High-frequency otoacoustic emissions in universal newborn hearing screening

Area of Science:

• Audiology
• Neonatal care
• Otoacoustic emissions

Background:

• Distortion-product otoacoustic emissions (DPOAEs) are standard for newborn hearing screening.
• Conventional DPOAE testing (1-6 kHz) has a high false-positive rate.
• High-frequency DPOAEs may offer improved specificity.

Purpose of the Study:

• To evaluate the effectiveness of high-frequency DPOAEs in reducing false-positive rates in newborn hearing screening.
• To investigate the diagnostic utility of DPOAEs up to 12 kHz.

Main Methods:

• 255 healthy newborns underwent conventional DPOAE and automated auditory brainstem response (AABR) screening.
• High-frequency DPOAEs were measured up to 12 kHz.
• Signal-to-noise ratios (SNRs) were analyzed at various frequencies.

Main Results:

• 9% of newborns failed conventional DPOAE but passed AABR; 3% failed both.
• High-frequency DPOAEs (4-10 kHz) with an SNR threshold of 6 dB reduced the false-positive rate from 9% to 0.4%.
• Requiring only three of four high-frequency DPOAEs to exceed the threshold yielded zero false positives.

Conclusions:

• High-frequency DPOAE testing significantly lowers DPOAE failure and false-positive rates.
• These findings support the integration of high-frequency DPOAEs into universal newborn hearing screening protocols.
• Improved screening accuracy can lead to more efficient identification of infants with hearing loss.