Bone Conduction Brainstem Evoked Response Audiometry (BC‑BERA / BC‑ABR) is an objective hearing test that records how the hearing nerve and brainstem respond to sound delivered through a small bone vibrator placed over the mastoid or forehead. It bypasses the outer and middle ear and stimulates the inner ear directly, helping to estimate true cochlear hearing levels even when the ear canal or middle ear are not normal.
During the test, surface electrodes are placed on the scalp and forehead, and soft clicking or tone-burst sounds are given through the bone vibrator at different loudness levels. The test is painless, does not require active responses, and is usually done while the child is asleep or under mild sedation.
This test is especially useful in:
• Patients with atresia or microtia (absent/narrow ear canal).
• Chronic otitis media, ossicular problems, or persistent middle ear fluid.
• Suspected mixed hearing loss where air–bone gaps need clarification.
• Pre‑operative assessment for bone‑anchored hearing devices and other implantable hearing solutions.
