Identification of different subtypes of auditory neuropathy using electrocochleography

Currently, the physiological mechanisms underlying auditory neuropathy are unclear, and there are likely to be multiple sites of lesion. A better understanding of the disruption in individual cases may lead to more effective management and device selection. Frequency-specifi c round-window electrocochleography (ECochG) waveforms were used to assess local hair cell, dendritic, and axonal currents generated within the cochlea in 15 subjects with auditory neuropathy (16 ears). These results were compared with electrically evoked auditory brainstem response (EABR) measured after cochlear implantation. The results of this study demonstrate that predominantly two patterns of ECochG waveforms can be identifi ed: (i) a prolonged latency of the hair cell summating potential (SP) waveform with or without residual CAP activity and (ii) a normal latency SP, typically followed by a dendritic potential (DP). We show that seven of eight subjects with a prolonged SP showed a normal EABR waveform, consistent with a presynaptic lesion, whereas six of seven subjects with a normal latency SP showed poor morphology or absent EABR waveforms, consistent with a postsynaptic lesion. We suggest that a presynaptic and postsynaptic type of auditory neuropathy exist, which may have implications for the fi tting of cochlear implants.16 page(s

Temporary threshold shift after impulse-noise during video game play: Laboratory data

OBJECTIVE: Prevention of temporary threshold shift (TTS) after laboratory-based exposure to pure-tones, broadband noise, and narrow band noise signals has been achieved, but prevention of TTS under these experimental conditions may not accurately reflect protection against hearing loss following impulse noise. This study used a controlled laboratory-based TTS paradigm that incorporated impulsive stimuli into the exposure protocol; development of this model could provide a novel platform for assessing proposed therapeutics. DESIGN: Participants played a video game that delivered gunfire-like sound through headphones as part of a target practice game. Effects were measured using audiometric threshold evaluations and distortion product otoacoustic emissions (DPOAEs). The sound level and number of impulses presented were sequentially increased throughout the study. STUDY SAMPLE: Participants were normal-hearing students at the University of Florida who provided written informed consent prior to participation. RESULTS: TTS was not reliably induced by any of the exposure conditions assessed here. However, there was significant individual variability, and a subset of subjects showed TTS under some exposure conditions. CONCLUSIONS: A subset of participants demonstrated reliable threshold shifts under some conditions. Additional experiments are needed to better understand and optimize stimulus parameters that influence TTS after simulated impulse noise