Objective: OAE an audiologic study for diagnosis of exteracochlear auditory neuropathy.
Method & Material: Immitance audiometry, OAE and ABR and rehabilitation Intervention was performed for 3 children suffered from kernictrus.
Conclusion: 1) OAE in the from of screening, distorted product and transient evoked-otoacoustic emission has to be added to our audiology test battery. 2) OAE studies have their own merit when we are clinically involved with the diagnosis of especial clinical entities like neonatal hypoxia, kernicterus, multiple sclerosis, meningitides and meningoencephalitis. 3) Case selection for cochlear implantation needs a knowledge of patients' OAE results. 4) In the case of intracerebral auditory neuropathy the need for other rehabilitative measures will be better understood.

Background and Aim: Auditory neuropathy (AN) can be diagnosed by abnormal auditory brainstem response (ABR), in the presence of normal cochlear  microphonic (CM) and otoacoustic emissions (OAEs).The aim of this study was to investigate the ABR and other electrodiagnostic test results of six patients suspicious to AN with problems in speech recognition.
Materials and Methods: this cross sectional study was conducted on 6 AN patients with different ages evaluated by pure tone audiometry, speech discrimition score (SDS) , immittance audiometry , electrocochleography , ABR, middle latancy response (MLR), late latency response (LLR), and OAEs.
Results: Behavioral pure tone audiometric tests showed moderate to profouned hearing loss. SDS was so poor which is not in accordance with pure tone thresholds. All patients had normal tympanogram but absent acoustic reflexes. CMs and OAEs were within normal limits. There was no contralateral suppression of OAEs. None of cases had normal ABR or MLR although LLR was recorded in 4.
Conclusion: All patients in this study are typical cases of auditory neuropathy. Despite having abnormal input, LLR remains normal that indicates differences in auditory evoked potentials related to required neural synchrony. These findings shows that auditory cortex may play a role in regulating presentation of deficient signals along auditory pathways in primary steps.

Background and Aim: Physiologic measures of cochlear and auditory nerve function may be of assistance in distinguishing between hearing disorders due primarily to auditory nerve impairment from those due primarily to cochlear hair cells dysfunction. The goal of present study was to measure of cochlear responses (otoacoustic emissions and cochlear microphonics) and auditory brainstem response in some adults with auditory neuropathy/ dys-synchrony and subjects with normal hearing.
Materials and Methods: Patients were 16 adults (32 ears) in age range of 14-30 years with auditory neuropathy/ dys-synchrony and 16 individuals in age range of 16-30 years from both sexes. The results of transient otoacoustic emissions, cochlear microphonics and auditory brainstem response measures were compared in both groups and the effects of age, sex, ear and degree of hearing loss were studied.
Results: The pure-tone average was 48.1 dB HL in auditory neuropathy/dys-synchrony group and the frequency of low tone loss and flat audiograms were higher among other audiogram&aposs shapes. Transient otoacoustic emissions were shown in all auditory neuropathy/dys-synchrony people except two cases and its average was near in both studied groups. The latency and amplitude of the biggest reversed cochlear microphonics response were higher in auditory neuropathy/dys-synchrony patients than control people significantly. The correlation between cochlear microphonics amplitude and degree of hearing loss was not significant, and age had significant effect in some cochlear microphonics measures. Auditory brainstem response had no response in auditory neuropathy/dys-synchrony patients even with low stimuli rates.
Conclusion: In adults with speech understanding worsen than predicted from the degree of hearing loss that suspect to auditory neuropathy/ dys-synchrony, the frequency of low tone loss and flat audiograms are higher. Usually auditory brainstem response is absent in this patients and use of both otoacoustic emissions and cochlear microphonics responses to measure cochlear hair cells function are suggested in them.

Background and Aim: Hyperbilirubinemia during the neonatal period is known to be an important risk factor for neonatal auditory impairment, and may reveal as a permanent brain damage, if no proper therapeutic intervention is considered. In the present study some electroacoustic and electrophysiologic tests were used to evaluate function of auditory system in a group of children with severe neonatal Jaundice.
Materials and Methods: Forty five children with mean age of 16.1 14.81 months and 17 mg/dl and higher bilirubin level were studied, and the transient evoked otoacoustic emission, acoustic reflex, auditory brainstem response and auditory steady-state response tests were performed for them.
Results: The mean score of bilirubin was 29.37± 8.95 mg/dl. It was lower than 20 mg/dl in 22.2%, between 20-30 mg/dl in 24.4% and more than 30 mg/dl in 48.0% of children. No therapeutic intervention in 26.7%, phototherapy in 44.4%, and blood exchange in 28.9% of children were reported. 48.9% hypoxia and 26.6% preterm birth history was shown too. TEOAEs was recordable in 71.1% of cases. The normal result in acoustic reflex, ABR and ASSR tests was shown just in 11.1% of cases. The clinical symptoms of auditory neuropathy were revealed in 57.7% of children.
Conclusion: Conducting auditory tests sensitive to hyperbilirubinemia place of injury is necessary to inform from functional effect and severity of disorder. Because the auditory neuropathy/ dys-synchrony is common in neonates with hyperbilirubinemic, the OAEs and ABR are the minimum essential tests to identify this disorder.