Auditory neuropathy: a potentially under-recognized neonatal intensive care unit sequela.

Auditory neuropathy (AN) is a hearing disorder that affects newborns. Those with high-risk neonatal histories, family history of childhood hearing loss, and hyperbilirubinemia are at greatest risk. Current neonatal intensive care unit (NICU) hearing screening methods that rely only on otoacoustic emissions will fail to detect this disorder. Auditory neuropathy differs from conductive hearing loss and sensorineural hearing loss; a specific constellation of findings on audiologic evaluation are diagnostic of this disorder. The pathophysiology of AN is unclear; however, it may be caused by demyelinization or degeneration at points along the auditory pathway. The actual incidence of AN is unknown; it is more prevalent in high-risk infants. The course of AN varies widely among patients. Current management ranges from close monitoring of the child's development to cochlear implantation. Neonatal intensive care unit nurses need to be aware of this disorder to help support and educate at-risk families and to alert them of the need to monitor hearing and language development in their infants.