Rate of neural recovery in implanted children with auditory neuropathy spectrum disorder.

OBJECTIVES The study objectives were to compare the rate of neural recovery and speech perception performance in children with auditory neuropathy spectrum disorder (ANSD) and children with sensorineural hearing loss (SNHL) from other etiologies. STUDY DESIGN Cohort study. SETTING Academic hospital and cochlear implant center. SUBJECTS AND METHODS Ten children with ANSD were matched based on type of implant and age at implantation with peers diagnosed with SNHL. Electrically evoked compound action potential (ECAP) recovery functions were obtained to measure neural refractory behaviors in response to stimulation from the cochlear implant. Speech perception performance was measured using speech recognition thresholds (SRTs) for monosyllable and spondee word stimuli. These outcome measures were compared between groups. RESULTS There was no difference in average recovery function exponent in children with ANSD compared to children with SNHL. Similarly, there were no differences in average SRTs in quiet and in noise in children with ANSD compared to children with SNHL. Relationships between SRT and recovery rate were not present within groups or for all subjects for SRT in quiet, but a significant relationship was found for all subjects for SRT in noise (P = .04). CONCLUSIONS Dyssynchronous neural activity in ANSD may affect temporal encoding of electrical stimulation from a cochlear implant. As a group, children with ANSD did not demonstrate slower neural recovery compared to those with SNHL, but there was slower neural recovery observed for some subjects. The utility of ECAP recovery functions on optimizing the stimulation rate for individual patients with ANSD requires further investigation.