40-Hz Sinusoidal Auditory Steady-State Response and Tone Burst Auditory Brainstem Response Using a Kalman Filter to Determine Thresholds Pre- and Post-Myringotomy With Grommet Tube in Children With Mild, Low-Frequency Conductive Hearing Loss

2016 ◽  
Vol 25 (1) ◽  
pp. 41-53 ◽  
Author(s):  
Wafaa A. Kaf ◽  
Enass S. Mohamed ◽  
Hamza Elshafiey
Keyword(s):  
Hearing Loss ◽  
Otitis Media With Effusion ◽  
Low Frequency ◽  
Tone Burst ◽  
Auditory Brainstem ◽  
State Response ◽  
Behavioral Thresholds ◽  
Auditory Steady State Response ◽  
Brainstem Response ◽  
40 Hz

PurposeAccurate estimation of mild, low-frequency hearing loss is difficult in young children. This study aimed to determine the accuracy of 40-Hz sinusoidal auditory steady-state response (sASSR) compared with tone burst auditory brainstem response (TB-ABR) to detect mild, low-frequency hearing loss in children with otitis media with effusion and to measure postoperative thresholds.MethodsThresholds at 500 and 4000 Hz were measured behaviorally and electrophysiologically using TB-ABR and 40-Hz sASSR with a Kalman filter in 26 children with otitis media with effusion. Recording was conducted preoperatively and postoperatively while children were actively awake. Repeated measures mixed analyses of variance were conducted to determine effects among measures and the two test frequencies.ResultsBoth 40-Hz sASSR and TB-ABR accurately detected preoperative and postoperative thresholds and were within 5–10 dB of the behavioral thresholds at 4000 Hz. At 500 Hz, the mean 40-Hz sASSR threshold was only 5 dB above the behavioral thresholds and 18 dB better than the 500-Hz ABR threshold. Positive correlations were found but not between 40-sASSR and TB-ABR at 500 Hz. Also, the interrater judgment of the response was better for sASSR (89%) than TB-ABR (83%).ConclusionThe 40-Hz sASSR is more accurate than TB-ABR in determining a mild, low-frequency threshold.

scholarly journals 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

2019 ◽  
Vol 35 (2) ◽  
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.

scholarly journals Comparative Study of the Auditory Steady-State Response (ASSR) and Click Auditory Brainstem Evoked Response (ABR) Thresholds among Filipino Infants and Young Children

2009 ◽  
Vol 24 (1) ◽  
pp. 9-12
Author(s):  
Laurence Ian C. Tan ◽  
Maria Rina T. Reyes-Quintos ◽  
Maria Leah C. Tantoco ◽  
Charlotte M. Chiong
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Young Children ◽  
Auditory Brainstem Response ◽  
Auditory Brainstem ◽  
Steady State Response ◽  
State Response ◽  
Auditory Steady State Response ◽  
Brainstem Response ◽  
Infants And Young Children

