Specificity of auditory brainstem response audiometry criteria in acoustic neuroma screening as a function of deviations of reference values in patients with cochlear hearing loss

Gstœttner, Wolfgang; Neuwirth-Riedl, K; Swoboda, Herwig; Mostbeck, W; Burian, Maria

doi:10.1007/bf00714487

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…More importantly, the criterion IT5 and I-V values that achieve 95% sensitivity yield specifi city scores below 5%. The high specifi city (95%) for the IT5 measure using a 0.2 difference criterion ( fi g. 6 ) is similar to the fi ndings of Gstoettner et al [1992] in a population of patients with cochlear hearing loss. However, the sensitivity of the IT5 using the 0.2 ms difference criterion is only about 49% for small tumors.…”

Section: Discussionsupporting

confidence: 49%

The Stacked ABR: A Sensitive and Specific Screening Tool for Detecting Small Acoustic Tumors

Don¹,

Kwong²,

Tanaka

et al. 2005

Audiol Neurotol

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The failure of standard ABR measures to detect small (≤1 cm) acoustic tumors has led to the use of enhanced magnetic resonance imaging (MRI) as the standard to screen for small tumors. This study investigates the suitability of the stacked ABR as a sensitive screening alternative to MRI for small acoustic tumors (SATs). The objective of the study was to determine the sensitivity and specificity of the stacked ABR technique for detecting SATs. A total of 54 patients with acoustic tumors identified by MRI that were either ≤1 cm in size or undetected by standard ABR methods, irrespective of size, were studied. A control population of 78 nontumor normal-hearing subjects was also tested. For comparison, two standard ABR measures (IT5 and I-V delay) were also analyzed. The stacked ABR demonstrated 95% sensitivity and 88% specificity; 100% sensitivity was obtained at 50% specificity. Standard ABR measures were much poorer in detecting these tumors. In conclusion, the stacked ABR can be used as a sensitive, widely-available, cost-effective, and comfortable tool for screening SATs.

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Section: Discussionsupporting

confidence: 49%

The Stacked ABR: A Sensitive and Specific Screening Tool for Detecting Small Acoustic Tumors

Don¹,

Kwong²,

Tanaka

et al. 2005

Audiol Neurotol

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“…Controls had normal PTA results (threshold ≤ 25 dB HL for all frequencies). A unilateral sensorineural hearing loss was confirmed in all ISSNHL patients, characterized as cochlea being the lesion site based on results of reduced distortion-product otoacoustic emissions (DPOAEs) and within-normal-limit interaural latency differences for auditory brainstem responses (ABRs) [14]. Since for all patients, air and bone conduction thresholds were less than 65 dB HL at 1000 Hz (Figure 1, Table 1), the probing auditory stimulus was set at this frequency with an intensity of 75 dB SPL for the MEG exam.…”

Section: Methodsmentioning

confidence: 99%

Neuromagnetic Index of Hemispheric Asymmetry Prognosticating the Outcome of Sudden Hearing Loss

Shiao

Chen³

et al. 2012

PLoS ONE

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The longitudinal relationship between central plastic changes and clinical presentations of peripheral hearing impairment remains unknown. Previously, we reported a unique plastic pattern of “healthy-side dominance” in acute unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). This study aimed to explore whether such hemispheric asymmetry bears any prognostic relevance to ISSNHL along the disease course. Using magnetoencephalography (MEG), inter-hemispheric differences in peak dipole amplitude and latency of N100m to monaural tones were evaluated in 21 controls and 21 ISSNHL patients at two stages: initial and fixed stage (1 month later). Dynamics/Prognostication of hemispheric asymmetry were assessed by the interplay between hearing level/hearing gain and ipsilateral/contralateral ratio (I/C) of N100m latency and amplitude. Healthy-side dominance of N100m amplitude was observed in ISSNHL initially. The pattern changed with disease process. There is a strong correlation between the hearing level at the fixed stage and initial I/Camplitude on affected-ear stimulation in ISSNHL. The optimal cut-off value with the best prognostication effect for the hearing improvement at the fixed stage was an initial I/Clatency on affected-ear stimulation of 1.34 (between subgroups of complete and partial recovery) and an initial I/Clatency on healthy-ear stimulation of 0.76 (between subgroups of partial and no recovery), respectively. This study suggested that a dynamic process of central auditory plasticity can be induced by peripheral lesions. The hemispheric asymmetry at the initial stage bears an excellent prognostic potential for the treatment outcomes and hearing level at the fixed stage in ISSNHL. Our study demonstrated that such brain signature of central auditory plasticity in terms of both N100m latency and amplitude at defined time can serve as a prognostication predictor for ISSNHL. Further studies are needed to explore the long-term temporal scenario of auditory hemispheric asymmetry and to get better psychoacoustic correlates of pathological hemispheric asymmetry in ISSNHL.

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“…Among the causes of asymmetric sensorineural hearing loss, the rate of AN has been reported to range from 0.3 to 4.6% (16,21,22). Kotlarz (22) considers that ABR is the most efficient and economical screening technique for retrocochlear disease.…”

Section: Discussionmentioning

confidence: 99%

“…In this case an interaural difference of 0.2 ms is accepted, the ABR being considered to be a selection tool prior to MRI. Choosing less strict limits can improve sensitivity but at the cost of some loss in specificity and an increased number of false positives (16). This is only a relative drawback, since choosing to improve the sensitivity of ABR prevents the need for MRI in all patients.…”

Section: Methodsmentioning

confidence: 99%

Sensitivity of Auditory Brainstem Response in Acoustic Neuroma Screening

Godey

Morandi²,

Beust³

et al. 1998

Acta Oto-Laryngologica

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Auditory brainstem response (ABR) is the reference screening technique for acoustic neuromas, but because of a few false negatives and the increasing performance of magnetic resonance imaging (MRI), its role as the standard method has been questioned. We assessed sensitivity of screening tests in 89 patients with surgically proven acoustic neuromas. Sensitivity of ABR was 92%; 94% for extracanalicular neuromas and 77% for intracanalicular neuromas. For stapedius reflex (SR), sensitivity was 84% and for caloric vestibular response (CVR) 86%. The combined sensitivity of ABR + SR was 97% and of ABR + RS + CVR 98%. For false negatives, the greatest diameter including the intracanalicular portion was always less than 18 mm, with a mean of 15 mm, and none of these tumours reached the brainstem. For patients with unilateral cochleo-vestibular deficit, we propose ABR and SR as first-line screening tests. These tests are repeated at 6 months and at 1 year in the case of normal results. MRI is ordered for patients whose auditory threshold is too low and for those whose ABR or SR results favour retrocochlear disease.

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Specificity of auditory brainstem response audiometry criteria in acoustic neuroma screening as a function of deviations of reference values in patients with cochlear hearing loss

Cited by 9 publications

References 9 publications

The Stacked ABR: A Sensitive and Specific Screening Tool for Detecting Small Acoustic Tumors

The Stacked ABR: A Sensitive and Specific Screening Tool for Detecting Small Acoustic Tumors

Neuromagnetic Index of Hemispheric Asymmetry Prognosticating the Outcome of Sudden Hearing Loss

Sensitivity of Auditory Brainstem Response in Acoustic Neuroma Screening

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