Steady-state evoked potential and behavioral hearing thresholds in a group of children with absent click-evoked auditory brain stem response. 1998

G Rance, and R C Dowell, and F W Rickards, and D E Beer, and G M Clark
Royal Victorian Eye and Ear Hospital, Department of Otolaryngology, University of Melbourne, Australia.

OBJECTIVE 1) To examine the distribution of behavioral hearing thresholds in a group of children who had shown no click-evoked auditory brain stem response (ABR) at maximum presentation levels. 2) To describe the relationship between the 90 Hz steady-state evoked potential (SSEP) and behavioral thresholds in these subjects. METHODS A retrospective study based on clinical findings obtained from 108 infants and young children. Each of these children had shown no recordable ABR to clicks presented at maximum levels (100 dB nHL). SSEP audiograms were obtained using AM/FM tones at the octave frequencies 250 to 4000 Hz. The results of these evoked potential assessments were compared with hearing thresholds established behaviorally. RESULTS Click-ABR assessment could not differentiate between the subjects in our sample with total hearing losses and those with useful residual hearing. Although some of the ears were anacusic, more than a quarter showed residual hearing at each of the audiometric frequencies. Furthermore, at least 10% of the behavioral thresholds at each frequency fell within the moderate/severe hearing loss range. A far closer relationship was observed between SSEP and hearing thresholds. On occasions where the SSEP was absent at maximum levels, 99.5% of the ears showed either a total loss or a behavioral threshold within 10 dB of that level. When an SSEP was obtained, the hearing threshold was typically within 5 dB of the SSEP threshold. CONCLUSIONS The results suggested that in our group of selected subjects, the SSEP technique was able to assess ears with only minimal amounts of residual hearing. Where the brevity of the acoustic click limits both its frequency specificity and its presentation level, the modulated tones used for SSEP testing allow accurate, frequency-specific assessment at high presentation levels.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005072 Evoked Potentials, Auditory The electric response evoked in the CEREBRAL CORTEX by ACOUSTIC STIMULATION or stimulation of the AUDITORY PATHWAYS. Auditory Evoked Potentials,Auditory Evoked Response,Auditory Evoked Potential,Auditory Evoked Responses,Evoked Potential, Auditory,Evoked Response, Auditory,Evoked Responses, Auditory,Potentials, Auditory Evoked
D006310 Hearing Aids Wearable sound-amplifying devices that are intended to compensate for impaired hearing. These generic devices include air-conduction hearing aids and bone-conduction hearing aids. (UMDNS, 1999) Ear Molds, Hearing Aid,Aid, Hearing,Aids, Hearing,Hearing Aid
D006319 Hearing Loss, Sensorineural Hearing loss resulting from damage to the COCHLEA and the sensorineural elements which lie internally beyond the oval and round windows. These elements include the AUDITORY NERVE and its connections in the BRAINSTEM. Deafness Neurosensory,Deafness, Neurosensory,Deafness, Sensoryneural,Neurosensory Deafness,Sensorineural Hearing Loss,Sensoryneural Deafness,Cochlear Hearing Loss,Hearing Loss, Cochlear,Deafnesses, Neurosensory,Deafnesses, Sensoryneural,Neurosensory Deafnesses,Sensoryneural Deafness,Sensoryneural Deafnesses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000158 Acoustic Impedance Tests Objective tests of middle ear function based on the difficulty (impedance) or ease (admittance) of sound flow through the middle ear. These include static impedance and dynamic impedance (i.e., tympanometry and impedance tests in conjunction with intra-aural muscle reflex elicitation). This term is used also for various components of impedance and admittance (e.g., compliance, conductance, reactance, resistance, susceptance). Audiometry, Impedance,Electroacoustic Impedance Tests,Impedance Tests, Acoustic,Tympanometry,Acoustic Impedance Test,Electroacoustic Impedance Test,Impedance Audiometry,Impedance Test, Acoustic,Impedance Test, Electroacoustic,Impedance Tests, Electroacoustic,Test, Acoustic Impedance,Test, Electroacoustic Impedance,Tests, Acoustic Impedance,Tests, Electroacoustic Impedance
D001301 Audiometry, Pure-Tone Measurement of hearing based on the use of pure tones of various frequencies and intensities as auditory stimuli. Audiometry, Bekesy,Audiometry, Pure Tone,Bekesy Audiometry,Pure-Tone Audiometry
D001307 Auditory Perception The process whereby auditory stimuli are selected, organized, and interpreted by the organism. Auditory Processing,Perception, Auditory,Processing, Auditory

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