DOCSLIB.ORG

Chronic Auditory Toxicity in Late Preterm and Term Infants with Significant Hyperbilirubinemia

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Chronic Auditory Toxicity in Late Preterm and Term Infants with Significant Hyperbilirubinemia Chronic Auditory Toxicity in Late Sanjiv B. Amin, MBBS, MD, MS, a Satish Saluja, MBBS, MD, b Arvind Saili, MBBS, MD, c Mark Orlando, PretermPhD, d Hongyue Wang, PhD, e Nirupamaand Laroia, Term MBBS, MD, a AshaInfants Agarwal, MSf With Significant Hyperbilirubinemia BACKGROUND AND OBJECTIVES: abstract Significant hyperbilirubinemia (SHB) may cause chronic auditory toxicity (auditory neuropathy spectrum disorder and/or sensorineural hearing loss); however, total serum bilirubin (TSB) does not discriminate neonates at risk for auditory toxicity. Our objective was to compare TSB, bilirubin albumin molar ratio (BAMR), and ≥ unbound bilirubin (UB) for their association with chronic auditory toxicity in neonates with METHODS: SHB (TSB 20 mg/dL≥ or TSB’ that met criteria for exchange transfusion). Infants 34 weeks gestational age (GA) with SHB during the first 2 postnatal weeks were eligible for a prospective longitudinal study in India. Comprehensive auditory evaluations were performed at 2 to 3 months of age by using auditory brainstem response, tympanometry, and an otoacoustic emission test and at 9 to 12 months of age by using audiometry. The evaluations were performed by an audiologist unaware of the degree of RESULTS: jaundice. A total of 93 out of 100 infants (mean GA of 37.4 weeks; 55 boys, 38 girls) who were enrolled with SHB were evaluated for auditory toxicity. Of those, 12 infants (13%) had auditory toxicity. On regression analysis controlling for covariates, peak UB (but not – P = peak TSB or peak BAMR), was associated with auditory toxicity (odds ratio 2.41; 95% confidence interval: 1.43 4.07;P .001). There was significant difference in the area under the receiver operating characteristic curves between UB (0.866), TSB (0.775), and BAMR CONCLUSIONS: (0.724) for auditory toxicity ( = .03) after controlling for covariates. ≥ ’ Unconjugated hyperbilirubinemia indexed by UB (but not TSB or BAMR) is NIH associated with chronic auditory toxicity in infants 34 weeks GA with SHB. WHAT’SW KNO N ON THIS SUBJECT: Significant Departments of aPediatrics, dOtolaryngology, and eBiostatistics, University of Rochester, Rochester, New York; hyperbilirubinemia may be associated with auditory Departments of bPediatrics and fAudiology, Sir Ganga Ram Hospital, Delhi, India; and cDepartment of Pediatrics, toxicity as manifested by sensorineural hearing loss Kalawati Saran Children’s Hospital, Delhi, India and/or auditory neuropathy spectrum disorder. Total Dr Amin conceptualized and designed the study, supervised the study, and drafted the initial serum bilirubin and bilirubin albumin molar ratio used manuscript; Drs Saluja and Saili contributed to study design, coordinated and supervised subject for the management of significant hyperbilirubinemia enrollment and data collection, and critically reviewed the manuscript; Dr Orlando contributed are poor predictors of bilirubin-induced neurotoxicity. to study design, supervised auditory data collection, evaluated auditory results, and critically reviewed the manuscript; Dr Wang contributed to study design, conducted the analyses, and WHAT THIS STUDY AddS: Unbound bilirubin (but reviewed and revised the manuscript; Dr Laroia contributed to study design, validated data not total serum bilirubin or bilirubin albumin molar collection, and critically reviewed the manuscript; Mrs Agarwal contributed to study design, ratio) is associated with chronic auditory toxicity performed auditory evaluations, collected auditory data, and critically reviewed the manuscript; in late preterm and term infants with significant and all authors approved the final manuscript as submitted and agree to be accountable for all unconjugated hyperbilirubinemia. Unbound bilirubin is aspects of the work. a better predictor of chronic auditory toxicity. DOI: https:// doi. org/ 10. 1542/ peds. 2016- 4009 Accepted for publication Jul 17, 2017 To cite: Amin SB, Saluja S, Saili A, et al. Chronic Auditory Toxicity in Late Preterm and Term Infants With Significant Hyperbilirubinemia. Pediatrics. 