Objective: To compare the results of auditory steady-state response (ASSR) and click auditory brainstem response (click ABR) among infants and young children tested at the Ear Unit of a Tertiary General Hospital.   Methods: Design: Cross-sectional Study Setting: Tertiary General Hospital Population: Within-subject comparisons of click auditory brainstem response (click ABR) thresholds and auditory steady-state response (ASSR) thresholds among 55 infants and young children, 2 months to 35 months of age referred to the Ear Unit for electrophysiologic hearing assessment. Results: Click ABR showed strong positive correlation to all frequencies and averages of ASSR. Highest correlation was noted with the average of 1-4 kHz ASSR results with Pearson r = 0.89 (Spearman r=0.80), the average of 2-4 kHz had strong positive correlation r = 0.88 (0.79). Correlation was consistently strong through all ASSR frequencies (0.5 kHz at r=0.86 (0.74), 1 kHz at r=0.88 (0.78), 2 kHz at r=0. 87 (0.79), 4 kHz at r=0.85 (0.76)). Average differences of click ABR and ASSR thresholds were 8.2±12.9dB at 0.5 kHz, 8.6±12.6dB at 1 kHz, 5.3±11.8dB at 2 kHz and 7.8±13.4dB at 4 kHz. Among patients with no demonstrable waveforms by click ABR with maximal click stimulus, a large percentage presented with ASSR thresholds. Of these, 80.5% (33 of 41) had measurable results at 0.5 kHz with an average of 107.3±11.1dB, 85.4% (35 of 41) at 1 kHz with an average of 110.5±11.8dB, 73.2% (30 of 41) at 2 kHz with an average of 111.2±11.1dB and 63.4% (26 of 41) at 4 kHz with and average of 112.2±8.21dB. Auditory steady-state response results were comparable to auditory brainstem response results in normal to severe hearing loss, and provided additional information necessary for complete audiologic assessment especially among patients with severe to profound hearing loss wherein click ABR showed no responses. Up to 85.4% of patients that would have been noted to have no waveforms by click ABR still demonstrated measurable thresholds by ASSR   Conclusion: Our study suggests that ASSR may be the best available tool for assessing children with severe to profound hearing loss, and is a comparably effective tool in overall hearing assessment for patients requiring electrophysiological testing. The advantages of ASSR over click ABR include: 1) detection of frequency-specific thresholds and; 2) the detection of hearing loss thresholds beyond the limits of click ABR.     Key words: Auditory Steady-State Response, ASSR, Auditory Brainstem-Evoked Response, ABR, Hearing Thresholds, Electrophysiologic Testing  

scholarly journals Σύγκριση των click Auditory Brainstem Responses (ABR) και των chirp Auditory Steady-State Responses (ASSR), ηλεκτροφυσιολογικών (αντικειμενικών) μεθόδων που χρησιμοποιούνται για τον έλεγχο και τη διάγνωση της παιδικής βαρηκοΐας

2021 ◽  
Author(s):  
Κωνσταντίνος Μουρτζούχος
Keyword(s):  
Steady State ◽  
Tone Burst ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
State Response ◽  
Auditory Steady State Response ◽  
Brainstem Response ◽  
Steady State Responses ◽  
Auditory Steady State Responses ◽  
State Responses

