Neonatal hearing screening - does failure in TEOAE screening matter when the AABR test is passed?
Donata Gellrich1, Moritz Gröger2, Matthias Echternach2
1Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics and Pediatric Audiology, University Hospital, Ludwig-Maximilians-University Munich (LMU), Marchioninistr. 15, 81377, Munich, Germany. Donata.Gellrich@med.uni-muenchen.de.
Summary
Newborn hearing screening can miss hearing loss. Infants failing transient evoked otoacoustic emissions (TEOAE) but passing automatic auditory brainstem response (AABR) require follow-up, as many have hearing impairment, especially with risk factors.
Area of Science:
- Audiology
- Neonatal Care
- Pediatric Medicine
Background:
- Universal newborn hearing screening (UNHS) is crucial for early detection of hearing loss.
- Transient evoked otoacoustic emissions (TEOAE) and automatic auditory brainstem response (AABR) are common screening tools.
- Discordant results (TEOAE refer, AABR pass) often lack follow-up, potentially missing hearing impairment.
Purpose of the Study:
- To investigate the prevalence of hearing loss in newborns with discordant UNHS results (TEOAE refer, AABR pass).
- To analyze audiometric outcomes and risk factors in this specific infant population.
- To determine if ignoring TEOAE failures in the presence of normal AABR leads to missed diagnoses.
Main Methods:
- Retrospective analysis of newborns referred for UNHS failure between 2017-2021.
- Focus on infants who failed TEOAE but passed AABR screening.
- Analysis of clinical characteristics and audiometric outcomes at 1-year follow-up.
Main Results:
- 23% of referred infants (253/1095) had TEOAE failure with AABR pass.
- At follow-up, 21% had permanent hearing loss (HL), and 38% had HL due to middle ear effusion (MEE).
- Permanent HL was predominantly mild (78%); risk factors showed a stronger association with HL in this group.
Conclusions:
- Discordant TEOAE refer/AABR pass results in newborns are linked to significant hearing impairment rates.
- Follow-up is essential for infants with this screening profile.
- The presence of risk factors amplifies the likelihood of hearing issues in these infants.
