Characterization of Shared Patient Factors in Children Who Have Undergone Sedated Auditory Brainstem Response Evaluation.

Abstract

Purpose: This study aims to characterize patient characteristics of children undergoing sedated auditory brainstem response (ABR) at a tertiary-level medical center.

Method: A retrospective chart review analyzed children, under 18 years of age, who underwent sedated ABR evaluation in an operating room at a single tertiary academic center from January 1, 2013, to January 1, 2023. The following information was collected: sex, age, family history of hearing loss, newborn hearing screen status, and presence or absence of known risk factors for childhood hearing loss (neurodegenerative disorders, syndromes, congenital cytomegalovirus infection, other congenital infections, craniofacial anomalies, Apgar score at 5 min, neonatal intensive care unit stay of > 5 days, ototoxic medication treatment, low birth weight, assisted ventilation, and history of outer or middle ear pathology). Data were collected and stored using Research Electronic Data Capture software.

Results: The mean age of children undergoing sedated hearing assessment was 23.12 months. Roughly half the children who underwent sedated testing passed newborn hearing screening, while the other half referred. Findings show statistically significant difference in age of children undergoing sedated assessment that passed (30.57 months) versus referred (16.10 months) newborn hearing screening. While majority of children who passed newborn hearing screening were found to have normal hearing with sedated evaluation, 24% had sensorineural or mixed hearing loss and 18% conductive hearing loss. Findings showed a higher proportion of children subsequently identified with conductive hearing loss had sedated assessment completed in conjunction with another procedure. Overall, nearly 60% of children undergoing sedated ABR had another procedure in conjunction.

Conclusions: This study highlights the need for continued vigilance in hearing assessments to prevent delays in diagnosis. Both children who passed and referred newborn hearing screening subsequently underwent sedated ABR testing. We recommend whenever possible, children needing sedated hearing assessment do so in conjunction with another procedure to limit the need for multiple sedation events.