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

2009 ◽  
Vol 20 (10) ◽  
pp. 621-628 ◽  
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.

scholarly journals Threshold Mismatches between Pure-Tone Audiometry and Auditory Steady State Response in Non-Auditory Neuropathy Adults

2020 ◽  
Vol 63 (8) ◽  
pp. 350-357
Author(s):  
Heil Noh ◽  
Hyesook Lee
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Brain Lesions ◽  
Auditory Neuropathy ◽  
Steady State Response ◽  
State Response ◽  
Auditory Steady State Response ◽  
Brainstem 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.

Comparing pure-tone audiometry and auditory steady state response for the measurement of hearing loss

2007 ◽  
Vol 136 (6) ◽  
pp. 966-971 ◽  
Author(s):  
Joong Ho Ahn ◽  
Hyo-Sook Lee ◽  
Young-Jin Kim ◽  
Tae Hyun Yoon ◽  
Jong Woo Chung
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Steady State Response ◽  
State Response ◽  
Auditory Steady State Response

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

ORL ◽  
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

<b><i>Introduction:</i></b> 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. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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 (<i>p</i> &#x3c; 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. <b><i>Conclusion:</i></b> 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.

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

2008 ◽  
Vol 123 (1) ◽  
pp. 38-44 ◽  
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.

scholarly journals An integrative approach for pediatric auditory neuropathy spectrum disorders: revisiting etiologies and exploring the prognostic utility of auditory steady-state response

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pei-Hsuan Lin ◽  
Chuan-Jen Hsu ◽  
Yin-Hung Lin ◽  
Yi-Hsin Lin ◽  
Shu-Yu Yang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Auditory Neuropathy ◽  
Steady State Response ◽  
Distortion Product ◽  
State Response ◽  
Behavioral Thresholds ◽  
Auditory Steady State Response

Abstract Auditory neuropathy is an important entity in childhood sensorineural hearing loss. Due to diverse etiologies and clinical features, the management is often challenging. This study used an integrative patient-history, audiologic, genetic, and imaging-based approach to investigate the etiologies and audiologic features of 101 children with auditory neuropathy. Etiologically, 48 (47.5%), 16 (15.8%), 11 (10.9%), and 26 (25.7%) children were categorized as having acquired, genetic, cochlear nerve deficiency-related, and indefinite auditory neuropathy, respectively. The most common causes of acquired and genetic auditory neuropathy were prematurity and OTOF mutations, respectively. Patients with acquired auditory neuropathy presented hearing loss earlier (odds ratio, 10.2; 95% confidence interval, 2.2–47.4), whereas patients with genetic auditory neuropathy had higher presence rate of distortion product otoacoustic emissions (odds ratio, 10.7; 95% confidence interval, 1.3–85.4). In patients with different etiologies or pathological sites, moderate to strong correlations (Pearson’s r = 0.51–0.83) were observed between behavioral thresholds and auditory steady-state response thresholds. In conclusion, comprehensive assessments can provide etiological clues in ~75% of the children with auditory neuropathy. Different etiologies are associated with different audiologic features, and auditory steady-state responses might serve as an objective measure for estimating behavioral thresholds.

scholarly journals Measurement of Thresholds Using Auditory Steady-State Response and Cochlear Microphonics in Children with Auditory Neuropathy

2019 ◽  
Vol 30 (08) ◽  
pp. 672-676 ◽  
Author(s):  
Ping Lu ◽  
Yue Huang ◽  
Wen-Xia Chen ◽  
Wen Jiang ◽  
Ni-Yi Hua ◽  
...  
Keyword(s):  
Steady State ◽  
Normal Hearing ◽  
Auditory Neuropathy ◽  
High Signal ◽  
Steady State Response ◽  
Cochlear Microphonics ◽  
Behavioral Threshold ◽  
State Response ◽  
Auditory Steady State Response ◽  
The Difference

AbstractThe detection of precise hearing thresholds in infants and children with auditory neuropathy (AN) is challenging with current objective methods, especially in those younger than six months of age.The aim of this study was to compare the thresholds using auditory steady-state response (ASSR) and cochlear microphonics (CM) in children with AN and children with normal hearing.The thresholds of CM, ASSR, and visual reinforcement audiometry (VRA) tests were recorded; the ASSR and VRA frequencies used were 250, 500, 1000, 2000, and 4000 Hz.The participants in this study were 15 children with AN (27 ears) (1–7.6 years, median age 4.1 years) and ten children with normal hearing (20 ears) (1–8 years, median age four years).The thresholds of the three methods were compared, and histograms were used to represent frequency distributions of threshold differences obtained from the three methods.In children with normal hearing, the average CM thresholds (84.5 dB) were significantly higher than the VRA thresholds (10.0–10.8 dB); in children with AN, both CM and VRA responses were seen at high signal levels (88.9 dB and 70.6–103.4 dB, respectively). In normal children, the difference between mean VRA and ASSR thresholds ranged from 17.5 to 30.3 dB, which was significantly smaller than the difference seen between the mean CM and VRA thresholds (71.5–72.3 dB). The correlation between VRA and ASSR in children with normal hearing ranged from 0.38 to 0.48, whereas no such correlation was seen in children with AN at any frequency (0.03–0.19).Our results indicated that ASSR and CM were poor predictors of the conventional behavioral threshold in children with AN.

Sign in / Sign up

Export Citation Format

Share Document