Bone conduction auditory brainstem responses in infants
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Updated: Aug 7, 2026
Infant Auditory Processing and Event-related Brain Oscillations
Published on: July 1, 2015
P E Campbell1, C M Harris, S Hendricks
1Plymouth Institute of Neuroscience, Plymouth University, Plymouth, UK.
Insights
Bone conduction auditory brainstem response (BC-ABR) testing is crucial for diagnosing infant hearing loss, differentiating between conductive and sensorineural types. Despite technical challenges, BC-ABR offers vital insights for early and accurate hearing assessment in children.
Area of Science:
- Audiology
- Neuroscience
- Pediatrics
Background:
- Air conduction auditory brainstem response (AC-ABR) is standard for pediatric hearing assessment.
- AC-ABR cannot distinguish between conductive and sensorineural hearing loss.
Observation:
- Bone conduction auditory brainstem response (BC-ABR) testing presents technical challenges.
- These include a narrow dynamic range, masking issues, stimulus artifact, and low-frequency underestimation.
Findings:
- Despite difficulties, BC-ABR testing significantly aids in accurate infant hearing loss assessment.
- Evidence supports BC-ABR's role in differential diagnosis between conductive and sensorineural hearing loss.
Implications:
- Modifications to BC-ABR protocols can overcome technical hurdles.
- BC-ABR should be integrated as a routine clinical tool for early hearing loss identification and management.
Abstract:
The contribution of air conduction auditory brainstem response (AC-ABR) testing in the paediatric population is widely accepted in clinical audiology. However, this does not allow for differentiation between conductive and sensorineural hearing loss. The purpose of this paper is to review the role of bone conduction auditory brainstem responses (BC-ABR). It is argued that despite such technical difficulties as a narrow dynamic range, masking dilemmas, stimulus artifact and low frequency underestimation of hearing loss, considerable evidence exists to suggest that BC-ABR testing provides an important contribution in the accurate assessment of hearing loss in infants. Modification of the BC-ABR protocol is discussed and the technical difficulties that may arise are addressed, permitting BC-ABR to be used as a tool in the differential diagnosis between conductive and sensorineural hearing. Two relevant case studies are presented to highlight the growing importance of appropriate management in early identification of hearing loss. It can be concluded that BC-ABR should be adopted as a routine clinical diagnostic tool.
