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Updated: Jul 14, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Transient deafness in young candidates for cochlear implants
1Department of Communication Disorders, University of Haifa, Haifa, Israel. attiasj@netvision.net.il
Insights
Auditory neuropathy (AN) in infants can resolve, showing improved auditory nerve function over time. Repeated testing is crucial before considering interventions like cochlear implants for hearing loss.
Area of Science:
- Neuroscience
- Audiology
- Pediatrics
Background:
- Auditory neuropathy (AN) is a hearing disorder where the cochlea functions but the auditory nerve does not transmit sound to the brain.
- Severe to profound neural hearing loss can be diagnosed shortly after birth, impacting auditory pathway synchronization.
Observation:
- Five infants diagnosed with AN and severe to profound neural hearing loss showed significant recovery within 7-12 months.
- Follow-up electrophysiological tests revealed the emergence of wave I, III, and V, indicating improved auditory nerve function.
Findings:
- Neonatal factors like hyperbilirubinemia, hypoxia, ischemia, and CNS immaturity may contribute to AN.
- The absence of an auditory brainstem response does not always indicate permanent hearing loss; AN can improve.
Implications:
- Clinicians should perform repeated auditory assessments to confirm persistent AN before considering interventions.
- Cochlear implants should be a last resort, only after behavioral hearing measures are obtained and AN is confirmed as persistent.
Abstract:
This study describes 5 infants who were diagnosed with auditory neuropathy (AN) associated with severe to profound neural hearing loss shortly after birth. However, on repetition of the tests 7-12 months later, all infants showed full or partial recovery. The follow-up electrophysiological patterns were characterized by the appearance of wave I, followed by wave III and V, reflecting synchronization of auditory pathways and improvement in auditory nerve function. Suspected causative or contributory factors were neonatal hyperbilirubinemia, hypoxia, ischemia, and central nervous system immaturity, alone or in combination. These findings indicate that lack of an auditory brain stem response does not necessarily mean no hearing and that the situation where AN exists can improve. Thus, clinicians should be made aware that although cochlear implants may yield better auditory performance when applied early, they should be considered a therapeutic option only after repeated measures have proved persistent AN, and no child should be considered for an implant until a behavioral measure of hearing has been obtained.
