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The clinical value of the multiple-frequency 80-Hz auditory steady-state response in adults with normal hearing and hearing loss

Wendy D'Haenens (UGent) , Ingeborg Dhooge (UGent) , Leen Maes (UGent) , Annelies Bockstael (UGent) , Hannah Keppler (UGent) , Birgit Philips (UGent) , Freya Swinnen (UGent) and Bart Vinck (UGent)
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Abstract
Objectives: To determine the ability of the air-conduction multiple-frequency auditory steady-state response (ASSR) technique to diagnose normal hearing (NH) and mild and moderate degrees of sensorineural hearing loss (SNHL), to assess patients with conductive hearing loss (CHL), to evaluate flat and sloping configurations of hearing impairment, and to provide sensitivity and specificity values for various ASSR cutoff criteria. Design: A comparative study between ASSR and criterion-standard behavioral thresholds. Setting: Ear, nose, and throat department at a university hospital. Patients: The study population comprised 40 adults with NH, 17 with SNHL, and 7 with CHL. Main Outcome Measures: The measure of interest was the difference between ASSR and behavioral thresholds at 0.5, 1.0, 2.0, and 4.0 kHz. The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency were calculated for several ASSR cutoff criteria. Results: The ASSR technique clearly distinguished moderate SNHL from NH, but the "mild SNHL and NH" and "mild SNHL and moderate SNHL" differentiation was particularly difficult at 0.5 and 2.0 kHz, respectively. Air-conduction ASSR thresholds accurately predicted behavioral thresholds in CHL. The ASSR system precisely reflected the flat and sloping configurations. Finally, the most appropriate ASSR cutoff point for normality seems to be the 30-dB-or-lower criterion. Conclusions: In adults, the multiple-frequency 80-Hz ASSR technique can be used to determine the degree and configuration of hearing loss. Although air-conduction ASSR thresholds accurately predicted behavioral thresholds in CHL, future research with bone-conduction ASSRs is necessary to establish the type of hearing loss. Furthermore, the applicability of these findings still needs to be confirmed for infants.
Keywords
STIMULUS, INFANTS, ACCURACY, THRESHOLD ESTIMATION, CHILDREN, MASTER, HZ

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Chicago
D’Haenens, Wendy, Ingeborg Dhooge, Leen Maes, Annelies Bockstael, Hannah Keppler, Birgit Philips, Freya Swinnen, and Bart Vinck. 2009. “The Clinical Value of the Multiple-frequency 80-Hz Auditory Steady-state Response in Adults with Normal Hearing and Hearing Loss.” Archives of Otolaryngology-head & Neck Surgery 135 (5): 496–506.
APA
D’Haenens, W., Dhooge, I., Maes, L., Bockstael, A., Keppler, H., Philips, B., Swinnen, F., et al. (2009). The clinical value of the multiple-frequency 80-Hz auditory steady-state response in adults with normal hearing and hearing loss. ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 135(5), 496–506.
Vancouver
1.
D’Haenens W, Dhooge I, Maes L, Bockstael A, Keppler H, Philips B, et al. The clinical value of the multiple-frequency 80-Hz auditory steady-state response in adults with normal hearing and hearing loss. ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY. 2009;135(5):496–506.
MLA
D’Haenens, Wendy et al. “The Clinical Value of the Multiple-frequency 80-Hz Auditory Steady-state Response in Adults with Normal Hearing and Hearing Loss.” ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY 135.5 (2009): 496–506. Print.
@article{663067,
  abstract     = {Objectives: To determine the ability of the air-conduction multiple-frequency auditory steady-state response (ASSR) technique to diagnose normal hearing (NH) and mild and moderate degrees of sensorineural hearing loss (SNHL), to assess patients with conductive hearing loss (CHL), to evaluate flat and sloping configurations of hearing impairment, and to provide sensitivity and specificity values for various ASSR cutoff criteria. 
Design: A comparative study between ASSR and criterion-standard behavioral thresholds. 
Setting: Ear, nose, and throat department at a university hospital. 
Patients: The study population comprised 40 adults with NH, 17 with SNHL, and 7 with CHL. 
Main Outcome Measures: The measure of interest was the difference between ASSR and behavioral thresholds at 0.5, 1.0, 2.0, and 4.0 kHz. The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency were calculated for several ASSR cutoff criteria. 
Results: The ASSR technique clearly distinguished moderate SNHL from NH, but the {\textacutedbl}mild SNHL and NH{\textacutedbl} and {\textacutedbl}mild SNHL and moderate SNHL{\textacutedbl} differentiation was particularly difficult at 0.5 and 2.0 kHz, respectively. Air-conduction ASSR thresholds accurately predicted behavioral thresholds in CHL. The ASSR system precisely reflected the flat and sloping configurations. Finally, the most appropriate ASSR cutoff point for normality seems to be the 30-dB-or-lower criterion. 
Conclusions: In adults, the multiple-frequency 80-Hz ASSR technique can be used to determine the degree and configuration of hearing loss. Although air-conduction ASSR thresholds accurately predicted behavioral thresholds in CHL, future research with bone-conduction ASSRs is necessary to establish the type of hearing loss. Furthermore, the applicability of these findings still needs to be confirmed for infants.},
  author       = {D'Haenens, Wendy and Dhooge, Ingeborg and Maes, Leen and Bockstael, Annelies and Keppler, Hannah and Philips, Birgit and Swinnen, Freya and Vinck, Bart},
  issn         = {0886-4470},
  journal      = {ARCHIVES OF OTOLARYNGOLOGY-HEAD \& NECK SURGERY},
  language     = {eng},
  number       = {5},
  pages        = {496--506},
  title        = {The clinical value of the multiple-frequency 80-Hz auditory steady-state response in adults with normal hearing and hearing loss},
  volume       = {135},
  year         = {2009},
}

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