EpistemisAuditory recruitment
Specialty: Otolaryngology.
Why it occurs
- Sensorineural hearing loss of cochlear origin due to damage to the outer hair cells of the organ of Corti
- Presbycusis in advanced stages due to cochlear sensory and neural cellular degeneration
- Acute acoustic trauma with selective destruction of cell populations in the cochlea
- Drug ototoxicity due to aminoglycosides or chemotherapy drugs that alter external cellular function
Initial workup
Tonal audiometry with Fowler test (binaural loudness balance if unilateral), determination of stapedial reflex thresholds by tympanometry (Metz test), brainstem auditory evoked potentials (BAEP) and brain MRI focused on internal auditory canals with contrast.
red flags
Sudden onset hearing loss in less than 72 hours associated with acute peripheral vertigo, marked unilateral hearing asymmetry, or suspected pathology of the internal auditory canal or cerebellopontine angle (e.g., vestibular schwannoma).
Standard management
- There are no specific drugs to reverse auditory recruitment once histological cellular damage is established.
- Adaptation of hearing aids — digital technology hearing aids with WDRC wide dynamic range compression to amplify soft sounds without exceeding the patient's discomfort threshold
- Antioxidants for cochlear support in acute phases of acoustic trauma such as oral N-acetylcysteine (600 mg every 12 hours for 10 days).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Otolaryngology
- Listed causes
- 4
- Treatment options
- 3