OBJECTIVE: To review the literature on auditory dyssynchrony (AD) or neuropathy which is characterized by absent auditory brainstem. Braz J Otorhinolaryngol. Jul-Aug;77(4) Auditory neuropathy/Auditory dyssynchrony in children with Cochlear Implants. [Article in English. Auditory neuropathy (AN)/auditory dyssynchrony (AD) is a very often missed diagnosis, hence an underdiagnosed condition in clinical practice.

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Auditory neuropathy in childhood. Determinants of speech perception in children after cochlear implantation. As such, these patients resemble other subject groups in whom temporal processing disorders have been correlated with speech perception deficits. J Am Acad Audiol.

Development of pre-word-learning skills in infants with cochlear implants. The children in each of these studies were identified and amplified in infancy. It examines how outer, middle, and inner ear dysfunction; auditory neuropathy; and brainstem dysfunction influence the characteristics of the ABR and other auditory tests by a basic review of clinical cases. Mechanisms of noise damage in the inner ear. Optic cochleovestibular degerations in heriditary ataxias. Frequency discrimination as a function of tonal duration and excitation-pattern dyssgnchrony in normal and hearing-impaired listeners.

Hearing loss in adult Refsum’s disease. J Assoc Res in Otolaryngol 1 1: Fisher’s exact test was applied to check the relation between TOAE results and hearing abilities.

A case report with review of literature. Cochlear microphonic responses in these children were relatively unchanged, with similar amplitudes obtained before and after emission loss and only a slight morphologic change reported in one case.

Auditory neuropathy/Auditory dyssynchrony in children with Cochlear Implants.

In contrast, these authors found 1 patient who showed a 15 to 20 dB threshold improvement over time. Estimation of the pure-tone audiogram by the auditory brainstem response: The main positive peaks in the auditory brainstem response are separated by only about 1 ms. A previous study 22 also reported a similar rate: Perceptual consequences of cochlear hearing loss and their implications for the design of hearing aids.


Clearly, the subjects in the former group, all but one of whom had near complete access to the amplified speech spectrum with aided articulation index values of 0.

Auditory neuropathy/auditory dyssynchrony in children with cochlear implants

These studies established detection thresholds for brief tonal stimuli presented at various timing intervals relative to the start and end of a longer duration masker.

In Jerger J, editor. When measuring CM, it is important to compare responses obtained with condensation stimuli to those obtained with rarefaction stimuli Berlin et al. Such effects have been suggested for two cases reported in the literature thus far. This webinar will be open captioned. Clinical findings for a group of infants and young children with auditory neuropathy. A report of two cases. Cochlear implants or hearing aids. This spectral processing is thought to be achieved in the normal cochlea by means of basilar membrane mechanics and is aided by the active process that is mediated by the outer hair cells, which leads to amplification and sharpening of the peaks in basilar membrane movement Yates et al.

The children had typically been diagnosed in infancy, and had all been fit with conventional amplification to the level of their hearing loss at least 12 months before speech perception was assessed.

Auditory Neuropathy/Auditory Dys-Synchrony

Factors observed in infants include hyperbilirubinemia, exchange transfusion, premature birth, and perinatal asphyxia e. Furthermore, Zeng audutory al. This has the overall effect of reducing the level difference between low-level and high-level speech inputs and is obviously not desirable for listeners who already have difficulty perceiving amplitude fluctuations. John P, et al.

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Ann Otol Rhinol Laryingol. Ear Hear dyssynchrojy 2: The variability in the clinical features seen in this group may represent differing degrees of the same pathology or may be the result of a range of audiyory auditory pathway disorders. An example of the findings for one such child can be seen in Figure 3. The site of the disorder affecting the auditory nerve and auditory brainstem in these cases may be the myelin sheath or the neuron itself.


Frequency resolution, also referred to as frequency selectivityis the ability of the auditory system to separate or resolve the components in a complex sound. Phototherapy and the brainstem auditory evoked response in neonatal hyperbilirubinemia.

The search for auditory neuropathy dysynchrony and connexin 26 patients in schools for the deaf. Otolaryngol Head Neck Surg auditroy No formal results for this strategy have yet been published, but Zeng et al.

Absent auditory brainstem response: Clinical and audiological features in auditory neuropathy. Audiol Today 14 3: However, the other 8 children did show a significant aided benefit, with a mean PBK-phoneme score of Graph shows Hz frequency discrimination limens for each subject plotted as a function of consonant-nucleus-consonant CNC dyszynchrony score.

Neurological aspects of infant hearing assessment.

Temporal cues for consonant recognition: Relations between psychophysical data and speech perception for hearing-impaired subjects. Such inconsistencies highlight the functional differences between the two responses and raise questions as to the best way to measure preneural function in the clinic.

Speech perception and auditoy event related potentials in children with auditory neuropathy.

J Am Acad Audiol. Predicting speech-hearing from the audiogram.

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