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Zheng D, Liu X. Cochlear Implantation Outcomes in Patients With OTOF Mutations. Front Neurosci 2020; 14:447. [PMID: 32508568 PMCID: PMC7253664 DOI: 10.3389/fnins.2020.00447] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/09/2020] [Indexed: 01/26/2023] Open
Abstract
Auditory neuropathy is a special type of hearing loss caused by dysfunction of the synapse of the inner hair cells, the auditory nerve, and/or the auditory nerve itself. For patients with auditory neuropathy who have severe to profound hearing loss or failed auditory skills development with hearing-aids, cochlear implantation (CI) serves as the only possible effective treatment. It is accepted that the exact sites of lesion causing auditory neuropathy determine the CI performance. Mutations in the OTOF gene were the first identified and the most common cause of congenital auditory neuropathy. The site of lesion in patients with auditory neuropathy caused by biallelic OTOF mutations (OTOF-related auditory neuropathy) is presumed to be presynaptic, leaving auditory nerve function intact. Thus, OTOF-related auditory neuropathy is expected to have good CI performances. In this review, we describe the CI outcomes in patients with OTOF mutations. We will focus on whether biallelic OTOF mutations are ideal indications for CI in patients with auditory neuropathy. Also, the factors that may still influence the CI outcomes in patients with OTOF mutations are discussed.
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Affiliation(s)
- Dandan Zheng
- Department of Otorhinolaryngology, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiao Liu
- Department of Otorhinolaryngology, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Ehrmann-Müller D, Back D, Kühn H, Hagen R, Shehata-Dieler W. Long-term treatment outcomes in children with auditory neuropathy spectrum disorder (ANSD). Int J Pediatr Otorhinolaryngol 2020; 132:109938. [PMID: 32062495 DOI: 10.1016/j.ijporl.2020.109938] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/27/2020] [Accepted: 02/06/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The present article shows long-term results in the hearing and speech development of children with auditory neuropathy spectrum disorder (ANSD). Some children were followed up for nearly 20 years, monitoring their progress through childhood into adulthood. METHODS This retrospective study examined data from 10 children who were diagnosed and treated at our tertiary referral center. All children were provided with hearing aids and/or cochlear implants. The children's hearing and speech development and their social and educational development were evaluated. RESULTS Seven children were provided with cochlear implants on both sides; three children, one of which had single-sided deafness, received hearing aids. All children with cochlear implants on both sides used their devices full-time. Speech perception ranged between 100% and 0% on one side. Five children attended a school for the hearing impaired; four children attended a regular school. Four children attended vocational training. CONCLUSIONS At present, there is a lack of literature on the long-term outcomes of treatment in children with ANSD. The data presented show that the hearing and speech development in children with ANSD are significantly heterogeneous. Regular school education and social integration of children with ANSD can be achieved with intensive and supportive rehabilitative methods.
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Affiliation(s)
- Désirée Ehrmann-Müller
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany.
| | - Daniela Back
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Heike Kühn
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
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White-Schwoch T, Anderson S, Kraus N. Long-term Follow-up of a Patient With Auditory Neuropathy and Normal Hearing Thresholds. JAMA Otolaryngol Head Neck Surg 2020; 146:499-501. [DOI: 10.1001/jamaoto.2019.4314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Travis White-Schwoch
- Auditory Neuroscience Laboratory, Department of Communication Sciences, Northwestern University
| | - Samira Anderson
- Department of Hearing and Speech Sciences, University of Maryland College Park
| | - Nina Kraus
- Auditory Neuroscience Laboratory, Department of Communication Sciences, Northwestern University
- Departments of Neurobiology & Otolaryngology, Northwestern University
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Auditory Neuropathy Spectrum Disorders: From Diagnosis to Treatment: Literature Review and Case Reports. J Clin Med 2020; 9:jcm9041074. [PMID: 32290039 PMCID: PMC7230308 DOI: 10.3390/jcm9041074] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/21/2020] [Accepted: 04/01/2020] [Indexed: 12/21/2022] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by deteriorated speech perception, despite relatively preserved pure-tone detection thresholds. Affected individuals usually present with abnormal auditory brainstem responses (ABRs), but normal otoacoustic emissions (OAEs). These electrophysiological characteristics have led to the hypothesis that ANSD may be caused by various dysfunctions at the cochlear inner hair cell (IHC) and spiral ganglion neuron (SGN) levels, while the activity of outer hair cells (OHCs) is preserved, resulting in discrepancies between pure-tone and speech comprehension thresholds. The exact prevalence of ANSD remains unknown; clinical findings show a large variability among subjects with hearing impairment ranging from mild to profound hearing loss. A wide range of prenatal and postnatal etiologies have been proposed. The study of genetics and of the implicated sites of lesion correlated with clinical findings have also led to a better understanding of the molecular mechanisms underlying the various forms of ANSD, and may guide clinicians in better screening, assessment and treatment of ANSD patients. Besides OAEs and ABRs, audiological assessment includes stapedial reflex measurements, supraliminal psychoacoustic tests, electrocochleography (ECochG), auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs). Hearing aids are indicated in the treatment of ANSD with mild to moderate hearing loss, whereas cochlear implantation is the first choice of treatment in case of profound hearing loss, especially in case of IHC presynaptic disorders, or in case of poor auditory outcomes with conventional hearing aids.
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55
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Yüksel M, Çiprut A. Music and psychoacoustic perception abilities in cochlear implant users with auditory neuropathy spectrum disorder. Int J Pediatr Otorhinolaryngol 2020; 131:109865. [PMID: 31945735 DOI: 10.1016/j.ijporl.2020.109865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 01/05/2020] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Auditory neuropathy spectrum disorder (ANSD) is a condition wherein the pre-neural or cochlear outer hair cell activity is intact, but the neural activity in the auditory nerve is disrupted. Cochlear implant (CI) can be beneficial for subjects with ANSD; however, little is known about the music perception and psychoacoustic abilities of CI users with ANSD. Music perception in CI users is a multidimensional and complex ability requiring the contribution of both auditory and nonauditory abilities. Even though auditory abilities lay the foundation, the contribution of patient-related variables such as ANSD may affect the music perception. This study aimed to evaluate the psychoacoustic and music perception abilities of CI recipients with ANSD. STUDY DESIGN Twelve CI users with ANSD and twelve age- and gendermatched CI users with sensorineural hearing loss (SNHL) were evaluated. Music perception abilities were measured using the Turkish version of the Clinical Assessment of Music Perception (T-CAMP) test. Psychoacoustic abilities were measured using the spectral ripple discrimination (SRD) and temporal modulation transfer function (TMTF) tests. In addition, the age of diagnosis and implantation was recorded. RESULTS Pitch direction discrimination (PDD), timbre recognition, SRD, and TMTF performance of CI users with ANSD were concordant with those reported in previous studies, and differences between ANSD and SNHL groups were not statistically significant. However, the ANSD group performed poorly compared with SNHL group in melody recognition subtest of T-CAMP, and the difference was statistically significant. CONCLUSION CI can prove beneficial for patients with ANSD with respect to their music and psychoacoustic abilities, similar to patients with SNHL, except for melody recognition. Recognition of melodies requires both auditory and non-auditory abilities, and ANSD may have an extensive but subtle effect in the life of CI users.
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Affiliation(s)
- Mustafa Yüksel
- Marmara University, Institute of Health Sciences, Audiology and Speech Disorders Program, İstanbul, Turkey.
| | - Ayça Çiprut
- Marmara University Faculty of Medicine, Audiology Department, İstanbul, Turkey
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56
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Musacchia G, Hu J, Bhutani VK, Wong RJ, Tong ML, Han S, Blevins NH, Fitzgerald MB. Frequency-following response among neonates with progressive moderate hyperbilirubinemia. J Perinatol 2020; 40:203-211. [PMID: 31263204 DOI: 10.1038/s41372-019-0421-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 05/01/2019] [Accepted: 05/23/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the feasibility of auditory monitoring of neurophysiological status using frequency-following response (FFR) in neonates with progressive moderate hyperbilirubinemia, measured by transcutaneous (TcB) levels. STUDY DESIGN ABR and FFR measures were compared and correlated with TcB levels across three groups. Group I was a healthy cohort (n = 13). Group II (n = 28) consisted of neonates with progressive, moderate hyperbilirubinemia and Group III consisted of the same neonates, post physician-ordered phototherapy. RESULT FFR amplitudes in Group I controls (TcB = 83.1 ± 32.5µmol/L; 4.9 ± 1.9 mg/dL) were greater than Group II (TcB = 209.3 ± 48.0µmol/L; 12.1 ± 2.8 mg/dL). After TcB was lowered by phototherapy, FFR amplitudes in Group III were similar to controls. Lower TcB levels correlated with larger FFR amplitudes (r = -0.291, p = 0.015), but not with ABR wave amplitude or latencies. CONCLUSION The FFR is a promising measure of the dynamic neurophysiological status in neonates, and may be useful in tracking neurotoxicity in infants with hyperbilirubinemia.
