Recommended Auditory Brainstem Responses to Stimulation and Recording Parameters for Hidden Hearing Loss: A Systematic Review and Meta-Analysis

Although a lesion of hidden hearing loss (HHL) has focused on the sprial ganglion, stimulation and recording parameters for auditory brainstem response (ABR) are not yet specific enough to confirm its dysfunction. In the current review, we identify ABR parameters, especially Wave I, for diagnosing HHL through both a systemic review and meta-analysis of 14 articles retrieved from seven journal data bases. The most commonly used parameters were a click or 4 kHz tone burst as the stimulus at a rate of less than 11/sec at more than 80 dB intensity levels with alternating polarity through the ear canal. For quantitative results, our meta-analysis from eight articles demonstrated a significant difference in the overall effect size for amplitude between HHL patients and their counterparts with normal hearing. For the subgroup and its analysis, tone burst and high intensity level revealed significantly lower effect size in HHL patients compared to the control group, whereas the stimuli rate and electrode montage statstically were not statistical significance. Although we examined a small number of studies and their heterogenity, obtaining ABR Wave I was clinically differentiated when noise-induced HHL was considered. We thus suggest that stimulation and recording parameters should be applied to a large number of patients and thereby standardized as sensitive features for Wave I in the clinic.