Contribution of bone conduction click-evoked auditory brainstem responses to diagnosis of hearing loss in infants in France

Introduction: Neonatal hearing screening in France involves confirmation by a childhood hearing expert centre in case of suspected hearing loss. Although click-evoked air-conduction auditory brainstem responses (AC-ABR) are the gold standard in France, there are no guidelines for bone-conduction ABRs (BC-ABR). The present study assessed the interest of associating click-evoked BC-and AC-ABRs for diag-nostic confirmation in neonatal hearing screening. Materials and methods: A retrospective study included 59 infant ears with conductive hearing loss referred to the centre of Lyon, France. Objective hearing thresholds were compared between click-evoked BC-and AC-ABRs on a method previously validated in a normal-hearing population. Results: There was a significant difference in mean threshold between AC-ABR (53.27 +/- 1.189 dBnHL) and BC-ABR (28.1 +/- 0.935 dBnHL) (P < 0.001). AC thresholds ranged from 40 to 60 dBnHL while BC thresholds exceeded 40 dBnHL in only 9 ears. Conclusion: Using BC-ABRs could reduce the false-positive rate in neonatal bilateral permanent hear-ing loss screening, in complement to AC-ABRs using the same stimulus. Click-evoked BC-ABR could be contributive whenever conductive hearing loss is suspected, in complement to AC-ABR, without unreasonably increasing examination time. (c) 2020 Elsevier Masson SAS. All rights reserved.