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Affiliation(s)
- Gabriella Musacchia
- Department of Audiology, University of the Pacific, San Francisco, CA, 94103, USA. .,Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, CA, 94305, USA.
| | - Jiong Hu
- Department of Audiology, University of the Pacific, San Francisco, CA, 94103, USA
| | - Vinod K Bhutani
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Ronald J Wong
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Mei-Ling Tong
- Department of Pediatrics, Nanjing Maternal and Child health Hospital of Nanjing Medical University, Nanjing, China
| | - Shuping Han
- Department of Pediatrics, Nanjing Maternal and Child health Hospital of Nanjing Medical University, Nanjing, China
| | - Nikolas H Blevins
- Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, CA, 94305, USA
| | - Matthew B Fitzgerald
- Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, CA, 94305, USA
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Ehrmann-Müller D, Cebulla M, Rak K, Scheich M, Back D, Hagen R, Shehata-Dieler W. Evaluation and therapy outcome in children with auditory neuropathy spectrum disorder (ANSD). Int J Pediatr Otorhinolaryngol 2019; 127:109681. [PMID: 31542652 DOI: 10.1016/j.ijporl.2019.109681] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aims of the present study are to: describe diagnostic findings in patients with auditory neuropathy spectrum disorder (ANSD); and demonstrate the outcomes of different therapies like hearing aids (HAs) or cochlear implantation. METHODS 32 children were diagnosed and treated at our tertiary referral center and provided with HAs or cochlear implants (CIs). All of them underwent free-field or pure-tone audiometry. Additionally, otoacoustic emissions (OAEs), impedance measurements, auditory brainstem responses (ABRs), auditory steady-state responses (ASSR), electrocochleography, and cranial magnetic resonance imaging (cMRI) were all performed. Some patients also underwent genetic evaluation. Following suitable provision pediatric audiological tests, psychological developmental diagnostic and speech and language assessments were carried out at regular intervals in all the children. RESULTS OAEs could initially be recorded in most of the children; 17 had no ABRs. The other eight children had a poor ABR morphology. Most of the children had typical, long-oscillating cochlear microphonics (CMs) in their ABRs, which was also observed in all of those who underwent electrocochleography. Eight children were provided with a HA and 17 received a CI. The functional gain was between 32 and 65 decibel (dB) with HAs and between 32 and 50 dB with CI. A speech discrimination level between 35 and 100% was achieved during open-set monosyllabic word tests in quiet with HA or CI. With the Hochmair-Schulz-Moser (HSM) sentence test at 65 dB SPL (sound pressure level), 75% of the children with a CI achieved a speech discrimination in noise score of at least 60% at a signal to noise ratio (SNR) of 5, and four scored 80% or higher. Most of the children (72%) were full-time users of their devices. All the children with a CI used it on a regular basis. CONCLUSION Only a few case reports are available in the literature regarding the long-term outcomes of ANSD therapy. The present study reveals satisfactory outcomes with respect to hearing and speech discrimination in children with CIs or HAs. The nearly permanent use of the devices reflects a subjective benefit for the children. Provision with a suitable hearing device depends on audiological results, the speech and language development of an individual child, and any accompanying disorders. Repeated audiological evaluations, interdisciplinary diagnostics, and intensive hearing and speech therapy are essential for adequate rehabilitation of this group of children.
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Affiliation(s)
- Désirée Ehrmann-Müller
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany.
| | - Mario Cebulla
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Matthias Scheich
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Daniela Back
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
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58
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Atilgan A, Yuksel M, Ciprut A. Cochlear Implantation in a Case of Auditory Neuropathy Spectrum Disorder with CAPOS Syndrome. Medeni Med J 2019; 34:318-323. [PMID: 32821455 PMCID: PMC7433731 DOI: 10.5222/mmj.2019.53503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/14/2019] [Indexed: 11/29/2022] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a hearing disorder which characterized with normal outer hair cell function but disrupted neural synchrony in the afferent auditory pathway. CAPOS (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss) syndrome can manifest itself with ANSD and this rare situation and audiological rehabilitation outcomes have not well documented in the literature. We aim to present a cochlear implant user subject with CAPOS syndrome and ANSD. A 14-year-old girl diagnosed with ANSD and CAPOS syndrome. She received unilateral cochlear implant (CI). Her hearing sensitivity and speech perception abilities have been improved with CI. Also, she has a good music perception ability measured with the Turkish version of Clinical Assessment of Music Perception Test. After detailed audiological evaluations, CI could be a good option for patients who have ANSD and CAPOS syndrome.
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Affiliation(s)
- Atılım Atilgan
- Marmara University, Department of Audiology, Istanbul, Turkey
| | - Mustafa Yuksel
- Marmara University, Department of Audiology, İstanbul, Turkey
| | - Ayca Ciprut
- Marmara University, Department of Audiology, İstanbul, Turkey
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Giuliani N, Holte L, Shy M, Grider T. The audiologic profile of patients with Charcot-Marie Tooth neuropathy can be characterised by both cochlear and neural deficits. Int J Audiol 2019; 58:902-912. [PMID: 31318300 DOI: 10.1080/14992027.2019.1633022] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The primary goal of this study was to characterise the cochlear and neural components of hearing loss in a large cohort of people with Charcot-Marie Tooth neuropathy who reported hearing difficulties.Design: A full complement of audiologic measures including behavioral, physiologic and subjective assessments were administered.Study sample: Seventy-nine participants completed the study. Forty-four people had CMT1, 27 had CMT2 and four had CMT-INT.Results: Pure tone average was related to age and the absence of high-frequency DPOAE energy, suggesting a strong cochlear component. Acoustic reflexes were often elevated or absent and many participants exhibited abnormal ABR waveforms, suggesting additional neural hearing loss components. Participants with an abnormal or absent ABR wave V exhibited poorer speech perception abilities. There was an association between a prolonged ABR wave I latency and an abnormal or absent ABR wave V with a higher Charcot-Marie Tooth Neuropathy Score (indicating greater disability).Conclusions: The hearing abilities of people with CMT are highly variable. While there were strong neural hearing loss components, speech perception abilities were not disproportionately affected in most participants. Therefore, a hearing aid trial is recommended. ABR responses may be a useful tool for monitoring the progression of CMT over time.
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Affiliation(s)
- Nicholas Giuliani
- Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Lenore Holte
- Department of Communications Sciences and Disorders, University of Iowa, Iowa City, IA, USA.,Center for Disabilities and Development, University Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Michael Shy
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Tiffany Grider
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Tobia A, Khayr R, Shpak T, Peleg C, Genizi J, Khnifes R, Borissovsky N, Luntz M. Idiopathic Intracranial Hypertension Presenting as Auditory Neuropathy Hearing Disorder in a Child. Laryngoscope 2019; 129:E407-E411. [PMID: 31268557 DOI: 10.1002/lary.28150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/19/2019] [Accepted: 06/03/2019] [Indexed: 11/11/2022]
Abstract
Otologic manifestations are known to occur in patients with idiopathic intracranial hypertension (IIH), but the occurrence of sensorineural hearing loss, especially in pediatric populations, has been addressed in only a few reports. Here, we describe a pediatric patient who presented with IIH and severe bilateral hearing loss. The patient's hearing loss was diagnosed as a form of auditory neuropathy (AN) and resolved after prompt treatment of the increased intracranial pressure. This case points to a possible association between IIH and AN and suggests that IIH may potentially be a reversible cause of AN spectrum disorder. Laryngoscope, 129:E407-E411, 2019.
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Affiliation(s)
- Amjad Tobia
- Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Haifa, Israel.,The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ranin Khayr
- Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Haifa, Israel
| | - Talma Shpak
- Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Haifa, Israel
| | - Caroline Peleg
- Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Haifa, Israel
| | - Jacob Genizi
- Department of Pediatrics, Bnai-Zion Medical Center, Haifa, Israel.,The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Riyad Khnifes
- Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Haifa, Israel.,The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Nina Borissovsky
- Department of Radiology, Bnai-Zion Medical Center, Haifa, Israel.,The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Michal Luntz
- Department of Otolaryngology-Head and Neck Surgery, Bnai-Zion Medical Center, Haifa, Israel.,The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Ear and Hearing Unit, ARAM Medical Center for Otolaryngology, Head and Neck, and Maxillofacial Surgery, Assuta Medical Center, Tel Aviv, Israel
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61
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Shearer AE, Hansen MR. Auditory synaptopathy, auditory neuropathy, and cochlear implantation. Laryngoscope Investig Otolaryngol 2019; 4:429-440. [PMID: 31453354 PMCID: PMC6703118 DOI: 10.1002/lio2.288] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/17/2019] [Accepted: 06/13/2019] [Indexed: 02/03/2023] Open
Abstract
Cochlear implantation has become the standard-of-care for adults and children with severe to profound hearing loss. There is growing evidence that qualitative as well as quantitative deficits in the auditory nerve may affect cochlear implant (CI) outcomes. Auditory neuropathy spectrum disorder (ANSD) is characterized by dysfunctional transmission of sound from the cochlea to the brain due to defective synaptic function or neural conduction. In this review, we examine the precise mechanisms of genetic lesions causing ANSD and the effect of these lesions on CI outcomes. Reviewed data show that individuals with lesions that primarily affect the cochlear sensory system and the synapse, which are bypassed by the CI, have optimal CI outcomes. Individuals with lesions that affect the auditory nerve show poor performance with CIs, likely because neural transmission of the electrical signal from the CI is affected. We put forth a nuanced molecular classification of ANSD that has implications for preoperative counseling for patients with this disorder prior to cochlear implantation. We propose that description of ANSD patients should be based on the molecular site of lesion typically derived from genetic evaluation (synaptopathy vs. neuropathy) as this has implications for expected CI outcomes. Improvements in our understanding of genetic site of lesions and their effects on CI function should lead to better CI outcomes, not just for individuals with auditory neuropathy, but all individuals with hearing loss.
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Affiliation(s)
- Aiden Eliot Shearer
- Department of Otolaryngology-Head and Neck Surgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A
| | - Marlan R Hansen
- Department of Otolaryngology-Head and Neck Surgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A.,Department of Neurosurgery University of Iowa Carver College of Medicine Iowa City Iowa U.S.A
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62
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Advances in cochlear implantation for hereditary deafness caused by common mutations in deafness genes. JOURNAL OF BIO-X RESEARCH 2019. [DOI: 10.1097/jbr.0000000000000037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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63
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Effect of acoustic features on discrimination ability in individuals with auditory neuropathy spectrum disorder: an electrophysiological and behavioral study. Eur Arch Otorhinolaryngol 2019; 276:1633-1641. [PMID: 30937559 DOI: 10.1007/s00405-019-05405-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/20/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The present study aimed to investigate the discrimination ability for acoustic cues in individuals with auditory neuropathy spectrum disorder (ANSD) using both behavioral and neural measures and to compare the result with normal hearing individuals. METHODS Four naturally produced syllables /ba/, /da/, /ma/ and /pa/ were used to study discrimination skills. They were combined in pairs such that the two syllables differ in acoustic features, that is place (/ba/-/da/), manner (/ba/-/ma/) and voicing (/ba/-/pa/) cues. Thirty individuals with ANSD and 30 individuals with normal hearing sensitivity were the participants. Syllable discrimination skill was assessed using behavioral (reaction time, sensitivity and D-prime) and neural (P300) measures. RESULTS There was prolongation in latency and reduction in amplitude of P300 in individuals with ANSD compared to individuals with normal hearing sensitivity. Individuals with ANSD showed better discrimination skill for stimulus pairs differing in the manner followed by place and the least perceived was voicing information. CONCLUSION Discrimination ability of individuals with ANSD is found to be affected as evident on behavioral and neural measures. The discrimination ability varies with acoustic features of speech.
