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Published on: January 23, 2017
External and middle ear effects on infant hearing screening test results
K J Doyle1, P Rodgers, S Fujikawa
1University of California Irvine Medical Center, CA, USA.
Insights
Cleaning newborn ears of vernix and addressing middle ear issues significantly improves hearing screening success rates using auditory brain stem response (ABR) and otoacoustic emissions (EOAEs). This enhances early detection of hearing loss in infants.
Area of Science:
- Audiology
- Neonatal Medicine
- Otolaryngology
Background:
- Newborn hearing screening is crucial for early detection of hearing impairment.
- Automated auditory brain stem response (ABR) and transient-evoked otoacoustic emissions (EOAEs) are common screening methods.
- External and middle ear conditions can affect screening outcomes.
Purpose of the Study:
- To investigate the impact of external and middle ear factors on ABR and EOAE hearing screening results in newborns.
- To determine the effectiveness of clearing occluding vernix on screening pass rates.
- To assess the influence of tympanic membrane mobility on ABR and EOAE outcomes.
Main Methods:
- Screening of 200 healthy newborns (5-48 hours old) using ABR and EOAE.
- Otoscopic examination to assess external and middle ear conditions, including vernix presence and tympanic membrane mobility.
- Comparison of screening results before and after vernix removal.
Main Results:
- Initial ABR and EOAE pass rates were 91% and 58.5%.
- Occluding vernix was present in 28% of ears; its removal increased ABR and EOAE pass rates to 96% and 69%.
- Decreased tympanic membrane mobility affected EOAEs (33.4% pass) but not significantly ABR (95% pass).
Conclusions:
- Clearing vernix is essential for accurate newborn hearing screening.
- Automated ABR is less affected by middle ear effusion or decreased tympanic membrane mobility compared to EOAEs.
- Addressing external ear canal obstructions improves the reliability of neonatal hearing screening programs.
Abstract:
This study investigated the relationship between external and middle ear factors and hearing screening results by automated auditory brain stem response (ABR) and transient-evoked otoacoustic emissions (EOAEs). The ears of 200 healthy newborns aged 5 to 48 hours underwent screening by ABR and EOAE, followed by otoscopic examination. The pass rates for ABR and EOAE were 91% and 58.5%, respectively. On otoscopic examination, 28% (112/400) ears had occluding vernix obscuring the view of the tympanic membrane. Cleaning of vernix was successfully performed in all but 2 ears that had occluding vernix. Cleaning of vernix significantly increased the pass rates of all 400 ears for ABR and EOAE to 96% and 69%. Decreased tympanic membrane mobility was found in 22.7% (90/396) of ears that were evaluated otoscopically. Decreased tympanic membrane mobility had a significant effect on EOAE screening; only 33.4% of ears passed EOAE testing. Decreased tympanic membrane mobility did not significantly affect pass rates for ABR screening; 95% of these ears passed the automated ABR screen. Implications for newborn hearing screening are discussed.
