by EBSCO Medical Review Board
(AN; Auditory Dyssynchrony; Auditory Synaptopathy; Neuropathy, Auditory; Auditory Processing Disorder)


Auditory neuropathy (AN) is when the nerve system of the inner ear does not process sounds coming from the outer ear.

The Ear
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The outer ear sends vibrations to the inner ear. There, hair cells break them into electrical signals. These are sent to the brain. It filters them as sound.

AN may be due to 1 or more of these causes:

  • Problems with the hair cells in the inner ear
  • Bad links between the hair cells and the nerve to the brain
  • A damaged nerve
  • Nerve problems

Risk Factors

Things that may raise the risk of this problem are:

  • Other family members who have had hearing loss
  • Lack of oxygen at birth
  • Very low birth weight
  • Jaundice after birth
  • Gilbert syndrome—a genetic disorder
  • Infections, such as mumps
  • Problems with the immune system
  • Being around chemicals or medicines that cause hearing loss, such as some chemotherapies
  • Tumors of the nerve or those that press on the nerve
  • Neurofibromatosis type 2—a genetic problem that causes tumors in the nerves
  • Trauma


Problems vary from person to person. They may be:

  • Sounds that are heard but are not clear enough to hear
  • Sounds that tune in and out
  • Words and sounds that seem out of sync
  • Ringing in the ears


The doctor will ask about your symptoms and health history. A physical exam will be done.

These tests may be done:

  • Auditory brainstem response (ABR) to measure brainwaves
  • Otoacoustic emissions (OAE) to record how the cells in the ear react to clicking sounds


The goal of treatment is to:

  • Save the person's current level of hearing
  • Restore lost hearing
  • Learn new ways to communicate

Treatment options are:

  • Devices to help with hearing, such as hearing aids, listening devices, and cochlear implants
  • Speech-language therapy, such as sign language and speech reading


There are no known guidelines to prevent AN.


American Speech-Language-Hearing Association 

National Institute on Deafness and Other Communication Disorders 


Ontario Association for Speech-Language Pathologists and Audiologists 

Speech-Language & Audiology Canada 


Auditory neuropathy. National Institute on Deafness and Other Communication Disorders website. Available at: Accessed October 5, 2020.

Cochlear implants. American Academy of Otolaryngology website. Available at: Accessed October 5, 2020.

Ototoxic medications (medication effects). American Speech-Language-Hearing Association website. Available at: Accessed October 5, 2020.

Ototoxicity. Vestibular Disorders Association website. Available at: Accessed October 5, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 09/2020
  • Update Date: 05/21/2021