2017;140(4):e20164009 Downloaded from www.aappublications.org/news by guest on September 24, 2021 PEDIATRICS Volume 140, number 4, October 2017:e20164009 ARTICLE Amin et al 2017 ROUGH GALLEY PROOF Chronic Auditory Toxicity in Late Preterm https://doi.org/10.1542/peds.2016-4009 October 2017 and Term Infants With Significant Hyperbilirubinemia 4 140 Pediatrics Significant unconjugated measures (UB, BAMR, and TSB) excluded. GA was evaluated by hyperbilirubinemia (SHB) is among with chronic auditory toxicity has obstetrical dating criteria, including the most common– readmission not been studied. Therefore, our first trimester ultrasound, or when diagnoses 1for4 neonates throughout objectives were to evaluate the obstetric history was inadequate, by the world. SHB is considered incidence of chronic auditory toxicity Ballard examination. Infants received a sentinel event, and an urgent as manifested by ANSD and/or SNHL appropriate evaluation and therapy therapeutic intervention is during infancy and compare UB, TSB, for hyperbilirubinemia as outlined in needed to prevent acute bilirubin and BAMR for their association with AAP guidelines and described in an ≥ ’ 5, 13 encephalopathy that can result chronic auditory toxicity in infants Bearlierilirubin- reportAlbumin. Binding Variables in death or kernicterus, including 34 weeks GA with SHB. (Exposure Variables) permanent sensorineural hearing METHODS loss (SNHL). Although there are Study Design specific management guidelines The detailed methodology for (based on hour-specific total serum the collection, shipping, and bilirubin [TSB], gestational age [GA] ≥ ’ measurements of bilirubin- This was a prospective longitudinal of the patient, and presence of clinical albumin binding variables has been study involving infants 34 weeks 13 risk factors) from the American previously described. The blood GA admitted with SHB from 2011 to Academy of Pediatrics (AAP) for the samples for the measurement of 2014 at 2 academic centers in Delhi, use of phototherapy and exchange ’ TSB for individual participants India (Sir Ganga Ram Hospital and transfusion (ET), the guidelines5 are were drawn as clinically indicated Kalawati Saran Children s Hospital), based on limited evidence. More at the discretion of the attending who were evaluated earlier for acute specifically, TSB correlates6, 7 poorly neonatologist and measured auditory toxicity during the neonatal with kernicterus. 13 immediately (in <2 hours) at the period. The study was approved by institutional clinical chemistry the institutional ethics committee. The auditory system is highly laboratory by using the colorimetric Parental consent was obtained for sensitive to overt bilirubin-induced method. For each participant, the each subject enrolled. neurotoxicity; however, few studies Subject Population serum albumin was measured have rigorously examined the ≥ ’ (grams per deciliter [multiply by relationship between SHB and 151 to convert to micromoles per auditory neuropathy spectrum Infants 34 weeks GA who ≥ liter]) at the time of admission, disorder (ANSD) or chronic were admitted to the NICU with µ with subsequent TSB measurement auditory toxicity (SNHL), which SHB (defined as TSB 20 mg/dL if jaundice increased despite can be assessed much earlier– in [342 mol/L] or TSB that met phototherapy, and before ET by using life than other sequelae of8 acute12 the ET criteria according to the the bromocresol green method. The bilirubin encephalopathy. We AAP guidelines) during the first 2 peak TSB and the concurrent serum recently demonstrated that SHB was weeks of life were eligible for the 1,5, 11, 12’ 0/7 albumin were used to calculate the associated with a high incidence of study6/7 . For infants 34 to peak BAMR for each participant. acute auditory toxicity as manifested 34 weeks GA, we used a TSB ≥ The same aliquot of blood used to by abnormal auditory threshold concentration that met ET0/7 criteria ’ measure TSB was used to measure and/or acute13 ANSD in infants 34 for6/7 infants with1 a GA of 35 to weeks GA. However, the natural 37 weeks. Infants who met the UB for each participant. UB was ≥ ’ course of acute auditory toxicity in following conditions were excluded measured (micrograms per deciliter [multiply by 17.1 to convert to infants 34 weeks GA with SHB has because these conditions are often12 not been prospectively studied. It is associated with hearing disorders : nanomoles per liter]) by the modified possible that acute auditory toxicity (1) craniofacial malformations; (2) peroxidase method at 2 enzyme may be reversible and resolve over chromosomal disorders; (3) family concentrations (1:25 and 1:12.5 time or progress as chronic auditory history of congenital deafness; (4) dilutions) of precalibrated peroxidase