An infant with suspected severe-to-profound hearing loss shows no recordable responses even at maximum click-evoked ABR stimulus levels. Which additional electrophysiological test provides frequency-specific estimates of auditory thresholds at high intensities to guide rehabilitation planning?

• A Transient evoked otoacoustic emissions
• B Conditioned play audiometry
• C Stapedial reflex threshold measurement
• D Auditory steady state response (ASSR) ✓

Explanation

The auditory steady state response uses amplitude and frequency modulated tones that evoke phase locked brainstem responses, allowing automated, frequency-specific threshold prediction up to about 100 to 110 dB HL even when click ABR shows no response. It is therefore valuable for estimating residual hearing before cochlear implantation decisions. OAEs require functioning outer hair cells and disappear in severe loss, reflexes are absent in profound loss, and conditioned play audiometry is unreliable below a developmental age of about two years.

Reference: Katz's Handbook of Clinical Audiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.