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 ... Research Article
Research Article  |   March 01, 2016
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
 
Author Affiliations & Notes
  • Wafaa A. Kaf
    Missouri State University, Springfield
  • Enass S. Mohamed
    Assiut University, Egypt
  • Hamza Elshafiey
    Assiut University, Egypt
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Wafaa A. Kaf: wafaakaf@missouristate.edu
  • Editor and Associate Editor: Larry Humes
    Editor and Associate Editor: Larry Humes×
Article Information
Hearing Disorders / Research Articles
Research Article   |   March 01, 2016
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
American Journal of Audiology, March 2016, Vol. 25, 41-53. doi:10.1044/2015_AJA-15-0052
History: Received August 28, 2015 , Revised December 2, 2015 , Accepted December 22, 2015
 
American Journal of Audiology, March 2016, Vol. 25, 41-53. doi:10.1044/2015_AJA-15-0052
History: Received August 28, 2015; Revised December 2, 2015; Accepted December 22, 2015

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.

Acknowledgments
We wish to acknowledge Vivosonic Incorporation; we specifically acknowledge the deceased Isaac Kurtz for providing the Integrity system for data collection and thank Aaron Steinman for continual technical assistance. We also thank the RStats Institute at Missouri State University for assistance with statistical analysis. Additional thanks goes to my graduate assistants, Alana Kennedy and Shannon Lefler, for proofreading this article. Part of these data were presented at the HEAL 2014: Hearing Across the Lifespan Conference, Cernobbio, Lake Como, Italy (June 5–7, 2014).
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