Threshold estimation in normal and impaired ears using Auditory Steady State Responses

Abstract

The Auditory Steady State Response (ASSR) procedure has been established as a frequency specific, objective audiologic measure, which can provide reliable thresholds to within 10 dB of the behavioral thresholds. In order for ASSR to find its place in the existing framework of audiometric procedures, the full potential of the procedure needs to be explored. The aim of this study was to determine the accuracy of monotic ASSR in estimating hearing thresholds in a group of 15 normal hearing subjects and 15 hearing-impaired subjects. A comparative research design was implemented. Indicating that results obtained in the study was compared to relevant literature where dichotic multiple ASSR was implemented. This was done in order to ascertain ASSR’s capabilities with regard to stimulus presentation methods. Monotic single ASSR predicted behavioural thresholds in the normal hearing subjects within an average of 24 dB across the frequency range (0.5, 1, 2&4 kHz). In the hearing-impaired group, ASSR thresholds more closely resembled behavioural thresholds, with an average difference of 18 dB, which is consistent with recent literature. The literature suggests that better prediction of behavioural thresholds will occur with greater degrees of hearing loss, due to recruitment. The focus in this group also centered on the accurate prediction of the configuration of the hearing loss. It was found that ASSR could reasonably accurately predict the configuration of the hearing loss. In the last instance, monotic single and dichotic multiple ASSR were compared with regard to threshold estimation and prediction of configuration of the hearing loss in the hearing-impaired group. Little difference was reported between the two techniques with regard to the estimation of thresholds in both the normal hearing and hearing impaired groups. In conclusion it was established that monotic ASSR could predict behavioural thresholds of varying degrees and configurations of hearing loss in normal and hearing-impaired subjects with a reasonable amount of accuracy. At this stage, however, more research is required to establish the clinical validity of the procedure, before it is routinely included within an objective test battery.