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Distortion-product and click-evoked otoacoustic emissions of preterm and full-term infants
J Smurzynski1, M D Jung, D Lafreniere
1Department of Surgery, University of Connecticut Health Center, Farmington.
Insights
This study shows that otoacoustic emissions tests are feasible for assessing hearing in preterm infants. Both click-evoked (CEOEs) and distortion-product (DPOEs) otoacoustic emissions effectively identify hearing issues in newborns.
Area of Science:
- Neonatal audiology
- Otoacoustic emissions
- Hearing screening
Background:
- Newborn hearing screening is crucial for early detection of hearing loss.
- Otoacoustic emissions (OAEs) are a non-invasive method for assessing cochlear function.
- Preterm infants represent a high-risk group for hearing impairment.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of click-evoked otoacoustic emissions (CEOEs) and distortion-product otoacoustic emissions (DPOEs) for hearing assessment in preterm infants.
- To compare the performance of CEOEs and DPOEs in identifying hearing deficits in this population.
- To investigate the correlation between OAE measures and auditory brainstem response (ABR) in preterm infants.
Main Methods:
- CEOEs and DPOEs were recorded from preterm infants and compared to normative data from full-term newborns.
- A fail criterion based on root-mean-square (RMS) levels in half-octave bands was established.
- Auditory brainstem response (ABR) was used as a gold standard for auditory assessment in a subset of infants.
Main Results:
- A significant percentage of preterm infants passed both DPOE (68%) and CEOE (80%) tests, indicating normal cochlear function.
- A notable proportion of infants who passed OAE tests still exhibited OAE levels above the 90th percentile of full-term newborns.
- CEOE demonstrated higher specificity (86%) compared to DPOE (74%) when correlated with ABR results.
- All infants who failed ABR also failed OAE tests.
Conclusions:
- CEOEs and DPOEs are feasible and valuable tools for hearing screening in preterm infants.
- Combined use of CEOEs, DPOEs, and ABR provides a comprehensive approach to neonatal hearing assessment.
- These OAE measures can aid in the early identification of hearing loss in high-risk preterm populations.
Abstract:
Full-term and preterm infants were evaluated with click-evoked and distortion-product otoacoustic emissions (CEOEs and DPOEs). The CEOEs and DPOEs recorded from each individual ear were analyzed by calculating the root-mean-square levels within half-octave bands. The fail criterion of the OE tests was that the half-octave RMS DPOE or CEOE levels of an ear under test were below the 10th percentile of full-term newborns in two or more bands. The DPOE data were collected from 118 ears of 61 premature babies; 80 (68%) ears passed the DPOE test, 30 (25%) ears without middle ear effusions failed the test, and 8 (7%) ears with effusions also failed. The CEOE data were collected from 128 ears of 65 premature babies; 102 (80%) ears passed the CEOE test, 18 (14%) ears without middle ear effusions failed the test, and 8 (6%) ears with effusions also failed. In 23 of 80 ears (29%) that passed the DPOE test and in 23 of 102 ears (23%) that passed the CEOE test, RMS OE levels of preterm infants were above the 90th percentile of full-term newborns. The analyses of the combined DPOE and CEOE data obtained from a group of 25 ears of full-term newborns and from a group of 72 ears of preterm babies showed statistically significant correlations between the DPOE and CEOE root-mean-square levels in each of the half-octave bands in the 1.4 to 4 kHz region. For 42 preterm infants tested with auditory brain stem response (ABR), specificity was 86% for CEOE and 74% for DPOE. All infants who failed the ABR also failed OE tests. To the best of our knowledge, this study is the first using combined DPOEs, CEOEs, and ABRs for preterm babies. It showed the feasibility of DPOEs and CEOEs for this population.
