Clinical Case · Trainee

An adult with an occupational noise history

Vignette

A 52-year-old with two decades of industrial noise exposure is tested for medicolegal purposes; a fully reliable behavioural audiogram is also available. The ASSR estimate is compared with pure-tone audiometry.

Audiogram

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

ASSR finding

ASSR estimated thresholds overestimate the behavioural thresholds by roughly 10–20 dB but closely track the shape of the audiogram, with the greatest loss around 4000 Hz.

Diagnostic question

What does the relationship between the ASSR and behavioural results illustrate here?