[Auditory neuropathy]

Auditory neuropathy is a type of neurosensorial hypoacusis that produces significant impairment in language comprehension. Etiologically, this neuropathy has been related to perinatal hypoxia, hyperbilirubinemia, metabolic disorders and degenerative entities that affect the auditory pathway.

We report five children with this disorder. Two of the children were referred for otorhinolaryngeal assessment after failing the neonatal hearing screening and one was referred because of a history of perinatal hypoxia. The two eldest children were referred because of schooling problems and language impairment. In all the children, auditory brainstem response, otoacoustic emissions, tympanometry stapedius reflex were examined and liminal and condition-orientation reflex audiometry were performed. After diagnosis, the children were followed-up for 3 consecutive years.

In all five children, tympanogram and otoacoustic emissions were normal. The stapedius reflex and auditory brainstem responses with 80-90 dli stimuli were absent. Medium latency and conical and cognitive potentials were normal in the only child (aged 9 years) in whom they could be performed. In two children (aged 7 and 9 years), verbal discrimination was within the normal range for theft age. In all the children, audiometry revealed bilateral mild-to-moderate hypacusla, which did not change during follow up.

Auditory neuropathy can be detected by the combined use of neonatal hearing screening techniques, auditory brainstem responses and otoacoustic emissions. Interest in the early identification and diagnosis of this disorder Is due to the clear benefit to language development secondary to the early treatment and rehabilitation of these children.