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Alzhrani F, Yousef M, Almuhawas F, Almutawa H. Auditory and speech performance in cochlear implanted ANSD children. Acta Otolaryngol 2019; 139:279-283. [PMID: 30947614 DOI: 10.1080/00016489.2019.1571283] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Auditory neuropathy spectrum disorder (ANSD) is a distinct type of SNHL that is characterized by the presence of otoacoustic emissions and/or cochlear microphonics. Cochlear implantation was initially not recommended for ANSD children, later studies showed variable outcomes among those subjects. OBJECTIVE To assess the auditory and speech performance of cochlear implanted children with auditory neuropathy spectrum disorder (ANSD) and to compare these results to those obtained from cochlear implanted children with sensorineural hearing loss (SNHL) Material and methods: 18 cochlear implanted children with ANSD and 40 cochlear implanted children with SNHL were included in this study. Auditory and speech performance results were compared across both subject groups using the Category of Auditory Performance (CAP) and Speech Intelligibility Rate (SIR) tests, with measurements recorded one year post implantation. RESULTS Cochlear implanted children with ANSD showed clinically significant improvements that were comparable to those observed from cochlear implanted subjects without ANSD. CONCLUSIONS Children with ANSD benefit from early cochlear implantation and can reach similar auditory and speech performance results as that achieved by children without ANSD.
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Affiliation(s)
- Farid Alzhrani
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Medhat Yousef
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Audiology Unit, ENT Department, Faculty of Medicine, Menoufia University, Al Menoufia, Egypt
| | - Fida Almuhawas
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hisham Almutawa
- ENT Surgery Unit, Department of Surgical Specialists, King Fahad Medical City, Riyadh, Saudi Arabia
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Yawn RJ, Nassiri AM, Rivas A. Auditory Neuropathy: Bridging the Gap Between Hearing Aids and Cochlear Implants. Otolaryngol Clin North Am 2019; 52:349-355. [PMID: 30765091 DOI: 10.1016/j.otc.2018.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a complex and heterogeneous disorder associated with altered neural synchrony with respect to auditory stimuli. Patients have characteristic auditory findings including normal otoacoustic emissions in the setting of abnormal auditory brainstem response. Patients with ANSD have a high incidence of comorbid developmental delay that may impact speech outcomes. Treatment options for ANSD include hearing amplification and cochlear implantation. The article highlights issues and controversies with the diagnosis and treatment of this complex disorder.
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Affiliation(s)
- Robert J Yawn
- The Otology Group of Vanderbilt, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 7209 Medical Center East, South Tower 1215 21st Avenue South, Nashville, TN 37232-8605, USA
| | - Ashley M Nassiri
- The Otology Group of Vanderbilt, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 7209 Medical Center East, South Tower 1215 21st Avenue South, Nashville, TN 37232-8605, USA
| | - Alejandro Rivas
- The Otology Group of Vanderbilt, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 7209 Medical Center East, South Tower 1215 21st Avenue South, Nashville, TN 37232-8605, USA.
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Mathai JP. Behavioural and Electrophysiological Correlates of Aided Performance in Individuals with Late Onset Auditory Neuropathy Spectrum Disorder: A Review. J Audiol Otol 2018; 22:171-177. [PMID: 30269458 PMCID: PMC6233941 DOI: 10.7874/jao.2018.00031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/01/2018] [Indexed: 11/25/2022] Open
Abstract
Hearing aids are one of the rehabilitative options for individuals with late onset auditory neuropathy spectrum disorder (ANSD). There is a growing body of evidence that supports the effectiveness of hearing aids among these individuals. The objective of the study was to review the behavioural and electrophysiological factors that determine the effectiveness of amplification in individuals with late onset ANSD. An intensive search was carried out using the PubMed, SpringerLink and Google Scholar databases using the following keywords: auditory neuropathy, late onset ANSD, hearing aids and amplification. There were both retrospective and experimental research studies that showed aided improvement in individuals with late onset ANSD. The aided improvement in these studies has been attributed to preserved neural synchrony. Hence, it was concluded that, hearing aids are effective in improving speech perception in a sub-group of individuals with late onset ANSD. Measures that evaluate neural synchrony are promising tools to identify the sub-group of such individuals. Speech identification scores at higher sensation levels and cortical potentials are the two clinical measures that indicate aided performance in individuals with late onset ANSD.
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Unilateral Versus Bilateral Cochlear Implantation in Children With Auditory Neuropathy Spectrum Disorder (ANSD). Otol Neurotol 2018; 39:e810-e816. [DOI: 10.1097/mao.0000000000001971] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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El-Badry MM, Gamal R, Fawzy A. Evaluation of saccular and inferior vestibular nerve function in children with auditory neuropathy spectrum disorder. Eur Arch Otorhinolaryngol 2018; 275:2925-2931. [PMID: 30259131 DOI: 10.1007/s00405-018-5149-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The aim of the current work was to evaluate the function of the saccule and inferior vestibular nerve in children with auditory neuropathy spectrum disorder (ANSD) by recording the cervical-evoked myogenic potentials (C-VEMP) on those children and to compare C-VEMP results in ANSD children of pre-lingual onset to those in ANSD children of post-lingual onset. METHODS The study included 38 ANSD children of pre-lingual onset, 16 ANSD children of post-lingual onset, and 20 control children. All participant children were subjected to C-VEMP testing using 500 Hz tone burst stimuli. RESULTS The vast majority of ANSD children of pre-lingual onset (35 out of 38; 92.1%) had bilateral intact C-VEMP response with C-VEMP parameters (amplitude, asymmetric ratio, latency, and inter-aural latency difference) that were not statistically different than those in the control children. Only three children had bilateral absent C-VEMP response. On the other hand, the majority of ANSD children of post-lingual onset (11 out of 16; 68.75%) had bilateral absent C-VEMP response. The remaining five children had bilateral intact C-VEMP response with C-VEMP parameters that were not statistically different than those in the control children. CONCLUSIONS The pathology of ANSD spares the saccule and inferior vestibular nerve in the vast majority of ANSD children of pre-lingual onset, while it involves them in the majority of ANSD of post-lingual onset reflecting different site(s) of lesion between the two ANSD categories. Such results have important clinical implications as regards to the management of ANSD in children.
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Affiliation(s)
| | - Reham Gamal
- Audio-Vestibular Unit, Minia University, Minia, Egypt
| | - Amira Fawzy
- Audio-Vestibular Unit, Minia University, Minia, Egypt
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In Vivo Electrocochleography in Hybrid Cochlear Implant Users Implicates TMPRSS3 in Spiral Ganglion Function. Sci Rep 2018; 8:14165. [PMID: 30242206 PMCID: PMC6154996 DOI: 10.1038/s41598-018-32630-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/10/2018] [Indexed: 11/16/2022] Open
Abstract
Cochlear implantation, a surgical method to bypass cochlear hair cells and directly stimulate the spiral ganglion, is the standard treatment for severe-to-profound hearing loss. Changes in cochlear implant electrode array design and surgical approach now allow for preservation of acoustic hearing in the implanted ear. Electrocochleography (ECochG) was performed in eight hearing preservation subjects to assess hair cell and neural function and elucidate underlying genetic hearing loss. Three subjects had pathogenic variants in TMPRSS3 and five had pathogenic variants in genes known to affect the cochlear sensory partition. The mechanism by which variants in TMPRSS3 cause genetic hearing loss is unknown. We used a 500-Hz tone burst to record ECochG responses from an intracochlear electrode. Responses consist of a cochlear microphonic (hair cell) and an auditory nerve neurophonic. Cochlear microphonics did not differ between groups. Auditory nerve neurophonics were smaller, on average, in subjects with TMPRSS3 deafness. Results of this proof-of-concept study provide evidence that pathogenic variants in TMPRSS3 may impact function of the spiral ganglion. While ECochG as a clinical and research tool has been around for decades, this study illustrates a new application of ECochG in the study of genetic hearing and deafness in vivo.
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Daneshi A, Mirsalehi M, Hashemi SB, Ajalloueyan M, Rajati M, Ghasemi MM, Emamdjomeh H, Asghari A, Mohammadi S, Mohseni M, Mohebbi S, Farhadi M. Cochlear implantation in children with auditory neuropathy spectrum disorder: A multicenter study on auditory performance and speech production outcomes. Int J Pediatr Otorhinolaryngol 2018; 108:12-16. [PMID: 29605339 DOI: 10.1016/j.ijporl.2018.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/31/2018] [Accepted: 02/03/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To evaluate the auditory performance and speech production outcome in children with auditory neuropathy spectrum disorder (ANSD). The effect of age on the outcomes of the surgery at the time of implantation was also evaluated. METHODS Cochlear implantation was performed in 136 children with bilateral severe-to- profound hearing loss due to ANSD, at four tertiary academic centers. The patients were divided into two groups based on the age at the time of implantation; Group I: Children ≤24 months, and Group II: subjects >24 months. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were evaluated after the first and second years of implantation. The differences between the CAP and SIR scores in the two groups were assessed. RESULTS The median CAP scores improved significantly after the cochlear implantation in all the patients (p value < 0.001). The improvement in the CAP scores during the first year in Group II was greater than Group I (p value: 0.007), but the improvement in CAP scores tended to be significantly higher in patients who were implanted at ≤24 months (p value < 0.001). There was no significant difference between two groups in SIR scores at first-year and second-year follow-ups. The evaluation of the SIR improvement revealed significantly higher values for Group I during the second-year follow-up (p value: 0.003). CONCLUSION The auditory performance and speech production skills of the children with ANSD improved significantly after cochlear implantation, and this improvement was affected by age at the time of implantation.
