![]() ![]() Further, all the other tests were repeated on the client. The cochlear microphonics was present in both ears till 3.5 ms (Figure 3). The ABR was done at 90 dBnHL with an 11.1/s repetition rate using click stimulus, and the results showed no identifiable peak in both ears. A calibrated Biologic Navigation Pro system (version 7.0.0) fitted with an ER-3A insert receiver was used for ABR recording. The third evaluation was done on 10/11/21. Though the client came with the complaint of reduced hearing sensitivity in both ears, speech audiometry, otoacoustic emission (OAEs), and auditory brainstem response (ABR) could not be done due to the pandemic.įigure 2: Pure tone audiogram of the client on the second visit. Tympanometry indicated an 'A' type tympanogram in both ears with ipsilateral reflexes present in the right and left ear. Immittance evaluation was done using GSI- TympStar (Grason-Stadler, MN, USA) to assess tympanometry and acoustic reflex. Pure tone audiometry revealed a minimal hearing loss in the right ear (Pure tone average, PTA: 20 dB) and normal hearing sensitivity in the left ear (PTA: 7.5 dB) (Figure 1). A calibrated two-channel diagnostic audiometer, MA-53 (MAICO Diagnostics, Germany), equipped with TDH39 headphones, was used to perform pure tone audiometry. The routine audiological evaluations included pure tone audiometry, and immittance evaluations were performed on the client. The present case study highlights the importance of the test battery approach for diagnosing ANSD during the Corona Pandemic.Ī sixteen-year-old male reported to the Department of Audiology on with the complaint of reduced hearing sensitivity in both ears from six months, with sudden onset and acquired in nature. The audiological practice has been modified during COVID 19 and the test is decided based on the client's urgent need. Low- and no-touch services are necessary for audiology patients - who are typically at the highest risk for COVID-19 morbidity and mortality due to their age - to access medical care. Performing the audiological evaluations and utilizing the test battery was a challenging task during COVID-19. To effectively diagnose various audiological conditions, a test battery approach is required. Some of the children's health services were interrupted to control the infection and protect the vulnerable population from getting affected by the COVID-19. The COVID-19 pandemic has adversely affected health care services worldwide, including India. For the effective diagnosis of ANSD, the test battery should include an effective case history, pure tone audiometry, acoustic reflex testing, otoacoustic emissions, auditory brainstem responses, and neurological evaluation. A test battery approach includes various diagnostic tests during the initial evaluation, including pure-tone audiometry, acoustic reflex testing, imaging, and auditory brainstem response testing to differentially diagnose. ANSD is a complex hearing disorder requiring methodic identification and a test battery approach to achieve a proper diagnosis. It is characterized by reduced hearing sensitivity with fluctuating loss, difficulty understanding speech in noise, answering inappropriately, or limited response to a conversational level. ![]() Test battery, Differential diagnosis, ANSD, Pandemic, Case reportĪuditory Neuropathy Spectrum Disorder (ANSD) is a form of sensorineural hearing impairment reported to cause impaired neural conduction with preserved cochlear outer hair cells. The diagnosis of the client was made after three evaluations as ANSD.Ĭonclusion: It is concluded that depending upon the population, it is necessary to add in all the tests for audiological evaluation so that there is no delay in the diagnosis. The case: A sixteen-year-old male reported reduced hearing sensitivity in both ears from six months, with sudden onset and acquired in nature. The present case study highlights the importance of the test battery approach for the effective diagnosis of Auditory Neuropathy Spectrum Disorder (ANSD) during the Corona Pandemic. A test battery approach is required to effectively diagnose various audiological conditions, and utilizing a test battery was challenging during COVID-19. Background: The COVID-19 pandemic has adversely affected health care services worldwide, including India.
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