Abstract
Abstract The aim of the study was to find out the predictive value of single monotic auditory steady-state response (ASSR) in hearing threshold estimation in children with severe to profound sensorineural hearing loss (SNHL). Forty-eight children (96 ears) with severe to profound SNHL were included. They were subjected to age-based audiological evaluation. Single monotic ASSR was obtained and analyzed for all children using test signals of 250, 500, 1000, 2000, and 4000 Hz, modulated in either ears at high rates of 67, 74, 81, 88, and 95 Hz, respectively, using GSI Audera evoked potential system. The number and percentage of ASSR detected were highest at 1000, 500, and 2000 Hz, respectively in all children. The ASSR thresholds obtained were statistically correlated with the behavioral audiometric thresholds at the corresponding frequencies. A considerable number of ears with no sound field thresholds or click auditory brainstem response responses showed ASSR. Single monotic ASSR, with high modulation frequencies, has shown to be a reasonable method for estimating hearing sensitivity in the mid-conventional audiometric frequencies in children with severe to profound SNHL.
Highlights
Auditory steady-state response (ASSR) audiometry is a commercially available tool used to predict behavioral auditory threshold
The absence of the response at 4 kHz in a large number of children could be related to the severity of the hearing loss at this particular frequency. This is in agreement with the study by Ahn et al [11] who found that the largest percentage of absent ASSR was at 4 kHz (31.6%) in adult patients with severe to profound sensorineural hearing loss (SNHL)
The presence of ASSR thresholds at increased intensities not attainable with Auditory brainstem response (ABR) and often not with behavioral measures in young children makes this technique uniquely suited to the evaluation of severe and profound SNHL
Summary
Auditory steady-state response (ASSR) audiometry is a commercially available tool used to predict behavioral auditory threshold. Its particular value stems from its ability to measure frequency-specific responses in the background electroencephalogram (EEG) to auditory stimuli presented across a broad range of frequencies and sound pressure levels [1]. The test stimuli are reasonably frequency specific regardless of the mode of modulation. The steady tonal stimuli used in ASSR permit higher outputs to be realized than do the typical evoked response test systems. ASSR can provide threshold information at intensity levels of 120 dB and higher. This helps to differentiate between severe and profound categories of sensorineural hearing loss (SNHL) [2]. The spectrum of the response is predicted precisely without the need of subjective interpretation of the recorded response
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