toxicity during infancy. We also toxoplasmosis, other infections, (Arrows Company, Ltd, Osaka, demonstrated that unbound bilirubin rubella, cytomegalovirus infection, Japan) by using an FDA-approved UB (UB), but not TSB or bilirubin and herpes simplex infections; and Canalyzerhronic A UA-1uditory (Arrows Toxicity Company). (Outcome albumin molar ratio (BAMR), was (5) surgical interventions at the time Variables) ≥ ’ associated with acute auditory of SHB. Furthermore, infants with toxicity in infants13, 14 34 weeks a failed newborn hearing screening GA with SHB. However, the evaluation before SHB or whose Each participant had a association of bilirubin biochemical parents lived outside Delhi were comprehensive auditory evaluation Downloaded
Load more

Recommended publications
  • Auditory Neuropathy Spectrum Disorder - Information for Parents
    Auditory Neuropathy Spectrum Disorder - Information for parents This leaflet is for families of babies who have auditory neuropathy spectrum disorder (ANSD). It should help you to understand more about ANSD and what it means for you and your baby. ANSD used to be called auditory neuropathy or auditory dys-synchrony. What is a hearing loss? Usually a hearing loss is described as conductive or sensorineural. Conductive hearing loss means that sound cannot pass easily through the outer and middle ear to the inner ear. Sensorineural hearing loss means that either the cochlea in the inner ear, or the hearing nerve (auditory nerve), is not working as well as it should be. Sometimes a mixture of both conductive and sensorineural hearing loss can happen together. Inner ear Outer ear (Cochlea) Auditory nerve Middle ear Earlobe Auditory neuropathy spectrum disorder is the name used to describe a type of hearing problem which stops sound reaching the brain in the normal way. Sound may pass normally through the middle ear and the cochlea, but it does not pass normally from the cochlea to the auditory nerve or along the auditory nerve to the brain. This means that the sound reaching the brain may not be Version 2 02.09 understood and the quality may be poor. The results of different hearing tests will help the audiologist (hearing specialist) decide if your baby has ANSD. Testing for ANSD We can carry out tests that show how well the cochlea and auditory nerve are working, even if your baby is very young. If the tests show the cochlea is working well but the auditory nerve is not working as it should be, then ANSD could be the cause.
    [Show full text]
  • Starkey Audiology Series
    STARKEY AUDIOLOGY SERIES DIAGNOSIS AND MANAGEMENT OF PEDIATRIC AUDITORY NEUROPATHY Deborah Hayes, Ph.D. Chair, Audiology, Speech Pathology and Language Services The Children’s Hospital - Colorado Auditory neuropathy (AN) is a complex auditory resonance imaging (MRI) evidence of auditory nerve disorder, which results in a distinct pattern of abnormality. For an excellent review of auditory audiometric test results and a wide range of neuropathy, see Yvonne Sininger and Arnold Starr symptoms and auditory complaints. The range of (editors): Auditory Neuropathy A New Perspective functional auditory abilities in individuals with AN on Hearing Disorders. is vast and may include normal hearing sensitivity and limited auditory complaints, fluctuating hearing Although the scientific and professional community sensitivity and difficulty understanding speech, have made significant progress in understanding the especially in noise, or profound hearing loss and nature and variable consequences of AN, optimal inability to understand even amplified speech in clinical management options for individuals with quiet despite evidence of normal cochlear outer hair this disorder remain elusive, especially for infants cell function. and very young children. For infants with “typical” sensory hearing loss who are identified through Early reports of auditory neuropathy described newborn hearing screening, excellent and detailed the paradox of individuals with normal pure-tone guidelines for identification, diagnosis, and early audiograms but absent or severely abnormal intervention are widely accepted (Joint Committee auditory brainstem responses (ABR). In some cases, on Infant Hearing, 2007). These guidelines do not individuals demonstrated pure-tone audiograms with address, however, some of the specific challenges mild to moderately-elevated detection thresholds, in providing families with appropriate management absent/abnormal ABRs, and absent middle options for infants with AN.
