Importance of BERA Test in Advanced Diagnosis of Hearing Loss

Hearing loss is a common problem in society. Auditory problems can be encountered in every age group due to different reasons. Hearing problems, especially in the early stages, are very important as they can affect the speech processes of children. For this purpose, it is important to carry out the necessary examinations from infancy. Thus, early diagnosis and treatment opportunities for possible hearing loss can be utilized. Early treatment interventions are critical for the development of the child's speech skills. There are different methods applied for the evaluation of auditory functions in children. The clinical ABR (BERA) test is the most reliable of these techniques.

What is the Clinical ABR Test?

ABR test, which is the English abbreviation of auditory brainstem response, also known as BERA test, is a method used to evaluate hearing functions in children. In some places it can also be identified by the abbreviation “Auditory Evoked Potential” or AEP. The ear, which is responsible for hearing sounds, is handled in 3 parts; as the outer, middle and inner ear. The inner ear region contains a special structure called the cochlea, which is responsible for hearing. With the clinical ABR test, the electrical activity generated by sound transmission in the neural pathways extending from the inner ear to the cortex is evaluated. Hearing loss may occur as a result of disruptions in any stage of this mechanism. The clinical ABR test allows us to obtain important information especially for hearing loss due to a problem in the neural structures including the parts of the brain from the inner ear. The person who has any hearing-related complaints should first be examined by a specialist physician. This test, which should then be applied by an audiologist, is a preferred procedure especially for hearing loss caused by problems in the brain pathways. Hearing loss can be seen due to many factors. Therefore, it requires a comprehensive and broad examination. There are different tests that can be applied for the evaluation of hearing:

These tests;

• Middle Ear Tests [Acoustic Immitansmetry (Tympanometry / Acoustic Reflex)]
• Pure Sound Audiometry
• Speech Test
• Otoacoustic Emission n
• ABR Test

Clinical ABR (BERA) test gives very important results in cases where sufficient information cannot be obtained with other tests or especially when cerebral mechanisms need to be examined. In addition, the application of tests together plays an important role in reaching a definitive diagnosis.

Why Clinical ABR Test is Performed?

Clinical ABR testing is generally performed for 2 purposes:

Detection of hearing thresholds

Evaluation of the functionality of nerve pathways that make up the sense of hearing

What is the Grading of Hearing Loss in the Clinical ABR Test?

Decibel (dB) is a unit used to measure the intensity of sounds.

I. 0-15 dB: Normal Hearing
II. 16-25 dB: Very Mild Hearing Loss
III. 26-40 dB: Mild Hearing Loss
IV. 41-60 dB: Moderate Hearing Loss
V. 61-75 dB: Moderate to Severe Hearing Loss
VI. 76-90 dB: Severe Hearing Loss
VII. 90 dB and above: Severe Hearing Loss

With the clinical ABR test, it can be determined from which sound intensity hearing is perceived. Thus, you can have an idea about the level of any hearing problem. In addition, information on the cause of the current hearing loss can be accessed with the Clinical ABR test. The audiologist can use this method when he/she deems it necessary while investigating the source of the hearing loss. Thus, delays in diagnosis, especially in children with auditory problems, can be prevented and activities aimed at speaking skills can be planned.

Who Is the Clinical ABR Test for?

Unlike other methods, the clinical ABR test is more independent of patient compliance. is technical. For this reason, it can be applied in all age groups, especially children and babies. It is the procedure applied to determine the causative agent in auditory problems detected in children in the early period. Adaptation problems that can be observed in relation to developmental or mental problems may prevent the hearing test from being performed correctly. In such a case, the ABR test can be used. In addition, more accurate results can be obtained with the ABR test in individuals with communication difficulties. It is a problem that needs to be recognized early. For this purpose, there are some screening tests applied to newborn babies. A more detailed assessment of any auditory impairment observed in the Screening ABR, which is used in newborn hearing screenings, is made with the Clinical ABR. However, it is obligatory to perform the Clinical ABR test in infants with risk factors despite having passed the screening test.

How is the Clinical ABR Test Performed?

This test performed by an audiologist in adults and children with hearing problems It is a painless procedure. During the clinical ABR test, electrodes are placed after the skin is cleaned at certain points in the head area and around the ears. After the computer connection is established with these electrodes, the electrical activity against the sounds sent through the headphones is examined. Movements should be avoided during the procedure. For this reason, the test is usually performed while asleep. In infants younger than 6 months, the test can be performed in their natural sleep without the need for any sedation. For this, the audiologist may recommend that your baby be fasted for a while before the procedure and be fed when they come for the test. Thus, the baby is encouraged to fall asleep. The test can be performed with the sleeping baby in the supine position. In infants older than 6 months and adults, mild sedation may be preferred in order to obtain the desired efficiency from the ABR test. In this way, it is possible to avoid unwanted movements and noises during the application. The data obtained during the whole test is transferred to the computer environment and recorded. The audiology specialist examines and evaluates this information in detail. As a result of the interpretation of the test results, detailed information about the quality of auditory functions and the causes of possible problems is obtained. Thus, in case of any hearing loss, a treatment program can be created.

Treatments Based on Test Result

Your specialist can inform you about the necessary treatment options in case of a possible hearing loss according to the test results. There are many treatment methods developed for hearing loss. Some of the factors considered in determining the appropriate one among these methods are as follows:

• Degree of Hearing Loss
• The Main Cause of Auditory Loss
• Age
• Ability to Adapt to Treatment Method
• Individual's Own Preferences in Line with Doctor's Recommendations

When these factors are evaluated together, the most appropriate treatment options for the individual can be determined. There are many alternatives in the treatment of hearing loss. Eardrum or bone abnormalities are causes that can lead to hearing loss and may need to be treated surgically. In such a case, your doctor can provide detailed information about the mechanism that causes your auditory problem and the necessary procedures for treatment. Some people may experience hearing loss due to recurrent ear infections. In such cases, treatment can be managed by placing some tubes in order to expel the fluid accumulated in the ear. Depending on the type and degree of hearing loss; Hearing aids are among the most preferred treatment methods due to many advantages. They can make a significant contribution to early auditory problems, especially in young children. Thanks to hearing aids, problems that can be encountered during the development of speaking skills can be prevented. Patients can be referred to cochlear implants in severe and severe hearing loss or in cases where other treatments are not effective. A cochlear implant is a surgically placed device that directly stimulates the auditory nerve by excluding the damaged area in the inner ear. As a result, there are many treatment methods that can be selected according to the source of hearing loss. For the most accurate approach, you should consult a specialist physician as soon as possible.

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