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Screening all newborns for hearing loss using transient evoked otoacoustic emissions
Insights
Transient evoked otoacoustic emissions (TEOAEs) show promise for newborn hearing screening. This study evaluated TEOAEs in 1850 infants, identifying hearing loss and suggesting its potential for universal screening.
Area of Science:
- Audiology
- Neonatal Medicine
- Public Health
Background:
- Early identification of hearing loss in infants is critical for development.
- Transient evoked otoacoustic emissions (TEOAEs) show potential for newborn hearing screening.
- Large-scale clinical data are needed to validate TEOAEs for diverse infant populations.
Purpose of the Study:
- To evaluate the effectiveness of TEOAE screening in a large cohort of newborns.
- To determine the prevalence of hearing loss in well-baby nursery (WBN) and neonatal intensive care unit (NICU) populations using TEOAEs.
- To assess TEOAEs as a tool for universal newborn hearing screening.
Main Methods:
- A two-stage TEOAE screening process was applied to 1850 infants.
- Infants who did not pass the initial screen received a second TEOAE test before hospital discharge.
- Referrals from the second stage underwent diagnostic auditory brainstem response (ABR) and/or behavioral audiological evaluations.
Main Results:
- Eleven infants (5.95 per 1000) were diagnosed with sensorineural hearing loss (> 25 dB).
- Thirty-seven infants (20.0 per 1000) were identified with recurrent conductive hearing loss (> 25 dB).
- TEOAE screening successfully identified infants requiring further audiological assessment.
Conclusions:
- TEOAE is a viable and promising technique for screening newborns for hearing loss.
- Further evaluation of TEOAEs is recommended for implementation in universal newborn hearing screening programs.
- Early detection through TEOAEs facilitates timely intervention and management of hearing impairment.
Abstract:
The importance of identifying hearing loss before 12 months of age is well established. Although recent research provides some evidence for the value of transient evoked otoacoustic emissions (TEOAEs) in newborn hearing screening, data are needed from large-scale clinical evaluations about the value of using TEOAE for screening high-risk and healthy babies. A cohort of 1850 infants from the well-baby nursery (WBN) and neonatal intensive care unit (NICU) were screened with TEOAE using a 2-stage process. Infants referred from the first stage prior to being discharged from the hospital were rescreened 4 to 6 weeks later. Those who did not pass the second-stage TEOAE screening were referred for diagnostic auditory brainstem response (ABR) and/or behavioral audiological evaluation for confirmation of hearing loss, fitting with amplification, and enrollment in early intervention programs. Eleven infants with unilateral or bilateral sensorineural hearing loss > 25 dB (a prevalence of 5.95 per 1000) and 37 with unilateral or bilateral recurrent conductive hearing loss > 25 dB (a prevalence of 20.0 per 1000) were identified from this cohort. These results suggest that TEOAE is a promising technique for screening newborns for hearing loss and should be evaluated further as a tool for universal newborn hearing screening.