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Published on: January 23, 2017
The effect of real-ear adjusted chirp stimuli on auditory brainstem response threshold estimation and wave V
G Sh Tufatulin1,2,3,4, M A Goleva2, M I Soganov5
1St Petersburg Scientific Research Institute of Ear, Nose, Throat and Speech, St Petersburg, Russia.
Objective:
To evaluate the effectiveness of an individually modified chirp stimulus adjusted using real-ear to coupler difference (RECD) values in improving the accuracy of auditory brainstem response (ABR) threshold estimation and wave V parameters in children.
Design:
Prospective comparative randomised study.
Study Sample:
ABR was recorded in response to a standard broadband CE-Chirp® and a modified RECD-chirp stimulus in 24 children (aged 2 months to 17 years). Wave V amplitude, latency, and threshold were compared. ABR thresholds for both stimuli were compared to behavioural thresholds in 12 children (24 ears).
Results:
The RECD-chirp elicited responses with significantly shorter wave V latency compared to the standard chirp (7.02 msec vs. 7.17 msec, p = 0.005). The mean difference between ABR and behavioural thresholds was significantly smaller for the RECD-chirp, mostly at 2-4 kHz (+1.9 dB vs. +5.1 dB, p < 0.001). The RECD-chirp also demonstrated higher coefficients of determination (R2) in linear regression models predicting behavioural thresholds.
Conclusions:
Individual modification of the chirp stimulus using measured RECD values significantly improves the accuracy of ABR threshold estimation in children and leads to faster neural synchronisation, as evidenced by shorter wave V latency. This method represents a promising advancement for obtaining ear- and frequency-specific thresholds in paediatric audiology.
