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Bilirubin and the auditory system.

S M Shapiro1, H Nakamura

  • 1Department of Neurology, Medical College of Virginia, Randolph Minor Hall, 307 College Street, 7th Floor, Richmond, VA 23219, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|January 23, 2002
PubMed
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Bilirubin toxicity can harm the auditory system, causing auditory neuropathy or processing issues. Early detection using auditory brainstem response (ABR) is crucial for neonates.

Area of Science:

  • Neuroscience
  • Audiology
  • Toxicology

Background:

  • The auditory system is vulnerable to bilirubin toxicity.
  • Bilirubin-induced damage can lead to auditory neuropathy, auditory dyssynchrony, and auditory processing problems, potentially with or without hearing loss.
  • This dysfunction may be present in infants even without overt signs of kernicterus.

Purpose of the Study:

  • To highlight the auditory system's sensitivity to bilirubin.
  • To identify the specific auditory pathways affected by bilirubin toxicity.
  • To emphasize the importance of early detection of bilirubin-induced auditory dysfunction.

Main Methods:

  • Review of existing literature on bilirubin toxicity and auditory function.
  • Analysis of auditory neurophysiological test results, specifically auditory brainstem response (ABR) or brainstem auditory response (BAER).

Related Experiment Videos

Main Results:

  • Bilirubin selectively damages brainstem auditory nuclei, the auditory nerve, and spiral ganglion.
  • The inner ear, thalamic, and cortical auditory pathways appear unaffected.
  • Auditory neuropathy or dyssynchrony and processing problems can occur with or without deafness.

Conclusions:

  • Auditory neurophysiological tests like ABR are vital for early detection of bilirubin-induced central nervous system dysfunction in neonates.
  • Prompt identification allows for timely intervention to mitigate long-term auditory and neurological consequences.