Bera

BERA

Q. 1

Investigation of choice for audiometric evaluation of an infant is

 A

Pure Tone Audiometry

 B

High frequency Audiometry

 C

Tympanometry

 D

BERA

Q. 1

Investigation of choice for audiometric evaluation of an infant is

 A

Pure Tone Audiometry

 B

High frequency Audiometry

 C

Tympanometry

 D

BERA

Ans. D

Explanation:

 

Auditory brainstem response (ABR): Also called BAER or BAEP (brainstem auditory evoked response or potential) or BERA (brainstem evoked response audiometry) is to elicit brainstem responses to auditory stimulation by clicks or tone bursts. It is a non-invasive technique to find the integrity of central auditory pathways through the VIIIth nerve, pons and midbrain. It measures hearing sensitivity in the range of 1000-4000 Hz.

ABR is used:

  1. As a screening procedure for infants.
  2. To determine the threshold of hearing in infants; also in children and adults who do not cooperate and in malingerers.
  3. To diagnose retrocochlear pathology particularly acoustic neuroma.
  4. To diagnose brainstem pathology, e.g. multiple sclerosis or pontine tumours.
  5. To monitor CN VIII intraoperatively in surgery of acoustic neuromas to preserve the function of cochlear nerve.

Q. 2 Which of the following is the investigation of choice in assessing hearing loss in neonates?
 A Impedance audiometry      
 B BAER
 C Free field audiometry    
 D Behavioral audiometry
Q. 2 Which of the following is the investigation of choice in assessing hearing loss in neonates?
 A Impedance audiometry      
 B BAER
 C Free field audiometry    
 D Behavioral audiometry
Ans. B

Explanation:

•   The   Brainstem  auditory   evoked   response

(BAER) test 

measures responses in brain waves that are stimulated by a clicking sound to check the central auditory (Hearing) pathways of the brainstem. The test can be done for all ages.

• Infant test or (Birth to 1 year) 

• Toddler test or (1 to 3 years)

• Preschooler Test or (3 to 6 years)

• School age test or (6- 12 years)

• Adolescent test (12 to 18 years) ‘

• The test is performed to help diagnose nervous system abnormalities, hearing losses (especially in low-birth weight newborns), and to assess neurologic functions.

• The auditory brain stem values are in a normal range.

• This range varies among patients and instruments used.

• In a normal person, 7 waves are produced in the first 100 milliseconds


Q. 3

Which is the best screening test to evaluate hearing in a neonate?

 A

Pure Tone Audiometry

 B

Stapedial Reflex

 C

Otoacoustic Emissions

 D

Brainstem evoked auditory response

Q. 3

Which is the best screening test to evaluate hearing in a neonate?

 A

Pure Tone Audiometry

 B

Stapedial Reflex

 C

Otoacoustic Emissions

 D

Brainstem evoked auditory response

Ans. C

Explanation:

Otoacoustic emissions (OAEs) are objective, noninvasive, and rapid measures (typically less than 2 minutes) used to determine cochlear outer hair cell function. 

OAE testing is commonly used in newborn hearing screening because of its speed and noninvasive nature.
It is also used in confirming pure-tone test results obtained from young children, in patients for whom a functional hearing loss is suspected, for audiometric configuration confirmation, for ototoxic drug monitoring, and in hearing aid candidacy.
More recently, OAEs, in conjunction with ABR, can be used in identifying individuals with auditory neuropathy, also termed auditory dyssynchrony.

 

 

 

Ref: Sweetow R.W., Sabes J.H. (2012). Chapter 45. Audiologic Testing. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology—Head & Neck Surgery, 3e.

 


Q. 4

Which is the investigation of choice in assessing hearing loss in neonates?

 A

Free field audiometry

 B

Behavioral audiometry

 C

Impedance audiometry

 D

Brainstem Evoked Response Audiometry (BERA)

Q. 4

Which is the investigation of choice in assessing hearing loss in neonates?

 A

Free field audiometry

 B

Behavioral audiometry

 C

Impedance audiometry

 D

Brainstem Evoked Response Audiometry (BERA)

Ans. D

Explanation:

Brainstem evoked response audiometry is the investigation used to detect acoustic neuromas or determine hearing thresholds in children.

In Brainstem Evoked Response Audiometry electrodes are placed over various areas of the skull and sounds of various frequencies are projected to the ear with a headphone. The potentials generated by the brain in response to the sound are recorded and studied. 


Q. 5

Which of the following is used for initial screening of auditory function in a neonate?

 A

Otoacoustic emission (OAE)

 B

Auditory brainstem response (ABR)

 C

Pure tone audiometry (PTA)

 D

Free field audiometry

Q. 5

Which of the following is used for initial screening of auditory function in a neonate?

 A

Otoacoustic emission (OAE)

 B

Auditory brainstem response (ABR)

 C

Pure tone audiometry (PTA)

 D

Free field audiometry

Ans. A

Explanation:

Most screening programmes for newborn hearing ability uses otoacoustic emission as the initial test. It this test fails then auditory brainstem response is used for screening.

Otoacoustic emissions are low level sound emitted spontaneously by the cochlea on presentation of an auditory stimulus. Persons with normal hearing produce oatoacoustic emissions whereas those who have hearing loss of 30-40db HL or greater do not produce OAE.

Auditory brainstem response testing is used with babies between the ages of birth and 5 months. It is the electrophysiological response to an acoustic stimulus and originates from the eight cranial nerve and auditory brain stem. It can be used to determine the degree of hearing loss at different audiometric frequencies. 


Q. 6

The screening investigation of high risk neonates in ICU for suspected hearing loss is:

 A

Otoacoustic emissions

 B

Free field audiometry

 C

Stapedial reflex testing

 D

Pure tone audiometry

Q. 6

The screening investigation of high risk neonates in ICU for suspected hearing loss is:

 A

Otoacoustic emissions

 B

Free field audiometry

 C

Stapedial reflex testing

 D

Pure tone audiometry

Ans. A

Explanation:

 

The screening investigation of choice of high-risk neonates in ICU for suspected hearing loss is otoacoustic emissions. 


Q. 7

Wave II in BERA originates from ‑

 A

Cochlear nucleus

 B

Lateral laminiscus

 C

Proximal eighth nerve

 D

Distal eighth nerve

Q. 7

Wave II in BERA originates from ‑

 A

Cochlear nucleus

 B

Lateral laminiscus

 C

Proximal eighth nerve

 D

Distal eighth nerve

Ans. C

Explanation:

 

Brain Stem Response Audiometry (BERA)

It is a non-invasive procedure which objectively helps to find the integrity of central auditory pathway through the VIII nerve, pons and mid brain. It is accurate to within 10 or 15 dB of the psychoacoustic thereshold. It is the most reliable audiological method of differentiating between cochlear and Retrocochlear hearing losses. It is an objective test and can be done under sedation.

It is used both as a screening test and as a definative hearing assessment test in children. Best test to detect deafness in infants (reliably recorded even from premature infants of 30 weeks gestational age) and mentally retarded or malingering subjects. It is also used for Identification of the site of lesion in Retrocochlear pathologies and to diagnose brainstem pathology e.g. multiple sclerosis or pontine tumor.



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