Hearing screening in the newborn intensive care nursery: comparison of methods.
Patients in the neonatal intensive care unit were tested by hearing screening tests including auditory brain stem response (ABR), transient and distortion-product otoacoustic emissions (TEOAEs and DPOAEs), and acoustic stapedius reflex (ASR), and by middle ear function tests including multifrequency tympanometry and pneumatic otoscopy. Pass rates on hearing tests were 75% to 89%. TEOAEs produced the lowest pass rate, and DPOAEs the highest. TEOAE, DPOAE, or ASR testing followed by ABR testing of initial failures produced pass rates of about 90%. The most efficient combination was DPOAEs followed by ABR. Pass rates tended to decrease with age. Of patients who failed 226-Hz and 678-Hz tympanometry, 30% to 67% passed hearing tests, suggesting a high false-positive rate for these immittance tests. The 3 ears that failed the 1000-Hz tympanogram failed all hearing tests. Many ears were abnormal by pneumatic otoscopy but passed hearing tests, suggesting that the usual ear examination criteria may not apply to infants.
Rhodes
M C
MC
Northland ENT Associates, Duluth; the Department of Otolaryngology, University of Minnesota, Minneapolis, USA.
Margolis
R H
RH
Hirsch
J E
JE
Napp
A P
AP
D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006320:Hearing Tests / Q000379:methods*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008403:Mass Screening / Q000379:methods; D008910:Minnesota; D017084:Otoacoustic Emissions, Spontaneous; D012189:Retrospective Studies