Chirp Auditory Steady State Response versus Click Auditory Brain Stem Response in Hearing Assessment of Newborns and Infants

Amal Mohamed Mohamed Emam


Accurate and early assessment of hearing sensitivity in infants and children is critical to best serve a child‘s auditory needs, these assessments are most informative when they include a measure providing frequency-specific threshold information, and indicate the type of hearing loss. Click-evoked-ABR is the most widely used electrophysiologic procedure for estimating auditory sensitivity in infants and children who cannot provide reliable behavioral results. Click stimulus activates a large portion of the cochlea with firing of neural units over an extended frequency range (Don et al., 1979). This yields a highly repeatable response in the (2000 to 4000) Hz frequency region. The auditory steady-state response (ASSR) is a frequency-specific physiological diagnostic tool that has increasingly gained clinical interest for its potential to assess infants and children. However, limited number of studies exists for the applicability of chirp ASSR in this group with different degrees of hearing. Accordingly this study was designed to investigate the value of chirp ASSR in estimating different degrees of hearing in group of infants compromised of 59 infants (116 ears), their age was below 2 years. All infants of the study were subjected to careful history taking, and otological examination. Click-evoked ABR was performed for detection of hearing threshold, followed by narrow band CE chirp ASSR on 0.5, 1, 2 and 4 kHz. The current study confirmed the clinical usefulness of the multiple frequencies, simultaneously evoked ASSR as an objective methodology for frequency specific audiometry in infants with and without hearing impairment, and expanded the evidence that ASSR yields better predictions of the degree of peripheral sensitivity than the click-evoked responses. Moreover, the stimulation of ASSR using narrow band chirp supported the hypothesis that the compensation for traveling wave delay implemented in the chirp stimulus would improve the detectability and shorten the timing of the stimulation of the basilar membrane hair cells (Elberling et al., 2007), as better hearing thresholds obtained with NB CE-chirp ASSR compared to click ABR, in relatively short measurement times. These findings are

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Other Titles الجهـد السمعـى المثـار بواسطـة الحافـز ذو الحالة المستقرة باستخدام نغمات التغريد مقابل الجهد السمعى لجذع المخ المثار بالنقر فى تقييم السمع لدى الأطفال حديثى الولادة والرضـع
Issue Date 2016

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