Comparison Of Narrowband CE-Chirp Evoked ASSR And ABR In The Evaluation Of Hearing Threshold In Children With Otitis Media With Effusion

Objective To evaluate the value of Narrowband CE-Chirp evoked ASSR and ABR in the evaluation of hearing threshold in children with otitis media with effusion,and to compare the advantages and disadvantages of these two electrophysiological tests.Methods 1.Twenty seven children(41 ears)with otitis media with effusion(OME)aged 3-6 years were screened.The children with air conduction mean hearing threshold≥ 20 dB HL and<50 dB HL at 0.5,1,2,4 kHz frequencies according to behavioural audiometry(game audiometry)were included in the study.At the same time,the children with bone conduction mean hearing threshold ≤15 dB HL were included in the study.According to the hearing loss classification standard published by WHO in 2021,22 ears with air conductance behavioral thresholds≥ 20 dB HL and<35dB HL were included in the mild conductive hearing loss(CHL)group,and 19 ears with behavioral thresholds ≥35 dB HL and<50dB HL were included in the moderate CHL group.2.All subjects received electrootoscope,acoustic immittance,DPOAE,behavioural audiometry(game audiometry),Narrowband CE-Chirp ASSR and Narrowband CE-Chirp ABR tests in turn on the same day.Correction factors were used to convert the results of Narrowband CE-Chirp evoked ASSR and ABR tests into units.3.SPSS21.0 statistical software was used to analyze the data,compare the correlation and stability of pure tone hearing threshold with ASSR and ABR reaction threshold,the test time of ASSR and ABR,and the difference between mild CHL group and moderate CHL group,and draw charts.Results 1.The correlation between pure tone threshold of 41 ears and ASSR and ABR evoked by Narrowband CE-Chirp was statistically significant at each frequency.The correlation coefficients between pure tone hearing threshold and ASSR response threshold at 0.5,1,2,4 kHz in 41 ears were 0.659,0.605,0.723,0.857,and the correlation coefficients between pure tone hearing threshold and ABR response threshold were 0.587,0.684,0.753,0.802,respectively.2.At the frequency of 0.5,1,2 and 4 kHz,the proportion of the tested ears with the difference between ASSR reaction threshold and pure tone hearing threshold≤10dB is 29%,41%,58%and 60%,and the proportion of the tested ears with the difference between ABR reaction threshold and pure tone hearing threshold≤10dB is 49%,55%,45%and 74%.3.At the frequency of 0.5,1,2 and 4 kHz,the average difference between pure tone hearing threshold and ASSR response threshold of 41 ears was 5.6,5.7,2 and 5.6 dB;The average difference with ABR reaction threshold was-5.6,-1.4,-6.8,3.2 dB.4.The correlation between pure tone hearing threshold and ASSR,ABR reaction threshold in mild CHL group and moderate CHL group was poor at low frequency and good at high frequency,and the correlation was statistically significant at 4000Hz.The 500Hz correlation of moderate CHL group was better than that of mild CHL group.5.The time to complete single ear Narrowband CE-Chirp ASSR test was 5.9 minutes,while the time to complete Narrowband CE-Chirp ABR test was 17.0 minutes.Conclusion Among children with otitis media with effusion,Narrowband CE-Chirp evoked ASSR and ABR have a good correlation with behavioral hearing threshold.Narrowband CE-Chirp ASSR has advantages in test time and evaluation of hearing structure,and Narrowband CE-Chirp ABR is more reliable than ASSR.However,the stability of Narrowband CE-Chirp evoked ASSR and ABR results is not good,which can not replace behavioral audiometry to evaluate the true hearing of children with OME,and can be used as an auxiliary means.