Threshold estimation in adult normal- and impaired-hearing subjects using auditory steady-state responses

BACKGROUND: The aim of the study was to compare the estimation of hearing threshold values by behavioral and electrophysiological (ASSR) methods in subjects with normal hearing and those with sensorineural hearing impairment. MATERIAL/METHODS: Thirty-two subjects (17 male and 15 female) were tested, with a total of 61 ears. Of these, 11 (22 ears) presented normal hearing threshold values (0-19 dBHL) and 21 (39 ears) sensorineural deficits. RESULTS: The data showed that for the normal-hearing subjects the mean +/-SD ASSR threshold was approximately 20+/-11 dB for frequencies of 0.25-1.0 kHz. For higher frequencies the ASSR threshold increased to 40+/-12.5 dB at 8.0 kHz. Regression analysis confirmed that the difference between the ASSR-estimated and behavioral threshold values decreased significantly with the amount of hearing loss. The data showed that for a 10-dB increment of the behavioral threshold, the ASSR threshold increased by 7 dB. The difference of about 27 dB between the two methods observed in normal subjects tends to cancel in hearing loss greater than 95-100 dBHL. CONCLUSIONS: The results of these analyses indicate that the threshold estimates are rather discordant with the behavioral thresholds. in particular it seems that the correction factor applied here does not rely on factors adequately modeled (in terms of instrumentation) to compensate for the effects of hearing loss on ASSR thresholds. The threshold estimation is adequately modeled for high levels of hearing loss, particularly for patients requiring a cochlear implant.