Non-Sedated Auditory Brainstem Response / Otoacoustic Emission Hearing Tests (ABR/BAER/OAE)
What is ABR/OAE? ABR (Auditory Brainstem Response) also known as BAER (Brainstem Auditory Evoked Response), as well as another different test called OAE (Oto-Acoustic Emission) are specialized hearing tests that can evaluate whether a child/infant/newborn can hear without requiring them to respond.
PLEASE NOTE that these tests can only be performed AFTER an evaluation by one of our ENT doctors. A referral or order from a physician outside our practice will NOT be accepted. As such, if you desire such testing in our office, you must first make an appointment with one of our ENT doctors. The only exception are newborn infants who have failed initial hearing screening; such infants do not require an initial office visit with one of our ENT physicians.
These tests are completely non-invasive. Just like an EKG measures a heart's electrical activity using little stickers, ABR/OAE testing checks out the electrical activity from the ear to the brain. Special stickers on the head enable us to "see" whether the brain "hears" any sounds introduced into the ear.
If the ABR/OAE testing comes back normal, rest assured your child's hearing in both ears is normal.
Specifically, OAE is performed by placing an earpiece and playing clicks into the ear. The machine than listens for an echo which indicates that the ear "heard" the clicks.
ABR is performed just like an OAE, but special leads are placed behind the ear and forehead which measures brainwaves (just like an EEG or an EKG) to see if the brain "hear" the clicks produced by the testing machine. There are several different types of ABR (regular, tone burst, bone conduction, ASSR) depending on the age of testing and reason for the testing.
ABR Test Results
Traditionally, ABR/OAE testing required sedation in order to obtain accurate and reliable results as any muscle activity can lead to false reports. Furthermore, there are a lot of wires going from the patient to the equipment and as such required the patient to stay still. In the case of infants/children, this mandated general anesthesia in a hospital operating room.
Although we still offer sedated ABR/OAE testing, fortunately new technology that our office now possesses eliminates the need for such sedation for most patients and still obtain accurate ABR/OAE test results. Our office uses Vivosonic Integrity which incorporates wireless technology and the use of an in-situ bio-amplifier which amplifies biologic electrical activity at the ear source thereby reducing interference from environmental electric, magnetic, and RF field-induced noises. This also dramatically reduces artifacts which result from other muscular and ocular electrical activity.
What does this all mean for a patient?
It means that an ABR/OAE can be obtained in our office on a child/infant who is (calmly) moving and playing around... all without being attached to wires. No sedation. No medications. No needles. No pain. Testing as shown on to the right is no longer necessary!
Although the equipment used does not require sedation, it is still sensitive to excessive noise and movement interference. It is very important for the patient to be relaxed and quiet during testing. Natural sleep state is not required, but is the best condition for testing.
For those patients who are not able to tolerate even having electrodes placed or keep ear plugs in, we do offer safe sedated ABR/OAE testing as well using this technology. The sedation is provided by an anesthesiologist inside a hospital operating room to provide the safest possible environment.
Please note that these tests require approximately 30-60 minutes to complete under ideal testing conditions. If too much noise or movement interferes with the validity of the test, the audiologist will stop the test and the patient will be rescheduled to complete testing OR sedated testing will be recommended.
Watch a video showing how this testing is performed on a young child below or here.
If hearing loss is discovered, the next step is to determine what is the cause of the hearing loss in order to initiate appropriate corrective interventions. Watch this video that goes over the various different causes of hearing loss.
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