Re: Microelectrode recordings before pallidotomy

[Gary Goldberg MD <goldberg@VM.TEMPLE.EDU>]

We have been doing objective audiometry (ObjAud) with BAEP testing on
neonates in our laboratory for several years.  The babies are screened in
the NICU for auditory impairment and then sent to us if they fail a
screening examination.  Otherwise we only test the most high-risk infants
with ObjAud.  The OEA examination may be useful as a screening tool only if
it has significantly more false positive results than false negative
results.  We looked at this technology a few years ago and did not feel it
offered much advantage over ObjAud or our current screening techniques
which are BAEP-based (although not at all perfected).  We believe that
BAEP-based objective audiometry is the most accurate test but it is fairly
expensive and time-consuming to perform and therefore not suitable for
screening large numbers of infants.  I think the challenge in this area is
to create a series of examinations that begins with a determination of
clinical risk and then goes to a suitable screening examination (relatively
quick and inexpensive but with a relatively large number of false positive
results but low number of false negative results) followed by a
high-accuracy examination like ObjAud.  I would be very interested in
hearing of others' experiences with this techology applied to this clinical
problem.  Thanks.
Gary Goldberg MD
Director, Evoked Potential Lab
MossRehab Hospital
Albert Einstein Healthcare Network


>I haven't got experience with microelectrodes, I'm sorry, but I would like
>to put another question to you or anyone in the list: what do you think
>about the transient evoked otoacoustic emission screening for the risk
>newborn? Are they really useful? Are we the clinical neurophysiologists who
>must do it? Neonatologists in my hospital are asking to us for this test,
>but in the bibliograghy it seems to be done by audiologists instead.
>Besides, as I have read the BAEP are more useful because there is a high
>rate of false negatives with the otoacoustic emissions. I would like to
>read your opinions.
>Thank you very much
>
>Alicia Saenz de C.
>Clinical Neurophysiologist  Hospital Miguel Servet
>Zaragoza -Spain