Analysis of auditory and neurologic effects associated with ventral bulla osteotomy for removal of inflammatory polyps or nasopharyngeal masses in cats

OBJECTIVE: To determine whether cats undergoing ventral bulla osteotomy (VBO) for removal of inflammatory polyps or nasopharyngeal masses have altered ability to hear and whether polyp or mass removal affects auditory function as measured via air-conducted brainstem auditory evoked response (BAER). DESIGN: Prospective case series. ANIMALS: 21 cats. PROCEDURES: Cats were sedated and had otic-oral examinations to confirm presence of nasopharyngeal masses; BAER testing was done immediately prior to and following the completion of a VBO and polyp or mass removal. Recheck examination, including otic examination and BAER in sedated cats, was performed when possible. Results-17 cats met final inclusion criteria, and long-term follow-up was available for 15. Six of 17 had deafness as measured via air-conducted BAER prior to surgery. Mean followup time was 161 days, and there was no change from presurgical status in auditory ability in any cat. Eleven of 17 developed ipsilateral Horner syndrome in the immediate postoperative period, and 1 of 16 had polyp regrowth. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that in cats, VBO for removal of inflammatory polyps or masses is unlikely to affect hearing as measured via air-conducted BAER. Most cats developed short-term Horner syndrome. Cats with deafness prior to surgery did not regain auditory function. Ventral bulla osteotomy to remove nasopharyngeal polyps or masses provided no functional advantage with regard to restoration of hearing, compared with other surgical techniques. Polyp recurrence and long-term adverse effects were uncommon.     

Evoked otoacoustic emissions: An alternative test of auditory function in horses

Reasons for performing study: Deafness has been reported in horses due to a variety of causes and objective auditory assessment has been performed with brainstem auditory evoked potential testing. Evoked otoacoustic emission (OAE) tests are widely used in human patients for hearing screening, detecting partial hearing loss (including frequency‐specific hearing loss) and monitoring cochlear outer hair cell function over time. OAE tests are noninvasive, quick and affordable. Two types of OAE are commonly used clinically: transient evoked OAEs (TEOAEs) and distortion product OAEs (DPOAEs). Detection of OAEs has not been reported and OAE testing has not been evaluated for auditory assessment in horses. Objectives: To investigate whether TEOAEs and DPOAEs can be recorded in horses, and to evaluate the use of human OAE screening protocols in horses with apparently normal hearing. Methods: Sixteen systemically healthy horses with normal behavioural responses to sound were included. OAE testing was performed during general anaesthesia using commercially available equipment and the final outcome for each ear for the TEOAE test (after a maximum of 3 runs) and the DPOAE test (after one run) were compared. Results: TEOAEs and DPOAEs can be recorded in horses. Using the chosen TEOAE protocol, 96% of ears achieved a pass. Seventy percent of ears passed DPOAE testing, despite all of these ears passing TEOAE testing. Conclusions: Using the chosen stimulus and analysis protocols, TEOAEs were recorded from most ears; however, a smaller proportion of ears passed the DPOAE protocol, suggesting that this may be overly stringent and require further optimisation in horses. Potential relevance: OAE testing is rapid and easily performed in anaesthetised horses. It provides frequency‐specific information about outer hair cell function, and is a promising tool for audiological assessment in the horse; however, it has not been assessed in conscious or sedated animals.     

Use of BAER to identify loss of auditory function in older horses

Objective To use the brainstem auditory evoked response (BAER) to test the hypothesis that auditory function could be worse in older horses than in younger horses. Procedure BAER waveforms in response to click stimuli were measured in five younger horses (5–8 years) and four older horses (17–22 years). Results Compared with the younger horses, the older horses showed significantly (P < 0.02) worse BAER thresholds and significantly (P < 0.02) worse BAER wave V amplitudes to the 90 decibels above normal hearing level stimulus. These results were consistent with partial deafness in the older horse group. Conclusion BAER assessment can be used to identify partial deafness in older horses. Such horses should be managed appropriately, with particular care taken in noisy environments where hearing loss could put the horse and/or its owner at risk of harm.     

