VRA

Question 1

Initial VRA should include

Answer 1

1. Ear-specific AC @ 2k, 500 & 4kHz plus 1kHz if required (same rules apply as ABR)
2. Ear specific MLV thresholds (SDT)
3. BC if required
4. DPOAE & noise thresholds @ nominal F2 of 1.5,2,3,4
5. Tymp & ipsi ART

Question 2

Target population

Answer 2

6-30months with PCHL, or any referral babies

Question 3

Transducer

Answer 3

Inserts unless anatomically contraindicated (in which case use TDH headphone)

Question 4

SF normal. What’s next?

Answer 4

Verify normal hearing by running DPOAE in each ear and immittance testing (to rule out ANSD)

Question 5

SF elevated. What’s next?

Answer 5

Book appt to get separate ear info.

If HL is confirmed, ensure separate ear info is obtained prior to HA fitting which may require GA ABR.

Question 6

Stimulus tone & freq.

Answer 6

NBN pulsed

2-500-4kHz

Question 7

Threshold procedure

Answer 7

Appendix 8

Question 8

Auditory dys-synchrony inference from VRA

Answer 8

Normal DPOAE + reliable VRA =>55dB —> probable ANSD due to days-synchrony.
Should do click ABR with GA

Question 9

Minimum testing level for normal hearing for VRA

Answer 9

20dB HL