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Affiliation(s)
- Ahmad Daneshi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Marjan Mirsalehi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Seyed Basir Hashemi
- Department of Otorhinolaryngology, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Ajalloueyan
- Department of Otorhinolaryngology, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mohsen Rajati
- Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohammad Mahdi Ghasemi
- Sinus and Surgical Endoscopic Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hesamaldin Emamdjomeh
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Alimohamad Asghari
- Skull Base Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Shabahang Mohammadi
- Department of Otorhinolaryngology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Mohseni
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Saleh Mohebbi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Mohammad Farhadi
- ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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Guillen‐Ahlers H, Erbe CB, Chevalier FD, Montoya MJ, Zimmerman KD, Langefeld CD, Olivier M, Runge CL. TMTC2 variant associated with sensorineural hearing loss and auditory neuropathy spectrum disorder in a family dyad. Mol Genet Genomic Med 2018; 6:653-659. [PMID: 29671961 PMCID: PMC6081214 DOI: 10.1002/mgg3.397] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 02/02/2018] [Accepted: 03/09/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Sensorineural hearing loss (SNHL) is a common form of hearing loss that can be inherited or triggered by environmental insults; auditory neuropathy spectrum disorder (ANSD) is a SNHL subtype with unique diagnostic criteria. The genetic factors associated with these impairments are vast and diverse, but causal genetic factors are rarely characterized. METHODS A family dyad, both cochlear implant recipients, presented with a hearing history of bilateral, progressive SNHL, and ANSD. Whole-exome sequencing was performed to identify coding sequence variants shared by both family members, and screened against genes relevant to hearing loss and variants known to be associated with SNHL and ANSD. RESULTS Both family members are successful cochlear implant users, demonstrating effective auditory nerve stimulation with their devices. Genetic analyses revealed a mutation (rs35725509) in the TMTC2 gene, which has been reported previously as a likely genetic cause of SNHL in another family of Northern European descent. CONCLUSION This study represents the first confirmation of the rs35725509 variant in an independent family as a likely cause for the complex hearing loss phenotype (SNHL and ANSD) observed in this family dyad.
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Affiliation(s)
- Hector Guillen‐Ahlers
- Department of GeneticsTexas Biomedical Research InstituteSan AntonioTXUSA
- Present address:
Department of Internal MedicineSection of Molecular MedicineWake Forest University School of MedicineWinston‐SalemNCUSA
| | - Christy B. Erbe
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWIUSA
| | | | - Maria J. Montoya
- Department of GeneticsTexas Biomedical Research InstituteSan AntonioTXUSA
| | - Kip D. Zimmerman
- Department of Biostatistical SciencesWake Forest University School of MedicineWinston‐SalemNCUSA
| | - Carl D. Langefeld
- Department of Biostatistical SciencesWake Forest University School of MedicineWinston‐SalemNCUSA
| | - Michael Olivier
- Department of GeneticsTexas Biomedical Research InstituteSan AntonioTXUSA
- Present address:
Department of Internal MedicineSection of Molecular MedicineWake Forest University School of MedicineWinston‐SalemNCUSA
| | - Christina L. Runge
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWIUSA
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Valero MD, Hancock KE, Maison SF, Liberman MC. Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice. Hear Res 2018; 363:109-118. [PMID: 29598837 DOI: 10.1016/j.heares.2018.03.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/20/2018] [Accepted: 03/09/2018] [Indexed: 10/17/2022]
Abstract
Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions, is greatly weakened in synaptopathic regions, and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.
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Affiliation(s)
- Michelle D Valero
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA.
| | - Kenneth E Hancock
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA
| | - Stéphane F Maison
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA
| | - M Charles Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA
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Norrix LW, Velenovsky D. Clinicians' Guide to Obtaining a Valid Auditory Brainstem Response to Determine Hearing Status: Signal, Noise, and Cross-Checks. Am J Audiol 2018; 27:25-36. [PMID: 29392291 DOI: 10.1044/2017_aja-17-0074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/16/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The auditory brainstem response (ABR) is a powerful tool for making clinical decisions about the presence, degree, and type of hearing loss in individuals in whom behavioral hearing thresholds cannot be obtained or are not reliable. Although the test is objective, interpretation of the results is subjective. METHOD This review provides information about evidence-based criteria, suggested by the 2013 Newborn Hearing Screening Program guidelines, and the use of cross-check methods for making valid interpretations about hearing status from ABR recordings. RESULTS The use of an appropriate display scale setting, templates of expected response properties, and objective criteria to estimate the residual noise, signal level, and signal-to-noise ratio will provide quality data for determining ABR thresholds. Cross-checks (e.g., immittance measures, otoacoustic emissions testing, functional indications of a child's hearing) are also needed to accurately interpret the ABR. CONCLUSIONS Using evidence-based ABR signal detection criteria and considering the results within the context of other physiologic tests and assessments of hearing function will improve the clinician's accuracy for detecting hearing loss and, when present, the degree of hearing loss. Diagnostic accuracy will ensure that appropriate remediation is initiated and that children or infants with normal hearing are not subjected to unnecessary intervention.
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Affiliation(s)
- Linda W. Norrix
- Department of Speech, Language, & Hearing Sciences, The University of Arizona, Tucson
| | - David Velenovsky
- Department of Speech, Language, & Hearing Sciences, The University of Arizona, Tucson
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Sarankumar T, Arumugam SV, Goyal S, Chauhan N, Kumari A, Kameswaran M. Outcomes of Cochlear Implantation in Auditory Neuropathy Spectrum Disorder and the Role of Cortical Auditory Evoked Potentials in Benefit Evaluation. Turk Arch Otorhinolaryngol 2018; 56:15-20. [PMID: 29988272 DOI: 10.5152/tao.2017.2537] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/02/2017] [Indexed: 11/22/2022] Open
Abstract
Objective To compare the outcomes of cochlear implantation (CI) in children with auditory neuropathy spectrum disorder (ANSD) and age-matched controls with profound sensorineural hearing loss, using categories of auditory performance (CAP), speech intelligibility rate (SIR), meaningful auditory integration scale (MAIS), and meaningful use of speech scale (MUSS), and to determine the role of Cortical Auditory Evoked Potentials (CAEP) in benefit evaluation after CI. Methods Ten patients (8 males and two females) with ANSD who underwent CI were included in the study. Auditory and speech scores were compared between baseline and after 12 months of habilitation in children with ANSD. Post CI speech scores in children with ANSD were compared with the control group (age-matched children with profound sensorineural hearing loss) at 12 months of habilitation. P1 latency of CAEP has a good correlation with auditory and speech scores in children with ANSD in the study group. Results Significant benefits were seen in children with ANSD who underwent CI compared to the baseline CAP and SIR scores and one year after habilitation. There is no statistically significant difference in outcomes between the two groups with CI (ANSD and profound sensorineural hearing loss) (p-value: CAP=1.00, SIR=0.84, MAIS=0.33, MUSS=0.08). Speech perception in noise test (SPIN) scores in children with ANSD were 63% and 80% with 0 dB signal noise ratio (SNR) and +10dB SNR, respectively. P1 wave of CAEP has a good correlation with the subjective outcomes. Conclusion CI in children with ANSD has showed benefits comparable to children with profound sensorineural hearing loss. CAEP is a useful tool in objectively assessing cortical maturity in children with ANSD following CI.
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Affiliation(s)
| | | | - Sunil Goyal
- Department of Otorhinolaryngology, Madras ENT Research Foundation, Chennai, India
| | - Neha Chauhan
- Department of Otorhinolaryngology, Madras ENT Research Foundation, Chennai, India
| | - Abha Kumari
- Department of Otorhinolaryngology, Madras ENT Research Foundation, Chennai, India
| | - Mohan Kameswaran
- Department of Otorhinolaryngology, Madras ENT Research Foundation, Chennai, India
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Farinetti A, Raji A, Wu H, Wanna B, Vincent C. International consensus (ICON) on audiological assessment of hearing loss in children. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S41-S48. [PMID: 29366866 DOI: 10.1016/j.anorl.2017.12.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 11/24/2022]
Abstract
The prevalence of hearing loss in newborns and infants is estimated between 1 to 3.47 cases per 1000 live births. Early diagnosis and rehabilitation of congenital hearing loss are mandatory in order to achieve a satisfactory linguistic and cognitive development. Without appropriate opportunities to learn language, these children will fall behind their normal hearing peers in communication, cognition, reading and socio-emotional development. After promising results, neonatal screening for hearing loss and audiological evaluation are becoming more extensively carried out. In planning universal neonatal hearing screening programs, transient evoked otoacoustic emissions and auditory brainstem responses are the gold standard for the screening and diagnosis program. However, there is no consensus regarding the use of audiometry and other electrophysiological tests (such as auditory steady-state responses) in current practices. Several screening and audiological assessment procedures have been described and advocated all around the world. But, a systematic scheme of performing diagnosis in the pediatric audiology population is lacking. A consensus conference was held at the International Federation of Oto-rhino-laryngological Societies Congress, in June 2017, to discuss the different current practices and to identify the best neonatal hearing screening and audiological assessment management. This article is intended to provide professionals with recommendations about the "best practice" based on consensus opinion of the session's speakers, and a review of the literature on the efficacy of various assessment options for children with hearing loss.
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Affiliation(s)
- A Farinetti
- Department of Pediatric Otolaryngology, Hôpital La Timone Enfants, AP-HM, 264, avenue Saint-Pierre, 13005 Marseille, France.
| | - A Raji
- Department of Otolaryngology, Mohammed VI Hospital, avenue Ibn Sina Amerchich, BP2360 Marrakech-principal, Morocco
| | - H Wu
- Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital & Shanghai Jiaotong University School of Medicine, 639, Zhizaoju Road, 200011 Shanghai, China
| | - B Wanna
- Department of Otolaryngology Head and Neck, Middle East Institute of Health-University Hospital, Bsalim main road, Mezher street, 60387 Bsalim-Metn, Lebanon
| | - C Vincent
- Department of Otolaryngology, Hôpital Roger-Salengro, Centre Hospitalier Régional de Lille, rue du Professeur-Emile-Laine, 59000 Lille, France
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Prabhu P, Jamuar P. Evaluation of Dizziness Handicap in Adolescents and Adults with Auditory Neuropathy Spectrum Disorder. Int Arch Otorhinolaryngol 2018; 22:14-18. [PMID: 29371893 PMCID: PMC5783682 DOI: 10.1055/s-0037-1602693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/09/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction
Vestibular symptoms and damage to the vestibular branch of the eighth cranial nerve is reported in individuals with auditory neuropathy spectrum disorder (ANSD). However, the real life handicap caused by these vestibular problems in individuals with ANSD is not studied.
