Otological evaluation of newborns who failed otoacoustic emission screening

Early identification of congenital hearing loss and early rehabilitation is extremely important. Otoacoustic emissions (OAE) are an efficient tool for hearing screening. Previous studies using click evoked otoacoustic emissions (CEOAEs) for newborn hearing screening resulted in approximately 70% pass rate, reflecting intact hearing. The aim of our study was to perform a detailed otological evaluation of newborns who failed OAE screening, using otoscopy, tympanometry and ABR. CEOAEs were recorded from 257 newborns prior to their release from the hospital. Those babies who did not pass the CEOAE were examined by DPOAE, otoscopy, tympanometry and ABR, if needed. 73% of all the newborns had CEOAE in both ears. 20% had CEOAE in only one ear. When the test was administered again three days postpartum, the CEOAE pass rate increased; 98% passed in at least one ear. Most of the newborns (84%) who failed had an obstruction of the external ear canal (collapsed ear canal or debris). There was a good correlation between the otoscopy and the tympanometry. Based on the above results, a newborn hearing screening protocol was introduced.