Prediction of Hearing Threshold in Infants Using Auditory Steady-State Evoked Potentials

2002 ◽  
Vol 13 (05) ◽  
pp. 236-245 ◽  
Author(s):  
Gary Rance ◽  
Field Rickards
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Hearing Threshold ◽  
Normal Hearing ◽  
Older Children ◽  
Behavioral Thresholds ◽  
Similar Threshold ◽  
Highly Correlated ◽  
The Relationship ◽  
Audiometric Test

This retrospective study examines the relationship between auditory steady-state evoked potential (ASSEP) thresholds determined in infancy and subsequently obtained behavioral hearing levels in children with normal hearing or varying degrees of sensorineural hearing loss. Overall, the results from 211 subjects showed that the two test techniques were highly correlated, with Pearson r values exceeding .95 at each of the audiometric test frequencies between 500 and 4000 Hz. Analysis of the findings for babies with significant hearing loss (moderate to profound levels) showed similar threshold relationships to those obtained in previous studies involving adults and older children. The results for infants with normal or near-normal hearing did, however, differ from those reported for older subjects, with behavioral thresholds typically 10 to 15 dB better than would have been predicted from their ASSEP levels.

Hearing Threshold Estimation in Infants Using Auditory Steady-State Responses

2005 ◽  
Vol 16 (05) ◽  
pp. 291-300 ◽  
Author(s):  
Gary Rance ◽  
Richard Roper ◽  
Lindsay Symons ◽  
Lisa-Jane Moody ◽  
Christine Poulis ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Hearing Threshold ◽  
Auditory Neuropathy ◽  
Hearing Thresholds ◽  
Steady State Responses ◽  
Assessment Techniques ◽  
Behavioral Audiogram ◽  
Highly Correlated ◽  
Auditory Steady State Responses

Successful early intervention in children with permanent hearing loss requires assessment techniques that can accurately reflect the behavioral audiogram in infancy. This retrospective study compared auditory steady-state response (ASSR) findings from subjects tested in the first three months of life with subsequently obtained behavioral hearing levels. ASSR audiograms were established using amplitude and frequency modulated tones at octave frequencies (500 Hz to 4 kHz). Results obtained from 575 subjects including 285 with normal hearing, 271 with sensorineural hearing loss, and 19 with auditory neuropathy-type hearing loss are presented. ASSR and behavioral hearing thresholds for subjects in the normal and sensorineural groups were highly correlated, with Pearson r values exceeding 0.95 at each of the test frequencies. In contrast, ASSR thresholds in children with AN-type hearing loss did not accurately reflect the behavioral audiogram. Overall, the findings indicate that ASSR testing can offer useful insights into the hearing acuity of children tested in infancy.

An Evaluation of the Relationship between Retinal Nerve Fiber Thickness, Cochlear Nerve Thickness, the Level of Tinnitus, and Hearing Loss in Unilateral Tinnitus Patients

2021 ◽  
pp. 1-8
Author(s):  
Mustafa Avcu ◽  
Mehmet Metin ◽  
Raşit Kılıç ◽  
Muhammed Alpaslan
Keyword(s):  
Hearing Loss ◽  
Nerve Fiber ◽  
Normal Hearing ◽  
Cochlear Nerve ◽  
Significant Difference ◽  
The Relationship ◽  
Fiber Thickness ◽  
Moderate Hearing Loss ◽  
Group 1 ◽  
Retinal Nerve Fiber

