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Can You Use a TM Electrode with a Sleeping Baby?

James W. Hall III, PhD

August 5, 2013

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Question

Do you think it's possible to use a TM electrode on a naturally sleeping baby? I'm wondering if this might greater inform interpretation with an infant when ANSD is suspected?

Answer

I've never tried using a tympanic membrane (TM) electrode on a sleeping baby, but I think it would be quite challenging. It's likely the pressure of a well-placed electrode on the TM would create enough discomfort to wake a naturally sleeping baby. It certainly would be important to check and verify if the TM electrode is FDA-approved for use with infants and young children. My suspicion is that the electrode is approved only for adults.

For audiologists, a simple electrode option for ECochG in infants is a pediatric-sized TIPtrode but the ear canal would need to be prepared in advance with abrasive substance (e.g., NuPrep). Infants will not willingly tolerate that process due to some discomfort so the prep would need to be done before the child fell asleep. The TIPtrode option would be feasible with an anesthetized child.

With otology support at a children’s hospital, the best ECochG approach to use (if you really wanted test results for decisions about a CI) would be a trans-tympanic needle recording with a sub-dermal needle.

This Ask the Expert was asked as a follow up question to Dr. Hall's course, Clinical Applications of Electrocochleography Today, which can be accessed in the AudiologyOnline Course Library.


james w hall iii

James W. Hall III, PhD

James W. Hall III, PhD is an internationally recognized audiologist with 40-years of clinical, teaching, research, and administrative experience. He received his Ph.D. in audiology from Baylor College of Medicine under the direction of James Jerger.  During his career, Dr. Hall has held clinical and academic audiology positions at major medical centers. Dr. Hall now holds appointments as Professor at Salus University and the University of Hawaii, and as Extraordinary Professor at the University of Pretoria South Africa. Dr. Hall is the author of over 160 peer-reviewed journal articles, monographs, or book chapters, and nine textbooks including the 2014 Introduction to Audiology Today and the 2015 eHandbook of Auditory Evoked Responses.

 


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