Prediction of hearing outcomes by auditory steady-state response in patients with sudden sensorineural hearing loss

Background There has been no report on the predictive value of auditory steady-state response (ASSR) in the hearing prognosis of sudden sensorineural hearing loss (SSNHL). Aims/objectives To investigate whether ASSR can be a prognostic indicator of hearing outcome in patients with SSNHL after systemic steroid treatment. Material and methods Fifty-three patients with unilateral mild to severe SSNHL (<= 90 dB HL at 0.5k, 1k, 2k, and 4 kHz, 4FA) were included. All patients received systemic high dose steroid therapy within one month after onset. The difference between the threshold levels measured by ASSR and PTA on the same day [ASSR - PTA] was calculated. The hearing recovery (HR) was defined as a < 30 dB HL of final degree of hearing loss and a > 15 dB HL of hearing gain. Results The HR (+) group showed significantly worse ASSR predicted threshold than pure-tone threshold in univariate (t(51) = 2.412, p = .020) and multivariate analysis (OR 0.910, p = .012). The [ASSR - PTA] threshold showed significantly moderate correlation with hearing gain (r = -0.303, p = .028). Conclusions Worse ASSR predicted threshold than pure-tone threshold predicted poor hearing outcome after systemic steroid treatment in mild to severe unilateral SSNHL.