ABR Evaluations

Jeffrey Sirianni audioman at HCTC.NET
Wed Nov 6 02:47:54 EST 1996


{Joel R. Bealer writes:}

>I saw a patient file cross my desk the other day that kind of put me
>in shock. It was a patient with a unilateral hearing loss and poor
>discrim in one ear. He was referred to an ENT group whose audiology
>department did a threshold ABR (did not repeat any of the recordings)
>that had suspect peaks in the affected ear below 60 dBnHL. The report
>stated that the affected ear actually had "normal hearing" and that
>the audiological evaluation must have been in error or the patient was
>faking the loss. 
>Does anyone else see the problem here? Since when do we qualify
>normal hearing with a threshold ABR? I am about 6 months removed from
>clinical settings (now working in occupational audiology) however, as
>I recall, all ABR recordings are repeated for the basic reason of
>validity.

I guess it depends on patient history (re: possible psuedohypocusis), but
I agree that ABR results cannot be used to prove normal hearing, just as
normal OAE results cannot prove normal hearing.

>The truly sad part is that the same audiology department administered
>another hearing evaluation the following day to this patient and came
>up with the same unilateral loss. 

Any explanations from them ??

>These are my peers performing these studies. Not just one
>audiologist, but several participated in the evaluation of this
>patient. 
>How would you handle this? Would appreciate your feedback.

It sounds like the person(s) who adminstered and/or interpreted the ABR is
looking for an easy way out.  I agree that without a ABR retest to validate
the prior results, one cannot say that hearing is "normal" when the pure tone
tests say otherwise.  Perhaps the ABR administer/interpreter carries more
weight in this setting than the audiometric person(s).

-- 
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* Jeff Sirianni, M.A., CCC-A           *
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