When should automatic Auditory Brainstem Response test be used for newborn hearing screening?

Area of Science:

• Audiology
• Neonatal Care
• Public Health

Background:

• Newborn hearing screening is crucial for early detection of hearing loss.
• Transient Evoked Otoacoustic Emissions (TEOAE) and automatic Auditory Brainstem Response (aABR) are common screening methods.
• Determining the optimal screening pathway, especially regarding the use of aABR, is essential for efficient and accurate diagnosis.

Purpose of the Study:

• To investigate the referral rates for newborn hearing screening.
• To determine the appropriate timing and criteria for utilizing aABR in neonatal hearing assessment.
• To compare the effectiveness of TEOAE and aABR in identifying hearing impairments in different infant populations.

Main Methods:

• Enrolled 2933 healthy full-term infants and 176 infants with perinatal risk factors.
• Utilized TEOAE screening for healthy infants, with repeat testing for those who failed.
• Referred infants who failed TEOAE multiple times or had risk factors for aABR testing.

Main Results:

• 85 infants (2.9%) failing TEOAE and 176 with risk factors underwent aABR.
• 10 (11.7%) of TEOAE-failed infants and 14 (7.9%) of risk-factor infants failed aABR.
• Hearing loss was confirmed in 10 (0.34%) of the healthy infants screened.

Conclusions:

• TEOAE screening should be performed at least twice in healthy infants before resorting to aABR due to aABR's resource-intensive nature.
• Infants without risk factors should primarily undergo TEOAE screening, while those with risk factors or failing TEOAE require aABR.
• Caution is advised as TEOAE may miss auditory neuropathy in infants without perinatal risk factors, highlighting the importance of aABR in specific cases.