Objective
The present study attempted to evaluate the dizziness-related handicap in adolescents and adults with ANSD.
Method
The dizziness handicap inventory (DHI) was administered to 40 adolescents and adults diagnosed with ANSD. The study also attempted to determine if there is any gender effect on DHI scores and its correlation to the reported onset of hearing loss.
Results
The results of the study showed that adolescents and adults with ANSD had a moderate degree of dizziness-related handicap. The dizziness affected their quality of life, causing emotional problems. There was no gender effect, and the level of the handicap was greater in the cases in which the onset of the hearing loss was reported soon after the diagnosis of ANSD. There could be a vestibular compensation that could have resulted in a reduction in symptoms in individuals in whom the onset of the hearing loss was reported later on.
Conclusion
Thus, a detailed assessment of vestibular problems and their impact on quality of life is essential in adolescents and adults with ANSD. Appropriate management strategies should be considered to resolve their vestibular problems and improve their quality of life.
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Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Naimisham Campus Manasagangothri, Mysore, Karnataka, India
| | - Pratyasha Jamuar
- Department of Audiology, All India Institute of Speech and Hearing, Naimisham Campus Manasagangothri, Mysore, Karnataka, India
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The management of pediatric hearing loss caused by auditory neuropathy spectrum disorder. Curr Opin Otolaryngol Head Neck Surg 2018; 25:396-399. [PMID: 28708635 DOI: 10.1097/moo.0000000000000390] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Auditory neuropathy spectrum disorder (ANSD) is a condition in which auditory testing reveals normal otoacoustic emissions, but auditory brainstem testing is abnormal or absent and speech discrimination is poor. This constellation of findings ostensibly suggests that the cochlea is healthy and an abnormality of conduction or processing of sound occurs along the nerve fibers. As more is learned about this condition, it is becoming clear that ANSD describes heterogeneous, distinct clinical entities that must be taken into account when devising treatment modalities. RECENT FINDINGS Modern auditory testing, genetic testing, and neuroimaging can allow for an accurate understanding of the location of the lesion causing ANSD in the auditory pathway. Contributing causes can include genetic mutations, absent or deficient cochlear nerve, hypoxia and jaundice among others. Hearing aids can be successful in the management of ANSD. Several studies suggest that cochlear implantation can lead to successful hearing outcomes in a subset of this patient population. SUMMARY Auditory neuropathy spectrum disorder represents a relatively rare but important diagnosis for clinicians. Treatment for this condition includes hearing aids and FM systems in more mild cases, and cochlear implants in severe cases. Cochlear implantation for many patients can lead to a good hearing outcomes but the outcome can vary greatly depending on the underlying etiology of ANSD.
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Evidence of noise-induced subclinical hearing loss using auditory brainstem responses and objective measures of noise exposure in humans. Hear Res 2018; 361:80-91. [PMID: 29370962 DOI: 10.1016/j.heares.2018.01.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/21/2017] [Accepted: 01/08/2018] [Indexed: 01/19/2023]
Abstract
Exposure to loud sound places the auditory system at considerable risk, especially when the exposure is routine. The current study examined the impact of routine auditory overexposure in young human adults with clinically-normal audiometric thresholds by measuring the auditory brainstem response (ABR), an electrophysiological measure of peripheral and central auditory processing. Sound exposure was measured objectively with body-worn noise dosimeters over a week. Participants were divided into low-exposure and high-exposure groups, with the low-exposure group having an average daily noise exposure dose of ∼11% of the recommended exposure limit compared to the high-exposure group average of nearly 500%. Compared to the low-exposure group, the high-exposure group had delayed ABRs to suprathreshold click stimuli and this prolongation was evident at ABR waves I and III but strongest for V. When peripheral differences were corrected using the I-V interpeak latency, the high-exposure group showed greater taxation at faster stimulus presentation rates than the low-exposure group, suggestive of neural conduction inefficiencies within central auditory structures. Our findings are consistent with the hypothesis that auditory overexposure affects peripheral and central auditory structures even before changes are evident on standard audiometry. We discuss our findings within the context of the larger debate on the mechanisms and manifestations of subclinical hearing loss.
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McKnight RJ, Glick H, Cardon G, Sharma A. The Effects of Stimulus Rate on ABR Morphology and its Relationship to P1 CAEP Responses and Auditory Speech Perception Outcomes in Children with Auditory Neuropathy Spectrum Disorder: Evidence from Case Reports. HEARING, BALANCE AND COMMUNICATION 2017; 16:1-12. [PMID: 32953369 PMCID: PMC7500459 DOI: 10.1080/21695717.2017.1418803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Auditory Neuropathy Spectrum Disorder (ANSD) affects approximately 5-15% of children with sensorineural hearing loss. ANSD is characterized by the presence of otoacoustic emissions (OAE) and an absent or abnormal auditory brainstem response (ABR). The purpose of this study was to investigate the prognostic value of slow-rate ABR in predicting the auditory cortical development and auditory speech perception outcomes in case studies of children with ANSD. DESIGN ABR waveform characteristics were collected at slow stimulation rates (5.1 clicks/second) and a fast stimulation rates (>11-31.1 clicks/second, rates typically used in a clinical setting) in 3 case reports of children with ANSD. P1 CAEP responses and measures of auditory speech perception using the Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS) were also collected in these children. Retrospective analysis was performed to evaluate the prognostic value of slow- versus fast-rate ABR in predicting P1 CAEP responses and auditory speech perception outcomes in these children. STUDY SAMPLE Participants included case reports of 3 pediatric participants with a clinical diagnosis of ANSD. RESULTS Slow-rate ABR did not elicit significant improvements in waveform morphology compared to fast-rate ABR. P1 CAEP results were present in 2 out of 3 cases and were consistent with auditory speech perception outcomes. CONCLUSIONS Even when ABR stimulation rates were slowed, ABR responses in these children with ANSD did not display any characteristic or replicable pattern, and ABR responses were not predictive of cortical auditory maturation or behavioral performance. In contrast, P1 CAEP responses provided valuable information regarding the maturational status of the auditory cortex and P1 CAEP responses were consistent with behavioral measures of auditory speech perception. Overall, results highlight the high prognostic value of P1 CAEP testing when used in conjunction with behavioral measures of auditory speech perception in children with ANSD.
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Affiliation(s)
- Rosemary J McKnight
- Speech, Language, and Hearing Sciences Department, University of Colorado at Boulder, Boulder, CO 80309, USA; Speech, Language, and Hearing Sciences Department, Institute of Cognitive Science, Center for Neuroscience University of Colorado at Boulder, Boulder, CO 80309, USA
| | - Hannah Glick
- Speech, Language, and Hearing Sciences Department, University of Colorado at Boulder, Boulder, CO 80309, USA; Speech, Language, and Hearing Sciences Department, Institute of Cognitive Science, Center for Neuroscience University of Colorado at Boulder, Boulder, CO 80309, USA
| | - Garrett Cardon
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Anu Sharma
- Speech, Language, and Hearing Sciences Department, University of Colorado at Boulder, Boulder, CO 80309, USA; Speech, Language, and Hearing Sciences Department, Institute of Cognitive Science, Center for Neuroscience University of Colorado at Boulder, Boulder, CO 80309, USA
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80
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Prabhu P. Is tinnitus a major concern in individuals with auditory neuropathy spectrum disorder? - Questionnaire based study. World J Otorhinolaryngol Head Neck Surg 2017; 5:1-5. [PMID: 30775694 PMCID: PMC6364510 DOI: 10.1016/j.wjorl.2017.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/27/2017] [Accepted: 07/04/2017] [Indexed: 11/23/2022] Open
Abstract
Objective Our study attempted to determine if tinnitus is a major concern in individuals with auditory neuropathy spectrum disorder (ANSD). The study also attempted to determine if pure tone average (PTA), speech identification scores (SIS), or reported duration of hearing loss could predict the tinnitus severity and functional handicap in adults with ANSD. Methods Tinnitus functional index (TFI) and tinnitus severity index (TSI) were administered on all the 40 participants diagnosed with ANSD. Results The mean TFI score was 44.3, which suggested moderate degree of tinnitus related functional impairment. The mean TSI score was found to be 33.3, which suggested moderate degree of severity in individuals with ANSD. The study also showed that tinnitus causes functional impairment that leading to sleep disturbances, emotional problems, and affecting the quality of life. There was no significant correlation (P > 0.05) between PTA, SIS, reported onset of hearing loss and scores of TFI or TSI. Conclusion Tinnitus in individuals with ANSD should also be given priority during assessment and provide appropriate tinnitus management.
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Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Naimisham Campus, Mysore, Karnataka, 570006, India
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81
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Lang-Roth R, Fischer-Krall E, Kornblum C, Nürnberg G, Meschede D, Goebel I, Nürnberg P, Beutner D, Kubisch C, Walger M, Volk AE. AUNA2: A Novel Type of Non-Syndromic Slowly Progressive Auditory Synaptopathy/Auditory Neuropathy with Autosomal-Dominant Inheritance. Audiol Neurootol 2017; 22:30-40. [PMID: 28601886 DOI: 10.1159/000474929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/31/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Auditory synaptopathy/neuropathy (AS/AN) is a heterogeneous disorder, which may be caused by environmental factors like postnatal hyperbilirubinemia or by genetic factors. The genetic forms are subdivided into syndromic and non-syndromic types, and show different inheritance patterns with a strong preponderance of autosomal-recessive forms. To date, only a single locus for non-syndromic autosomal-dominant AS/AN (AUNA1) has been reported in a single family, in which a non-coding DIAPH3 mutation was subsequently described as causative. MATERIALS AND METHODS Here, we report detailed clinical data on a large German AS/AN family with slowly progressive postlingual hearing loss. Affected family members developed their first symptoms in their second decade. Moderate hearing loss in the fourth decade then progressed to profound hearing impairment in older family members. Comprehensive audiological and neurological tests were performed in the affected family members. Genetic testing comprised linkage analyses with polymorphic markers and a genome-wide linkage analysis using the Affymetrix GeneChip® Human Mapping 250K. RESULTS AND CONCLUSION We identified a large family with autosomal-dominant AS/AN. By means of linkage analyses, the AUNA1 locus was excluded, and putatively linked regions on chromosomal bands 12q24 and 13q34 were identified as likely carrying the second locus for autosomal-dominant AS/AN (AUNA2). AUNA2 is associated with a slowly progressive postlingual hearing loss without any evidence for additional symptoms in other organ systems.
