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Comparative Study
. 2013 Feb;33(1):29-35.

Identifying congenital hearing impairment: preliminary results from a comparative study using objective and subjective audiometric protocols

A Ciorba  1 , S Hatzopoulos, J Petruccelli, M Mazzoli, A Pastore, K Kochanek, P Skarzynski, A Wlodarczyk, H Skarzynski
Affiliations
Comparative Study

Identifying congenital hearing impairment: preliminary results from a comparative study using objective and subjective audiometric protocols

A Ciorba et al. Acta Otorhinolaryngol Ital. 2013 Feb.

Abstract
in English, Italian

To compare objective and subjective protocols assessing hearing loss in young children and evaluate frequency-specific hearing impairment through a comparison between auditory steady state responses (ASSR), auditory brainstem responses (ABR), transient otoacoustic emissions and conditioned orientation reflex responses (COR). Thirty-five hearing-impaired children (20 male and 15 female), aged between 14 months and 4 years, participated in the study. Hearing threshold levels and peripheral auditory function were assessed by measurements of ABR, ASSR, otoacoustic emissions and COR. The analysis of the COR and ASSR variables showed significant correlations in the majority of tested frequencies. The data highlight a characteristic of the COR procedure, which is an underestimation of the hearing threshold in comparison to the ASSR estimate. The data show that the COR threshold assessment follows the pattern of the other two established electrophysiological methods (ABR, ASSR). The correlation analyses did not permit evaluation of the precision of these estimates. Considering that the ASSR variables show a better relationship with ABR (higher correlation values) than COR, it might be advantageous to utilize the ASSR to gain frequency-specific information.

Obiettivo del nostro studio è stato confrontare protocolli di valutazione uditiva oggettivi e soggettivi nei bambini e valutare la perdita uditiva anche in rapporto alle frequenze, mediante il confronto tra i dati ottenuti attraverso l'utilizzo dei potenziali evocati uditivi di stato stazionario (ASSR), i potenziali evocati uditivi del tronco encefalico (ABR), le emissioni otoacustiche (OAE) e l'audiometria a riposte condizionate (COR). Sono stati inclusi in questo studio trentacinque bambini ipoacusici (20 maschi e 15 femmine) di età compresa tra 14 mesi e 4 anni. I valori di soglia uditiva sono stati valutati attraverso l'utilizzo di questi protocolli: ASSR, ABR, OAE e COR. I valori di soglia ottenuti mediante COR e ASSR mostrano una correlazione significativa nella maggior parte delle frequenze testate. Dall'analisi dei dati si è riscontrato che la valutazione della soglia mediante COR segue il modello degli altri due metodi elettrofisiologici (ABR, ASSR). Tuttavia l'analisi di correlazione non permettere una valutazione della precisione di queste stime. Considerando che le variabili ASSR mostrano valori di correlazione più alti con l'ABR rispetto al COR, potrebbe essere vantaggioso utilizzare le ASSR per ottenere informazioni di soglia più precise, anche in merito alle diverse frequenze.

Keywords: Auditory brain-stem responses (ABR); Auditory steady state responses (ASSR); Conditioned orientation reflex (COR); Otoacoustic emissions (OAE); Sensorineural hearing loss.

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Figures

Fig. 1.
Fig. 1.
Distribution of ASSR data (x-axis in all graphs) from right ears at 1000 Hz and all tested COR variables (y-axis in all graphs). The scatter plots show the relationships quantified by the estimated correlations.
Fig. 2.
Fig. 2.
Distribution of ASSR data (x-axis in all graphs) from right ears at 2000 Hz and all tested COR variables (y-axis in all graphs). The scatter plots show the relationships quantified by the estimated correlations.
Fig. 3.
Fig. 3.
Distribution of click-evoked ABR thresholds from the right and left ears. Both distributions show asymmetries to the right.
Fig. 3.
Fig. 3.
Distribution of click-evoked ABR thresholds from the right and left ears. Both distributions show asymmetries to the right.
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