CASE STUDY
AUDIOLOGICAL EVALUATION OF TRAUMATIC BRAIN INJURY – A CASE STUDY
Caroline Donadon 1,2, A-F
,
 
Natalia Ferrazoli 1,2, A-B,D-E
,
 
,
 
,
 
Piotr H Skarzynski 3,4,5, A,E,G
,
 
Daniela Capra 6,7, C,F
,
 
Milaine Sanfins 1,7, A-B,D-E
 
 
 
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1
Audiology Department, Clinica Respirare, Brazil
 
2
School of Medical Sciences, University of Campinas, Brazil
 
3
Department of Teleaudiology and Hearing Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Poland
 
4
Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Poland
 
5
Institute of Sensory Organs, Warsaw, Poland
 
6
Instituto Nacional de Neurociência Translacional, Universidade Federal do Rio de Janeiro, Brazil
 
7
Centro de Eletrofisiologia e Neuroaudiologia Avançada, ,, Brazil
 
 
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
 
 
Submission date: 2020-05-20
 
 
Final revision date: 2020-11-05
 
 
Acceptance date: 2020-11-23
 
 
Publication date: 2020-12-31
 
 
Corresponding author
Caroline Donadon   

Audiology Department, Clinica Respirare, 146 Gonçalves Cesar St, 13073-230, Campinas, Brazil
 
 
J Hear Sci 2020;10(4):91-97
 
KEYWORDS
TOPICS
ABSTRACT
Background:
Traumatic brain injury (TBI) is a pathology frequently causing mortality or serious sequelae. About 20% of individuals with TBI will have some degree of auditory alteration. The aim of the present study was to use behavioural and electrophysiological assessments to analyse the hearing of a patient with TBI.

Case report:
A young male adult who had suffered severe TBI caused by a motorcycle accident was evaluated. The patient underwent a peripheral hearing evaluation and electrophysiological assessment. Pure tone audiometry revealed profound sensorineural hearing loss in the left ear and normal hearing in the right. In the electrophysiological assessment, an ABR click test showed the presence of a response in the right ear at 80 dB HL but no response in the left ear at 90 dB HL. Evaluation of the Middle Latency Response revealed the presence of both an electrode effect (C3) and an ear effect (A1). The P300 wave showed an event-related potential within normal limits in the right ear and no responses in the left.

Conclusions:
The present case study verifies the importance of assessing the peripheral and central auditory nervous system in cases of patients with a history of TBI. It reinforces the need for diagnosis and audiological monitoring of these patients.

 
REFERENCES (32)
1.
Lew HL, Poole JH, Guillory SB, Salerno RM, Leskin G, Sigford B. Persistent problems after traumatic brain injury: the need for long-term follow-up and coordinated care. J Rehabil Res Dev, 2006; 43(2): vii–x.
 
2.
Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabil, 2007; 22(5): 341–53.
 
3.
Anderson V, Catroppa C, Morse S, Haritou F, Rosenfeld J. Functional plasticity or vulnerability after early brain injury? Pediatrics, 2005; 116(6): 1374–82.
 
4.
Sturzenegger M, Meienberg O. Basilar artery migraine: a followup study of 82 cases. Headache, 1985; 25: 408–15.
 
5.
Lew H, Jerger J, Guillory S, Henry J. Auditory dysfunction in traumatic brain injury. J Rehabil Res Dev, 2007; 44: 921–8.
 
6.
Abd al-Hady M, Shehata O, el-Mously M, Sallam F. Audiological findings following head trauma. J Laryngol Otol, 1990; 104: 927–36.
 
7.
Marion M, Cevette M. Tinnitus. Mayo Clinic Proc, 1991; 66: 614–20.
 
8.
White CL, Griffith S, Caron JL. Early progression of traumatic cerebral contusions: characterization and risk factors. J Trauma, 2009; 67(3): 508–14.
 
9.
Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet, 1974; 2(7872): 81–4.
 
10.
World Health Organization. Grades of hearing impairment, 2014. Available from: http://www.who.int/pbd/deafnes....
 
11.
Coats AC. The summating potential and Meniere’s disease. I Summating potential amplitude in Meniere and non-Meniere ears. Arch Otolaryngol, 1981; 107(4): 199–208.
 
