The complexity of ANSD starts at the time of diagnosis

Ms Florencia Montes1, Ms Monica Wilkinson1, Ms Carolyn Cottier1

1Sydney Children’s Hospital, Randwick, NSW, Australia
The complexity of ANSD starts at the time of diagnosis

ANSD is characterised by absent or “abnormal” ABR with normal cochlear outer hair cell function as evidenced by present otoacoustic emissions and/or cochlear microphonic responses. The term ANSD covers a wide range of conditions and outcomes, from normal to profound hearing loss, from minimal problems understanding speech in noise to severe difficulties making sense of speech. In cases of ANSD “abnormal” ABR waveform morphology also presents differently in different patients and in some cases can be confounded with SNHL. Sometimes the diagnosis is not clear cut.

The main goal of this workshop is to provide practical knowledge and skills to improve the diagnosis of ANSD.
Through case studies and group discussions, participants will have the opportunity to reflect on the challenges of ANSD diagnosis, reflect on current practice and protocols and discuss strategies for clarifying the diagnosis in difficult cases.
We will explore what constitutes “abnormal” ABR waveform, look at variations in CM responses, what can we change in our testing protocol to increase precision in diagnosis, discuss strategies that can be used when there is uncertainty about the diagnosis and how we report our findings


Florencia Montes: Audiologist working in neonate and infant diagnostic evaluation at Sydney Children Hospital.

Monica Wilkinson: Head of the Audiology Department at Sydney Children’s Hospital,. Monica has been involved with the SWISH program since it’s conception and is working in diagnostics.

Carolyn Cottier, Paediatrician at the Hearing Support Service Clinic for investigations into the cause of the hearing loss