Auditory brainstem response thresholds and functional hearing: implications for cochlear implant candidacy

Area of Science:

• Audiology
• Neuroscience
• Otolaryngology

Background:

• Sensorineural hearing loss (SNHL) significantly impacts speech perception and quality of life.
• Cochlear implantation (CI) is a viable treatment for severe to profound SNHL.
• Accurate assessment of functional hearing is crucial for determining CI candidacy.

Purpose of the Study:

• To evaluate the clinical relevance of auditory brainstem response (ABR) thresholds in assessing functional hearing.
• To determine the correlation between ABR thresholds and speech perception scores in adults with SNHL.
• To assess the utility of ABR thresholds in predicting cochlear implantation (CI) candidacy.

Main Methods:

• A retrospective analysis of 191 adult patients with SNHL.
• Correlation analysis between ABR thresholds, pure-tone audiometry, and speech perception scores in quiet.
• Comparison of correlations across different degrees of SNHL and potential CI candidates.

Main Results:

• A significant negative correlation was found between ABR thresholds and unaided speech perception scores (R = -0.397, P < 0.0001).
• This correlation was significant for patients with better speech perception (≥50%) but not for those with poorer scores (<50%).
• A moderate correlation was observed for ABR thresholds better than 60 dB nHL, but not for thresholds of 60 dB nHL or worse.

Conclusions:

• Auditory brainstem response (ABR) thresholds show limited clinical validity for assessing functional auditory performance in severe SNHL.
• ABR thresholds do not reliably correlate with speech perception in patients with severe hearing loss (speech perception <50% or ABR thresholds ≥60 dB nHL).
• The findings suggest that ABR thresholds alone may be insufficient for evaluating cochlear implantation candidacy in individuals with severe SNHL.