Comparison of frequency-Specific hearing thresholds between pure-tone audiometry and auditory steady-state response

Background and Objectives To evaluate mismatches between pure-tone audiometry (PTA) and auditory steady-state response (ASSR) tests in non-auditory neuropathy adults and investigate brain lesions that may explain the mismatches, especially in cases where the ASSR threshold was worse than the estimated PTA threshold.Subjects and Method PTA, speech audiometry, auditory brainstem response, ASSR, and neuroimaging tests were carried out on individuals selected. Among them, medical records of 30 subjects (16 males, 14 females; mean age=54.4±13.2 years) with significant mismatches between PTA and estimated ASSR thresholds were analyzed retrospectively. All neuroimaging tests were reviewed to identify any neurologic abnormalities.Results Pathologic brain lesions were found in 19 cases (63.3%) in the study group, all of which showed significant mismatch in hearing threshold between PTA and ASSR. Seven case of ischemic brain lesions (23.3%), five tumorous lesions (16.6%), and four brain vessel anomalies (13.3%) were found. Brain hemorrhage due to trauma were found in two cases (6.6%) as well as one case (3.3%) of unruptured aneurysm. Central auditory pathway disorder was suspected in two cases. The 11 cases showing normal results in the imaging studies included one mental retardation, one brain concussion, and seven cases (23.3%) with no specific causes. Six tinnitus cases included two subjects showing discrepancies between frequency matching in the tinnitogram.Conclusion In adults with a mismatch between PTA thresholds and estimated ASSR thresholds, especially for those with moderate to profound hearing loss, additional neuroimaging tests and other audiologic tests may reveal other possible causes of hearing loss.

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Assessing Agreement between Frequency-Specific Chirp Auditory Steady-State Response and Pure Tone Audiometry in Adults by Intraclass Correlation Coefficient

ORL ◽

10.1159/000515237 ◽

2021 ◽

pp. 1-9

Author(s):

Mo Chen ◽

Yi Wei ◽

Xianren Wang ◽

Liman Liu ◽

Min Liu ◽

...

Keyword(s):

Hearing Loss ◽

Steady State ◽

Pure Tone ◽

Intraclass Correlation ◽

Pure Tone Audiometry ◽

Systematic Difference ◽

Steady State Response ◽

Limits Of Agreement ◽

State Response ◽

Auditory Steady State Response

Introduction: Chirp auditory steady-state response (ASSR) can be used to assess frequency-specific hearing thresholds. However, its reliability has not been confirmed yet. The purpose of this proposed study is to analyze the agreement of thresholds measured by chirp-ASSR and pure tone audiometry (PTA) to investigate the value of chirp-ASSR in hearing threshold evaluation. Methods: Participants with normal hearing (age: 18–66, 108 ears) and patients with sensorineural hearing loss (age: 22–82, 75 ears) were tested using PTA and chirp-ASSR at 0.5, 1, 2, and 4 kHz, respectively. Intraclass correlation coefficient (ICC) and Bland-Altman plot were introduced to analyze the agreement between the 2 methods. Results: One-hundred eight participants underwent both chirp-ASSR and PTA to estimate their thresholds. The ICCs yielded by these 2 methods are 0.757, 0.893, 0.883, and 0.921 (p < 0.001) at 0.5, 1, 2, and 4 kHz carrier frequency, respectively. However, there is a significant difference between the 2 methods at 2 kHz: the mean value of the ASSR thresholds is 5.27 dB HL higher than the value of PTA thresholds. Additionally, the 95% limits of agreement range from −27.48 to 26.66 dB HL at 0.5 kHz, from −18.19 to 17.87 dB HL at 1 kHz, from −12.01 to 22.55 dB HL at 2 kHz, and from −21.29 to 19.17 dB HL at 4 kHz, which are large enough to affect clinical decision-making. Conclusion: In this study, we have confirmed good to excellent correlation between chirp-ASSR and PTA in threshold estimation for adults with and without hearing loss. The degree of correlations is higher for participants with hearing loss and for measurements at high frequencies. However, significant systematic difference and large limits of agreement between the 2 methods have been found. These findings show that chirp-ASSR can be treated as a supplementary method to PTA when evaluating the hearing level, but the 2 methods are not interchangeable due to their systematic difference and large limits of agreement.

