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Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
Clinic of Audiology and ENT, University of Ferrara, Ferrara, Italy
Institute of Physiology and Pathology of Hearing, Warsaw, Poland
Medical University of Warsaw, Dept. of Heart Failure and Cardiac Rehabilitation, Poland.
Institute of Sensory Organs, Kajetany, Poland
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;
Milaine Dominici Sanfins   

Milaine Dominici Sanfins, Faculty Medical Science, UNICAMP Rua Tessália Vieira de Camargo, 185., CEP: 13083-887, Campinas/SP. Brazil, Email: msanfins@uol.com.br or misanfins@uol.com.br, Phone: +55 11 97060-3838
Publication date: 2020-04-10
J Hear Sci 2017;7(4):9–19
Otitis media in childhood may result in changes in auditory information processing and speech perception. Once a failure in decoding information has been detected, an evaluation can be performed by auditory evoked potential as FFR.

Material and Methods:
60 children and adolescents aged 8 to 14 years were included in the study. The subjects were assigned into two groups: a control group (CG) consisted of 30 typically developing children with normal hearing; and an experimental group (EG) of 30 children, also with normal hearing at the time of assessment, but who had a history of secretory otitis media in their first 6 years of life and who had undergone myringotomy with placement of bilateral ventilation tubes. Each group was sub-divided into two age subgroups: 8–10 and 11–14 years. All children completed audiological evaluation (audiometry, speech audiometry, and immitance audiometry) and electrophysiological assessment.

The subjects who participated in the study presented behavioral thresholds and click-ABR within normal limits (p > 0.05). No differences were observed in the FFR responses from different age groups (8–10 years and 11–14 years). Significant differences in FFR were observed in the latency values (p < 0.05) when compared to control group, although amplitude values did not show significant differences between groups (p > 0.05).

Children suffering from secretory otitis media in their first 6 years of life and who have undergone myringotomy for bilateral ventilation tube placement exhibit changes in their electrophysiological responses to speech. Keywords Frequency-following response; otitis media, speech perception, electrophysiology