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Affiliation(s)
- Ruth Lang-Roth
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
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Prabhu P, Barman A. Effectiveness of low-cut modified amplification strategy and channel-free hearing aid in individuals with auditory neuropathy spectrum disorder. Int J Audiol 2017; 56:759-766. [DOI: 10.1080/14992027.2017.1323123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
| | - Animesh Barman
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
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Abstract
Reported here are audiological findings from an adult with thin cochlear nerves. Magnetic resonance imaging (MRI) revealed that he had a thinner cochlear nerve in the left ear than in the right ear. He had a higher degree of hearing loss in the left ear and poor speech recognition scores for both ears. He had normal middle ear and cochlear functioning. The auditory brainstem response and acoustic reflexes were absent, indicating a retrocochlear pathology. Long latency responses (LLR) revealed normal cortical functioning. Hence, implantation of an auditory brainstem implant might be an option, but the patient would need to be aware of its limitations. This case highlights the importance of MRI in evaluating congenital malformations of the cochlear nerve when audiological findings indicate a retrocochlear pathology.
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Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
- Address correspondence to: Dr. Prashanth Prabhu, Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Naimisham Campus, Mysore, Karnataka 570006, India. E-mail:
| | - Jyothi Shivaswamy
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
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84
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Prabhu P, Jamuar P. Prevalence of vestibular symptoms in individuals with auditory neuropathy spectrum disorder - A retrospective study. Intractable Rare Dis Res 2017; 6:46-49. [PMID: 28357181 PMCID: PMC5359352 DOI: 10.5582/irdr.2016.01098] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The objective of the study was to retrospectively determine the prevalence of vestibular symptoms in individuals with auditory neuropathy spectrum disorder (ANSD). It was also attempted to determine the prevalence of vestibular symptoms and factors (gender and age of reported hearing loss) that could affect the prevalence in individuals with ANSD. The vestibular symptoms reported in the case history were analyzed in individuals diagnosed with ANSD. The symptoms reported by a total of 316 individuals (185 females and 131 males) with ANSD were analyzed. The result of the study showed that one in five individuals with ANSD reported at least one of the vestibular symptom. The vestibular symptoms were in more females and in individuals with earlier onset of hearing loss. The result of the study supports that there is a vestibular damage in individuals with ANSD. However, it is essential to carry out prospective studies validating these vestibular symptoms with objective vestibular tests before generalizing the results.
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Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
- Address correspondence to: Dr. Prashanth Prabhu, Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Naimisham Campus, Mysore, Karnataka 570006, India. E-mail:
| | - Pratyasha Jamuar
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
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85
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Harris SL, Kazmierczak M, Pangršič T, Shah P, Chuchvara N, Barrantes-Freer A, Moser T, Schwander M. Conditional deletion of pejvakin in adult outer hair cells causes progressive hearing loss in mice. Neuroscience 2017; 344:380-393. [PMID: 28089576 DOI: 10.1016/j.neuroscience.2016.12.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 12/27/2016] [Accepted: 12/29/2016] [Indexed: 10/20/2022]
Abstract
Mutations in the Pejvakin (Pjvk) gene cause autosomal recessive hearing loss DFNB59 with audiological features of auditory neuropathy spectrum disorder (ANSD) or cochlear dysfunction. The precise mechanisms underlying the variable clinical phenotypes of DFNB59 remain unclear. Here, we demonstrate that mice with conditional ablation of the Pjvk gene in all sensory hair cells or only in outer hair cells (OHCs) show similar auditory phenotypes with early-onset profound hearing loss. By contrast, loss of Pjvk in adult OHCs causes a slowly progressive hearing loss associated with OHC degeneration and delayed loss of inner hair cells (IHCs), indicating a primary role for pejvakin in regulating OHC function and survival. Consistent with this model, synaptic transmission at the IHC ribbon synapse is largely unaffected in sirtaki mice that carry a C-terminal deletion mutation in Pjvk. Using the C-terminal domain of pejvakin as bait, we identified in a cochlear cDNA library ROCK2, an effector for the small GTPase Rho, and the scaffold protein IQGAP1, involved in modulating actin dynamics. Both ROCK2 and IQGAP1 associate via their coiled-coil domains with pejvakin. We conclude that pejvakin is required to sustain OHC activity and survival in a cell-autonomous manner likely involving regulation of Rho signaling.
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Affiliation(s)
- Suzan L Harris
- Department of Cell Biology and Neuroscience, Rutgers the State University of New Jersey, Piscataway, NJ 08854, United States
| | - Marcin Kazmierczak
- Department of Cell Biology and Neuroscience, Rutgers the State University of New Jersey, Piscataway, NJ 08854, United States
| | - Tina Pangršič
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, 37099 Göttingen, Germany; Collaborative Research Center 889, University of Göttingen, 37099 Göttingen, Germany
| | - Prahar Shah
- Department of Cell Biology and Neuroscience, Rutgers the State University of New Jersey, Piscataway, NJ 08854, United States
| | - Nadiya Chuchvara
- Department of Cell Biology and Neuroscience, Rutgers the State University of New Jersey, Piscataway, NJ 08854, United States
| | - Alonso Barrantes-Freer
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, 37099 Göttingen, Germany; Collaborative Research Center 889, University of Göttingen, 37099 Göttingen, Germany
| | - Tobias Moser
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, 37099 Göttingen, Germany; Collaborative Research Center 889, University of Göttingen, 37099 Göttingen, Germany
| | - Martin Schwander
- Department of Cell Biology and Neuroscience, Rutgers the State University of New Jersey, Piscataway, NJ 08854, United States.
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86
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Yuvaraj P, Jayaram M. Audiological Profile of Adult Persons with Auditory Neuropathy Spectrum Disorders. J Audiol Otol 2016; 20:158-167. [PMID: 27942602 PMCID: PMC5144811 DOI: 10.7874/jao.2016.20.3.158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 07/20/2016] [Accepted: 08/03/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The auditory profile of a large number of persons with late onset auditory neuropathy spectrum disorder (ANSD) is recently described in the Indian context. The purpose of study was 1) to profile data on routine audiological parameters, cortical evoked potentials, and temporal processing, 2) to analyze the benefit from hearing aids for persons with ANSD, and 3) to understand the association between benefit from hearing aids and auditory profile. SUBJECTS AND METHODS Thirty-eight adults with late onset ANSD and a matched group of 40 normally hearing adults participated in the study. Basic audiological tests, recording of cortical evoked potentials, and temporal processing tests were carried out on both groups of participant while only persons with ANSD were fitted with hearing aid. RESULTS Subjects in the two groups were significantly different on all the audiological parameters. ANSD group seemed to benefit from hearing aids variably. The mean amplitude of N2 was significantly different between normally-hearing participants and patients with ANSD. CONCLUSIONS Residual temporal processing, particularly amplitude modulation detection seems to be associated with benefit from hearing aids in patients with ANSD.
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Affiliation(s)
- Pradeep Yuvaraj
- Department of Speech-Language Pathology & Audiology, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Mannarukrishnaiah Jayaram
- Department of Speech-Language Pathology & Audiology, National Institute of Mental Health & Neurosciences, Bangalore, India
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87
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Prabhu P, Barman A. Effectiveness of Low Cut Modified Amplification using Receiver in the Canal Hearing Aid in Individuals with Auditory Neuropathy Spectrum Disorder. Int Arch Otorhinolaryngol 2016; 21:243-249. [PMID: 28680492 PMCID: PMC5495591 DOI: 10.1055/s-0036-1593471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/23/2016] [Indexed: 10/31/2022] Open
Abstract
Introduction The studies on hearing aid benefit in individuals with auditory neuropathy spectrum disorder (ANSD) shows limited benefit. Low cut modified amplification is found to be effective in few individuals with ANSD. With advancement in technology, receiver in the canal (RIC) hearing aids have proven to be more effective than traditional behind the ear (BTE) hearing aids. Objective Thus, the present study attempts to determine the effectiveness of low cut modified amplification using RIC and BTE. Method Twenty participants with ANSD were fitted with BTE and RIC using traditional and low cut modified amplification. We divided them into good and poor performers based on unaided speech identification scores (SIS). We then compared aided SIS and aided benefit across conditions in good and poor performers with ANSD across both conditions using BTE and RIC. Results The results of the study showed that the aided performance improved with low cut modified amplification in both BTE and RIC hearing aids. The improvement noticed with low-cut modified fitting with RIC was significant in more than BTE, especially in good performers with ANSD. Conclusion The improved clarity and naturalness of sound with RIC may have led to better aided scores and better acceptance of the hearing aid. Thus, low-cut modified amplification, preferably with RIC, needs to be attempted in fitting individuals with ANSD, especially in those with good unaided SIS in quiet.