12.
Baba A, Takasaki K, Tanaka F, Tsukasaki N, Kumagami H, Takahashi H. Amplitude and area ratios of summating potential/action potential (SP/AP) in Meniere’s disease. Acta Otolaryngol, 2009; 129(1): 25–9.
 
13.
Musiek F, Lee W. Potenciais auditivos de média e longa latência. In: Musiek F, editor. Perspectivas atuais em avaliação auditiva. São Paulo: Manole; 2001, 239–67.
 
14.
McPherson D. Late potentials of the auditory system. San Diego: Singular Publishing Group; 1996.
 
15.
Cochran A, Scaife ER, Hansen KW, Downey EC. Hyperglycemia and outcomes from pediatric traumatic brain injury. J Trauma, 2003; 55(6): 1035–8.
 
16.
Chiasson C. Traumatic Brain Injury (TBI): A primer for the hearing healthcare practitioner. Hearing Review, 2015; 22: 14.
 
17.
Saraiya PV, Aygun N. Temporal bone fractures. Emerg Radiol, 2009; 16(4): 255–65.
 
18.
Johnson F, Semaan M, Megerian C. Temporal bone fracture: evaluation and management in the modern era. In: Dornhoffer J, Chandra R, editors. Otolaryngologic Clinics of North America. Philadelphia: Elsevier Saunders; 2008, 597–618.
 
19.
Yetiser S, Hidir Y, Birkent H, Satar B, Durmaz A. Traumatic ossicular dislocations: etiology and management. Am J Otolaryngol, 2008; 29(1): 31–6.
 
20.
Asai H, Mori N. Change in the summating potential and action potential during the fluctuation of hearing in Meniere’s disease. Scand Audiol, 1989; 18(1): 13–7.
 
21.
Mori N, Asai H, Sakagami M. The role of summating potential in the diagnosis and management of Meniere’s disease. Acta Oto-Laryngologica Suppl, 1993; 501: 51–3.
 
22.
Ferraro JA. Electrocochleography: a review of recording approaches, clinical applications, and new findings in adults and children. J Am Acad Audiol, 2010; 21(3): 145–52.
 
23.
Lindsay KW Carlin J, Kennedy I, Fry J, McInnes A, Teasdale GM. Evoked potentials in severe head injury: analysis and relation to outcome. J Neurol Neurosurg Psychiatry, 1981; 44: 796–802.
 
24.
Scherg M, von Cramon D, Elton M. Brain-stem auditory-evoked potentials in post-comatose patients after severe closed head trauma. J Neurol, 1984; 231(1): 1–5.
 
25.
Tsurukiri J, Nagata K, Hoshiai A, Oomura T, Jimbo H, Ikeda Y. Middle latency auditory-evoked potential index monitoring of cerebral function to predict functional outcome after emergency craniotomy in patients with brain damage. Scand J Trauma Resusc Emerg Med, 2015; 23(1): 80.
 
26.
Kraus N, McGee T. The middle latency response generating system. Electroencephalogr Clin Neurophysiol, 1955; 44: 93–101.
 
27.
Doi R, Morita K, Shigemori M, Tokutomi T, Maeda H. Characteristics of cognitive function in patients after traumatic brain injury assessed by visual and auditory event-related potentials. Am J Phys Med Rehabil, 2007; 86(8): 641–9.
 
28.
Duncan CC, Kosmidis MH, Mirsky AF. Closed head injury-related information processing deficits: an event-related potential analysis. Int J Psychophysiol, 2005; 58(2-3): 133–57.
 
29.
Elting JW, Maurits N, Weerden T, Spikman J, Keyser J, Naalt J. P300 analysis techniques in cognitive impairment after brain injury: comparison with neuropsychological and imaging data. Brain Inj, 2008; 22(11): 870–81.
 
30.
Melcher JR, Sigalovsky IS, Guinan JJ, Levine RA. Lateralized tinnitus studied with functional magnetic resonance imaging: abnormal inferior colliculus activation. J Neuphysiol, 2000; 83(2): 1058–72.
 
31.
Jastreboff PJ. Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res, 1990; 8(4): 221–54.
 
32.
Shulman A. A final common pathway for tinnitus. The medial temporal lobe system. Int Tinnitus J, 1995; 1(2): 115–26.
 
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