Background: In this study, optic coherence tomography (OCT) examination was performed to check whether there was any interaction between ophthalmic axonal structures in unilateral tinnitus patients, and the relationship between optic nerve thickness and cochlear nerve thickness was evaluated. Objective: The aim of the study was to evaluate the relatioship between hearing loss, tinnitus, and nerve thicknesses. Study Design: Prospective study. Setting: Tertiary referral university hospital. Patients: The study included 88 patients with unilateral tinnitus, for which no organic cause could be found in physical examination, psychiatric evaluation, or with imaging methods. Study groups were formed of the tinnitus side and control groups were formed of the healthy side as follows: Group 1 (Non-tinnitus side normal hearing values – n = 30), Group 2 (non-tinnitus side minimal hearing loss – n = 27), Group 3 (non-tinnitus side moderate hearing loss – n = 31), Group 4 (tinnitus side normal hearing values – n = 25), Group 5 (tinnitus side minimal hearing loss – n = 25), and Group 6 (tinnitus side moderate hearing loss – n = 38). Intervention: Retinal nerve fiber layer (RNFL) thickness was evaluated with OCT, and the cochlear nerve cross-sectional area was evaluated with MRI. Main Outcome Measures: RNFL measurements were taken with OCT from the subfoveal area (RNFL-SF) and 1.5 mm temporal to the fovea (RNFL-T µm) and nasal (RNFL-N µm) sectors. On MRI, 3 measurements were taken along the nerve from the cerebellopontine angle as far as the internal auditory canal, and the mean value of these 3 measurements was calculated. Results: When the groups were evaluated in respect of cochlear nerve thickness, a significant difference was seen between Group 1 and both the groups with hearing loss and the tinnitus groups. In the subgroup analysis, a statistically significant difference was determined between Group 1 and Groups 3, 4, 5, and 6 (p = 0.013, p = 0.003, p < 0.001, and p < 0.001, respectively). When the groups were evaluated in respect of the RNFL-SF (µm), RNFL-T (µm), and RNFL-N (µm) values, the differences were determined to be statistically significant (p < 0.001 for all). In the correlation analysis, a negative correlation was determined between hearing loss and cochlear nerve diameter (r: −0.184, p = 0.014), and RNFL-N (r: −0.272, p < 0.001) and between tinnitus and cochlear nerve diameter (r: −0.536, p < 0.001), and RNFL-T (r: −0.222, p < 0.009). Conclusion: The study results clearly showed a relationship between cochlear nerve fiber thickness and hearing loss and the severity of tinnitus in cases with unilateral tinnitus and that there could be neurodegenerative factors in the disease etiology. A similar relationship seen with the RNFL supports the study hypothesis.

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 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.

The Effects of Hearing Loss and Noise Masking on the Masking Release for Speech in Temporally Complex Backgrounds

1998 ◽  
Vol 41 (3) ◽  
pp. 549-563 ◽  
Author(s):  
Sid P. Bacon ◽  
Jane M. Opie ◽  
Danielle Y. Montoya
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Sensorineural Hearing Loss ◽  
Pure Tone ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
The Other ◽  
Signal To Noise ◽  
Noise Masking ◽  
Masking Release

Speech recognition was measured in three groups of listeners: those with sensorineural hearing loss of (presumably) cochlear origin (HL), those with normal hearing (NH), and those with normal hearing who listened in the presence of a spectrally shaped noise that elevated their pure-tone thresholds to match those of individual listeners in the HL group (NM). Performance was measured in four backgrounds that differed only in their temporal envelope: steady-state (SS) speech-shaped noise, speech-shaped noise modulated by the envelope of multi-talker babble (MT), speech-shaped noise modulated by the envelope of single-talker speech (ST), and speech-shaped noise modulated by a 10-Hz square wave (SQ). Threshold signal-to-noise ratios (SNRs) were typically best in the ST and especially the SQ conditions, indicating a masking release in those modulated backgrounds. SNRs in the SS and MT conditions were essentially identical to one another. The masking release was largest in the listeners in the NH group, and it tended to decrease as hearing loss increased. In 5 of the 11 listeners in the HL group, the masking release was nearly identical to that obtained in the NM group matched to those listeners; in the other 6 listeners, the release was smaller than that in the NM group. The reduced masking release was simulated best in those HL listeners for whom the masking release was relatively large. These results suggest that reduced masking release for speech in listeners with sensorineural hearing loss can only sometimes be accounted for entirely by reduced audibility.

