| Objective To compare the accuracy of multiple auditory steady state responses (MASSR) and auditory brainstem responses to toneburst (Tb-ABR) in estimating the behavior thresholds in a sample of children with sensorineural hearing loss. To determine MASSR thresholds to multiple bone-conduction stimuli in participants with conductive hearing loss. To investigate the characters of MASSR in patients with auditory neuropathy. Method 37 sensorineural hearing loss children were tested with MASSR, Tb-ABR and behavior measures. 30 conductive hearing loss participants were measured with MASSR and pure-tone audiometry (PTA). 28 patients with auditory neuropathy were measured with MASSR and PTA. Carrier frequency of stimuli were 0.5, 1, 2 and 4kHz, modulated in amplitude at different rate between 70~110Hz. The stimuli were presented simultaneously for conditions tested. Air-conduction stimuli were presented using ER-3A insert earphones. Bone-conduction stimuli were presented to a Radioear B-71 bone oscillator. For each subject the response thresholds at 0.5, 1, 2 and 4 kHz were determined automatically and compared with the corresponding behavioral thresholds and/or Tb-ABR thresholds. Data were analyzed by Stata software. Results In sensorineural hearing loss children, ①The behavior thresholds and the response thresholds of MASSR, Tb-ABR were significantly correlated and the correlation coeffient (r) were 0.80, 0.87, 0.89, 0.88 for MASSR and 0.76, 0.83, 0.86, 0.87 for Tb-ABR.② Response thresholds for MASSR were on average between 9~15dB above the behavior thresholds, and response thresholds for Tb-ABR were on average between 9~17dB above the behavior thresholds. ③ The mean and standard deviation of difference between MASSR and behavior thresholds at 0.5, 1, 2 and 4 kHz were 15.8±13.5dB, 10.1±11.7dB, 9.9±11.2 dB, 9.8±12.1dB respectively. There was significantdifference among carrier frequencies with the biggest difference found at 0.5 kHz (P=0.001). The mean and standard deviation of difference between Tb-ABR and behavior thresholds at 0.5, 1, 2 and 4 kHz were 17.1±14.6dB, 13.8±13.1dB, 10.0±12.3 dB, 9.6±12.8dB respectively. There was significant difference among carrier frequencies with the biggest difference found at 0.5, 1 kHz (P=0.000).@ An analysis of variance(ANOVA) comparing the response-behavior thresholds differences with MASSR and Tb-ABR showed a significant effect of MASSR versus Tb-ABR and also a significant effect of carrier (P=0.000). In patients of conductive hearing loss ?The bone conduction thresholds of pure-tone audiometry (PTA-BC) and the bone conduction thresholds of MASSR (MASSR-BC) were significantly correlated and the correlation coeffient (r) were 0.78, 0.77, 0.83, and 0.81. ?Response thresholds of MASSR-BC were on average between 14~18dB above the thresholds of PTA-BC. ?The mean and standard deviation of difference between thresholds of MASSR-BC and PTA-BC at 0.5, 1, 2 and 4 kHz were 15.2±8.3dB, 18.8±8.4dB, 16.3±5.4 dB, 14.5±5.3dB respectively. There was no significant difference among carrier frequencies (P=0.553).? There was no significant difference between the mean differences with bone conduction to air conduction for MASSR and PTA (P=19.52). In patients of auditory neuropathy.? there was low correlation between thresholds of MASSR and PTA, and the correlation coeffient (r) were 0.10, 0.19, 0.27, and 0.24 at 0.5, 1, 2 and 4 kHz. ?The mean and standard deviation of difference between MASSR and PTA at 0.5, 1, 2 and 4 kHz were 26.4±19.2 dB, 45.4+18.4 dB, 58.0±20.1 dB, 47.7±16.0 dB respectively. The thresholds of MASSR were on average 45dB above PTA. ? There was significant difference between the accuracy to estimating the thresholds of PTA using MASSR for patients with auditory neuropathy and patients with sensorineural hearing loss(P=0.000). Conclusion MASSR and Tb-ABR can both be used to estimate the frequency-specific behavior thresholds. Both methods have similar accuracy to estimate the behavior thresholds at 2 and 4 kHz, but the accuracy to estimate the...
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