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KEYWORDS
Auditory brainstem
response;
Click;
Tone burst stimuli
(logon)
Summary
Objectives: To provide age-equivalent norms for a 500 Hz logon evoked ABR obtained
in a group of children ranging 40 weeks4 years old and compare these 500 Hz tonal
norms to age-equivalent norms for click-evoked ABR.
Methods: Seventy-seven infants and children ranging from conceptional age of 40
weeks (term babies) to 4 years were tested with both click and tonal ABR without any
risk factors for hearing loss.
Results: Data analyses were consisted of 6 age groups. Mean wave V latencies were
compared with the adult norms. Latencies were decreased by age in both click and
tonal ABR recordings.
Conclusion: Five hundred Hertz of tonal ABR wave V latency did not mature until to
24 years old but, click ABR wave V latency reached maturity at the same age range.
# 2007 Elsevier Ireland Ltd. All rights reserved.
1. Introduction
The primary goal of evoked potential audiometry is
to provide the accurate audiometric information for
infants and difficult-to-test children. The auditory
brain stem response (ABR) to air-conducted clicks is
the most widely employed evoked potential audiometry technique. While informative and accurate in
most cases, the use of clicks has many drawbacks.
Clicks cannot provide reliable estimates of low fre-
0165-5876/$ see front matter # 2007 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.ijporl.2007.01.016
776
S. Ku
lekci et al.
2. Methods
2.1. Subjects
Seventy-seven infants and children ranging from
conceptional age of 40 weeks (term babies) to 4
years were tested with ABR without any risk factors
for hearing loss. Thirty of them were female, 47 of
them were male.
Fig. 1
Both for the click and tonal ABR stimuli, they had
responses at 70, 55 and 30 dB nHL. Only the latency
data from the right ear were used for analyses.
Testing 20 young adults with normal hearing
(thresholds for 2508000 Hz were 15 dB HL) indicated that the average and modal psychophysical
threshold for the 500 Hz ABR stimuli was
35 dB peSPL and for the click stimuli it was 30 dB
peSPL.
2.2. Procedures
The infants were sedated with chloral hydrate
(40 mg/kg) and were medically cleared of middle
ear disease. Testing was performed in a sound proof
test room (IAC) using Amplaid MK 15 evoked potentials systems. The stimuli were 70, 55 and 30 dB nHL
and (re:30 dB peak equivalent SPL) alternating
100 ms duration clicks at a rate of 31 s 1 with the
filter bandpass at 1002500 Hz and the time base at
15 ms. For the 500 Hz logon testing, the bandpass
was 301500 Hz with a 20 ms timebase. The stimuli
were 70, 55 and 30 dB nHL and the repetition rate
was 31 s 1. This stimuli is a short pure tone stimulus
in which the bandwidth is kept constant, and it has a
fixed number of cycles on the rise-plateau-fall time.
The frequency/amplitude spectrum of a 500 Hz
logon as well as the acoustic waveform, are illustrated in Fig. 1. Due to its physical features, delta
time and delta frequency, it guarantees a constant
band of frequencies in octaves for the different
frequencies of the test [21]. All ABRs were two
channel recordings from Cz-M1 versus Cz-M2, Fpz.
Each ABR was replicated twice and at least 2000
sweeps collected.
Statistical analysis was evaluated with paired ttest (SPSS ver.14), p < 0.05.
777
3940 weeks
4446 weeks
24 months
68 months
1016 months
24 years
14
10
12
12
10
19
3. Results
Seventy-seven infants and children were divided
into six groups as outlined in Table 1.
Absolute latencies were measured for wave V at
70, 55 and 30 dB nHL in response to click, and 500 Hz
logon stimuli. The mean wave V latency data were
analyzed by age groups for significant changes using
a paired sample t-test p < 0.05. Table 2 lists the
means 2.5 S.D.s of wave V data by ages for click
and 500 Hz logon stimuli.
The latency values of waves V at 70 dB nHL both
for click and tonal stimuli are displayed in Fig. 2.
Fig. 3 shows the latency values for the click
stimuli at 70, 55 and 30 dB nHL.
Fig. 4 displays the latency values for the 500 Hz
logon stimuli at 70, 55 and 30 dB nHL. There is a
Table 2 Mean S.D. latency values by CA for click and 500 Hz logon stimuli
Age (n)
Click 70 dB
Click 55 dB
Click 30 dB
.5k 70 dB
.5k 55 dB
.5k 30 dB
6.79
6.61
6.35
6.19
5.95
5.73
5.50
7.13
6.94
6.71
6.46
6.14
5.98
5.82
8.15
8.03
7.63
7.28
7.11
7.01
9.66
9.14
9.00
8.79
8.72
8.61
7.56
11.58
11.13
11.13
10.52
10.25
10.45
8.79
13.32
12.82
13.16
12.79
12.68
12.74
10.80
(0.29)
(0.28)
(0.20)
(0.27)
(0.26)
(0.22)
(0.05)
(0.34)
(0.29)
(0.19)
(0.26)
(0.24)
(0.25)
(0.25)
(0.39)
(0.27)
(0.28)
(0.30)
(0.36)
(0.37)
(0.46)
(0.85)
(0.59)
(0.24)
(0.37)
(0.98)
(0.37)
(0.87)
(0.92)
(1.30)
(0.77)
(0.58)
(1.25)
(0.58)
(1.39)
(1.13)
(1.23)
(0.91)
(1.20)
(1.28)
(0.79)
778
4. Discussion
Our study had three purposes: (1) to provide ageequivalent norms for a 500 Hz logon evoked ABR
obtained from a group of infants; (2) to compare
these logon ABR norms to age-equivalent norms for
click-evoked ABR; and (3) to investigate the issue of
maturational development according to 500 Hz
logon stimuli.
Wave V latency in response to 500 Hz logon
decreased with age and did not stabilize by 24 years
of age. Wave V latency in response to clicks decreased
S. Ku
lekci et al.
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