Wideband acoustic-reflex test in a test battery to predict middle-ear dysfunction

Area of Science:

• Audiology
• Otoacoustic Emissions
• Hearing Science

Background:

• Newborn hearing screening (NHS) protocols often rely on otoacoustic emissions.
• Accurate assessment of middle-ear status is crucial for identifying hearing impairments in newborns.
• Limitations exist in current screening methods for detecting conductive dysfunction and auditory neuropathy.

Purpose of the Study:

• To evaluate the accuracy of a wideband (WB) aural acoustical test battery in classifying newborn hearing screening outcomes.
• To compare the efficacy of WB acoustic tests (ARTs and ATFs) against 1-kHz tympanometry for NHS referrals.
• To explore the potential of middle-ear assessment to enhance NHS programs.

Main Methods:

• A WB acoustic test battery, including acoustic-reflex thresholds (ARTs) and acoustic-transfer functions (ATFs), was employed.
• Ipsilateral ARTs were measured using broadband noise or tonal activators and clicks, assessing reflex shifts.
• ARTs were analyzed at low (0.8-2.8 kHz) and high (2.8-8 kHz) frequencies using maximum likelihood estimation.

Main Results:

• The median low-frequency ART was significantly elevated (24 dB) in NHS refers compared to passes.
• An optimal combination of ATF and ART tests demonstrated superior prediction of NHS outcomes compared to individual tests.
• WB acoustic tests outperformed 1-kHz tympanometry in classifying NHS outcomes.

Conclusions:

• WB acoustic test batteries, incorporating ARTs and ATFs, offer enhanced accuracy for classifying newborn hearing screening results.
• These WB tests provide a more effective method for identifying middle-ear dysfunction and potential auditory neuropathy in newborns.
• The findings support the integration of comprehensive WB acoustic assessments into newborn hearing screening protocols.