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


Purpose: Accurate 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.

Methods: Thresholds 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.

Results: Both 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%).

Conclusion: The 40-Hz sASSR is more accurate than TB-ABR in determining a mild, low-frequency threshold.


Communication Sciences and Disorders

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American Journal of Audiology