    [Show full text]
  • Speech Perception in Individuals with Auditory Neuropathy
    Speech Perception in Individuals With Auditory Neuropathy Fan-Gang Zeng Sheng Liu Purpose: Speech perception in participants with auditory neuropathy (AN) was University of California, Irvine systematically studied to answer the following 2 questions: Does noise present a particular problem for people with AN? Can clear speech and cochlear implants alleviate this problem? Method: The researchers evaluated the advantage in intelligibility of clear speech over conversational speech in 13 participants with AN. Of these participants, 7 had received a cochlear implant. Eight sentence-recognition experiments were conducted to examine the clear speech advantage in 2 listening conditions (quiet and noise) using 4 stimulation modes (monaural acoustic, diotic acoustic, monaural electric, and binaurally combined acoustic and electric stimulation). Results: Participants with AN performed more poorly in speech recognition in noise than did the normal-hearing, cochlear-impaired, and cochlear implant controls. A significant clear speech advantage was observed, ranging from 9 to 23 percentage points in intelligibility for all listening conditions and stimulation modes. Electric stimulation via a cochlear implant produced significantly higher intelligibility than acoustic stimulation in both quiet and in noise. Binaural hearing with either diotic acoustic stimulation or combined acoustic and electric stimulation produced significantly higher intelligibility than monaural stimulation in quiet but not in noise. Conclusions: Participants with AN most likely derive the clear speech advantage from enhanced temporal properties in clear speech and improved neural synchrony with electric stimulation. Although the present result supports cochlear implantation as one treatment choice for people with AN, it suggests that the use of innovative hearing aids may be another viable option to improve speech perception in noise.
    [Show full text]
  • Diagnosis and Management of Auditory Neuropathy Spectrum
    Understanding Auditory Neuropathy: Diagnosis and Management EHDI: Partnering for Progress Raleigh, NC October 26-28, 2011 Patricia Roush, AuD University of North Carolina School of Medicine Chapel Hill, North Carolina, USA University of North Carolina Department of Otolaryngology UNC Hospitals Audiologists: Laura Fleenor McCall, AuD Otolaryngologists: Nissele Franco, AuD Oliver Adunka, MD Corinne Macpherson, AuD Craig Buchman, MD Sarah Martinho, AuD Amelia Drake, MD Patty Reitz, M.S. Austin Rose, MD Jill Ritch, AuD Carlton Zdanski, MD Patricia Roush, AuD Harold Pillsbury, III, MD University of North Carolina Department of Otolaryngology Carolina Children’s Communicative Disorders Program Center for the Acquisition of Spoken Language through Listening Enrichment Audiologists: Debora Hatch, AuD Speech-Language Pathologists: Lisa Park, AuD Hannah Eskridge, AVT Jennifer Woodard, AuD Lillian Henderson, AVT Holly Teagle, AuD Sandra Hancock, AVT Erin Thompson, AVT Maegan Evans, PhD Outline • Overview and Definitions • Protocol for Diagnosis and Management • Case Studies • Implications for Clinical Practice Auditory Neuropathy: A Definition Clinical syndrome characterized by electrophysiological evidence of normal or near normal cochlear function and absent or abnormal auditory pathway transduction Audiologic Findings Ø Normal outer hair cell function as measured by present otoacoustic emissions (OAEs) or the presence of a cochlear microphonic (CM). Ø OAEs may be present initially but disappear over time Ø Abnormal auditory nerve response as observed
    [Show full text]
  • Identification and Management of Infants and Young Children with Consensus
    Guidelines for Identification and Management of Infants and Young Children with Auditory Neuropathy Spectrum Disorder Guidelines Development Conference at NHS 2008, Como, Italy More Hearing. Slim Design. WaterResistant. Now available: Naída, designed for moderately-severe to profound hearing loss. Restoration of high frequency audibility and uncompromised performance. Get the power to change life, now for all degrees of significant hearing loss. www.naida.phonak.com Guidelines for Identification and Management of Infants and Young Children with Auditory Neuropathy Spectrum Disorder Co-Chairs Deborah Hayes, PhD Co-Chair, Bill Daniels Center for Children’s Hearing Kelley Family/Schlessman Family Scottish Rite Masons Chair in Childhood Language Disorders The Children’s Hospital – Colorado Yvonne S. Sininger, PhD Professor, Head and Neck Surgery David Geffen School of Medicine University of California, Los Angeles Los Angeles, California Editor Jerry Northern, PhD Professor Emeritus University of Colorado School of Medicine Colorado Hearing Foundation Denver, Colorado Conference and Editorial Assistant Valerie Hernandez Program Assistant Bill Daniels Center for Children’s Hearing The Children’s Hospital – Colorado This monograph is sponsored in part by a generous grant from the Kelley Family/Schlessman Family Scottish Rite Masons Chair in Childhood Language Disorders The Children’s Hospital – Colorado ©2008 The Children’s Hospital – Colorado, Aurora, Colorado USA. All Rights Reserved. The ONLYONLY handheld OAE-Tympanometry combination system... Audiologists Physicians Birth-to-3 Programs School Health TM BENEFITS • Sequenced protocols permit a full test battery with the press of only one button. • OAE and tympanometry are completed in as little as 20 seconds. • Easy operation for every level of tester.
