Screening all newborns for hearing loss using transient evoked otoacoustic emissions

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.