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The term auditory neuropathy is more recently referred to as auditory dys-synchrony. Auditory dys-synchrony is a more accurate term because "neuropathy" implies a problem with the eighth nerve, when in fact the nerve may not be affected. It is a dysfunction in the auditory system in which a person has normal outer hair cell function, but heshe has a dys-synchronous connection between the inner hair cells and the eighth nerve. In general, this means that patients display normal OAEs (otoacoustic emissions) and a measurable cochlear microphonic, but they have absent ABRs (auditory brainstem response) and acoustic reflexes (Hood Andrew Ladd Jersey , 2002). The responses could be caused by a problem with the inner hair cells, select outer hair cells, the synapse between the hair cells and the auditory nerve, the neural axon or dendrite, the myelin sheath Mathew Barzal Jersey , the spiral ganglion cells, or a combination of all of these (Mason, De Michele, Stevens, Ruth Throwback New York Islanders Jerseys , & Hashisaki, 2003).

Clinical Test Results

According to Dr. Chuck Berlin, patients with auditory neuropathy have absent acoustic reflexes, present OAEs, present cochlear microphonic Custom New York Islanders Jerseys , an absent ABR, and normal radiographic results. A full test battery is required to accurately detect and identify auditory dys-synchrony. These tests include tympanometry, acoustic reflexes, OAEs, cochlear microphonic Authentic New York Islanders Jerseys , and ABR.

After confirming normal middle ear status with tympanometry, then the otoacoustic emissions and cochlear microphonics are used to assess outer hair cell function (which should be normally functioning in these patients), and acoustic reflexes and ABR are used to assess the synchrony of the eighth nerve (which would be abnormal in these patients). Radiologic testing can also be done to rule out eighth nerve lesions or multiple sclerosis. Persons with true auditory dys-synchrony would not show any abnormalities on radiographic testing (Hood, 2002).

Diagnosis

According to Dr. Chuck Berlin, a diagnosis cannot be based on a patient's audiogram or speech scores alone. Pure-tone thresholds and speech testing can vary greatly among these patients. Patients will often complain that they have difficulty hearing or understanding speech New York Islanders Jerseys For Sale , especially amidst background noise. However, this is common among people with typical cochlear loss, and therefore a whole range of testing is needed before an accurate diagnosis can be made. The first clinical sign (after confirming normal middle ear status) would be present OAEs and absent reflexes. These results indicate a need to conduct further testing (ABR and ECochG).

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