Τα προκλητά δυναμικά κατέχουν σημαντική θέση στον προσδιορισμό των ουδών της ακοής σε παιδιά πολύ μικρά για να εξεταστούν με τις συμβατικές συμπεριφορικές μεθόδους και σε άλλους πληθυσμούς που παρουσιάζουν δυσκολίες κατά την εξέταση. Το ABR (Auditory Brainstem Response), μέθοδος που χρησιμοποιείται κατά τα τελευταία 50 χρόνια, έχει σήμερα ευρέως αναγνωριστεί ως η πιο αποτελεσματική τεχνική προκλητών δυναμικών και χρησιμοποιείται καθημερινά, με click και tone burst ως ερεθίσματα, για την εκτίμηση της ακουστικής ικανότητας σε βρέφη και παιδιά πολύ μικρά για άλλες εξεταστικές μεθόδους. Η καταγραφή του ABR, ωστόσο, υπόκειται σε περιορισμούς ως προς το ανώτερο επίπεδο έντασης χορήγησης του ερεθίσματος, όπως επίσης και εξαιτίας της υποκειμενικής μεθόδου ελέγχου για τον προσδιορισμό του ουδού, ενώ οι καταγραφές με tone burst ερεθίσματα είναι συχνά πιο απαιτητικές ως προς την ερμηνεία τους, λόγω του ότι οι κυματομορφές μπορεί να είναι λιγότερο χαρακτηριστικές. Το ASSR (Auditory Steady-State Response) αποτελεί μια πιο πρόσφατη εναλλακτική πρόταση έναντι των καθιερωμένων ABR τεχνικών καταγραφής. Σε αντίθεση με το παροδικού τύπου ερέθισμα click που χρησιμοποιείται στις ABR καταγραφές, το διαμορφωμένο συνεχούς τύπου ερέθισμα του ASSR εκλύει μια περιοδική ή “steady-state” κυματομορφή, της οποίας τα φασματικά χαρακτηριστικά (εύρος και φάση) αναλύονται στο frequency ή και στο time domain για τον προσδιορισμό της παρουσίας ή της απουσίας απάντησης. Το αυτόματο σύστημα ανίχνευσης της απάντησης που χρησιμοποιείται στην καταγραφή του ASSR εξαλείφει την ανάγκη για υποκειμενικό τρόπο ελέγχου των απαντήσεων. Ο τύπος του ASSR ερεθίσματος που χρησιμοποιήθηκε σε αυτήν την μελέτη ήταν το narrowband CE-chirp, ένα είδος chirp που εισήλθε σχετικά πολύ πρόσφατα στις συσκευές που διατίθενται στο εμπόριο. Σκοπός αυτής της μελέτης ήταν να συγκρίνει αυτές τις δύο ηλεκτροφυσιολογικές μεθόδους και τον βαθμό στον οποίο συσχετίζονται, σε ένα μεγάλο πληθυσμό παιδιών με διάφορου βαθμού νευροαισθητήρια βαρηκοΐα, που εξετάστηκαν με φαρμακευτικό ύπνο στο Ακοολογικό Κέντρο της Κλινικής μας κατά το διάστημα 2010-14. Εξετάστηκαν συνολικά 130 παιδιά, 90 άρρενα και 40 θήλεα (n = 260 αυτιά), ηλικίας 5 έως 79 μηνών (μέση ηλικία: 32.7 ± 14.0 μήνες), με μια ποικιλία προβλημάτων και διαταραχών. Η τελική στατιστική ανάλυση για σύγκριση των δύο μεθόδων περιέλαβε αφ’ ενός τις τιμές ουδών που αποκτήθηκαν από το click ABR και αφ’ ετέρου τους μέσους όρους των ουδών που αποκτήθηκαν από το chirp ASSR στις συχνότητες 1, 2 και 4 kHz και 2 και 4 kHz. Τα αποτελέσματα αυτής της μελέτης ανέδειξαν ισχυρές συσχετίσεις μεταξύ των click ABR ουδών και των μέσων όρων των chirp ASSR ουδών στα 1000, 2000 και 4000 Hz (rs = .826, p < .001) και στα 2000 και 4000 Hz (rs = .824, p < .001) και συμφωνούν γενικά με τα αποτελέσματα παρόμοιων μελετών της διεθνούς βιβλιογραφίας. Συμπερασματικά φαίνεται ότι το ASSR είναι αναγκαίο για την ακριβή ποσοτικοποίηση της υπολειπόμενης ακοής στην ζώνη της μεγάλου προς πολύ μεγάλου βαθμού βαρηκοΐας, σε περιοχές εντάσεων άνω των ορίων των περισσοτέρων ABR συσκευών. Η «ακοολογική πληροφορία» που αποκτάται με το ASSR τεστ, ειδικά στην ανωτέρω περιοχή, είναι πολύτιμη στην λήψη αποφάσεων για περαιτέρω παρέμβαση σε παιδιά με νευροαισθητήρια βαρηκοΐα (ενίσχυση, κοχλιακή εμφύτευση), ιδίως για τα παιδιά εκείνα που δεν μπορούν να μετρηθούν με συμπεριφορικές μεθόδους. Τα αποτελέσματα αυτά ενισχύουν την χρήση του ASSR ως εναλλακτικού τεστ σε σχέση με το ABR στην εκτίμηση και αντιμετώπιση της παιδικής βαρηκοΐας.

The Auditory Steady State Response in Individuals with Neurological Insult of the Central Auditory Nervous System

2007 ◽  
Vol 18 (10) ◽  
pp. 826-845 ◽  
Author(s):  
Jennifer B. Shinn ◽  
Frank E. Musiek
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Neurological Impairment ◽  
Control Group ◽  
Steady State Response ◽  
Hearing Sensitivity ◽  
State Response ◽  
Behavioral Thresholds ◽  
Auditory Steady State Response ◽  
Neurological Insult