    [Show full text]
  • Neural and Receptor Cochlear Potentials Obtained by Transtympanic Electrocochleography in Auditory Neuropathy Q
    Clinical Neurophysiology 119 (2008) 1028–1041 www.elsevier.com/locate/clinph Neural and receptor cochlear potentials obtained by transtympanic electrocochleography in auditory neuropathy q Rosamaria Santarelli a,*, Arnold Starr b, Henry J. Michalewski b, Edoardo Arslan a a Department of Medical and Surgical Specialities, Service of Audiology and Phoniatrics, University of Padua, Via Giustiniani 2, I-35128 Padua, Italy b Department of Neurology, University of California, Irvine, CA, USA Accepted 26 January 2008 Abstract Objective: Transtympanic electrocochleography (ECochG) was recorded bilaterally in children and adults with auditory neuropathy (AN) to evaluate receptor and neural generators. Methods: Test stimuli were clicks from 60 to 120 dB p.e. SPL. Measures obtained from eight AN subjects were compared to 16 normally hearing children. Results: Receptor cochlear microphonics (CMs) in AN were of normal or enhanced amplitude. Neural compound action potentials (CAPs) and receptor summating potentials (SPs) were identified in five AN ears. ECochG potentials in those ears without CAPs were of negative polarity and of normal or prolonged duration. We used adaptation to rapid stimulus rates to distinguish whether the gen- erators of the negative potentials were of neural or receptor origin. Adaptation in controls resulted in amplitude reduction of CAP twice that of SP without affecting the duration of ECochG potentials. In seven AN ears without CAP and with prolonged negative potential, adaptation was accompanied by reduction of both amplitude and duration of the negative potential to control values consistent with neural generation. In four ears without CAP and with normal duration potentials, adaptation was without effect consistent with receptor generation.
    [Show full text]
  • Hyperbilirubinemia and Follow-Up Auditory Brainstem Responses in Preterm Infants
    Clinical and Experimental Otorhinolaryngology Vol. 12, No. 2: 163-168, May 2019 https://doi.org/10.21053/ceo.2018.00899 pISSN 1976-8710 eISSN 2005-0720 Original Article Hyperbilirubinemia and Follow-up Auditory Brainstem Responses in Preterm Infants Gi-Sung Nam1 ·Sang Hyun Kwak2·Seong Hoon Bae2·Sung Huhn Kim2·Jinsei Jung2,* ·Jae Young Choi2,* 1Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju; 2Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea Objectives. Neonatal hyperbilirubinemia is considered one of the most common causative factors of hearing loss. Preterm infants are more vulnerable to neuronal damage caused by hyperbilirubinemia. This study aimed to evaluate the ef- fect of hyperbilirubinemia on hearing threshold and auditory pathway in preterm infants by serial auditory brain- stem response (ABR). In addition, we evaluate the usefulness of the unconjugated bilirubin (UCB) level compared with total serum bilirubin (TSB) on bilirubin-induced hearing loss. Methods. This study was conducted on 70 preterm infants with hyperbilirubinemia who failed universal newborn hearing screening by automated ABR. The diagnostic ABR was performed within 3 months after birth. Follow-up ABR was conducted in patients with abnormal results (30 cases). TSB and UCB concentration were compared according to hearing threshold by ABR. Results. The initial and maximal measured UCB concentration for the preterm infants of diagnostic ABR ≥40 dB nHL group (n=30) were statistically higher compared with ABR ≤35 dB nHL group (n=40) (P=0.031 and P=0.003, re- spectively). In follow-up ABR examination, 13 of the ABR ≥40 dB nHL group showed complete recovery, but 17 had no change or worsened.