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Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing Ringgold Standard Institution, Mysore, Karnataka, India
| | - Animesh Barman
- Department of Audiology, All India Institute of Speech and Hearing Ringgold Standard Institution, Mysore, Karnataka, India
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88
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Gardner-Berry K, Chang H, Ching TYC, Hou S. Detection Rates of Cortical Auditory Evoked Potentials at Different Sensation Levels in Infants with Sensory/Neural Hearing Loss and Auditory Neuropathy Spectrum Disorder. Semin Hear 2016; 37:53-61. [PMID: 27587922 DOI: 10.1055/s-0035-1570330] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
With the introduction of newborn hearing screening, infants are being diagnosed with hearing loss during the first few months of life. For infants with a sensory/neural hearing loss (SNHL), the audiogram can be estimated objectively using auditory brainstem response (ABR) testing and hearing aids prescribed accordingly. However, for infants with auditory neuropathy spectrum disorder (ANSD) due to the abnormal/absent ABR waveforms, alternative measures of auditory function are needed to assess the need for amplification and evaluate whether aided benefit has been achieved. Cortical auditory evoked potentials (CAEPs) are used to assess aided benefit in infants with hearing loss; however, there is insufficient information regarding the relationship between stimulus audibility and CAEP detection rates. It is also not clear whether CAEP detection rates differ between infants with SNHL and infants with ANSD. This study involved retrospective collection of CAEP, hearing threshold, and hearing aid gain data to investigate the relationship between stimulus audibility and CAEP detection rates. The results demonstrate that increases in stimulus audibility result in an increase in detection rate. For the same range of sensation levels, there was no difference in the detection rates between infants with SNHL and ANSD.
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Affiliation(s)
| | - Hsiuwen Chang
- Department of Audiology and Speech Language Pathology, Mackay Medical College, Taiwan
| | | | - Sanna Hou
- National Acoustic Laboratories, Melbourne, Australia
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89
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Chambers AR, Salazar JJ, Polley DB. Persistent Thalamic Sound Processing Despite Profound Cochlear Denervation. Front Neural Circuits 2016; 10:72. [PMID: 27630546 PMCID: PMC5005347 DOI: 10.3389/fncir.2016.00072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 08/19/2016] [Indexed: 11/13/2022] Open
Abstract
Neurons at higher stages of sensory processing can partially compensate for a sudden drop in peripheral input through a homeostatic plasticity process that increases the gain on weak afferent inputs. Even after a profound unilateral auditory neuropathy where >95% of afferent synapses between auditory nerve fibers and inner hair cells have been eliminated with ouabain, central gain can restore cortical processing and perceptual detection of basic sounds delivered to the denervated ear. In this model of profound auditory neuropathy, auditory cortex (ACtx) processing and perception recover despite the absence of an auditory brainstem response (ABR) or brainstem acoustic reflexes, and only a partial recovery of sound processing at the level of the inferior colliculus (IC), an auditory midbrain nucleus. In this study, we induced a profound cochlear neuropathy with ouabain and asked whether central gain enabled a compensatory plasticity in the auditory thalamus comparable to the full recovery of function previously observed in the ACtx, the partial recovery observed in the IC, or something different entirely. Unilateral ouabain treatment in adult mice effectively eliminated the ABR, yet robust sound-evoked activity persisted in a minority of units recorded from the contralateral medial geniculate body (MGB) of awake mice. Sound driven MGB units could decode moderate and high-intensity sounds with accuracies comparable to sham-treated control mice, but low-intensity classification was near chance. Pure tone receptive fields and synchronization to broadband pulse trains also persisted, albeit with significantly reduced quality and precision, respectively. MGB decoding of temporally modulated pulse trains and speech tokens were both greatly impaired in ouabain-treated mice. Taken together, the absence of an ABR belied a persistent auditory processing at the level of the MGB that was likely enabled through increased central gain. Compensatory plasticity at the level of the auditory thalamus was less robust overall than previous observations in cortex or midbrain. Hierarchical differences in compensatory plasticity following sensorineural hearing loss may reflect differences in GABA circuit organization within the MGB, as compared to the ACtx or IC.
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Affiliation(s)
- Anna R Chambers
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary Boston, MA, USA
| | - Juan J Salazar
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBoston, MA, USA; Department of Biology, École Normale Supérieure, PSL Research UniversityParis, France
| | - Daniel B Polley
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBoston, MA, USA; Department of Otolaryngology, Harvard Medical SchoolBoston, MA, USA
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90
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Prabhu P. Evaluation of Depression, Anxiety, and Stress in Adolescents and Young Adults with Auditory Neuropathy Spectrum Disorder. SCIENTIFICA 2016; 2016:4378269. [PMID: 27579218 PMCID: PMC4992756 DOI: 10.1155/2016/4378269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 06/29/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
The aim of the present study was to determine the severity of stress, anxiety, and depression using Depression Anxiety Stress Scales (DASS) in adolescents and young adults with auditory neuropathy spectrum disorder (ANSD). DASS was administered to 20 individuals with auditory neuropathy spectrum disorder. The effect of gender on severity of anxiety, stress, and depression on DASS scores was determined. It was attempted to determine the correlation of severity of anxiety, stress, and depression with the reported onset of the problem, degree of hearing loss, and speech identification scores. The results of the study showed that individuals with ANSD had a moderate degree of depression and anxiety. The results also showed that the symptoms were more seen in females than in males. Correlation analysis revealed that DASS scores correlated with the reported onset of condition and speech identification scores (SIS) and the degree of hearing loss showed no correlation. The study concludes that individuals with ANSD experience depression and anxiety and this could be because of the inadequate management options available for individuals with ANSD. Thus, there is a need to develop appropriate management strategies for individuals with ANSD and provide appropriate referral for management of psychological issues.
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Affiliation(s)
- Prashanth Prabhu
- All India Institute of Speech and Hearing, Mysore 570 006, India
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91
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Boudewyns A, Declau F, van den Ende J, Hofkens A, Dirckx S, Van de Heyning P. Auditory neuropathy spectrum disorder (ANSD) in referrals from neonatal hearing screening at a well-baby clinic. Eur J Pediatr 2016; 175:993-1000. [PMID: 27220871 DOI: 10.1007/s00431-016-2735-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/04/2016] [Accepted: 05/16/2016] [Indexed: 11/29/2022]
Abstract
UNLABELLED Auditory neuropathy spectrum disorder (ANSD) is a particular kind of hearing disorder characterised by normal outer hair cell function and abnormal or absent auditory brain stem responses. Little data are available regarding the prevalence of this condition in healthy newborns. We performed a retrospective medical records review of 791 referrals from universal neonatal hearing screening (UNHS) at a well-baby clinic to investigate the prevalence of ANSD. Hearing screening was performed by automated auditory brain stem response (ABR) testing. A diagnosis of ANSD was established when ABR tracings were absent in the presence of otoacoustic emissions and/or a cochlear microphonic. Amongst 201 infants with confirmed congenital hearing loss, 13 infants were diagnosed with ANSD. The condition was unilateral in six and bilateral in seven infants. A risk factor for hearing loss could be identified in three infants. Abnormalities on magnetic resonance imaging were found in six infants; five of them had cochlear nerve deficiency. CONCLUSION The prevalence of ANSD was 6.5 % amongst well babies with confirmed congenital hearing loss identified through UNHS. The estimated incidence of ANSD in our population of newborns at the well-baby clinic was 0.09/1000 live births. Magnetic resonance revealed an underlying anatomical abnormality in about half of the patients. WHAT IS KNOWN • Auditory neuropathy dyssynchrony spectrum disorder (ANSD) is a particular form of hearing loss, mostly encountered in neonatal intensive care unit (NICU) graduates. • Little data are available on the prevalence and risk factors for ANSD in healthy newborns. What is new: • The estimated prevalence of ANSD in healthy newborns is 0.09/1000 live births. • In about half of the healthy newborns with ANSD, a structural abnormality was detected on magnetic resonance imaging of the posterior fossa/brain.
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Affiliation(s)
- A Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
| | - Frank Declau
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Jenneke van den Ende
- Department of Medical Genetics, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Anouk Hofkens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Sara Dirckx
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
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Abstract
From the therapeutic perspective, the etiology and pathophysiology of hearing loss can be classified based on the extent of the primary cause. Hearing loss can have very different consequences for cell preservation in the organ of Corti and the spiral ganglion. These not only have implications for prosthetic therapy outcome, but may also influence the potential for future causal molecular therapies. Etiologies leading to deficits that are limited to one or a few molecules without having an effect on cell survival have the greatest potential for future causal therapy using molecular and cellular approaches. Preliminary success for molecular therapy was recently reported in animal experiments. Unfortunately, the incidence of these types of hearing loss is very low and in the future the therapy of hearing loss will therefore also require several different approaches. In addition to peripheral pathophysiology, hearing loss has consequences on the functioning of the brain, which can vary greatly due to individual adaptation to the situation without hearing. The authors therefore argue for individualization of the diagnostics and therapy that focus not only the symptom of hearing loss, but also the individual pathophysiology and consequences. Only with individualized therapy can the success of treating hearing disorders be significantly improved.
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Abstract
Preterm neonates with increased bilirubin production loads are more likely to sustain adverse outcomes due to either neurotoxicity or overtreatment with phototherapy and/or exchange transfusion. Clinicians should rely on expert consensus opinions to guide timely and effective interventions until there is better evidence to refine bilirubin-induced neurologic dysfunction or benefits of bilirubin. In this article, we review the evolving evidence for bilirubin-induced brain injury in preterm infants and highlight the clinical approaches that minimize the risk of bilirubin neurotoxicity.
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Liu X. Current trends in outcome studies for children with hearing loss and the need to establish a comprehensive framework of measuring outcomes in children with hearing loss in China. J Otol 2016; 11:43-56. [PMID: 29937810 PMCID: PMC6002604 DOI: 10.1016/j.joto.2016.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/25/2016] [Accepted: 04/26/2016] [Indexed: 11/22/2022] Open
Abstract
Since the 1970s, outcome studies for children with hearing loss expanded from focusing on assessing auditory awareness and speech perception skills to evaluating language and speech development. Since the early 2000s, the multi-center large scale research systematically studied outcomes in the areas of auditory awareness, speech-perception, language development, speech development, educational achievements, cognitive development, and psychosocial development. These studies advocated the establishment of baseline and regular follow-up evaluations with a comprehensive framework centered on language development. Recent research interests also include understanding the vast differences in outcomes for children with hearing loss, understanding the relationships between neurocognitive development and language acquisition in children with hearing loss, and using outcome studies to guide evidence-based clinical practice. After the establishment of standardized Mandarin language assessments, outcomes research in Mainland China has the potential to expand beyond auditory awareness and speech perception studies.
