Diagnosis and treatment of auditory disorders

Auditory disorders can arise from the peripheral auditory system or the central auditory system. Peripheral auditory disorders impact hearing, while disorders of the central auditory system affect higher-level auditory functions, including sound recognition and comprehension. Auditory disorders can be developmental or acquired. Developmental and acquired disorders of the peripheral auditory system are typically associated with structural abnormalities of the outer, middle, and/ or inner ear. Developmental disorders of the central auditory system occur in the absence of structural abnormalities, while acquired central auditory disorders are commonly associated with structural lesions. We will focus on acquired disorders of the central auditory system at the level of the cerebral cortex. Because the peripheral and central auditory systems are physically contiguous, disorders of the peripheral system can affect central auditory processing. This is especially relevant for people who have had strokes who, in addition to speech comprehension difficulties, may have preexisting hearing loss. Therefore, comprehensive auditory evaluations should assess both peripheral and central auditory functions. We begin by reviewing the diagnosis and treatment of peripheral hearing loss.