The auditory steady state response (ASSR) has recently gained attention with respect to estimates of hearing sensitivity and configuration of hearing loss. The present investigation compared behavioral thresholds to estimated ASSR thresholds in subjects with confirmed CANS lesions to determine if this population can be accurately evaluated with ASSR techniques. Comparisons were made between the experimental group and a normal control group matched for age and hearing sensitivity. ASSR thresholds were obtained for the carrier frequencies of 500 and 2000 Hz with a 46 Hz modulation rate and compared to behavioral thresholds. Within and between group comparisons were made. The control group demonstrated strong correlation between their behavioral and estimated ASSR thresholds which significantly contrasted the neurological group. Additionally, individuals with neurological impairment of the CANS exhibited elevated thresholds that were on average 24 dB greater at 2000 Hz than their behavioral thresholds. These results suggest that individuals with neurological insult may appear as hearing impaired or having greater hearing loss than is actually present. As a result, the ASSR may demonstrate the potential to assist in the detection of CANS dysfunction. Las respuestas auditivas de estado estable (ASSR) han ganado atención recientemente con respecto a la estimación de la sensibilidad auditiva y la configuración de la pérdida auditiva. La presente investigación comparó los umbrales conductuales con umbrales estimados por ASSR en sujetos con lesiones CANS confirmadas para determinar si esta población podía ser evaluada con exactitud por medio de técnicas de ASSR. Las comparaciones se realizaron entre el grupo experimental y un grupo control normal ordenados por edad y sensibilidad auditiva. Los umbrales de los ASSR se obtuvieron por medio de frecuencias portadoras de 500 y 2000 Hz, con una tasa de modulación de 46 Hz y se compararon con los umbrales conductuales. Se realizaron comparaciones entre los grupos y dentro de un mismo grupo. El grupo de control mostró una fuerte correlación entre sus umbrales conductuales y los estimados por ASSR, que contrastó significativamente con el grupo neurológico. Adicionalmente, los individuos con un trastorno neurológico de CANS exhibieron umbrales elevados que fueron en promedio 24 dB más alto en 2000 Hz que sus umbrales conductuales. Estos resultados sugieren que los individuos con alteraciones neurológicas pueden lucir como alterados auditivamente o teniendo una pérdida auditiva mayor de la realidad. Como resultados, los ASSR puede demostrar el potencial para ayudar en la detección de la disfunción por CANS.

scholarly journals Auditory steady state response in hearing assessment in infants with cytomegalovirus

2013 ◽  
Vol 31 (4) ◽  
pp. 550-553 ◽  
Author(s):  
Daniela Polo C. Silva ◽  
Priscila Suman Lopez ◽  
Jair Cortez Montovani
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Hearing Aids ◽  
Otoacoustic Emissions ◽  
Steady State Response ◽  
Case Description ◽  
Congenital Cytomegalovirus ◽  
State Response ◽  
Auditory Steady State Response ◽  
Brainstem Response

OBJECTIVE: To report an infant with congenital cytomegalovirus and progressive sensorineural hearing loss, who was assessed by three methods of hearing evaluation. CASE DESCRIPTION: In the first audiometry, at four months of age, the infant showed abnormal response in Otoacoustic Emissions and normal Auditory Brainstem Response (ABR), with electrophysiological threshold in 30dBnHL, in both ears. With six months of age, he showed bilateral absence of the ABR at 100dBnHL. The behavioral observational audiometry was impaired due to the delay in neuropsychomotor development. At eight months of age, he was submitted to Auditory Steady State Response (ASSR) and the thresholds were 50, 70, absent in 110 and in 100dB, respectively for 500, 1,000, 2,000 and 4,000Hz in the right ear, and 70, 90, 90 and absent in 100dB, respectively for 500, 1,000, 2,000 and 4,000Hz in the left ear. COMMENTS: In the first evaluation, the infant had abnormal Otoacoustic Emission and normal ABR, which became altered at six months of age. The hearing loss severity could be identified only by the ASSR, which allowed the best procedure for hearing aids adaptation. The case description highlights the importance of the hearing status follow-up for children with congenital cytomegalovirus.

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

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. 

40 Hz auditory steady‐state response in eleven subjects with false hearing loss

2020 ◽  
Vol 45 (4) ◽  
pp. 600-603
Author(s):  
Mustafa Yüksel ◽  
Atılım Atılgan ◽  
Ufuk Derinsu
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Steady State Response ◽  
State Response ◽  
Auditory Steady State Response ◽  
40 Hz
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