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

Abstract

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 1033 neonates (2066 ears) from two hospitals were recruited. Subjects had their hearing screened in both ears using a combined approach-both click evoked OAEs (CEOAEs) and 1 kHz tone burst evoked OAEs (TBOAEs). Results: 1 kHz TBOAEs were more robust than CEOAEs in terms of emission response level and signal-to-noise ratio (SNR) at both 1 and 1.5 kHz 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 1 kHz TBOAE/CEOAE screening protocol is a feasible and effective way to reduce referral rates, and hence false positive rates, in neonatal hearing screening programs. © 2007 Elsevier Ireland Ltd. All rights reserved.