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BENITO-OREJAS JI, PONCELA-BLANCO M, GARCÍA-VICARIO F, BENITO-GONZÁLEZ F, MARTÍN-SIGÜENZA G, SAN ROMÁN-CARBAJO J. ¿Es fácil encargarse de coordinar un «Programa de Hipoacusia Infantil»? REVISTA ORL 2016. [DOI: 10.14201/orl201672.14237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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96
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Abdollahi FZ, Ahmadi T, Manchaiah V, Lotfi Y. Auditory Brainstem Response Improvements in Hyperbillirubinemic Infants. J Audiol Otol 2016; 20:13-6. [PMID: 27144228 PMCID: PMC4853896 DOI: 10.7874/jao.2016.20.1.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/02/2015] [Accepted: 11/29/2015] [Indexed: 12/04/2022] Open
Abstract
Background and Objectives Hyperbillirubinemia in infants have been associated with neuronal damage including in the auditory system. Some researchers have suggested that the bilirubin-induced auditory neuronal damages may be temporary and reversible. This study was aimed at investigating the auditory neuropathy and reversibility of auditory abnormalities in hyperbillirubinemic infants. Subjects and Methods The study participants included 41 full term hyperbilirubinemic infants (mean age 39.24 days) with normal birth weight (3,200-3,700 grams) that admitted in hospital for hyperbillirubinemia and 39 normal infants (mean age 35.54 days) without any hyperbillirubinemia or other hearing loss risk factors for ruling out maturational changes. All infants in hyperbilirubinemic group had serum bilirubin level more than 20 milligram per deciliter and undergone one blood exchange transfusion. Hearing evaluation for each infant was conducted twice: the first one after hyperbilirubinemia treatment and before leaving hospital and the second one three months after the first hearing evaluation. Hearing evaluations included transient evoked otoacoustic emission (TEOAE) screening and auditory brainstem response (ABR) threshold tracing. Results The TEOAE and ABR results of control group and TEOAE results of the hyperbilirubinemic group did not change significantly from the first to the second evaluation. However, the ABR results of the hyperbilirubinemic group improved significantly from the first to the second assessment (p=0.025). Conclusions The results suggest that the bilirubin induced auditory neuronal damage can be reversible over time so we suggest that infants with hyperbilirubinemia who fail the first hearing tests should be reevaluated after 3 months of treatment.
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Affiliation(s)
| | - Tayebeh Ahmadi
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.; Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.; Audiology India, Mysore, Karnataka, India
| | - Yones Lotfi
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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97
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Valero MD, Hancock KE, Liberman MC. The middle ear muscle reflex in the diagnosis of cochlear neuropathy. Hear Res 2016; 332:29-38. [PMID: 26657094 PMCID: PMC5244259 DOI: 10.1016/j.heares.2015.11.005] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 11/14/2015] [Accepted: 11/17/2015] [Indexed: 02/04/2023]
Abstract
Cochlear neuropathy, i.e. the loss of auditory nerve fibers (ANFs) without loss of hair cells, may cause hearing deficits without affecting threshold sensitivity, particularly if the subset of ANFs with high thresholds and low spontaneous rates (SRs) is preferentially lost, as appears to be the case in both aging and noise-damaged cochleas. Because low-SR fibers may also be important drivers of the medial olivocochlear reflex (MOCR) and middle-ear muscle reflex (MEMR), these reflexes might be sensitive metrics of cochlear neuropathy. To test this hypothesis, we measured reflex strength and reflex threshold in mice with noise-induced neuropathy, as documented by confocal analysis of immunostained cochlear whole-mounts. To assay the MOCR, we measured contra-noise modulation of ipsilateral distortion-product otoacoustic emissions (DPOAEs) before and after the administration of curare to block the MEMR or curare + strychnine to also block the MOCR. The modulation of DPOAEs was 1) dominated by the MEMR in anesthetized mice, with a smaller contribution from the MOCR, and 2) significantly attenuated in neuropathic mice, but only when the MEMR was intact. We then measured MEMR growth functions by monitoring contra-noise induced changes in the wideband reflectance of chirps presented to the ipsilateral ear. We found 1) that the changes in wideband reflectance were mediated by the MEMR alone, and 2) that MEMR threshold was elevated and its maximum amplitude was attenuated in neuropathic mice. These data suggest that the MEMR may be valuable in the early detection of cochlear neuropathy.
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Affiliation(s)
- Michelle D Valero
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA 02115, USA.
| | - Kenneth E Hancock
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA 02115, USA
| | - M Charles Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA 02115, USA
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98
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Central Gain Restores Auditory Processing following Near-Complete Cochlear Denervation. Neuron 2016; 89:867-79. [PMID: 26833137 DOI: 10.1016/j.neuron.2015.12.041] [Citation(s) in RCA: 209] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 11/05/2015] [Accepted: 12/16/2015] [Indexed: 11/23/2022]
Abstract
Sensory organ damage induces a host of cellular and physiological changes in the periphery and the brain. Here, we show that some aspects of auditory processing recover after profound cochlear denervation due to a progressive, compensatory plasticity at higher stages of the central auditory pathway. Lesioning >95% of cochlear nerve afferent synapses, while sparing hair cells, in adult mice virtually eliminated the auditory brainstem response and acoustic startle reflex, yet tone detection behavior was nearly normal. As sound-evoked responses from the auditory nerve grew progressively weaker following denervation, sound-evoked activity in the cortex-and, to a lesser extent, the midbrain-rebounded or surpassed control levels. Increased central gain supported the recovery of rudimentary sound features encoded by firing rate, but not features encoded by precise spike timing such as modulated noise or speech. These findings underscore the importance of central plasticity in the perceptual sequelae of cochlear hearing impairment.
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99
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Acoustically evoked auditory change complex in children with auditory neuropathy spectrum disorder: a potential objective tool for identifying cochlear implant candidates. Ear Hear 2016; 36:289-301. [PMID: 25422994 DOI: 10.1097/aud.0000000000000119] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The overall aim of the study was to evaluate the feasibility of using electrophysiological measures of the auditory change complex (ACC) to identify candidates for cochlear implantation in children with auditory neuropathy spectrum disorder (ANSD). To achieve this overall aim, this study (1) assessed the feasibility of measuring the ACC evoked by temporal gaps in a group of children with ANSD across a wide age range and (2) investigated the association between gap detection thresholds (GDTs) measured by the ACC recordings and open-set speech-perception performance in these subjects. DESIGN Nineteen children with bilateral ANSD ranging in age between 1.9 and 14.9 years (mean: 7.8 years) participated in this study. Electrophysiological recordings of the auditory event-related potential (ERP), including the onset ERP response and the ACC, were completed in all subjects and open-set speech perception was evaluated for a subgroup of 16 subjects. For the ERP recordings, the stimulus was a Gaussian noise presented through ER-3A insert earphones to the test ear. Two stimulation conditions were used. In the "control condition," the stimulus was an 800-msec Gaussian noise. In the "gapped condition," the stimuli were two noise segments, each being 400 msec in duration, separated by one of five gaps (i.e., 5, 10, 20, 50, or 100 msec). The interstimulation interval was 1200 msec. The aided open-set speech perception ability was assessed using the Phonetically Balanced Kindergarten (PBK) word lists presented at 60 dB SPL using recorded testing material in a sound booth. For speech perception tests, subjects wore their hearing aids at the settings recommended by their clinical audiologists. For a subgroup of five subjects, psychophysical GDTs for the Gaussian noise were also assessed using a three-interval, three-alternative forced-choice procedure. RESULTS Responses evoked by the onset of the Gaussian noise (i.e., onset responses) were recorded in all stimulation conditions from all subjects tested in this study. The presence/absence, peak latency and amplitude, and response width of the onset response did not correlate with aided PBK word scores. The objective GDTs measured with the ACC recordings from 17 subjects ranged from 10 to 100 msec. The ACC was not recorded from two subjects for any gap durations tested in this study. There was a robust negative correlation between objective GDTs and aided PBK word scores. In general, subjects with prolonged objective GDTs showed low-aided PBK word scores. GDTs measured using electrophysiological recordings of the ACC correlated well with those measured using psychophysical procedures in four of five subjects who were evaluated using both procedures. CONCLUSIONS The clinical application of the onset response in predicting open-set speech-perception ability is relatively limited in children with ANSD. The ACC recordings can be used to objectively evaluate temporal resolution abilities in children with ANSD having no severe comorbidities, and who are older than 1.9 years. The ACC can potentially be used as an objective tool to identify poor performers among children with ANSD using properly fit amplification, and who are thus, cochlear implant candidates.
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100
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Zhang Q, Lan L, Shi W, Yu L, Xie LY, Xiong F, Zhao C, Li N, Yin Z, Zong L, Guan J, Wang D, Sun W, Wang Q. Temperature sensitive auditory neuropathy. Hear Res 2016; 335:53-63. [PMID: 26778470 DOI: 10.1016/j.heares.2016.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 01/10/2016] [Accepted: 01/11/2016] [Indexed: 11/29/2022]
Abstract
Temperature sensitive auditory neuropathy is a very rare and puzzling disorder. In the present study, we reported three unrelated 2 to 6 year-old children who were diagnosed as auditory neuropathy patients who complained of severe hearing loss when they had fever. Their hearing thresholds varied from the morning to the afternoon. Two of these patients' hearing improved with age, and one patient received positive results from cochlear implant. Genetic analysis revealed that these three patients had otoferlin (OTOF) homozygous or compound heterozygous mutations with the genotypes c.2975_2978delAG/c.4819C>T, c.4819C>T/c.4819C>T, or c.2382_2383delC/c.1621G>A, respectively. Our study suggests that these gene mutations may be the cause of temperature sensitive auditory neuropathy. The long term follow up results suggest that the hearing loss in this type of auditory neuropathy may recover with age.
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Affiliation(s)
- Qiujing Zhang
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Lan Lan
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Wei Shi
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Lan Yu
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Lin-Yi Xie
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Fen Xiong
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Cui Zhao
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Na Li
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Zifang Yin
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Liang Zong
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Jing Guan
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Dayong Wang
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
| | - Wei Sun
- Department of Communicative Disorders & Sciences, Center for Hearing and Deafness, University at Buffalo, The State University of New York, Buffalo, NY 14215, USA.
| | - Qiuju Wang
- Department of Otolaryngology/Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
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