Main Theme: Otology
Objective: To report a case of sevoflurane-induced false-positive auditory brainstem response findings mimicking sensorineural hearing loss in a child with normal behavioural hearing.
Methods: Serial auditory brainstem response assessments were performed over 18 months in a speech-delayed child aged 5 years and 9 months, using different anaesthetic techniques and natural sleep conditions. Behavioural audiometry and brain MRI were also conducted.
Results: Auditory brainstem response under sevoflurane-based general anaesthesia on two separate occasions revealed bilaterally elevated thresholds suggesting moderate sensorineural hearing loss (45–55 dB HL). In contrast, behavioural audiometry consistently demonstrated normal hearing (15–25 dB HL), and auditory brainstem response under natural sleep or sedation showed normal thresholds. Brain MRI was unremarkable.
Conclusion: Sevoflurane can produce reproducible false-positive auditory brainstem response results mimicking moderate sensorineural hearing loss. Clinicians should interpret auditory brainstem response findings under volatile anaesthesia cautiously when discordant with behavioural testing. Propofol-based anaesthesia may provide more reliable threshold estimates.
References
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