Correlation between free-field cortical auditory evoked potentials and behavioral audiometry thresholds in pediatric patients with hearing aids or cochlear implants

Objectives To determine the correlation between hearing thresholds obtained using free-field Cortical Auditory Evoked Potentials (CAEPs) and behavioral audiometry in children with sensorineural hearing loss after hearing-aids or cochlear-implant intervention, and to determine whether P1 latency and N1-P1 inter-peak amplitude can be used to assess hearing device outcome in young children. Methods Thirty-three children (2–14 years) with mild-to-profound sensorineural hearing loss were divided into a cochlear-implant group (22-ears) and a hearing-aid group (27-ears). Tone burst stimuli at 0.5-, 1-, 2-, and 4-kHz were used to evoke CAEPs and behavioral audiometry thresholds in a free field. The CAEP P1 latency and N1-P1 inter-peak amplitude were recorded. Results Free-field tone-burst CAEP P1 response thresholds were positively correlated with free-field behavioral audiometry thresholds at 0.5-, 1-, 2-, and 4-kHz in both the hearing-aid group (Pearson correlation coefficients: 0.567, 0.670, 0.637, and 0.762, respectively, p < 0.01) and the cochlear-implant group (0.825, 0.662, 0.538, and 0.567 respectively). At the tested frequencies, the mean differences between the 2 testing methods were 5–8 dB in the cochlear-implants group and 1–6 dB in the hearing-aid group. In both groups, the CAEP P1 latencies were 130–150 ms, and the N1-P1 inter-peak amplitudes were 6 μV. Conclusions When evaluating the efficiency of hearing interventions in clinical settings, free-field CAEP testing using tone-burst stimuli may serve as a clinically useful supplementary tool for pediatric patients who have difficulty cooperating with behavioral audiometry, provided its limitations are taken into account. Level of evidence This study is a diagnostic study providing Level 2b evidence. The results demonstrate a significant correlation between CAEP and behavioral hearing thresholds in children using hearing devices, supporting its potential applicable value as an objective clinical assessment tool.