BAER testing in a dog with bilateral external ear canal atresia

A 3 yr old male castrated Labrador retriever presented for evaluation and treatment of bilateral atresia of the external ear canals. The owners reported that the dog could hear only loud and high-pitched noises. Computed tomography of the head revealed intact vertical and horizontal ear canals filled with debris and a debris-filled right tympanic bulla. Air- and bone-conducted brainstem auditory evoked response (BAER) testing revealed an elevated response threshold to air-conducted stimuli and greater amplitude waveforms evoked by bone-conducted stimuli. The ear canals were surgically corrected via lateral ear canal resection. BAER testing postoperatively revealed a decrease in the air-conducted BAER threshold. This case is an example of the use of bone-conducted BAER testing to aid in the diagnosis of conductive deafness, and in determining prognosis for normal hearing after surgical treatment of external ear canal atresia.     

Deafness prevalence and pigmentation and gender associations in dog breeds at risk

Hearing function was tested in dogs from breeds at risk for pigment-associated congenital sensorineural deafness - Dalmatian, English setter (ES), English cocker spaniel (ECS), bull terrier (BT), Australian cattle dog (ACD), whippet, Catahoula leopard dog, and Jack Russell terrier. Deafness prevalence was highest in Dalmatians and lowest in ECS. Phenotype correlation studies were performed in breeds with >100 brainstem auditory evoked responses (BAER) tested subjects. No gender differences were observed. No differences were seen between black- and liver-spotted Dalmatians, among the ES roan colour varieties, among the ECS parti varieties, or among the ACD colour varieties. Blue eyes were positively associated and patches were negatively associated with deafness in the Dalmatian. Blue eyes were also associated with deafness in the ES and ECS. White BT were more likely than coloured BT to be deaf. Having one or more parent's ear deaf was positively associated with deafness in Dalmatians, ES, and ECS.     

Unilateral and Bilateral Congenital Sensorineural Deafness in Client-Owned Pure-Breed White Cats

Background: Congenital sensorineural deafness has been reported frequently in experimental mixed-breed white cats but there is a paucity of data on occurrence of deafness in client-owned pure-breed white cats.
Objective: To describe hearing status in client-owned pure-breed white cats.
Animals: Eighty-four pure-breed client-owned cats with white coat color of 10 registered breeds presented for routine hearing evaluation before breeding (1995–2008).
Methods: Hearing was assessed by click-evoked brainstem auditory evoked response.
Results: Overall deafness prevalence was 20.2%; 9 cats (10.7%) were bilaterally deaf and 8 cats (9.5%) were unilaterally deaf. There was no association between sex and deafness status ( P = .85). Deafness status was associated with iris color ( P = .04).
Conclusions and Clinical Importance: Congenital sensorineural deafness frequently occurs in pure-breed cats with white coat color. Unilateral sensorineural deafness was as common as bilateral deafness.     

N3 potentials in response to high intensity auditory stimuli in animals with suspected cochleo-saccular deafness

We describe a previously un-reported vertex-negative potential evoked by high intensity click auditory stimuli in some dogs and cats with suspected cochleo-saccular deafness. Brainstem auditory evoked potential tracings from 24 unilaterally or bilaterally deaf animals, 22 dogs and 2 cats, among which 21 belonged to breeds with high prevalence of suspected or histologically confirmed cochleo-saccular deafness, were studied retrospectively. Values for latency, amplitude and threshold of this potential in dogs were 2.15+/-0.23 ms, 0.49+/-0.25 microV, and 91.9+/-4.7 dB NHL, respectively (mean+/-SD). Latency and threshold values in cats were in the mean+/-2 SD range of the dog values. Sensitivity to click stimulus polarity and to click stimulus delivery rate pointed towards a neural potential instead of a receptor potential. The vertex-negative wave observed in these animals shares all characteristics with the N3 potential described in some deaf humans with cochlear deafness, where it is presumed to arise from saccular stimulation. The combined degeneration of cochlea and sacculus usually reported in deaf white dogs and cats suggest that N3 may have a different origin in these species.     