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Adults with Auditory Neuropathy: Comparison of Auditory Steady-State Response and Pure-Tone Audiometry

Journal of the American Academy of Audiology ◽

10.3766/jaaa.20.10.4 ◽

2009 ◽

Vol 20 (10) ◽

pp. 621-628 ◽

Cited By ~ 19

Author(s):

Zahra Jafari ◽

Saeed Malayeri ◽

Hassan Ashayeri ◽

Mahdi Azizabadi Farahani

Keyword(s):

Steady State ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Auditory Neuropathy ◽

High Rate ◽

Steady State Response ◽

Low Frequencies ◽

Auditory Thresholds ◽

State Response ◽

Auditory Steady State Response

Background: The relation between the auditory steady-state response (ASSR) and behavioral audiometric thresholds requires further clarification in the case of adults with auditory neuropathy/auditory dys-synchrony (AN/AD). Purpose: The aim of this study was to compare pure-tone audiometric threshold (PTAT) and ASSR in adults with AN/AD. Study Sample: Sixteen adult participants (32 ears) with AN/AD, ranging in age from 14 to 34 years. Data Collection and Analysis: PTAT and ASSR with high-rate stimulus modulation were measured at four octave frequencies, 500, 1000, 2000, and 4000 Hz, in each ear. The behavioral auditory thresholds were compared with ASSR estimated thresholds at each frequency. Analyses included comparison of group means and coefficients of correlation. Results: The average pure-tone thresholds revealed a moderate hearing loss in the AN/AD patients with a focus on the low frequencies. Low-frequency loss audiograms were observed in almost two-thirds of the participants. The estimated auditory thresholds measured by ASSR at all frequencies were substantially higher than the PTAT measures. There were no significant correlations between the PTAT and ASSR measurements at the 1000, 2000, and 4000 Hz frequencies (p > .05); the correlation between the two measures at 500 Hz (p = .029, r = 0.39) was weak but significant. Conclusion: There was no significant correlation between the PTAT and ASSR results at the majority of the frequencies usually tested in adults with AN/AD. Although ASSR is not a suitable method to estimate auditory thresholds in this group of patients, perhaps it can be utilized as an adjunct technique for the differential diagnosis of this disorder.

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Comparison of Correlation Between the Pure Tone Audiometry, the Auditory Brainstem Response and the Auditory Steady-State Response for the Evaluation of Hearing Disability in Adults

Journal of Clinical Otolaryngology ◽

10.35420/jcohns.2017.28.2.192 ◽

2017 ◽

Vol 28 (2) ◽

pp. 192-198

Author(s):

Yong-Hwi An ◽

Ji Hyang Yoon ◽

Hyeon Sik Oh ◽

Eun Sub Lee ◽

Dong Hyun Kim ◽

...

Keyword(s):

Steady State ◽

Auditory Brainstem Response ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Auditory Brainstem ◽

Steady State Response ◽

Hearing Disability ◽

State Response ◽

Auditory Steady State Response ◽

Brainstem Response

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Comparison of auditory brainstem response and auditory steady state response audiometry by evaluating the hearing thresholds obtained in children with different severity of hearing loss

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.2.688 ◽

2019 ◽

Vol 35 (2) ◽

Cited By ~ 1

Author(s):

Muhammad Azeem Aslam ◽

Adeela Javed ◽

Abdul Moiz

Keyword(s):

Hearing Loss ◽

Steady State ◽

Auditory Brainstem Response ◽

Auditory Brainstem ◽

Steady State Response ◽

State Response ◽

Hearing Thresholds ◽

Auditory Steady State Response ◽

Brainstem Response ◽

The Mean

Objectives: To compare the hearing thresholds obtained with auditory brainstem response (ABR) and auditory steady state response (ASSR) audiometry in children with hearing loss. Methods: Hearing thresholds were obtained by ABR and ASSR in children who presented with suspicion of deafness at Ear, nose & throat department of Al-Nafees Medical College Hospital Islamabad, between January to August 2018. The mean hearing thresholds obtained by two tests were compared within each category of severity of deafness. Time taken by both tests was also compared. Results: A total of 57 patients (114 ears) were included in the study. Among them 27 (47.4%) were male and 30 (52.6%) were female. The mean age of patients at presentation was 42 months (±30.9) with age range from one to 12 years. Mean hearing thresholds obtained by click ABR, chirp ABR, ASSR (1, 2, 4 kHz) & ASSR (0.5, 1, 2, 4 kHz) was 56.25 (±27.61), 58.88 (±27.44), 58.03 (±21.26) & 56.35 (±22.86) respectively. Mean thresholds were comparable between click ABR & ASSR (1, 2, 4 kHz) and between chirp ABR & ASSR (0.5, 1, 2, 4 kHz) in all degrees of hearing loss categories except in those patients with normal hearing thresholds. The mean time taken by clicks ABR, chirp ABR and ASSR were four minutes seven seconds, three minutes 15 seconds and 16 minutes and 7 seconds respectively. Conclusions: Hearing thresholds obtained by ABR and ASSR are comparable in all categories of severity of hearing loss. The time taken by ABR is less as compared to ASSR. How to cite this:Aslam MA, Javed A, Moiz A. Comparison of auditory brainstem response and auditory steady state response audiometry by evaluating the hearing thresholds obtained in children with different severity of hearing loss. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.688 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Comparison of auditory steady state response (ASSR) & auditory brainstem response (ABR) hearing thresholds in young children.

