The impact of high gain conventional hearingaid aid on OAEs in a case of auditory neuropathy/ dys-synchrony

Year 2010, Volume: 15 Issue: 1, 26 - 30, 15.01.2013

Piyali Kundu Nachiketa Rout

Abstract

Abstract. Aim of the study is to focus on the impact of high gain hearing aid on outer hair cells’ functioning as reflected by otoacoustic emission (OAE) changes. A child diagnosed as bilateral moderate -moderately severe sensori neural hearing loss with primary auditory neuropathy / dys-synchrony (AN/ AD) was referred to AYJNIHH (ERC) after being fitted with high gain hearing aid. She had used the hearing aid for less than a year. Audiological evaluation at AYJNIHH (ERC) was indicative of moderate to moderately severe hearing loss with absence of distortion product otoacoustic emissions (DPOAE). She was recommended to discontinue the use of the hearing aid for a couple of weeks. Auditory brainstem response (ABR) and OAE was administered after 14 days. No identifiable peak V was obtained in both the ears however the case had emissions on DPOAE. She was fitted a mild class hearing aid and included for speech language therapy. Conservative trials with amplification devices, diligent monitoring of amplification output levels and OAEs along with possibilities of a cochlear implant was to be explored during therapy. The primary reason behind deterioration in DPOAE may be temporary physiological changes resulting in temporary threshold shift. Therefore, high quality, low gain, wide dynamic range compression hearing aids may be the probable cause of return back of OAEs following two weeks without amplification. Amplification may contribute to loss of OAEs and the risk from use of amplification must be weighed against the benefits of amplification provided to the client.

Key words: Otoacoustic emissions, auditory neuropathy, outer hair cells’, ABR, temporary threshold shift.

Keywords

Otoacoustic emissions, auditory neuropathy, outer hair cells’, ABR, temporary threshold shift

References

• Davis H, Hirsh S. A slow brainstem response for low frequency audiometry. Audiology 1979; 18: 461.
• Worthington D, Peters J. Quantifiable hearing and no ABR: Paradox or error? Ear and Hearing 1980; : 281-285.
• Lenhardt M. Childhood central processing disorder with brainstem evoked response verification. Archives of Otolaryngology 1981; 107: 623-625.
• Krovs N. Auditory neuropathy:An historical and current perspective.In: Sininger Y, starr A (end). Auditory neuropathy: A new perspective on hearing disorders. Canada: Sıngular-Thomson hearnıng ; pp 233-250
• Berlin, C.I., Hood, L.J. & Rose, K. On renaming auditory neuropathy as auditory dys- synchrony. Audiol Today 2001; 13: 15-17.
• Starr, A., Picton, T.W., Sininger, Y.S., Hood, L.J. & Berlin, C.I. n. Brain 1996; 119(3): 741-753.
• Rance, G., McKay, C. & Grayden, D. Perceptual characterization of children with auditory neuropathy. Ear Hear 2004; 25: 34-46.
• Zeng, F.G., Kong, Y.Y., Michaelewski, H.J. & Starr, A. Perceptual consequences of disrupted auditory nerve activity. J Neurophysiol 2005; 93 (3050): 203-232. 3063.
• Deltenre P, Mansbach A L, Bozet C, Clercx A, Hecox K E. Auditory neuropathy: A report on three cases with early onsets and major neonatal illnesses. Elecroencephalography and Clinical Neurology 1997; 104: 17-22.
• Starr A, Sininger Y, Winter M, Derebery MJ, Oba, Michalewski HJ. Transient deafness due to temperature-sensitive auditory neuropathy. Ear and Hearing 1998; 19: 169-179.
• Rance, G. & Barker, E. Speech perception in children with auditory neuropathy/ dys-synchrony managed with either hearing aids or cochlear implants. OtolNeurotol 2007; 29: 179-182.
• Sininger, Y., Starr, A. Auditory neuropathy: an historical and current perspective. Auditory neuropathy: A new perspective on hearing disorders 2001; 1-10.
• Deltenre P, Mansbach A L, Bozet C, Christiaens F, Barthelemy P, Paulissen D et al. Auditory neuropathy with preserved cochlear microphonics and secondary loss of otoacoustic emissions. Audiology 1999; 38(4): 187–195.
• Rance G, Beer D. E, Cone-Wesson B et al. Clinical findings for a group of infants and young children with auditory neuropathy. Ear and Hearing ; 20: 238-252. Hood L J. Auditory neuropathy: what is it and what can we do about it. The Hearing Journal 1998; 51: 18.
• Cone-Wesson B, Rance G, Sininger Y. Amplification and rehabilitation strategies for patients with auditory neuropathy. In Sininger Y, Starr A (eds). Auditory neuropathy: A new perspective on hearing disorders. Canada: Sıngular- Thomson hearnıng 2001; pp 233-250.
• Zeng F G. Speech perceptions in individuals with auditory neuropathy. Journal of speech, Language and Hearing Research 2006; 49: 367-380.
• Berlin C I, Morlet, Hood L J. Auditory neuropathy/desynchrony: Its diagnosis and management. Pediatric clinics of North America ; 50: 331-340. Javel E, Shepherd R K. Electrical stimulation of the auditory nerve. Response initiation sites and temporal fine structure. Hearing Research 2000; (1–2): 45-76.
• Starr A, Michalewski HJ, Zeng FG et al. Pathology and physiology of auditory neuropathy with a novel mutation in the MPZ gene (Tyr145YSer). Brain ; 126(Pt. 7): 1604-1619.
• Douglas B L, (Central) auditory processing disorders: overview and amplification issues. The Hearing Journal 2007; 60: 44-47.