Barriers to auditory brainstem response testing under anesthesia

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-09-29 DOI:10.1016/j.ijporl.2024.112124

Alexandra E. Tunkel , Anisa Benbourenane , Hengameh K. Behzadpour , Md Sohel Rana , Tracey Ambrose , Eve Kronzek , Diego A. Preciado , Brian K. Reilly

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Abstract

Objective

Auditory brainstem response (ABR) testing is the gold standard for diagnosis of hearing loss in children who cannot complete behavioral audiometry. Testing under general anesthesia is often recommended when natural sleep ABR and/or behavioral audiometry are unsuccessful. This study aims to determine which demographic and patient factors serve as barriers to receiving this diagnostic testing.

Methods

A retrospective chart review from an internal database of patients who underwent ABR testing under anesthesia from 2017 to 2023 was completed. Patient demographics, clinical diagnoses, dates of initial recommendation, and dates of testing were recorded.

Results

A total of 395 patients met inclusion criteria, with a median time from initial evaluation to successful ABR under anesthesia of 5.1 months (range 0.1–209 months). This time was significantly higher in patients with public insurance compared to private insurance and in patients with the following medical complexities: cardiac disease, developmental delay, neurologic disease, eye disease, and genetic syndromes not associated with hearing loss. The interval was significantly shorter in patients with abnormal ear anatomy.

Conclusion

Patient factors, such as insurance type and certain medical diagnoses, may lead to delayed ABR testing under anesthesia and thus delayed diagnosis and management of hearing loss. This has implications for the timely care and treatment of children with hearing loss.

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麻醉状态下听觉脑干反应测试的障碍。

目的：听性脑干反应（ABR）测试是诊断无法完成行为测听的儿童听力损失的金标准。当自然睡眠 ABR 和/或行为测听不成功时，通常建议在全身麻醉下进行测试。本研究旨在确定哪些人口统计学因素和患者因素是接受这种诊断测试的障碍：从内部数据库中对 2017 年至 2023 年期间在麻醉状态下接受 ABR 测试的患者进行回顾性病历审查。结果：共有 395 名患者符合纳入条件：共有 395 名患者符合纳入标准，从初步评估到麻醉下成功 ABR 的中位时间为 5.1 个月（范围为 0.1-209 个月）。与参加私人保险的患者相比，参加公共保险的患者所需的时间明显更长，患有以下复杂疾病的患者所需的时间也明显更长：心脏病、发育迟缓、神经系统疾病、眼部疾病以及与听力损失无关的遗传综合征。在耳部解剖异常的患者中，间隔时间明显更短：结论：患者因素（如保险类型和某些医疗诊断）可能会导致麻醉下 ABR 测试延迟，从而延误听力损失的诊断和治疗。这对及时护理和治疗听力损失儿童具有重要意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.