Does a pleiotropic gene explain deafness and blue irises in white cats?

The prevalence of deafness is high in cat populations in which the dominant white gene is segregating. The objective of this study was to investigate whether there is a gene that is responsible for deafness as well as for blue eyes and to establish a plausible mode of inheritance. For this purpose, data from an experimental colony with deaf cats were analyzed. The hearing status was determined by acoustically evoked brain stem responses (BAER). Complex segregation analyses were conducted to find out the most probable mode of inheritance using maximum likelihood procedures. The prevalence of deafness and partial hearing in the experimental colony was 67% and 29%, respectively. The results of the bivariate segregation analysis support the hypothesis of a pleiotropic major gene segregating for deafness and blue iris colour. The high heritability coefficients for both traits, 0.55 and 0.75 respectively, indicate that beside the major gene there is an important influence of polygenic effects.     

Reference values of the brainstem auditory evoked response of methoxyflurane anesthetized and unanesthetized dogs

The brainstem auditory evoked response (BAER) was recorded from 7 unanesthetized and 27 methoxyflurane anesthetized dogs. A 0.1 msec, 70 dB stimulus delivered at 10 Hz evoked the expected seven wave BAER. Mean peak wave latencies and standard deviations were calculated. Differences were not found between neither right and left ears, nor male and female dogs. The anesthetized dogs had a significantly longer latency for all waves, except wave I, than the unanesthetized dogs. Use of the BAER as a diagnostic technique for brainstem lesions is recommended.     

MRI measurement of the canine auditory pathways and relationship with brainstem auditory evoked responses.

The objective of this study was to determine direct measurements of auditory pathways by magnetic resonance imaging (MRI) during the growth period of healthy Beagles, and to discover how canine brainstem auditory evoked response (BAER) latencies vary in relation to these MRI measurements. Eighty healthy Beagles were tested at eight, 16 and 52 weeks of age (stages 1, 2, 3, respectively) with BAER and brain MRI. The BAER interpeak latency (IPL) II-V and brain MRI neural generators of BAER waves II and V were identified. A linear distance was calculated in millimeters in order to determine the approximate length of auditory pathways. Sensory nerve conduction velocity (SNCV) of the auditory pathway between peak II and peak V was calculated for each group. A significant difference was observed between brain MRI distances among the three stages. Mean BAER IPL II-V were not significantly different between the three stages. The progressive growth of the skull and brain witnessed by the progressive increased distance of the MRI auditory pathways between peak II and peak V was not associated with a progressive maturation of the BAER IPL II-V. The SNCV of the auditory pathway between peak II and peak V was 6.14 m/sec for group 1; 6.76 m/sec for group 2; and 7.32 m/sec for group 3.     

Reference values of the brainstem auditory evoked response of methoxyflurane anesthetized and unanesthetized dogs

The brainstem auditory evoked response (BAER) was recorded from 7 unanesthetized and 27 methoxyflurane anesthetized dogs. A 0.1 msec, 70 dB stimulus delivered at 10 Hz evoked the expected seven wave BAER. Mean peak wave latencies and standard deviations were calculated. Differences were not found between neither right and left ears, nor male and female dogs. The anesthetized dogs had a significantly longer latency for all waves, except wave I, than the unanesthetized dogs. Use of the BAER as a diagnostic technique for brainstem lesions is recommended.Publication No. 1702, School of Veterinary Medicine, Auburn University, AL 36849, USA     

Clinical evaluation of cochlear hearing status in dogs using evoked otoacoustic emissions