Frequency-Discrimination Ability of Hearing-Impaired Listeners

1981 ◽  
Vol 24 (1) ◽  
pp. 108-112 ◽  
Author(s):  
P. M. Zurek ◽  
C. Formby
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Frequency Modulation ◽  
Hearing Threshold ◽  
Low Frequency ◽  
Frequency Discrimination ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Discrimination Ability ◽  
Hearing Sensitivity

Thresholds for frequency modulation were measured by an adaptive, two-alternative, forced-choice method with ten listeners: eight who showed varying degrees of sensorineural hearing impairment, and two with normal-hearing sensitivity. Results for test frequencies spaced at octave intervals between 125 and 4000 Hz showed that, relative to normal-hearing listeners, the ability of the hearing-impaired listeners to detect a sinusoidal frequency modulation: (1) is diminished above a certain level of hearing loss; and (2) is more disrupted for low-frequency tones than for high-frequency tones, given the same degree of hearing loss at the test frequency. The first finding is consistent with that of previous studies which show a general deterioration of frequency-discrimination ability associated with moderate, or worse, hearing loss. It is proposed that the second finding may be explained: 1) by differential impairment of the temporal and place mechanisms presumed to, encode pitch at the lower and higher frequencies, respectively; and/or, 2) for certain configurations of hearing loss, by the asymmetrical pattern of cochlear excitation that may lead to the underestimation, from measurements of threshold sensitivity, of hearing impairment for low-frequency tones and consequently to relatively large changes in frequency discrimination for small shifts in hearing threshold.

scholarly journals Significance of Pseudo-conductive Hearing Loss and Positional Nystagmus on Perilymphatic Fistula: Are they related to third window effects?

2021 ◽  
Author(s):  
Jong Sei Kim ◽  
Se-Eun Son ◽  
Min Bum Kim ◽  
Young Sang Cho ◽  
Won-Ho Chung
Keyword(s):  
Hearing Loss ◽  
Clinical Features ◽  
Conductive Hearing Loss ◽  
Hearing Threshold ◽  
Positional Nystagmus ◽  
Horizontal Semicircular Canal ◽  
Perilymphatic Fistula ◽  
The Relationship ◽  
Conductive Hearing ◽  
Lower Frequencies

Objectives. Clinical presentation is critical to identify suspected perilymphatic fistula (PLF). To explain characteristic of PLF, it was hypothesized that a third window lesion might be involved in the pathomechanism. The purpose of this study is to investigate clinical features in PLF and figure out the relationship of third window effect and PLF. Methods. Sixty patients underwent surgical exploration under suspicion of PLF and reinforecmenet of oval window and round window was performed. Clinical features including demographics, pure tone audiometry (PTA), and videonystagmography (VNG) were evaluated preoperatively and 1 month after operation. Surgical outcomes were analyzed according to the improvement of hearing and vestibular symptoms and signs. The conductive components of PTA (air-bone gap (ABG)) were measured, and the relationship between ABG closure after surgery and hearing improvement was analyzed. In addition, the postoperative subjective dizziness was assessed by interview in clinic. The change of positional nystagmus was analyzed according to ABG closure and hearing improvement.Results. ABG at lower frequencies (LFABG, 250 Hz, 500 Hz, 1,000 Hz) was present in 27 patients (45%). Postoperatively, the PTA was significantly improved after surgical repair. Among the patients with preoperative LFABG (n=27), 15 (55.5%) showed postoperative ABG closure and significant improvement in PTA at all frequencies compared with the patients without ABG closure (P=0.012). The subjective dizziness improved in 56 patients (91.8%). Positional nystagmus was found in 45 of 49 patients. Multiple canal involvement was more common than single canal (67% vs. 33%). The horizontal semicircular canal was most commonly involved, followed by the posterior and anterior canals. Postoperatively, the positional nystagmus disappeared, or the number of involved canals decreased in 22 of 34 (64.7%) patients. Conclusions. Pseudo-conductive hearing loss at the lower frequencies and positional nystagmus originating from multiple semicircular canals were common findings in PLF. Surgical reinforcement of the RW and OW improved hearing threshold accompanied by closure of ABG. The third window lesion might explain these clinical features that indicate PLF.

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