BAER & ECochG for Physicians

BAER & ECochG for Physicians: 

BAER & ECochG for Physicians Madison Audiology Associates 160 East 89 th Street New York, New York 10128 A Brief Course in the Value of These Procedures in Audiological Diagnosis Copyright 2012 by Alan M. Richards, Ph.D. Alan M. Richards, Ph.D.

Common Auditory Evoked Response Times: 

Common Auditory Evoked Response Times Time in Milliseconds BAER Recording Time (10 ms) ECochG Recording Time (5 ms) Transient Click Stimulus 0.10 ms Copyright 2012 by Alan M. Richards, Ph.D.

The Auditory Evoked Response: 

The Auditory Evoked Response BAER & ECochG Note that this is a logarithmic scale Copyright 2012 by Alan M. Richards, Ph.D.

Signal Averaging: 

Signal Averaging Parameters: 16 Traces of 10 ms 4 Averaged Groups 1 Final Waveform 10 ms Copyright 2012 by Alan M. Richards, Ph.D.

Recording Montage BAER: 

Recording Montage BAER Positive (+) Electrode on Forehead Negative (-) Electrode on Tested Ear Mastoid Ground Electrode in Non-Tested Ear Mastoid Typical Test Parameters Click Duration: 0.10 ms Clicks/Sec: 11 or More Clicks/Trial: 1500-2000 Click Polarity: Alternating Amplifier Filters: 100-4000 Hz Click Level: 85 dBnHL Right Ear Tested Copyright 2012 by Alan M. Richards, Ph.D.

BAER: Normal Waveform: 

BAER: Normal Waveform Interpretation of BAER Based on… 1-Morphology (Appearance of Waveforms) 2- IPLs (I-III, I-V, III-V) 3-ILD (0.2-0.3 ms) Copyright 2012 by Alan M. Richards, Ph.D.

Some Factors That Effect BAERs: 

Some Factors That Effect BAERs Intensity Click Rate Age Recording Montage Hearing Loss Medication Poor Technique Gender Cerumen in Ears Type of Hearing Loss Copyright 2012 by Alan M. Richards, Ph.D.

BAER Wavelets & Their Anatomical Origins: 

BAER Wavelets & Their Anatomical Origins I II III IV V VI VII Copyright 2012 by Alan M. Richards, Ph.D.

When to Use BAER: 

When to Use BAER Unilateral Hearing Loss Is the Loss of Cochlear or Retrocochlear Origin? In Cases of Imbalance, tinnitus, or Vertigo where Neurological Factors Need to be Ruled out. Suspected Malingering If one claims hearing loss, is the loss true or faked. If One is Incapable of Responding to Behavioral Audiometry . Young Children or adults Who Can’t or Won’t Respond. Copyright 2012 by Alan M. Richards, Ph.D.

BAER: Abnormal Findings (Tinnitus in Left Ear): 

BAER: Abnormal Findings (Tinnitus in Left Ear) Normal Thresholds on Audiometry, Including normal speech, immittance, and OAEs Right Ear: Normal ABRs Left Ear: Abnormal ABRs. Wave V at 7.80 ms, Wave I at 1.70 ms. Copyright 2012 by Alan M. Richards, Ph.D.

Latency-Intensity Function: Determination of Threshold Level: 

Latency-Intensity Function: Determination of Threshold Level Copyright 2012 by Alan M. Richards, Ph.D. Some Uses: Infants Potential Malingerers Young Children

Recording Montage: ECochG: 

Recording Montage: ECochG Typical Test Parameters Click Level: 90-95 dBnHL Rep Rate: 11/s Clicks/Trial: 1000-2000 Filter: 30-1500 Hz Time: 5 ms Click Polarity: Alternating Copyright 2012 by Alan M. Richards, Ph.D. “Tiptrodes”

ECochG: Calculation of SP/AP Ratio: 

ECochG: Calculation of SP/AP Ratio Copyright 2012 by Alan M. Richards, Ph.D. Ratio= Base-SP Amp (uv)/Base-AP Amp (uv)

Concluding Remarks: 

Concluding Remarks BAER & ECochG Should Not Be Performed in Isolation. Proper interpretation of both Techniques depends upon the following, among others : ENT and/or Neurological Assessment Complete Audiological Testing Immittance Audiometry Otoacoustic Emissions Videonystagmography Copyright 2012 by Alan M. Richards, Ph.D.

Contact Information: 

Alan M. Richards, Ph.D. may be contacted at: (212) 722-8100 or (516) 625-1400 Email: dr.a.richards@gmail.com. Contact Information Copyright 2012 by Alan M. Richards, Ph.D.