Objectives : Evoked otoacoustic emission testing is the preferred test in human patients for sensorineural deafness screening in neonates and cochlear outer hair cell function monitoring in adults. This study evaluated evoked otoacoustic emission testing for cochlear function assessment in dogs within a clinical setting. Methods : Two populations of anaesthetised dogs were included. In group 1 the evoked otoacoustic emission response was compared to the brainstem auditory evoked response in 10 dogs having hearing assessment. Group 2 comprised 43 presumed normal dogs, in which the suitability of two types of evoked otoacoustic emissions, transient‐evoked and distortion product otoacoustic emissions, were evaluated (brainstem auditory evoked response was not performed in this group). Results : Valid transient‐evoked otoacoustic emission and distortion‐product otoacoustic emission responses were successfully recorded within the clinical setting and correctly identified deaf and hearing ears. Within presumed healthy dogs, normal otoacoustic emission response was demonstrated in more than 80% of dogs using a single, short distortion‐product otoacoustic emission run and in 78% of dogs with valid transient‐evoked otoacoustic emission responses using a series of three repeated transient‐evoked otoacoustic emission short runs. Clinical Significance : Transient‐evoked otoacoustic emission and distortion‐product otoacoustic emission testing provided a rapid, non‐invasive frequency‐specific assessment of cochlear function. Transient‐evoked otoacoustic emission and distortion product otoacoustic emission testing is suitable as a screening procedure to detect loss of cochlear function in dogs, although further investigation is needed.     

Brainstem Auditory Evoked Responses Elicited by Tone-Burst Stimuli in Clinically Normal Dogs

Brainstem auditory evoked responses (BAERs) to click and tone-burst stimuli (0.5, 1, 2, 4, and 8 kHz) were recorded from 32 ears in 16 adult Beagles. BAERs were used to establish a normative database and describe response thresholds and latencies (wave I-IV) for the different stimuli. The frequencies of sound used were 8, 4, 2, 1, and 0.5 kHz. Sound stimuli were delivered by a closed headphone and masking stimuli were not applied. The BAER waveforms obtained were similar to those reported previously, except for a frequency-following response evoked by 1-kHz tone-bursts. The threshold was lowest when clicks and 4-kHz tone-bursts were used. Significant differences were observed between the mean values of the peak latencies for clicks and 4-and 8-kHz tone-bursts. The tone-burst stimulation used in our experiment was shown to be an appropriate method for detecting the BAERs. Thus, for investigating the frequency-specificity of the auditory sense, BAER data obtained using tone-burst sound in dogs may be meaningful.     

Abnormalities of the brainstem auditory response of the dog associated with equilibrium deficit and seizure

The brainstem auditory evoked response (BAER) was recorded from 20 dogs, 10 exhibiting vestibular deficit, and 10 presented with a history of seizures. Two dogs exhibited both types of signs. Abnormalities of the BAER, prolonged interwave latency, were seen in 8 of the 10 animals with vestibular problems, and in 7 of the 10 animals with seizure history. Several different diagnosis were associated with BAER abnormalities in both groups of animals. In 55.5% of the cases exhibiting abnormalities of the BAER, postmortem evidence of brainstem pathology was not detected. The electroencephalogram (EEG) was normal in three instances of abnormalities of the BAER. The BAER was normal in three dogs with abnormalities of the EEG. The BAER is presented as a useful diagnostic tool for brain lesions in animals with vestibular deficit and seizure history, but appears most useful when used in conjuction with the EEG. Correlations of abnormalities of the BAER and clinical course of disease are discussed.Publication No. 1707, School of Veterinary Medicine, Auburn University, AL 36849     

Electrodiagnostic evaluation of deafness in two English setter littermates

Two English Setter littermates (male and female) were evaluated for hearing difficulties at 4, 16, and 24 months of age. Auditory function was evaluated by behavioral response to pure-tone sounds, tympanometry, brain stem auditory evoked response, and acoustic reflex testing. Hereditary sensorineural deafness was diagnosed in both dogs. The extent of the hearing deficit, as characterized by these tests, was slightly different between the dogs, as well as between the ears in 1 dog.     