    [Show full text]
  • Audiologic Impairment Associated with Bilirubin-Induced Neurologic Damage
    Seminars in Fetal & Neonatal Medicine 20 (2015) 42e46 Contents lists available at ScienceDirect Seminars in Fetal & Neonatal Medicine journal homepage: www.elsevier.com/locate/siny Review Audiologic impairment associated with bilirubin-induced neurologic damage * Cristen Olds, John S. Oghalai Department of Otolaryngology e Head and Neck Surgery, Stanford University, 801 Welch Road, Stanford, CA 94305-5739, USA summary Keywords: Hyperbilirubinemia occurs commonly in neonates and is usually mild and transient, with no long-lasting Bilirubin sequelae. However, bilirubin-induced neurologic damage may occur in some infants. The auditory Kernicterus pathway is the most sensitive part of the central nervous system to bilirubin-induced toxicity, and Auditory neuropathy permanent sequelae may result from only moderately elevated total serum/plasma bilirubin levels. The Hyperbilirubinemia Auditory brainstem response damage to the auditory system occurs primarily within the brainstem and cranial nerve VIII, and manifests clinically as auditory neuropathy spectrum disorder. © 2014 Elsevier Ltd. All rights reserved. 1. Introduction auditory function [15]. This review explores the mechanisms contributing to auditory system damage due to BIND, and describes Hyperbilirubinemia affects up to 84% of term and late preterm its manifestations in the pediatric population. infants in the first week of life [1]. The elevation of total serum/ plasma bilirubin (TB) levels is generally mild, transitory, and, for most children, inconsequential. However, a subset of infants expe- 2. Cellular mechanisms of BIND riences lifelong neurological sequelae. Although the prevalence of classic kernicterus has fallen steadily in the USA in recent years, the Animal studies have shown that unconjugated bilirubin incidence of jaundice in term and premature infants has increased passively diffuses across cell membranes and the blood‒brain [2,3], and kernicterus remains a significant problem in the global barrier (BBB), and bilirubin not removed by organic anion efflux arena [4].
    [Show full text]
  • Auditory Neuropathy Spectrum Disorder Gail Padish Clarin, Aud
    ANATIONAL RESOURCE CENTER GUIDE FOR FOR EARLY HEARING HEARING ASSESSMENT DETECTION & & MANAGEMENT INTERVENTION Chapter 8 Auditory Neuropathy Spectrum Disorder Gail Padish Clarin, AuD uditory Neuropathy Spectrum (8th nerve). They advocate use of the term Use of the term Disorder (ANSD) is a term “neural hearing loss” to describe pathology “neuropathy” to describe Arecently recommended by an in spiral ganglion cells or the central this disorder has resulted expert panel in the audiology profession nervous system and “sensory hearing loss” in much discussion in the to describe hearing loss characterized by to describe loss resulting from pathology normal or near normal cochlear hair cell in the hair cells. audiology profession. function and absent or abnormal auditory nerve function.1 Difficulty hearing in noise, In an effort to be consistent with recent fluctuating hearing, and speech perception terminology used in the audiology performance not predicted by level of profession regarding this type of hearing residual hearing have been reported loss, the term ANSD will be utilized (Starr et al., 1996; Rance et al., 1999). in this chapter. The vast etiologies of The incidence of ANSD in children with ANSD result in a heterogeneous group severe-profound hearing loss has been of patients—each who must be managed reported as 13.4% (Sanyebhaa et al., 2009). methodically and individually for optimal communication and developmental Use of the term progress. An understanding of what is “neuropathy” to describe known about ANSD and what remains this disorder has resulted unknown will assist the pediatric in much discussion in audiologist in appropriate identification the audiology profession.
    [Show full text]
  • A Tutorial on Auditory Neuropathy/ Dyssynchrony for the Speech-Language Pathologist and Audiologist
    A Tutorial on Auditory Neuropathy/ Dyssynchrony for the Speech-Language Pathologist and Audiologist Kristin Uhler, Ph.D., CCC-A, FAAA,1 Amanda Heringer, B.A. (Au.D. candidate),2 Nanette Thompson, M.A., CCC-SLP,3 and Christine Yoshinaga-Itano, Ph.D.2 ABSTRACT This article presents information about developmental out- comes of children with auditory neuropathy/auditory dyssynchrony (AN). Colorado data on the number of children screened and the number of children identified with unilateral and bilateral AN will be described. Descriptive information about the percent of children with AN with cognitive disability and disabilities other than hearing loss will be presented. Language outcomes of children with normal cognitive development will be presented. This article will also provide informa- tion about etiologies and audiological information of children with AN. It includes assessment tools that have been useful in decision making for children with AN. KEYWORDS: Auditory neuropathy, auditory dyssynchrony, auditory neural hearing loss, auditory neuropathy spectrum Downloaded by: SASLHA. Copyrighted material. disorder, language development Learning Outcomes: As a result of this activity, the reader will be able to (1) describe the anticipated number of children with auditory neuropathy/auditory dyssynchrony (AN) with cognitive disability and the percentage of children anticipated with any disability other than hearing loss, (2) describe the etiologies associated with AN, (3) describe the considerations for cochlear implant candidacy of children with AN, (4) describe an assessment procedure that can be used in the first year of life to examine the child’s vocal development and the contribution of auditory skill to that development, (5) discuss issues related to choices of communication approaches and AN.
