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Abstract <p>Objective electrophysiological techniques play an important role in hearing threshold estimation when reliable behavioral audiometry cannot be obtained. Auditory steady-state response (ASSR) and auditory brainstem response (ABR) are widely used for this purpose; however, the extent to which different types of hearing loss influence their accuracy remains incompletely understood in adult populations.&#xa0;To evaluate the influence of sensorineural hearing loss (SNHL) and conductive hearing loss (CHL) on the accuracy of ASSR and ABR for estimation of behavioral hearing thresholds in adults.&#xa0;This prospective observational study included adults with hearing impairment who underwent pure tone audiometry (PTA), ASSR and frequency-specific tone-burst ABR testing. Hearing thresholds at 500&#xa0;Hz (Hz), 1&#xa0;kHz, 2&#xa0;kHz and 4&#xa0;kHz were analyzed. Based on audiometric findings, ears were classified into SNHL and CHL groups. Relationships between behavioral and electrophysiological thresholds were assessed using Pearson’s correlation coefficients, mean threshold differences and intraclass correlation coefficients (ICC).&#xa0;Fifty-eight ears were included, comprising 43 ears with SNHL and 15 ears with CHL. Significant positive correlations were observed between PTA and both electrophysiological modalities across all tested frequencies in both groups (<i>r</i> = 0.594–0.914; <i>p</i> &lt; 0.05). In the SNHL group, PTA–ASSR correlation coefficients ranged from 0.594 to 0.817, while PTA–ABR correlations ranged from 0.691 to 0.879. In the CHL group, PTA–ASSR correlations ranged from 0.613 to 0.914 and PTA–ABR correlations ranged from 0.730 to 0.910. Across both hearing-loss categories, ASSR demonstrated smaller mean threshold differences from PTA and consistently higher ICC values than ABR, indicating closer agreement with behavioral hearing thresholds. ASSR reduced threshold prediction error by approximately 4–10 decibels compared with ABR across the frequencies evaluated. ASSR also demonstrated a higher proportion of threshold estimates within clinically acceptable limits (± 10 dB and ± 15 dB) of behavioral PTA than ABR.&#xa0;Both ASSR and ABR provided clinically useful estimates of hearing sensitivity in adults with SNHL and CHL. However, ASSR showed better agreement with behavioral audiometric thresholds and may offer greater accuracy for frequency-specific threshold estimation in routine clinical practice.</p>

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Influence of Type of Hearing Loss on the Accuracy of Auditory Steady-State Response and Auditory Brainstem Response Threshold Estimation in Adults

  • 期刊论文

  • 发表日期：

    2026年7月20日

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  • Jitendra Bothra,
  • Tanuj Madan,
  • Rohit Singh,
  • Angshuman Dutta,
  • Rahul Naga,
  • Lovraj Goyal,
  • Vijay Bhalla

摘要

Abstract

Objective electrophysiological techniques play an important role in hearing threshold estimation when reliable behavioral audiometry cannot be obtained. Auditory steady-state response (ASSR) and auditory brainstem response (ABR) are widely used for this purpose; however, the extent to which different types of hearing loss influence their accuracy remains incompletely understood in adult populations. To evaluate the influence of sensorineural hearing loss (SNHL) and conductive hearing loss (CHL) on the accuracy of ASSR and ABR for estimation of behavioral hearing thresholds in adults. This prospective observational study included adults with hearing impairment who underwent pure tone audiometry (PTA), ASSR and frequency-specific tone-burst ABR testing. Hearing thresholds at 500 Hz (Hz), 1 kHz, 2 kHz and 4 kHz were analyzed. Based on audiometric findings, ears were classified into SNHL and CHL groups. Relationships between behavioral and electrophysiological thresholds were assessed using Pearson’s correlation coefficients, mean threshold differences and intraclass correlation coefficients (ICC). Fifty-eight ears were included, comprising 43 ears with SNHL and 15 ears with CHL. Significant positive correlations were observed between PTA and both electrophysiological modalities across all tested frequencies in both groups (r = 0.594–0.914; p < 0.05). In the SNHL group, PTA–ASSR correlation coefficients ranged from 0.594 to 0.817, while PTA–ABR correlations ranged from 0.691 to 0.879. In the CHL group, PTA–ASSR correlations ranged from 0.613 to 0.914 and PTA–ABR correlations ranged from 0.730 to 0.910. Across both hearing-loss categories, ASSR demonstrated smaller mean threshold differences from PTA and consistently higher ICC values than ABR, indicating closer agreement with behavioral hearing thresholds. ASSR reduced threshold prediction error by approximately 4–10 decibels compared with ABR across the frequencies evaluated. ASSR also demonstrated a higher proportion of threshold estimates within clinically acceptable limits (± 10 dB and ± 15 dB) of behavioral PTA than ABR. Both ASSR and ABR provided clinically useful estimates of hearing sensitivity in adults with SNHL and CHL. However, ASSR showed better agreement with behavioral audiometric thresholds and may offer greater accuracy for frequency-specific threshold estimation in routine clinical practice.