Clinical Case · Trainee

A young child with recurrent middle-ear disease

Vignette

A 3-year-old with a history of recurrent otitis media with effusion is tested by air-conducted ASSR. Tympanometry shows bilateral flat (type B) tracings. Air-conducted ASSR shows present responses with mildly elevated estimated thresholds at all carriers.

Audiogram

-10020406080100120500 Hz1k Hz2k Hz4k HzHearing level (dB HL)
O Right earX Left ear
Estimated thresholds by ear. O = right, X = left.

ASSR finding

A mild, roughly flat elevation of air-conducted estimated thresholds across all carriers, in the presence of flat tympanograms.

Diagnostic question

What is the most important limitation of this air-conducted ASSR result?