[Objective diagnosis of recruitment by brainstem audiometry (author's transl)]

The differential diagnosis in cochlear damage with brainstem potentials is easily done by looking for normal latencies that coincide with substantial hearing loss. Further validation can now be achieved with methods representing Fowler and SISI test equivalents. Amplitudes of brainstem potential were compared in 28 patients with marked differences of hearing loss in either ear. Amplitudes are balanced at the stimulus intensity corresponding to subjective loudness balance (Fig. 3). Intersubject comparison of input/output function steepness is not advisable because of the greater interindividual variation of amplitudes (Fig. 2). Amplitude modulation by short Gauss-shaped increments (Fig. 1) or by decrements of a continuous tone evokes clear brainstem potentials at thresholds of about 5dB above subjective detection, but it also depends upon stimulus duration or steepness (Fib. 4), frequency (Fig. 5) and the degree of modulation (Fig. 6). With a cochlear hearing loss of more than 40dB, a 1 dB increment evokes potentials for continuous tone intensities higher than 20 dB above subjective thresholds (Fig. 7). This test is mainly useful for children with retarded language development and lacking a stapedius reflex, for adults, who cannot sufficiently cooperate, and where there is a prolonged latency due to middle ear damage or a steep high frequency loss.