This work was supported by the Project “Integrated system of tools for diagnostics and telerehabilitation of sensory organs disorders (hearing, vision, speech, balance, taste, smell)” acr. INNOSENSE, co-financed by the National Centre for Research and Development (Poland), within the STRATEGMED program. Foundation for Research Support of the State of São Paulo (FAPESP), CAPES and CNPq. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Khavarghazalani B, Farahani F, Emadi M, Dastgerdi ZH. Auditory processing abilities in children with chronic otitis media with effusion. Acta Otolaryngol, 2016;136(5):1-4.
Mowery T, Kotak V, Sanes DH. Transient hearing loss within a critical period causes persistent changes to cellular properties in adult auditory cortex. Cereb Cortex, 2015; 25(8): 2083-94.
Sanfins M, Colella-Santos M. A review of the clinical applicability of speech-evoked auditory brainstem responses. J Hear Sci, 2016; 6(1): 9-16.
Johnson KL, Nicol T, Zecker SG, Kraus N. Developmental plasticity in the human auditory brainstem. J Neurosci, 2008; 28(15): 4000-7.
Kraus N, Hornickel J. cABR: a biological probe of auditory processing. In: Geffner DS, Ross-Swain D, eds. Auditory Processing Disorders: Assessment, management, and treatment. 2nd ed. San Diego: Plural Publishing; 2013. pp. 159-83.
Kent R, Read C. Análise Acústica da Fala. Cortez Editora: Brazil, 2015. 504 pp.
Johnson KL, Nicol TG, Kraus N. Brain stem response to speech: a biological marker of auditory processing. Ear Hear, 2005; 26(5): 424-34.
Skoe E, Kraus N. Auditory brainstem response to complex sounds: a tutorial. Ear Hear, 2010; 31: 320-24.
Sanfins M, Borges L, Ubiali T, Colella-Santos M. Speech-evoked auditory brainstem response in the differential diagnosis of scholastic difficulties. Braz J Otorhinolaryngol, 2017; 83(1): 112-6.
Chhetri S. Acute otitis media: a simple diagnosis, a simple treatment. Nepal Med Coll J, 2014; 16: 33-6.
Kong K, Coates H. Natural history, definitions, risk factors and burden of otitis media. Med J Australia, 2009; 191: S39-S43.
Bess F, Humess L. Patologias do sistema auditivo. Fundamentos de audiologia. Porto Alegre: Artmed; 1998. pp. 155-95.
Katz J, Tillery K, Mecca F, (tradução). Uma introdução ao processamento auditivo. In: Lichitg I, Carvallo R, eds. Abordagens atuais. São Paulo: Pró-Fono; 1997. pp. 145-72.
Borg E, Risberg A, McAllister B, Undermar B, Edquist G, Reinholdson A, et al. Language development in hearing-impaired children. Establishment of a reference material for a ‘Language test for hearing-impaired children’, LATHIC. Int J Pedriatr Otorhinolaryngol 2002; 65(1): 15-26.
Shriberg L, Flipsen PJ, Thielke H, Kwiatkowski J, Kertoy M, Katcher M, et al. Risk for speech disorder associated with early recurrent otitis media with effusion: two retrospective studies. J Speech Lang Hear Res, 2000; 43(1): 79-99.
Bento R, Souza Gd, Pinna M. Otite média secretora. In: Bento RF, Souza GMd, Pinna MH, eds. Tratado de Otologia, 2nd ed. São Paulo: Atheneu; 2013.
Borges LR, Paschoal JR, Colella-Santos MF. (Central) auditory processing: the impact of otitis media. Clinics (Sao Paulo), 2013; 68(7): 954-9.
Moore DR, Hine JE, Jiang ZD, Matsuda H, Parsons CH, King AJ. Conductive hearing loss produces a reversible binaural hearing impairment. J Neurosci, 1999; 19(19): 8704-11.
Gray L, Kesser B, Cole E. Understanding speech in noise after correction of congenital unilateral aural atresia: effects of age in the emergence of binaural squelch but not in use of head-shadow. Int J Pediatr Otorhinolaryngol, 2009; 73(9): 1281-7.
Polley D, Thompson J, Guo W. Brief hearing loss disrupts binaural integration during two early critical periods of auditory cortex development. Nature Communications, 2013; 4: 2547.
Kim G, Kandler K. Elimination and strengthening of glycinergic/GABAergic connections during tonotopic map formation. Nat Neurosci, 2003; 6: 282-90.
Nakamura P, Hsieh C, Cramer K. EphB signaling regulates target innervation in the developing and deafferented auditory brainstem. Dev Neurobiol, 2012; 72: 1243-55.
Caras ML, Sanes DH. Sustained perceptual deficits from transient sensory deprivation. J Neurosci, 2015; 35(30): 10831-42.
Caras ML, Sen K, Rubel EW, Brenowitz EA. Seasonal plasticity of precise spike timing in the avian auditory system. J Neurosci, 2015; 35(8): 3431-45.
Northern J, Downs M. Avaliação Auditiva Comportamental. In: Northern J, Downs M, eds. Audição na infância. Rio de Janeiro: Guanabara-Koogan; 2005. p. 129-67.
Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol, 1970; 92(4): 311-24.
Davis H, Silverman R. Hearing and deafness. 4th ed. New York: Rinehart and Winston; 1978.
Jasper H. The ten-twenty system of the International Federation. Electroenceph Clin Neurophysiol, 1958; 10: 371-75.
Sanfins MD, Borges LR, Ubiali T, Donadon C, Hein TAD, Hatzopoulos S, et al. Speech-evoked brainstem response in normal adolescent and children speakers of Brazilian Portuguese. Int J Pediatr Otorhinolaryngol, 2016; 90: 12-9.
Ahadi M, Pourbakht A, Jafari AH, Jalaie S. Effects of stimulus presentation mode and subcortical laterality in speech-evoked auditory brainstem responses. Int J Audiol, 2014; 53(4): 243-9.
Elkabariti RH, Khalil LH, Husein R, Talaat HS. Speech evoked auditory brainstem response findings in children with epilepsy. Int J Pediatr Otorhinolaryngol, 2014; 78(8): 1277-80.
Tahaei AA, Ashayeri H, Pourbakht A, Kamali M. Speech evoked auditory brainstem response in stuttering. Scientifica (Cairo), 2014; 2014:328646.
Yamamuro K, Ota T, Iida J, Nakanishi Y, Matsuura H, Uratani M, et al. Event-related potentials reflect the efficacy of pharmaceutical treatments in children and adolescents with attention deficit/hyperactivity disorder. Psychiatric Res, 2016; 30(242): 288-94.
