{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:48:57Z","timestamp":1767707337442,"version":"3.37.0"},"reference-count":14,"publisher":"American Academy of Audiology","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["j am acad audiol"],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:p><jats:bold>Abstract<\/jats:bold>  <jats:bold>Background<\/jats:bold>\u2003Intraoperative auditory brainstem response (ioABR) testing under general anesthesia is commonly performed on children when sleep-deprived ABR and behavioral testing are not reliable or feasible. Several studies have reported potential confounding\n results when tube insertion is combined with ABR testing. <jats:bold>Purpose<\/jats:bold>\u2003This article evaluates whether a temporary threshold shift (TTS) occurs following placement of tympanostomy tubes (TTs) in children who undergo ioABR testing. <jats:bold>Research Design<\/jats:bold>\u2003A case\u2010control\n prospective study. Patients scheduled for combined TT and ioABR procedures were enrolled into this study. <jats:bold>Study Sample<\/jats:bold>\u2003Twenty children (38 ears), ranging in age from 6 months to 10.5 years, were enrolled. <jats:bold>Data Collection and Analysis<\/jats:bold>\u2003ABR thresholds for tone\n bursts with center frequencies of 2 and 4\u2009kHz were compared before and after tube insertion. The indication for surgery, comorbidities, and status of the middle ear were also recorded. A paired <jats:italic>t<\/jats:italic>-test was used to determine statistical significance. <jats:bold>Results<\/jats:bold>\u2003Data\n collection did not necessarily indicate suctioning and tube placement were causing a TTS; however, fluid present in the middle ear space prior to TT placement appeared to influence results. Although a paired <jats:italic>t<\/jats:italic>-test did not show statistically significant differences in ABR thresholds\n between groups of individuals with and without fluid and before and after tube placement, 50% of patients with mucoid fluid (two out of four patients) were noted to have 10\u2009dB or greater worsening in ABR thresholds in two out of six ears. Twenty-nine percent of patients with serous\n fluid (two out of seven patients) were noted to have at least a 10\u2009dB worsening in ABR threshold in 2 out of 10 ears. Further testing is needed to confirm these trends. <jats:bold>Conclusion<\/jats:bold>\u2003This pilot study indicates that children with mucoid or serous fluid may experience worse\n ABR thresholds following TT insertion. ioABR testing immediately after TT tube placement and in the presence of middle ear fluid should be interpreted with caution. Additional studies with a larger sample size are needed to confirm these results.<\/jats:p>","DOI":"10.1055\/s-0040-1718933","type":"journal-article","created":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T23:53:46Z","timestamp":1607558026000},"page":"70-75","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Tympanostomy Tube Placement on Intraoperative Auditory Brainstem Response"],"prefix":"10.3766","volume":"32","author":[{"given":"Aleksandra","family":"Martinovic","sequence":"first","affiliation":[{"name":"Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayla","family":"Sivas","sequence":"additional","affiliation":[{"name":"Department of Audiology, Primary Children's Hospital, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Owens","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew A.","family":"Firpo","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert H.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Utah, Salt Lake City, Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2087","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1016\/j.otohns.2004.02.002","article-title":"Clinical practice guideline: otitis media with effusion","volume":"130","author":"R M Rosenfeld","year":"2004","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1542\/peds.102.5.1161","article-title":"Language of early- and later-identified children with hearing loss","volume":"102","author":"C Yoshinaga-Itano","year":"1998","journal-title":"Pediatrics"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.ijporl.2004.11.006","article-title":"Failed newborn hearing screens as presentation for otitis media with effusion in the newborn population","volume":"69","author":"R T Boone","year":"2005","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1097\/MAO.0b013e31821b0d07","article-title":"Otitis media with effusion: an underestimated cause of hearing loss in infants","volume":"32","author":"A Boudewyns","year":"2011","journal-title":"Otol Neurotol"},{"key":"ref5","first-page":"249","volume-title":"Auditory brainstem response: estimation of hearing sensitivity","author":"L J Hood","year":"2015"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"F359","DOI":"10.1136\/archdischild-2016-311800","article-title":"Anaesthetic considerations for surgery in newborns","volume":"102","author":"C S Houck","year":"2017","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/ALN.0000000000002232","article-title":"Neuropsychological and behavioral outcomes after exposure of young children to procedures requiring general anesthesia: the Mayo Anesthesia Safety in Kids (MASK) Study","volume":"129","author":"D O Warner","year":"2018","journal-title":"Anesthesiology"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.otohns.2009.09.009","article-title":"The role of intraoperative auditory brainstem response testing for infants and difficult-to-test children","volume":"142","author":"J G Yorgason","year":"2010","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1001\/archotol.1993.01880190058012","article-title":"Acoustical factors of noise created by suctioning middle ear fluid","volume":"119","author":"R F Wetmore","year":"1993","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"07","key":"ref10","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1017\/S0022215114001352","article-title":"Measurement of the sound intensity during suction of middle-ear fluid following myringotomy","volume":"128","author":"J C Wang","year":"2014","journal-title":"J Laryngol Otol"},{"issue":"08","key":"ref12","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1017\/S0022215100131159","article-title":"Raised ABR threshold after suction aspiration of glue from the middle ear: three case studies","volume":"109","author":"J D Mason","year":"1995","journal-title":"J Laryngol Otol"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1001\/archotol.1989.01860280050016","article-title":"Auditory brain-stem responses in children with previous otitis media","volume":"115","author":"R D Chambers","year":"1989","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1017\/S0022215106005226","article-title":"Hearing threshold assessment post grommet insertion. Is it reliable?","volume":"121","author":"H Griffiths","year":"2007","journal-title":"J Laryngol Otol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"350437","DOI":"10.1155\/2012\/350437","article-title":"Clinical experience of auditory brainstem response testing on pediatric patients in the operating room","volume":"2012","author":"G Zhou","year":"2012","journal-title":"Int J Otolaryngol"}],"container-title":["Journal of the American Academy of Audiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/aaa\/jaaa\/2021\/00000032\/00000002\/art00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T08:12:31Z","timestamp":1738829551000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.1055\/s-0040-1718933"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,1]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2,1]]}},"alternative-id":["1050-0545(20210201)32:2L.70;1-"],"URL":"https:\/\/doi.org\/10.1055\/s-0040-1718933","relation":{},"ISSN":["1050-0545"],"issn-type":[{"type":"print","value":"1050-0545"}],"subject":[],"published":{"date-parts":[[2021,2,1]]}}}