Objective To study normative thresholds and latencies for click and tone-burst auditory brainstem response (TB-ABR) for air and bone conduction in normal infants and those discharged from neonatal intensive care units (NICU), who passed newborn hearing screening and follow-up DPOAE. An evoked potential system (Vivosonic Integrity™) that incorporates Bluetooth electrical isolation and Kalman-weighted adaptive processing to improve signal to noise ratios was employed for this study. Results were compared with other published data. Research Design One hundred forty-five infants who passed two-stage hearing screening with transient-evoked otoacoustic emission (OAE) or automated ABR were assessed with clicks at 70 dB nHL and threshold TB-ABR. Tone-bursts at frequencies between 500 to 4000 Hz were employed for air and bone conduction ABR testing using a specified staircase threshold search to establish threshold levels and Wave V peak latencies. Results Median air conduction hearing thresholds using TB-ABR ranged from 0-20 dB nHL, depending on stimulus frequency. Median bone conduction thresholds were 10 dB nHL across all frequencies, and median air-bone gaps were 0 dB across all frequencies. There was no significant threshold difference between left and right ears and no significant relationship between thresholds and hearing loss risk factors, ethnicity or gender. Older age was related to decreased latency for air conduction. Compared to previous studies, mean air conduction thresholds were found at slightly lower (better) levels, while bone conduction levels were better at 2000 Hz and higher at 500 Hz. Latency values were longer at 500 Hz than previous studies using other instrumentation. Sleep state did not affect air or bone conduction thresholds. Conclusions This study demonstrated slightly better Wave V thresholds for air conduction than previous infant studies. The differences found in the current study, while statistically significant, were within the test step size of 10 dB. This suggests that threshold responses obtained using the Kalman weighting software were within the range of other published studies using traditional signal averaging, given step-size limitations. Thresholds were not adversely affected by variable sleep states.

Objective The purpose of this study was to evaluate pressurized wideband acoustic immittance (WAI) tests in children with Down syndrome (DS) and in typically developing children (TD) for prediction of conductive hearing loss (CHL) and patency of pressure equalizing tubes (PETs). Design Audiologic diagnosis was determined by audiometry in combination with distortion-product otoacoustic emissions, 226-Hz tympanometry and otoscopy. WAI results were compared for ears within diagnostic categories (Normal, CHL and PET) and between groups (TD and DS). Study Sample Children with DS (n=40; mean age 6.4 yrs.), and TD children (n=48; mean age 5.1 yrs.) were included. Results Wideband absorbance was significantly lower at 1–4 kHz in ears with CHL compared to NH for both TD and DS groups. In ears with patent PETs, wideband absorbance and group delay (GD) were larger than in ears without PETs between 0.25–1.5 kHz. Wideband absorbance tests performed similarly for prediction of CHL and patent PETs in TD and DS groups. Conclusions Wideband absorbance and group delay revealed specific patterns in both TD children and those with DS that can assist in detection of the presence of significant CHL, assess the patency of PETs, and provide frequency-specific information in the audiometric range.