A 2-year-old child with bilateral profound sensorineural hearing loss is being evaluated for cochlear implantation. Click-evoked ABR shows no identifiable responses. Which electrophysiological test is MOST appropriate to estimate frequency-specific thresholds in this situation?

• A Distortion product otoacoustic emissions
• B Acoustic reflex decay test
• C Short Increment Sensitivity Index
• D Auditory steady-state response (ASSR) ✓

Explanation

ASSR uses amplitude-modulated tones with objective frequency-domain analysis and can estimate thresholds even in severe to profound loss where ABR waves are absent. It provides frequency-specific information needed for hearing aid fitting and cochlear implant candidacy. OAEs require functioning outer hair cells and are absent in profound sensorineural loss, making distractor A unsuitable here.

Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.