Hostname: page-component-6766d58669-nqrmd Total loading time: 0 Render date: 2026-05-14T21:41:54.040Z Has data issue: false hasContentIssue false
  • English
  • Français

Cortical evoked potential criteria in the objective assessment of auditory threshold: a comparison of noise induced hearing loss with Ménière's disease

Published online by Cambridge University Press:  29 June 2007

Deepak Prasher ,
Mohamed Mula  and
Linda Luxon
Deepak Prasher*
Affiliation:
From the Medical Research Council, Section of Neuro-otology, Human Movement and Balance UnitNational Hospital for Neurology and Neurosurgery, London.
Mohamed Mula
Affiliation:
From the Medical Research Council, Section of Neuro-otology, Human Movement and Balance UnitNational Hospital for Neurology and Neurosurgery, London.
Linda Luxon
Affiliation:
Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London.
*
Dr Deepak Prasher, Institute of Laryngology and Otology, The Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, London WC1X 8EE.
Get access Rights & Permissions [Opens in a new window]

Abstract

Amplitude of the Nl component of the cortical response was used to objectively determine threshold of hearing at 1 kHz and 4 kHz in a series of consecutively referred medicolegal cases with alleged occupational noise induced hearing loss and a control group of patients with Ménière's disease who were not seeking compensation for their hearing loss. The cortical response thresholds were compared with the subjective pure tone audiometric (PTA) thresholds at the same frequencies. The cortical and PTA thresholds were ‘;within 10 dB’; for 84 and 92 per cent of the cases of noise induced hearing loss (NIHL) and Ménière's disease respectively, confirming the validity of CERA as a means of denning accurately the frequency specific thresholds and the audiometric configuration. Of the remaining 16 per cent of NIHL, 13 per cent exaggerated their PTA thresholds at 1 kHz and 10 per cent at 4 kHz whilst the error in cortical threshold estimation was beyond the 10 dB level for three and six per cent of cases at those frequencies respectively. The median exaggeration of threshold was 25 dB. For eight per cent of the Ménière's patients, thresholds exceeded 10 dB at both 1 and 4 kHz, four per cent of whom exaggerated their PTA thresholds and four per cent had a test error greater than 10 dB. A similar percentage (four per cent) of both groups revealed a cortical test error greater than 10 dB whereas three times as many cases of noise induced hearing loss (13 per cent) revealed exaggeration of their subjective audiometric thresholds compared with the Ménière's group (four per cent).

The value of latency criteria in the assessment of cortical threshold was established. The latency of Nl close to threshold was invariably greater than 150 ms and at 30 dB above threshold, irrespective of absolute levels, it was within 10 ms of 100 ms, thereby providing another criterion for the improved measurement of threshold.

Keywords

Hearing loss, noise induced, occupationalEvoked potentials, auditoryLegal medicine

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 9 , September 1993 , pp. 780 - 786
Copyright
Copyright © JLO (1984) Limited 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Alberti, P. W. (1981) Non-organic hearing loss in adults. In Audiology and Audiological Medicine. (Beagley, H. A., ed.), Oxford University Press, Oxford, pp. 910–931.Google Scholar
Beagley, H. A., Kellogg, S. E. (1968) A comparison of evoked response and subjective auditory thresholds. Audiology 7: 420–421.Google Scholar
British Society of Audiology (1981) Recommended procedures for pure-tone audiometry using a manually operated instrument. British Journal of Audiology 15: 213–216.CrossRefGoogle Scholar
Coles, R. R. A. (1982) Non-organic hearing loss. In Otology. (Gibb, A. G., Smith, M. F. W., eds.), Butterworth's International Medical Reviews, London, pp. 150–176.Google Scholar
Coles, R. R. A., Mason, S. M. (1984) The results of cortical electric response audiometry in medicolegal investigations. British Journal of Audiology 18: 71–78.CrossRefGoogle Scholar
Gleason, W. J. (1958) Psychological characteristics of the audiologically inconsistent patient. Archives of Otolaryngology 68: 42–46.CrossRefGoogle ScholarPubMed
Hyde, M., Albert, P., Matsumoto, N., Yao, L. L. (1986) Auditory evoked potentials in audiometric assessment of compensation and medicolegal patients. Annals of Otology, Rhinology and Laryngology 95: 514–519.CrossRefGoogle ScholarPubMed
Jones, L. A., Harding, G. F. A., Smith, P. A. (1980) Comparison of auditory evoked potentials, brain stem evoked potentials and post-auricular myogenic potentials in normals and patients with known auditory defects. In Evoked Potentials. (Barber, C. ed.), MTP Press, England, pp. 337–344.CrossRefGoogle ScholarPubMed
Keidel, W. D. (1976) The physiological background of the electric response audiometry. In Handbook of Sensory Physiology. (Neff, W. D., Keidel, W. D., eds.), Springer-Verlag, Berlin, pp. 105–231.Google Scholar
Martin, F. N. (1972) Differential diagnostic evaluation: non-organic loss and other special procedures. In Handbook of Clinical Audiology. (Katz, J., ed.), Williams and Wilkins, Baltimore, pp. 357–373.Google Scholar
Naatanen, R., Picton, T. (1987) The Nl wave of the human electric and magnetic response to sound: a review and analysis of the component structure. Psychophysiology 24 (4): 375–425.CrossRefGoogle Scholar
Parsuraman, R., Richer, E., Beatty, J. (1982) Detection and recognition: concurrent processes in perception. Perception and Psychophysics 31: 1–12.CrossRefGoogle Scholar
Picton, T. W., Woods, D. L., Baribeau-Braun, J., Healey, T. M. G. (1977) Evoked potential audiometry. Journal of Otolaryngology 6: 91–119.Google Scholar
Picton, T. W., Durieux-Smith, A. (1988) Auditory evoked potentials in the assessment of hearing. Neurologic Clinics 6: 791–808.CrossRefGoogle ScholarPubMed
Rose, D. E., Keating, L. W., Hedgecock, L. D., Schreuers, K. K., Miller, K. E. (1971) Aspects of acoustically evoked responses. Archives of Otolaryngology 94: 347–350.CrossRefGoogle ScholarPubMed
Stappels, D., Picton, T. W, Perez-Abalo, M. et al. (1985) Frequency specificity in evoked potential audiometry. In The Auditory Brain Stem Response. (Jacobson, J. T., ed.), College Hill Press, San Diego, pp. 147–168.Google Scholar
Starr, A., Don, M. (1988) Brain potentials evoked by acoustic stimuli. In Human Event-Related Potentials. (Picton, T. W., ed.), Elsevier, New York, pp. 97–105.Google Scholar
Squires, K. C., Squires, N. K., Hillyard, S. A. (1975) Decision related cortical potentials during an auditory signal detection task with cued observation intervals. Journal of Experimental Psychology: Human perception and Performance 1: 268–279.Google ScholarPubMed
Van der Drift, J. F. C., Brocaar, M. P., van Zanten, G. A. (1987) The relationship between the pure-tone audiogram and the click auditory brain stem response threshold in cochlear hearing loss. Audiology 26: 1–10.CrossRefGoogle ScholarPubMed