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External and middle ear status related to evoked otoacoustic emission in neonates
K W Chang1, B R Vohr, S J Norton
1Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle.
Objective:
Screening auditory status prior to neonatal hospital discharge to identify newborns with severe hearing impairment is an important pediatric care priority. Evoked otoacoustic emission (OAE) testing is a quick noninvasive method. The purpose of this study was to determine the relationship between external auditory canal and middle ear status with click-evoked OAE. It was hypothesized that vernix caseosa, debris in the ear canal, and middle ear fluid contribute to the OAE fail rate.
Design:
All neonates had an initial OAE examination. A second investigator, "blinded" to the results, examined all ears otoscopically, cleaned any obstructing debris, and repeated with a second OAE test.
Setting:
All neonates were tested in a designated nursery at a mean age of 43 +/- 21 hours.
Patients:
Forty-one full-term neonates were prospectively enrolled.
Intervention:
The ear canals with debris were cleaned under direct vision with a pediatric swab dampened by an alcohol wipe.
Outcome Measure:
The primary outcome measure was the postcleaning OAE pass rate.
Results:
The preotoscopic examination pass rate of 82 ears was 76%. The OAE pass rate improved to 91% after debris removal.
Conclusions:
The results indicate that the examination and cleaning of the external ear canal are important components of the neonatal screening process.