The comparison of auditory behavioral and evoked potential responses (steady state and cortical) in subjects with occupational noise-induced hearing loss.

OBJECTIVE: To define difference scores between PTA, ASSR and CERA thresholds in subjects with occupational NIHL. DESIGN: 44 subjects undergoing a medico-legal expert assessment for occupational NIHL and fulfilling criteria of reliability were considered. Assessment included: PTA, 40 Hz binaural multiple ASSR and CERA (1-2-3 kHz). RESULTS: The respective average difference scores (ASSR - PTA) for 1, 2 and 3 kHz are 13.01 (SD 10.19) dB, 12.72 (SD 8.81) dB and 10.38 (SD 8.19) dB. The average (CERA - ASSR) difference scores are 1.25 (SD 14.63) dB for 1 kHz (NS), 2.73 (SD 13.03) dB for 2 kHz (NS) and 4.51 (SD 12.18) dB for 3 kHz. The correlation between PTA and ASSR (0.82) is significantly stronger than that between PTA and CERA (0.71). In a given subject, PTA thresholds are nearly always lower (i.e., better) than ASSR thresholds, whatever the frequency (1-2-3 kHz) and the side (right - left). A significant negative correlation is found between the difference score (ASSR - PTA) and the degree of hearing loss. CONCLUSION: ASSR outperforms CERA in a medicolegal context, although overestimating the behavioral thresholds by 10-13 dB.