"Auditory neuropathy": physiologic and pathologic evidence calls for more diagnostic specificity.

摘要: Abstract The term “auditory neuropathy” is being used in a rapidly increasing number of papers the audiology/otolaryngology literature for variety individuals (mostly children) who fulfill following criteria: (1) understanding speech worse than predicted from degree hearing loss on their behavioral audiograms; (2) recordable otoacoustic emissions and/or cochlear microphonic; together with (3) absent or atypical auditory brain stem responses. Because general lack anatomic foundation label as currently used, we review anatomy pathway, definition neuropathy and its demyelinating, axonal, mixed variants. We submit that diagnostic anatomically inappropriate unless patients have documented evidence selective involvement either spiral ganglion cells axons, 8th nerve whole. In view biologic differences between peripheral nerves white matter tracts brain, pathologies affecting central pathway brainstem selectively. Published reports indicate they are extremely heterogeneous underlying medical diagnosis, age, severity, test results, only small undergone detailed investigations would enable more precise diagnosis locus pathologies. electrophysiology neuropathies deficits expected hair cells, axons (auditory sensu stricto), relays reviewed. order to serve adequately, including potential candidates implants, increase knowledge pathologies, make plea comprehensive evaluation audiologic criteria an effort pinpoint site suggest be limited cases which pathology processes, nerve, neural considered affect all higher levels cortex.