    [Show full text]
  • Redalyc.Auditory Evoked Potentials in a Newborn Wistar Rat Model Of
    Brazilian Journal of Otorhinolaryngology ISSN: 1808-8694 [email protected] Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico- Facial Brasil Çal, Gökdoan; Genç, Aydan; Gülbahar, Özlem; Gökdoan, Ozan; Helvac, Aye; Üstün Bezgin, Selin; Memi, Leyla Auditory evoked potentials in a newborn Wistar rat model of hyperbilirubinemia Brazilian Journal of Otorhinolaryngology, vol. 82, núm. 2, marzo-abril, 2016, pp. 144-150 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial São Paulo, Brasil Available in: http://www.redalyc.org/articulo.oa?id=392444758005 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Document downloaded from http://bjorl.elsevier.es day 04/04/2016. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. Braz J Otorhinolaryngol. 2016;82(2):144---150 Brazilian Journal of OTORHINOLARYNGOLOGY www.bjorl.org ORIGINAL ARTICLE Auditory evoked potentials in a newborn Wistar rat ଝ,ଝଝ model of hyperbilirubinemia a,∗ b c d C¸a˘gıl Gökdo˘gan , Aydan Genc¸ , Özlem Gülbahar , Ozan Gökdo˘gan , e f e Ays¸e Helvacı , Selin Üstün Bezgin , Leyla Memis¸ a Gazi University Hospital, Audiology Department, Ankara, Turkey b Hacettepe University Hospital, Audiology Department, Ankara, Turkey c Gazi University Hospital, Biochemistry Department, Ankara, Turkey d Memorial Hospital, ENT Department, Ankara, Turkey e Gazi University Hospital, Pathology Department, Ankara, Turkey f Gazi University Hospital, ENT Department, Ankara, Turkey Received 7 September 2014; accepted 6 January 2015 Available online 2 December 2015 KEYWORDS Abstract Hyperbilirubinemia; Introduction: Hyperbilirubinemia is a common health problem in newborns.
    [Show full text]
  • Auditory Neuropathies and Electrocochleography
    Hearing, Balance and Communication, 2013; 11: 130–137 ORIGINAL ARTICLE Auditory neuropathies and electrocochleography ROSAMARIA SANTARELLI 1 , IGNACIO DEL CASTILLO 2,3 & ARNOLD STARR 4 1 Department of Neuroscience, Service of Audiology and Phoniatrics, University of Padua, Padova, Italy, 2 Unidad de Gen é tica Molecular, Hospital Ram ó n y Cajal and 3 Centro de Investigacion Biomedica en Red de Enfermedades raras (CIBERER), Madrid, Spain, and 4 University of California, Irvine, California, USA Abstract Auditory neuropathy (AN) is a hearing disorder characterized by disruption of temporal coding of acoustic signals in audi- tory nerve fi bres resulting in impairment of auditory perceptions relying on temporal cues (1,2). Mechanisms suggested include both pre-synaptic and post-synaptic disorders affecting inner hair cell (IHC) depolarization, neurotransmitter release from ribbon synapses, spike initiation in auditory nerve terminals, loss of nerve fi bres and impaired conduction, all occurring in the presence of normal physiological measures of outer hair cell (OHC) activities (otoacoustic emissions (OAEs) and cochlear microphonic (CM)). Disordered synchrony of auditory nerve discharge has been suggested as the basis of both the profound alterations of auditory brainstem responses (ABRs) and impairment of speech perception (3). We review how electrocochleography (ECochG) can provide detailed information to help defi ne objectively the sites of auditory neural dysfunction as affecting IHC receptor summating potential (SP) and compound action
    [Show full text]