Auditory Steady State Response (ASSR)
Auditory Steady-State Response (ASSR) is a quick and simple objective electrophysiological measure producing frequency-specific hearing thresholds in response to rapid auditory stimuli. It estimates the behavioral pure-tone audiogram from which questions regarding hearing, hearing loss, and aural rehabilitation can be answered. It is well-suited for testing infants, young children, and other individuals unable to provide reliable behavioural responses.
The steady-state pure tone signals(modulated in amplitude and frequency) are used in ASSR unlike, the transient signals of tone bursts or clicks used in ABR producing a frequency-specific audiogram.
Auditory stimulus is presented through either insert ear phones, headphones or through BC transducer if doing BC ASSR. An ASSR typically uses frequency specific stimuli which is usually 500, 1000, 2000 and 4000 Hz with the aim of creating an estimated audiogram. In other words, ASSR is used to perform threshold estimation objectively.
Unlike auditory brainstem response which measures amplitude and latency of the response in the time domain, ASSR measures amplitudes and phases in the frequency domain. Another major difference is that in ABR it is only possible to test one frequency in one ear at a time in frequency-specific threshold ABR. ASSR allows for binaural testing; four frequencies in each ear at the same time. Which saves time and gives us more accurate information.
Uses :
- Hearing loss of more than 80 dB can be detected. It can help in the early detection of the children who need cochlear implantation.
- ASSR can be done in all ages, any mental state, any degree of hearing loss.
- Multiple frequencies can be assessed at the same time, as long as their carrier frequencies utilize different modulation rates.
- ASSR is an objective test that can be analysed and interpreted easily using statistical methods.
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Reference Textbooks.
- Scott-Brown, Textbook of Otorhinolaryngology-Head and Neck Surgery.
- Glasscock-Shambaugh, Textbook of Surgery of the Ear.
- P L Dhingra, Textbook of Diseases of Ear, Nose and Throat.
- Hazarika P, Textbook of Ear Nose Throat And Head Neck Surgery Clinical Practical.
- Mohan Bansal, Textbook of Diseases of Ear, Nose and Throat Head and Neck Surgery
- Hans Behrbohm, Textbook of Ear, Nose, and Throat Diseases With Head and Neck Surgery.
- Salah Mansour, Middle Ear Diseases – Advances in Diagnosis and Management.
- Logan Turner, Textbook of Diseases of The Nose, Throat and Ear Head And Neck Surgery.
- Rob and smith, Textbook of Operative surgery.
- Anirban Biswas, Textbook of Clinical Audio-vestibulometry.
- Arnold, U. Ganzer, Textbook of Otorhinolaryngology, Head and Neck Surgery.
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Dr. Rahul Bagla
MBBS (MAMC, Delhi) MS ENT (UCMS, Delhi)
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