Abstract:Objective To investigate the severity of conductive hearing loss in infants with non-syndromic cleft palate (NSCP) and to evaluate the correlation between click auditory brainstem response (ABR) and auditory steady-state response (ASSR) in assessing conductive hearing loss in these patients. Methods A retrospective analysis was conducted on NSCP patients under 36 months of age diagnosed with conductive hearing loss who were unable to cooperate with behavioral audiometry between January 2017 and December 2023. The severity of hearing loss was determined based on the V-wave threshold in c-ABR testing, while ASSR was used to assess the frequency distribution of hearing loss. The correlation between c-ABR and ASSR was evaluated using Spearman's coefficient, with comparative analysis based on age, gender, and cleft severity. Results Among 588 screened NSCP cases, 330 cases (660 ears) were included, comprising 103 male and 227 female infants. Based on c-ABR results, hearing loss severity was categorized as normal (118 ears), mild (442 ears), and moderate (100 ears). ASSR supplementation revealed a higher non-response rate at 0.5KHz. The overall analysis showed the highest correlation between ABR and ASSR thresholds at 2KHz (r=0.359). Age-stratified analysis demonstrated the highest correlation at 1KHz (r=0.350) in infancy and at 2KHz (r=0.433) in early childhood. Gender and cleft severity analysis revealed consistent and significant correlations at 2KHz, with female (r=0.386), male (r=0.255), cleft degree II (r=0.331), and cleft degree III (r=0.747). All correlations were statistically significant (P<0.01) but relatively weak (r<0.5). Conclusion c-ABR and ASSR are essential tools for audiological assessment in NSCP, facilitating early diagnosis and intervention of conductive hearing loss. Particular attention should be paid to 0.5KHz hearing supplementation. Although ABR and ASSR show high correlation in degree III cleft cases, their overall correlation remains weak, necessitating complementary use in clinical assessments. The combined application of both methods enables more accurate evaluation of NSCP.