[Pronounced bilateral mesocochlear hearing impairment from 40-45 dB in spite of regular TEOAE, DPOAE and inconspicuous click-BERA].

An objective screening method for assessment of inner ear function of babies and small children can be carried out by measuring TEOAE and DPOAE. In particular, TEOAE can be used as a cheap and quick method to determine, with very high sensitivity and moderate specificity, whether middle to severe peripheral hearing impairment is present. In order to assess the threshold more precisely, the click-BERA is routinely used. We present a case report of a 6 year old girl with regular TEOAE and DPOAE, and who also had bilateral normal thresholds in the click-BERA. With subjective audiometry, the girl could be diagnosed having bilateral mesocochlear hearing impairment (so called cookie-bite audiogram) ranging at 40-45 dB. The child was helped considerably by fitting of hearing aids bilaterally. In order to determine the auditory ability of children and to provide adequate care, subjective as well as objective tests should be used.