The accuracy of objective threshold determination at low frequencies: comparison of different auditory brainstem response (ABR) and auditory steady state response (ASSR) methods

Abstract

The LCBERA is recommended for use in routine clinical practice.

Hearing threshold estimation by auditory steady state responses (ASSR) in children

“…In addition, CE-Chirps have been reported to offer good signal-to-noise ratio when testing mid-low frequencies. However, most of the studies available in the literature so far report experiments on young adults or newborns with normal hearing 22-27 .…”

Current audiological diagnostics

“…Especially the exploration of thresholds at low frequencies in pediatric patients will benefit from this aspect. Regarding the question which method is most appropriate for this field of application, valuable knowledge could be gained in the past years [ 283 ], [ 285 ], [ 327 ].…”

“…The spectral properties of the chirp are similar to the tone pulse. Due to the high degree of synchronization, however, the AEP amplitudes are larger at identical stimulus levels and thus the threshold transition is easier to detect [ 284 ], [ 285 ].…”

“…Some time ago, modulation frequencies in the range of 90 Hz and above were considered more suitable for the examination of children because the evoked EEG activity is less dependent on vigilance and maturation, compared to the responses of lower modulation frequencies [ 319 ], [ 320 ], [ 321 ], [ 322 ], [ 323 ], [ 324 ]; especially since the introduction of narrowband chirp stimuli of different stimulus rates [ 278 ], [ 325 ] this seems to be questionable in the light of recent studies [ 326 ], [ 327 ], [ 328 ], [ 329 ]. Even at low frequencies, an acceptable estimation of the hearing threshold can be achieved by means of 40 Hz ASSR in adults [ 285 ] as well as in children [ 327 ]. Since the identification of ASSR (which that may be considered as general term for those paradigms that consist of signal description and signal confirmation in the frequency range [ 330 ], [ 331 ]) is based on the modulation frequencies of the stimulus represented in the EEG, the stimulation can be performed with several differently modulated carrier frequencies and even in both ears at the same time as long as the stimulus levels exclude mutual masking [ 317 ], [ 318 ], [ 332 ], [ 333 ].…”

Objective frequency-specific hearing thresholds definition for medicolegal purposes in case of occupational NIHL: ASSR outperforms CERA

“…In the past two decades, the primary clinical application of ASSR has been the hearing assessment of infants and children (Dimitrjevic and Cone, 2005). The low frequency range (500 Hz) can also be explored with ASSR ( Frank et al., 2017 ). However, audiological use of the 40 Hz-ASSR could also be of interest for expert assessments in adults undergoing assessment in a medicolegal context or for compensation purposes (Yüksel & al., 2020) (11 subjects).…”