Brainstem auditory evoked responses and ophthalmic findings in llamas and alpacas in Eastern Canada

Seventeen llamas and 23 alpacas of various coat and iris colors were evaluated for: (1) deafness by using brainstem auditory evoked response testing; and (2) for ocular abnormalities via complete ophthalmic examination. No animals were deaf. The most common ocular abnormalities noted were iris-to-iris persistent pupillary membranes and incipient cataracts.     

A method of assessing auditory and brainstem function in horses

Brainstem auditory evoked potential (BAEP) waveforms were recorded as a means of objectively evaluating auditory and brainstem function in horses. BAEP recordings were readily and repeatably recorded from horses, under minimal restraint, using signal averaging equipment. Clearly identified BAEP waveforms were obtained with compression clicks of 30-100 dB (HHL) at 10 Hz applied in the external auditory meatus of one ear and masking white noise (10 dB lower) in the other ear. Vertex positive (upwards) waveforms I through V were obtained with an active, subdermal electrode over the ipsilateral and contralateral zygomatic processes of the temporal bones and the reference electrode over the vertex. Recording sweep duration was 10 ms, amplifier sensitivity 10 microV/division, display gain x 10 and low and high amplifier filters set at 200 Hz to 2 kHz. Such recordings can be useful in evaluation of all clinical cases suspected of showing degrees of deafness, vestibular disease or brainstem disease, and in monitoring the progress of such cases.     

Brainstem auditory-evoked potential assessment of auditory function and congenital deafness in llamas (Lama glama) and alpacas (L. pacos)

Auditory function of llamas and alpacas was assessed objectively by means of brainstem auditory-evoked response audiometry (BAER) to establish the normal hearing range and to test the hypothesis of a correlation between blue eyes, white coat, and deafness. Sixty-three camelids were available for the study. Thirteen animals had blue irides; 1 animal had 1 blue and 1 pigmented iris. Wave latencies, amplitudes, and interpeak latencies were measured under general anesthetic. Click stimuli (dB [HL]) were delivered by an insert earphone. Four to five positive peaks could be detected; waves I, II, and V were reproducible; wave II appeared infrequently; and wave IV generally merged with wave V to form a complex. Peak latencies decreased and peak amplitudes increased as stimulus intensity increased. A hearing threshold level of 10-20 dB (HL) was proposed as the normal range in llamas and alpacas. None of the animals with pigmentation of coat and iris showed any degree of hearing impairment. Seven of the 10 blue-eyed, pure-white animals were bilaterally deaf and one of them was unilaterally deaf. However, 2 blue-eyed, white animals exhibited normal hearing ability. Three blue-eyed animals with pigmented coat did not show any hearing impairment. All white animals with normal iris pigmentation had normal auditory function; so did the 1 animal with 1 normal and 1 blue iris. The high frequency (78%) of bilaterally deaf animals with pure white coat and blue iris pigmentation supports the hypothesis of a correlation between pigmentation anomalies and congenital deafness in llamas and alpacas.     

Diagnosis of deafness in a horse by brainstem auditory evoked potential

Deafness was confirmed in a blue-eyed, 3-year-old, overo paint horse by brainstem auditory evoked potential. Congenital inherited deafness associated with lack of facial pigmentation was suspected. Assessment of hearing should be considered, especially in paint horses, at the time of pre-purchase examination. Brainstem auditory evoked potential assessment is well tolerated and accurate.     

Comparison of the brainstem auditory evoked responses during sevoflurane or alfaxalone anaesthesia in adult cats

Objective

To compare the effects of general anaesthesia using sevoflurane or alfaxalone on the brainstem auditory evoked response (BAER) test in adult healthy cats.