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J Audiol Otol. 2018 Apr;22(2):53-58. doi: 10.7874/jao.2017.00346. Epub 2018 Feb 26.

Update on Bone-Conduction Auditory Brainstem Responses: A Review.

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Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon, Korea.
Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea.


Auditory brainstem responses (ABR) have been used as a powerful and the most common objective tool to evaluate hearing sensitivity and to diagnose the types of hearing loss and neurological disorders, through the auditory peripheral pathway to a central level of the brainstem, since 1971. Although bone-conduction (BC) ABR could be an alternative to air-conduction (AC) ABR, as the former overcomes some limitations of the latter, the majority of clinicians rarely utilize it due to a lack of knowledge and no routine test administration. This review presents the weaknesses of AC ABR that apply to all clinical population, and discusses the development of BC ABR. The optimal placements of bone oscillators to obtain favorable clinical outcomes in infants, children, and adults, and the appropriate stimuli for BC ABR are examined. While providing absolute thresholds and latencies of BC ABR based on previous studies compared to AC ABR, this review includes clinical data of infants and young children with both normal hearing in terms of maturation, and with pathology such as congenital external auditory canal atresia. We recommend the future clinical application of BC ABR for candidacy as well as for patients with BC hearing implants.


Atresia; Bone oscillator; Bone-conduction auditory brainstem response

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