA.
Eve Kronzek, Division of Hearing and Speech, Children's National Hospital, Washington, DC, USA.
Diego A. Preciado, Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.
Brian K. Reilly, Department of Otolaryngology, Children's National Hospital, Washington, DC, USA. Electronic address: breilly@childrensnational.org.

Document Type

Journal Article

Publication Date

11-1-2024

Journal

International journal of pediatric otorhinolaryngology

Volume

186

DOI

10.1016/j.ijporl.2024.112124

Keywords

ABR; Auditory brainstem response; Hearing loss; Pediatric hearing loss

Abstract

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

APA Citation

Tunkel, Alexandra E.; Benbourenane, Anisa; Behzadpour, Hengameh K.; Rana, Md Sohel; Ambrose, Tracey; Kronzek, Eve; Preciado, Diego A.; and Reilly, Brian K., "Barriers to auditory brainstem response testing under anesthesia" (2024). GW Authored Works. Paper 6071.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/6071

Department

Surgery