Neonatal hearing screening: a combined click evoked and tone burst otoacoustic emission approach.

OBJECTIVE

This study evaluated an alternative transient evoked otoacoustic emissions method for screening hearing in newborn babies that may reduce the referral rate of initial screening.

METHODS

A total of 1,033 neonates (2,066 ears) from two hospitals were recruited. Subjects had their hearing screened in both ears using a combined approach-both click evoked OAEs (CEOAEs) and 1kHz tone burst evoked OAEs (TBOAEs).

RESULTS

1kHz TBOAEs were more robust than CEOAEs in terms of emission response level and signal-to-noise ratio (SNR) at both 1 and 1.5kHz frequency bands. The prevalence rate for CEOAE and TBOAE responses in these two frequency bands was significantly different. The combined protocol significantly reduced the referral rate-by almost 2 percentage points for first time screening.

CONCLUSIONS

The implementation of a combined 1kHz TBOAE/CEOAE screening protocol is a feasible and effective way to reduce referral rates, and hence false positive rates, in neonatal hearing screening programs.