Ngui Ling Xiu, Tang Ing Ping, Prepageran Narayanan, Lai Zhun Wieng
Department of ORL-HNS, University Malaya, Malaysia; Department of ORL-HNS, Sarawak General Hospital, Malaysia.
Department of ORL-HNS, Sarawak General Hospital, Malaysia; Department of ORL-HNS, University Malaysia Sarawak, Malaysia.
Int J Pediatr Otorhinolaryngol. 2019 May;120:184-188. doi: 10.1016/j.ijporl.2019.02.045. Epub 2019 Feb 27.
Congenital hearing loss is one of the commonest congenital anomalies. Neonatal hearing screening aims to detect congenital hearing loss early and provide prompt intervention for better speech and language development. The two recommended methods for neonatal hearing screening are otoacoustic emission (OAE) and automated auditory brainstem response (AABR).
To study the effectiveness of distortion product otoacoustic emission (DPOAE) and automated auditory brainstem response (AABR) as first screening tool among non-risk newborns in a hospital with high delivery rate.
A total of 722 non-risk newborns (1444 ears) were screened with both DPOAE and AABR prior to discharge within one month. Babies who failed AABR were rescreened with AABR ± diagnostic auditory brainstem response tests within one month of age.
The pass rate for AABR (67.9%) was higher than DPOAE (50.1%). Both DPOAE and AABR pass rates improved significantly with increasing age (p-value<0.001). The highest pass rate for both DPOAE and AABR were between the age of 36-48 h, 73.1% and 84.2% respectively. The mean testing time for AABR (13.54 min ± 7.47) was significantly longer than DPOAE (3.52 min ± 1.87), with a p-value of <0.001.
OAE test is faster and easier than AABR, but with higher false positive rate. The most ideal hearing screening protocol should be tailored according to different centre.
先天性听力损失是最常见的先天性异常之一。新生儿听力筛查旨在早期发现先天性听力损失，并提供及时干预以促进更好的言语和语言发育。推荐的两种新生儿听力筛查方法是耳声发射（OAE）和自动听性脑干反应（AABR）。
研究畸变产物耳声发射（DPOAE）和自动听性脑干反应（AABR）作为高分娩率医院非高危新生儿首次筛查工具的有效性。
共有722名非高危新生儿（1444耳）在出院前1个月内同时接受了DPOAE和AABR筛查。AABR筛查未通过的婴儿在1月龄内接受AABR±诊断性听性脑干反应测试的再次筛查。
AABR的通过率（67.9%）高于DPOAE（50.1%）。DPOAE和AABR的通过率均随年龄增长而显著提高（p值<0.001）。DPOAE和AABR的最高通过率均在36 - 48小时之间，分别为73.1%和84.2%。AABR的平均测试时间（13.54分钟±7.47）显著长于DPOAE（3.52分钟±1.87），p值<0.001。
OAE测试比AABR更快、更容易，但假阳性率更高。最理想的听力筛查方案应根据不同中心进行定制。
