BRAINSTEM EVOKED RESPONSE AUDIOMETRY TEST
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Audiometry Testing
Brainstem Evoked Response Audiometry test (BERA) is a helpful test in determining the child’s ability to hear.
It is conducted to examine auditory and brain functions in response to the sound stimulus.
T measures the auditory nerves response to the sound. It is also called as Auditory Brainstem Response (ABR).
It is most commonly done for newborns and children’s up to the age of seven.
Why Brainstem Evoked Response Audiometry Test?
It is done when a baby fails newborn hearing screening done in hospitals and for older children if hearing loss is suspected. It is done to investigate the hearing level in the children’s and the magnitude of hearing loss.
What are the benefits of BERA/ABR?
- It provides the audiologists information about your possible hearing loss.
- It can be done without needing patients active coordination.
- It helps in otoneurologic diagnosis for patients with unilateral or asymmetric hearing impairment.
- Helps to know if there is damage to retro Cochlear/Cochlear.
Auditory Steady State Response ASSR
Auditory Steady State Response (ASSR) is an objective test used for evaluation of hearing ability in children too young for traditional audiometric testing. Most children are referred for ASSR after a newborn hearing screen in the hospital indicates the possibility of hearing loss. Early intervention strategies, such as hearing devices or cochlear implantation, are necessary for the development of speech and language skills in a child with hearing impairment. The results obtained from ASSR testing can be used to estimate the behavioural pure-tone audiogram. This information is essential in the management of children with hearing loss.
The person being tested must be very quiet and still in order to obtain reliable ASSR results. Often, testing is performed under sedation or in natural sleep if the person is under 6 months of age. Results are obtained by measuring brain activity while the person listens to tones of varying frequency (pitch) and intensity (loudness).The brain activity is recorded using electrodes taped on the forehead and behind each ear. The use of electrodes eliminates the need for active participation of the patient (i.e., pushing a response button every time a tone is activated). The results are detected objectively using statistical formulas that determine the presence or absence of a true response. Similar to traditional audiometric testing, threshold is determined as the lowest level at each frequency at which a response is present. ASSR provides an accurate, frequency-specific estimate of the behavioral pure-tone audiogram
Auditory Steady State Response ASSR
Vestibular evoked myogenic potential (VEMP) is an emerging diagnostic tool for identifying vestibular lesions. The VEMP test is noninvasive and causes little or no discomfort to the patient. The VEMP test is administered like the traditional auditory brain stem response [ABR] test using surface electrodes placed on sternocleidomastoid muscles to detect sound evoked potentials due to inhibitory muscle activity in response to suprathreshold tonal sounds in each ear. VEMP testing targets the vestibule and neural connections to the sternocleidomastoid muscles of the neck. VEMP is a relatively new vestibular function test performed by stimulating one ear with repetitive pulse or click sound stimulation and then measuring surface EMG responses over selected muscles averaging the reaction of the muscle electrical activity associated with each sound click or pulse.
There are 2 types of VEMP testing :
cVEMP and oVEMP. A sound stimulus applied to one ear evokes a response within the ipsilateral sternocleidomastoid muscles that can be recorded with surface electrodes and averaged (cVEMP). Similarly, a sound stimulus to the ear also evokes a response that is largest when recorded from the contralateral inferior oblique muscle recorded by a surface electrode and averaged (oVEMP)
Methodology :
VEMPs are recorded using an evoked response computer, a sound generator, and surface electrodes to pick up neck muscle activation or other muscles.