TY - JOUR
TI - Transient infantile auditory neuropathy and its clinical implications
AU - Psarommatis, Ioannis
AU - Riga, Maria
AU - Douros, Konstantinos and
AU - Koltsidopoulos, Petros
AU - Douniadakis, Dimitrios
AU - Kapetanakis,
AU - Ioannis
AU - Apostolopoulos, Nikolaos
JO - International Journal of Pediatric Otorhinolaryngology
PY - 2006
VL - 70
TODO - 9
SP - 1629-1637
PB - Elsevier Ireland Ltd
SN - 0165-5876
TODO - 10.1016/j.ijporl.2006.05.005
TODO - auditory neuropathy/dyssynchrony; transient; infantile; prediction; high
risk infants; hearing screening
TODO - Objective: Auditory neuropathy (AN) has been a well-accepted clinical
entity during the last years. Though we are able to diagnose AN
reliably, little is known concerning its epidemiology, etiology and
prognosis. This study is aimed at presenting a particular characteristic
of the disease, namely its potential. transient behaviour, observed in a
group of high risk neonates suffering from AN. The ensuing clinical
implications are underlined.
Method: From 1995 to 2004, 1150 high risk (HR) neonates were subjected
consecutively to audiological. evaluation by auditory brain stem
responses (ABR), participating in a targeted hearing screening program
for HR neonates. All neonates with ABR threshold >40 dBnHL and middle
ear free from disease underwent otoacoustic emissions (OAEs) testing as
well. Children with elevated ABR thresholds were scheduled for
re-examination after 4-6 months. Only infants demonstrating considerably
elevated thresholds (>70 dBnHL), absent or atypical ABR in combination
with normal OAEs were considered as suffering from AN.
Results: One hundred and seventy-seven neonates showed elevated ABR
thresholds (15.4%). Seventy-nine of them demonstrated ABR thresholds >=
75 dBnHL, absent or strongly atypical waveforms at maximum test
intensity and among them 25 displayed findings consistent with AN.
Follow-up examination revealed a resolution of AN in 13 out of 20
infants retested, that is a restoration of ABR to normal and typical
OAEs recordings. Using multiple logistic regression, we found that tow
birth weight may represent a reliable predictor for clinical recovery of
AN infants.
Conclusion: This article bring to light the temporary character that AN
could show in HR neonates and especially in those with tow birth weight.
Based on the results of our study, the higher the birth weight, the less
likely it is for neonates to recover from AN. From a practical point of
view, these findings suggest that hearing screening protocols for HR
neonates should be revised in both their methodology and time of
application. Finally, the decision for amplification or cochlear
implantation in FIR infants with AN should be made very carefully and
well after the 6th month of age, since the maturation process may still
be in progress. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
ER -