Kok M R, van Zanten G A, Brocaar M P, Wallenburg H C
Department of Otorhinolaryngology/Audiology, Erasmus University, Rotterdam, The Netherlands.
Audiology. 1993 Jul-Aug;32(4):213-24. doi: 10.3109/00206099309072937.
Click-evoked oto-acoustic emissions (EOAEs) were recorded in 1036 ears of healthy newborns and in 71 normal-hearing adult ears. Newborns aged between 3 and 238 h were examined in a separate but not silent room of the obstetric ward. The adults were tested in a quiet but not sound-treated room. The recordings were more difficult in the newborn than in the adult, which was mirrored in recording parameters such as the time required for measurement (up to 7 min in newborns vs. 1-2 min in adult ears). Recording was always successful in adults, while retests were necessary in 4% of newborns. Also the artefact-rejection level and the stimulus stability were more favourable in adults. Still, EOAE recording for screening purposes in newborns seems feasible. Response levels in newborns (range 1.6-38.6; mean 20.2 dB SPL) appear to be higher than in adults (range 2.7-20.6; mean 12.8 dB SPL). The overall prevalence of EOAEs in newborns amounted to 93.4% and appeared to be age related. It rises from 78% in ears from newborns younger than 36 h to 99% in ears of newborns older than 108 h. This rise may be related to the middle ear clearance of amniotic fluid in the first days post partum. The prevalence in newborns older than 3-4 days is comparable with the prevalence of 97.2% in adults. Therefore, newborns should not be screened before the age of 4 days. In search of an objective EOAE detection variable, the prevalence of EOAEs for different age groups was calculated for various criterion values of reproducibility. These prevalences were compared to subjectively scored EOAE prevalences in the same age groups. A reproducibility criterion of about 50% appears to be useful for mass screening in newborns.
对1036例健康新生儿的耳及71例听力正常成人的耳进行了瞬态诱发耳声发射（EOAE）记录。对年龄在3至238小时之间的新生儿在产科病房一个单独但并非安静的房间内进行检查。对成人在一个安静但未进行隔音处理的房间内进行测试。新生儿的记录比成人更困难，这反映在诸如测量所需时间等记录参数上（新生儿最长达7分钟，而成人耳为1 - 2分钟）。成人记录总是成功的，而4%的新生儿需要重新测试。此外，成人的伪迹排除水平和刺激稳定性更有利。尽管如此，EOAE记录用于新生儿筛查似乎是可行的。新生儿的反应水平（范围为1.6 - 38.6；平均20.2 dB SPL）似乎高于成人（范围为2.7 - 20.6；平均12.8 dB SPL）。新生儿中EOAE的总体发生率为93.4%，且似乎与年龄有关。它从小于36小时新生儿耳中的78%升至大于108小时新生儿耳中的99%。这种上升可能与产后头几天中耳羊水的清除有关。3 - 4天以上新生儿的发生率与成人中97.2%的发生率相当。因此，不应在4天龄之前对新生儿进行筛查。为了寻找一个客观的EOAE检测变量，针对不同的可重复性标准值计算了不同年龄组EOAE的发生率。将这些发生率与同一年龄组主观评分的EOAE发生率进行了比较。约50%的可重复性标准似乎对新生儿大规模筛查有用。
