Clinical comparison of the auditory steady-state response with the click auditory brainstem response in infants

Abstract

Objectives: Our goal was to determine the effectiveness of using the auditory steady state response (ASSR) as a measure of hearing thresholds in infants who are suspected of having significant hearing loss, as compared with using the click-auditory brainstem response (C-ABR).

Methods: We retrospectively analyzed the audiologic profiles of 76 infants (46 boys and 30 girls, a total of 151 ears) who ranged in age from 1 to 12 months (average age: 5.7 months). The auditory evaluations in 76 infants who were suspected of having hearing loss were done via the C-ABR and ASSR. In addition, for reference, the mean ASSR thresholds were compared to those of 39 ears of infants and 39 ears of adults with normal hearing at 0.5, 1, 2, and 4 kHz.

Results: The highest correlation between the C-ABR and ASSR thresholds was observed at an average of 2-4 kHz (r=0.94). On comparison between the hearing of infants and adults at 0.5, 1, 2, and 4 kHz, the mean ASSR threshold in infants was 12, 7, 8, and 7 dB higher, respectively, than that in adults.

Conclusion: ASSR testing may provide additional audiometric information for accurately predicting the hearing sensitivity, and this is essential for the management of infants with severe to profound hearing loss.

Keywords: Auditory brain stem response; Auditory steady-state response; Auditory threshold; Click evoked response audiometry; Hearing.

Fig. 1

(A) The presence and absence of responses to ASSR and C-ABR for each ear. (B) Analysis of 77 ears with ASSR responses at 1 or more steady-state frequencies. The distribution of the responses was mainly at the level of 90-110 dBHL. ASSR: auditory steady state response; C-ABR: click-auditory brainstem response.

Fig. 2

Scatterplots of the ASSR and C-ABR thresholds at 2 and 4 kHz and the average of the 2 and 4 kHz thresholds. ASSR: auditory steady state response; C-ABR: click-auditory brainstem response.