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Feasibility of otoacoustic emissions as a hearing screen following grommet insertion
H E Cullington1, B U Kumar, L M Flood
1North Riding Infirmary, Middlesbrough.
Insights
Evoked otoacoustic emissions screening after grommet insertion did not effectively identify children needing follow-up. Most children had normal hearing, indicating this test is not a reliable early discharge tool for pediatric audiology.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Hearing Science
Background:
- Grommet insertion is a common procedure for middle ear issues in children.
- Post-insertion audiological assessment is crucial to rule out sensorineural hearing impairment.
- High patient volume creates a significant workload for ENT and audiology departments.
Purpose of the Study:
- To evaluate the effectiveness of evoked otoacoustic emissions (OAEs) screening in children post-grommet insertion.
- To determine if OAEs can facilitate early hospital discharge, reducing outpatient review needs.
- To assess the utility of OAEs as a screening tool in this specific clinical context.
Main Methods:
- A prospective study involving 108 children undergoing grommet insertion.
- Evoked otoacoustic emissions screening was performed before hospital discharge.
- Results were compared with subsequent outpatient audiology review findings.
Main Results:
- Bilateral normal OAEs were detected in 32% of the children screened.
- Despite OAE results, 99% of children attending outpatient review demonstrated normal hearing sensitivity.
- Only one-third of children could potentially be discharged early based on OAE screening.
Conclusions:
- Evoked otoacoustic emissions screening immediately after grommet insertion is not an effective method for identifying children who do not require further audiological follow-up.
- The low yield of OAE screening suggests it cannot reliably obviate the need for standard outpatient review appointments.
- Current OAE screening protocols at this stage are insufficient for streamlining pediatric audiology workflows.
Abstract:
Following grommet insertion, it is important to establish that there is no underlying sensorineural hearing impairment. In this hospital, approximately 1000 grommet insertions are performed each year, thus generating a heavy workload of review appointments for ENT and audiology. The present study investigates the efficacy of performing evoked otoacoustic emissions screening on 108 children when they were ready to leave the hospital following grommet insertion. Bilateral normal otoacoustic emissions were recorded in 32% (35 children), although 99% (105) of the 106 children attending the outpatient review appointment had normal hearing sensitivity. If normal hearing thresholds were established immediately following surgery, it can be argued that this obviates the need for an outpatient review appointment; however, in this study only one-third of children could be discharged after surgery. Otoacoustic emissions therefore does not represent an effective screen at this stage.
