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Studies investigating the clinical use of ASSRs during total intravenous anesthesia are currently lacking. The work presented in this article therefore investigates the application of ASSRs for intraoperative estimation of hearing classes.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>In 43 patients undergoing surgery for vestibular schwannoma, ASSR measurements were performed at the beginning and end of the surgical procedure. ASSR stimuli consisted of 80-dB hearing level amplitude-modulated tones with 5-minute duration, 90-Hz modulation, and 3 different carrier frequencies: 500, 1000, and 2000 Hz. Stimulation was performed unilaterally with and without contralateral masking, using single and combined carriers. Evoked responses were recorded and analyzed in the frequency domain. ASSRs were compared with extraoperative hearing classes and BAEPs using ANOVA, correlation, and receiver operating characteristic statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>ASSRs yielded high and consistent area under the curve (AUC) values (mean 0.83) and correlation values (mean \u22120.63), indicating reliable prediction of hearing classes. Analysis of BAEP amplitude changes showed lower AUC (mean 0.79) and correlation values (0.63, 0.37, and 0.50 for Waves I, III, and V, respectively). Latencies showed low AUC values (mean 0.6) and no significant correlation. Combination of several carriers for simultaneous evaluation reduced ASSR amplitudes and respective AUC values. Contralateral masking did not show a significant effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>ASSRs robustly estimate hearing class in patients under total intravenous anesthesia, even when using short measurement durations. The method provides a diagnostic performance that exceeds conventional BAEP monitoring and enables objective and automated evaluation. On the basis of these findings, continuous intraoperative auditory monitoring could become a promising alternative or adjunct to BAEPs.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.7.jns16460","type":"journal-article","created":{"date-parts":[[2016,10,14]],"date-time":"2016-10-14T13:59:00Z","timestamp":1476453540000},"page":"559-568","source":"Crossref","is-referenced-by-count":7,"title":["Intraoperative auditory steady-state monitoring during surgery in the cerebellopontine angle for estimation of postoperative hearing classes"],"prefix":"10.3171","volume":"127","author":[{"given":"Stefan","family":"Rampp","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonhard","family":"Rensch","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Simmermacher","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Rahne","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle (Saale), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Strauss","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Prell","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns16460","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1016\/j.otohns.2006.12.008","article-title":"Comparing pure-tone audiometry and auditory steady state response for the measurement of hearing loss","volume":"136","author":"Ahn JH,","year":"2007","unstructured":"Ahn JH, Lee HS, Kim YJ, Yoon TH, Chung JW: Comparing pure-tone audiometry and auditory steady state response for the measurement of hearing loss. 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