Cochlea and auditory nerve.
Level 5 - mechanism / opinion, no new human data
Narrative review of auditory physiology and diagnostic electrophysiology without original empirical data or systematic search methodology.
PubMed 31277867 · doi:10.1016/B978-0-444-64032-1.00029-1
What was done
This narrative review outlines the physiological mechanisms of cochlear and auditory nerve transduction and details clinical electrophysiological and acoustic tests, including electrocochleography (cochlear microphonic, summating potential, compound action potentials), otoacoustic emissions, narrow-band action potentials, and efferent olivocochlear bundle testing via contralateral suppression.
What was found
The abstract reports no numerical data, diagnostic accuracy metrics, or statistical comparisons. It qualitatively reports that preserved cochlear microphonics alongside absent compound action potentials indicate auditory neuropathy; summating potentials are frequently increased and prolonged in Ménière's disease but overlap with normal ranges; narrow-band action potentials aid in distinguishing Ménière's disease from vestibular schwannomas; and contralateral acoustic stimulation tests efferent olivocochlear bundle patency by suppressing otoacoustic emission amplitude.
Why it matters
It summarizes how combinations of cochlear electrophysiological tests can help differentiate between sensory and retrocochlear pathologies presenting with overlapping symptoms like hearing loss, tinnitus, and dizziness.
Limits
The abstract provides no primary data, sample sizes, or quantitative test performance metrics (such as sensitivity, specificity, or likelihood ratios). As a narrative review, it lacks a systematic search and appraisal methodology.
Cited by
- supports Otoacoustic emissions are sounds generated within the ear that can be measured using a microphone in the ear canal.