Journal of Shifa Tameer-e-Millat University ◽

10.32593/jstmu/vol2.iss1.21 ◽

2019 ◽

Vol 2 (1) ◽

pp. 17-21

Author(s):

Adil Munir ◽

Nazia Mumtaz ◽

Ghulam Saqulain ◽

Munir Ahmad

Keyword(s):

Steady State ◽

Hearing Threshold ◽

Auditory Brainstem ◽

Auditory Brainstem Responses ◽

Steady State Response ◽

Female Ratio ◽

State Response ◽

Hearing Thresholds ◽

Auditory Steady State Response ◽

Brainstem Response

Objective: Hearing loss (HL) with a local prevalence of 5.7%, is the commonest childhood disability, requiring Early Hearing Detection and Intervention (EHDI) programs to reduce the disability burden. Knowing the degree, type and configuration of HL is prerequisite for appropriate amplification, with Automated Auditory Brainstem Responses (ABR) being commonly used for this purpose, however Auditory Steady State Response (ASSR) has been recently introduced in the region. This study was conducted to compare ABR to ASSR, as an early diagnostic tool in children under five years of age. Methodology: This cross-sectional comparative study was performed at the Auditory Verbal Institute of Audiology and Speech (AVIAS) clinics in Rawalpindi and Islamabad, from December 2016 to September 2017. It included thirty-two cases (n=32) who visited AVIAS clinics for hearing assessment and conformed to the investigative protocol using non probability convenient sampling technique, and subjected to both ABR and ASSR for comparative purposes. Correlations were calculated between the thresholds obtained by ABR and ASSR. Results: N=32 children (64 ears) with male female ratio of 2.2:1 and mean age of 33.50±17.73 months were tested with ABR and ASSR for hearing thresholds and correlation coefficient between 2KHz, 4KHz ASSR and average of both with ABR was calculated to be 0.92 and 0.90 and 0.94 respectively. Conclusion: ASSR provides additional frequency specific hearing threshold estimation compared to C-ABR, essentially required for proper setting of amplification devices.

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Validation of multi-channel auditory steady-state response in adults with sensorineural hearing loss

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002351 ◽

2008 ◽

Vol 123 (1) ◽

pp. 38-44 ◽

Cited By ~ 1

Author(s):

Y-H Lin ◽

P-R Chen ◽

C-J Hsu ◽

H-P Wu

Keyword(s):

Hearing Loss ◽

Steady State ◽

Sensorineural Hearing Loss ◽

Pure Tone ◽

Sensorineural Hearing ◽

Steady State Response ◽

Academic Medical Centre ◽

State Response ◽

Auditory Steady State Response ◽

Response Thresholds

AbstractObjective:For various medico-legal and financial reasons, some patients may clinically demonstrate an exaggerated hearing loss that varies in degree, nature and laterality. The purpose of this study was to evaluate whether multi-channel auditory steady-state response measurement can be used as an objective test of auditory thresholds in adults with sensorineural hearing loss.Study design and setting:This was a prospective, comparative, experimental research design study conducted in an academic medical centre. From January to June 2007, 142 subjects (284 ears) with varying degrees of sensorineural hearing loss were included. Four commonly used frequencies (500, 1000, 2000 and 4000 Hz) were evaluated. Both pure tone thresholds and multi-channel auditory steady-state response thresholds were obtained for each ear in all subjects. The correlation of auditory steady-state response thresholds and pure tone thresholds was assessed. The time taken for multi-channel auditory steady-state response testing was also recorded.Results:Results for multi-channel auditory steady-state response thresholds and pure tone thresholds were compared for each test frequency. A difference of less than 15 dB was found in 71 per cent of patients, while a difference of less than 20 dB was found in 83 per cent. Correlation between auditory steady-state response thresholds and pure tone thresholds, expressed as the correlation coefficient (r), was 0.89, 0.95, 0.96 and 0.97 at 500, 1000, 2000 and 4000 Hz, respectively. The strength of the relationship between auditory steady-state response thresholds and pure tone thresholds increased with increasing frequency and increasing degree of hearing loss. The recorded auditory steady-state response thresholds were used to calculate regression lines predicting pure tone threshold results. The mean estimated pure tone thresholds calculated from these regression lines were all within 10 dB of the actual recorded pure tone thresholds. The average multi-channel auditory steady-state response test duration was 42 minutes per patient.Conclusion:Measurement of multi-channel auditory steady-state response could be a powerful, convenient electro-physiological examination with which to objectively certify clinical hearing impairment in adults.

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