In auditory neuropathy spectrum disorder (ANSD), which combination of audiological findings is characteristic?

• A Absent OAE + present ABR waves I-V
• B Present OAE (or present cochlear microphonic) + absent/markedly abnormal ABR ✓
• C Flat audiogram + absent middle ear reflexes
• D Type B tympanogram + absent OAE + absent ABR

Explanation

Auditory neuropathy spectrum disorder (ANSD) is characterised by normal outer hair cell function but disrupted synchronous neural transmission. The hallmark is: present OAE (or cochlear microphonic on ABR), confirming outer hair cell function, combined with absent or severely abnormal ABR (absent waves despite cochlear function). This indicates a lesion at the inner hair cells, auditory nerve, or auditory brainstem. Type B tympanogram indicates middle ear effusion, a separate condition.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.