Auditory Neuropathy in Childhood
Keywords:auditory neuropathy, transient otoacoustic emissions, auditory evoked brainstem potentials
The combination of transient otoacoustic emissions (TOAE) and auditory brainstem evoked potentials (ABR) allows us to identify a group of patients with auditory neuropathy (AN), whose clinical and therapeutic implications constitute a challenge in our otological practice. The pediatric population studied by us has not manifested an alteration in the neurological examination or in the magnetic resonance imaging of the brain or the inner ears. TOAE and type A tympanograms,
they were registered in 100% of the cases. Stapedial reflexes and ABR were absent in all patients. In tonal or behavioral audiometry, the degree of sensorineural hearing loss ranged from mild to moderate, being bilateral in all cases. The children who collaborated in the verbal tests showed a disproportionate decrease in the comprehension of the word that did not correspond to their tonal audiograms. Previous findings suggest that the lesion is sensorineural, with normal cochlear outer hair cell function (TOAE present). It cannot be determined whether the lesion is located in the inner hair cells, in the eighth pair, or in both. The most probable etiologies that have justified AN have been: hyperbilirubinemia, perinatal anoxia, prematurity or idiopathic. The result of speech rehabilitation with hearing aids shows limited effectiveness. All patients are being treated by a language therapist. The success of this therapy depends on its early introduction.
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