Song JH, Nicol T, Kraus N. Test–retest reliability of the speechevoked auditory brainstem response. Clin Neurophysiol, 2011; 122(2): 346-55.
Rana B, Barman A. Correlation between speech-evoked auditory brainstem responses and transient evoked otoacoustic emissions. J Laryngol Otol, 2011; 125(9): 911-6.
Karawani H, Banai K. Speech-evoked brainstem responses in Arabic and Hebrew speakers. Int J Audiol, 2010; 49(11): 844-9.
Gorga M, Abbas P, Worthington D. Stimulus calibration in ABR measurements. In: Jacobson J, ed. The Auditory Brainstem Response. San Diego: College-Hill Press; 1985.
Wagner R, Torgesen J, Rashotte C. Development of readingrelated phonological processing abilities: new evidence of bidirectional casuality from a latent variable longitudinal study. Development Psychology, 1994; 30(1): 73-87.
Russo N, Nicol T, Musacchia G, Kraus N. Brainstem responses to speech syllables. Clin Neurophysiol, 2004; 115: 2021-30.
Purdy SC, Kelly AS, Davies MG. Auditory brainstem response, middle latency response, and late cortical evoked potentials in children with learning disabilities. J Am Acad Audiol, 2002; 13(7): 367-82.
Moore J, Guan Y. Cytoarchitectural and axonal maturation in human auditory coortex J Assoc Res Otolaryngol, 2001; 2: 297-311.
Moore J, Linthicum F. The human auditory system: a timeline of development. Int J Audiol, 2007; 46(9): 460-78.
Hornickel J, Skoe E, Nicol T, Zecker S, Kraus N. Subcortical differentiation of stop consonants relates to reading and speechin-noise perception. Proc Natl Acad Sci USA, 2009; 106(31): 13022-7.
Vander Werff KR, Burns KS. Brain stem responses to speech in younger and older adults. Ear and Hearing, 2011; 32(2): 168-80.
Engineer CT, Perez CA, Carraway RS, Chang KQ, Roland JL, Kilgard MP. Speech training alters tone frequency tuning in rat primary auditory cortex. Behav Brain Res, 2013; 258: 166-178.
Krishnan A, Gandour J, Ananthakrishnan S, Bidelman G, CJ S. Functional ear (a)symmetry in brainstem neural activity relevant to encoding of voice pitch: a precursor for hemispheric specialization? Brain Lang, 2011; 119: 226-31.
Hall JW, Grose JH. The effect of otitis media with effusion on the masking-level difference and the auditory brainstem response. J Speech Hear Res, 1993; 36(1): 210-7.
Gravel JS, Roberts JE, Roush J, Grose J, Besing J, Burchinal M, et al. Early otitis media with effusion, hearing loss, and auditory processes at school age. Ear Hear, 2006; 27(4): 353-68.
King C, Warrier C, Hayes E, N K. Deficits in auditory brainstem pathway encoding of speech sounds in children with learning problems. Neurosci Lett, 2002; 319: 111–5.
Abrams DA, Nicol T, Zecker S, Kraus N. Rapid acoustic processing in the auditory brainstem is not related to cortical asymmetry for the syllable rate of speech. Clin Neurophysiol, 2010; 121(8): 1343-50.
Zahra Z, Saeed M, Reza R. Subcortical encoding of speech cues in children with attention deficit hyperactivity disorder. Clin Neurophysiol, 2015; 126: 325-32.
Tallal P, Miller S, Jenkins W, Merzenich M. The role of temporal processing in development language-based learning disorders: research and clinical implications. In: Blachman B, ed. Foundations of Reading Acquisition and Dyslexia: Implications for early intervention. Mahwah, NJ: Lawrence Erlbaum; 1997.
Borges L, Paschoal J, Colella-Santos M. (Central) Auditory Processing: the impact of otitis media. Clinics. 2013; 07(11).
Krishnan A. Human frequency-following responses: representation of steadystate synthetic vowels. Hear Res, 2002; 166: 192-201.
Galbraith G. Two-channel brainstem frequency-following responses to pure tone and missing fundamental stimuli. Electroencephalogr Clin Neurophysiol, 1994; 92: 321-30.
Hornickel J, Skoe E, Kraus N. Subcortical laterality of speech encoding. Audiol Neurotol, 2009; 14: 198-207.
Abrams D, Nicol T, Zecker S, Kraus N. Auditory brainstem timing predicts cerebral asymmetry for speech. J Neurosci, 2006; 26(43): 11131-37.
Krishnan A, Xu Y, Gandour J, Cariani P. Encoding of pitch in the human brainstem is sensitive to language experience. Brain Res Cogn Brain Res, 2005; 25(1): 161-8.
Krishnamurti S, Forrester J, Rutledge C, Holmes GW. A case study of the changes in the speech-evoked auditory brainstem response associated with auditory training in children with auditory processing disorders. Int J Pediatr Otorhinolaryngol, 2013; 77(4): 594-604.
Hall JW, Grose JH, Buss E, Dev MB, Drake AF, Pillsbury HC. The effect of otitis media with effusion on perceptual masking. Arch Otolaryngol Head Neck Surg, 2003; 129(10): 1056-62.
Besing JM, Koehnke J. A test of virtual auditory localization. Ear Hear, 1995; 16(2): 220-9.
Gravel J, Wallace I. Effects of otitis media with effusion on hearing in the first 3 years of life. J Speech Lang Hear Res, 2000; 43: 631-44.
Borges L, Sanfins M, Hein T, Paschoal J, Colella-Santos M. Audiological and behavior findings in children underwent a bilateral myringoplasty: a comparative study. Rev CEFAC, 2016; 18(4): 881-8.
White-Schwoch T, Davies EC, Thompson EC, Woodruff Carr K, Nicol T, Bradlow AR, et al. Auditory-neurophysiological responses to speech during early childhood: effects of background noise. Hear Res, 2015; 328: 34-47.
Hayes E, Warrier C, Nicol T. Neural plasticity following auditory training in children with learning problems. 2003; 114: 673-84.
Russo NM, Nicol TG, Zecker SG, Hayes EA, Kraus N. Auditory training improves neural timing in the human brainstem. Behav Brain Res, 2005; 156(1): 95-103.
Song JH, Banai K, Kraus N. Brainstem timing deficits in children with learning impairment may result from corticofugal origins. Audiol Neurotol, 2008; 13(5): 335-44.