Predicting Common Frequencies in Different Types of Hearing Loss Using Click Stimuli Auditory Brainstem Response in Children

Abstract

Background: Objective threshold estimation in infants and young children remains challenging because reliable behavioral testing is often not feasible; therefore, auditory brainstem response (ABR), particularly click-evoked ABR, is widely used for early identification of hearing loss and characterization of auditory pathway function. Objective: To predict common frequencies in different types of hearing loss by using click stimuli auditory brainstem response (ABR) in children. Methods: An analytical cross-sectional study was conducted at Fatima Memorial Hospital and The Children’s Hospital, Lahore, including 300 children of both sexes aged 0–4 years undergoing click-evoked ABR evaluation. Clinical history and otoscopy were performed, otoacoustic emissions were recorded, and wave-V parameters were documented for each ear. Hearing loss type (conductive vs sensorineural) and degree (mild to profound) were categorized based on ABR-derived threshold estimates and recorded on a structured proforma. Data were analyzed using SPSS version 25.0 and summarized as frequencies and percentages. Results: Of 300 participants, 198 (66.0%) were male and 102 (34.0%) were female; 177 (59.0%) were aged 3–4 years. Otoacoustic emissions showed refer in 300 (100.0%) children. Sensorineural hearing loss was identified in 261 (87.0%) and conductive hearing loss in 39 (13.0%). Profound hearing loss was most frequent (101, 33.6%), followed by mild (69, 23.0%) and moderately severe (69, 23.0%). The most common dominant wave-V frequency category was 2 kHz (97, 32.3%), followed by 3 kHz (77, 25.7%), 4 kHz (71, 23.7%), and 1 kHz (55, 18.3%). Conclusion: In this referred pediatric cohort, click-evoked ABR most commonly identified sensorineural hearing loss with a high proportion of profound impairment, and dominant wave-V responses were most frequently observed in the 2 kHz category.