Abstract
Objective:To explore the clinical relationship between auditory neuropathy (AN) and nervous system diseases.Methods:A total of 134 AN patients who were treated in our hospital from December 2011 to April 2016 were selected. Then 120 cases (240 ears) with complete data of pure tone audiometry and acoustic immittance test were selected as an AN1 group, which was compared with 30 patients (49 ears) with general sensorineural hearing loss (SHL) in regard to the results of pure tone audiometry and acoustic immittance test. On the other hand, 79 cases (158 ears) of the 134 patients with complete data of DP otoacoustic emission test were selected as an AN2 group, which was compared with 30 normal subjects (60 ears) regarding the results of DP otoacoustic emission test.Results:Increases in the pure-tone hearing threshold by air conduction of AN1 group significantly exceeded those of SHL group at 0.125 and 0.25 kHz (low frequency) (P<0.05). The former group had significantly lower values at 1.0, 2.0 kHz (moderate frequency) and 4.0, 8.0 kHz (high frequency) (P<0.05). Of 134 patients, 14 (19 ears) had evoked V wave upon auditory brainstem response, whereas no waves after I wave were evoked in other tested ears. Distortion product (DP) otoacoustic emissions could all be evoked. AN2 group had significantly higher amplitudes of DP-gram than those of normal control group at 0.5 and 0.7 kHz (low frequency) (P<0.05). Except for three cases of unsteady walking and 10 of dizziness, others did not suffer from typical symptoms of vertigo attack. As to caloric test-induced electronystagmograms, there were 30 bilaterally normal cases (75.0%), one case of left-side semicircular canal paresis (25%) and nine cases of bilateral semicircular canal paresis (22.5%). Four patients with other nervous system diseases were complicated with AN. Other nervous system disorders included three cases of optic nerve atrophy and 7 of lower limb nerve damage.Conclusion:According to characteristic hearing dysfunction, AN may occur in the afferent pathway of acoustic nerve, probably accompanied by the pathological changes of efferent nerve in the olivocochlear system inside the brainstem.
Highlights
First named by Starr et al in 1996, auditory neuropathy (AN) is a sensory neurological hearing loss with special clinical manifestations induced by the damage of auditory nerve branch of the VIII cranial nerve.[1]
Subjects and grouping: Of the 134 enrolled patients, 120 cases (240 ears) with complete data of pure tone audiometry and acoustic immittance test were selected as an AN1 group
The two groups were compared as regard the results of pure tone audiometry and acoustic immittance test
Summary
First named by Starr et al in 1996, auditory neuropathy (AN) is a sensory neurological hearing loss with special clinical manifestations induced by the damage of auditory nerve branch of the VIII cranial nerve.[1] Its audiological test results are usually inconsistent. Pak J Med Sci November - December 2017 Vol 33 No 6 www.pjms.com.pk 1495 missing or seriously abnormal auditory brainstem response and normal evoked otoacoustic emission.[2]. Otoacoustic emission provides reliable evidence for the identification and diagnosis of cochlear and retrocochlear lesions.[3] Despite numerous studies on AN, there remains controversy over its pathological sites, etiology, pathogenesis and epidemiological characteristics, and effective therapies are still lacking.[4] this still needs to be studied further
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