title: External and middle ear effects on infant hearing screening test results.
abstract: This study investigated the relationship between external and middle ear factors and hearing screening results by automated auditory brain stem response (ABR) and transient-evoked otoacoustic emissions (EOAEs). The ears of 200 healthy newborns aged 5 to 48 hours underwent screening by ABR and EOAE, followed by otoscopic examination. The pass rates for ABR and EOAE were 91% and 58.5%, respectively. On otoscopic examination, 28% (112/400) ears had occluding vernix obscuring the view of the tympanic membrane. Cleaning of vernix was successfully performed in all but 2 ears that had occluding vernix. Cleaning of vernix significantly increased the pass rates of all 400 ears for ABR and EOAE to 96% and 69%. Decreased tympanic membrane mobility was found in 22.7% (90/396) of ears that were evaluated otoscopically. Decreased tympanic membrane mobility had a significant effect on EOAE screening; only 33.4% of ears passed EOAE testing. Decreased tympanic membrane mobility did not significantly affect pass rates for ABR screening; 95% of these ears passed the automated ABR screen. Implications for newborn hearing screening are discussed.
authors.affiliation: University of California Irvine Medical Center, CA, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Doyle
authors.forename: P
authors.initials: P
authors.lastname: Rodgers
authors.forename: S
authors.initials: S
authors.lastname: Fujikawa
authors.forename: E
authors.initials: E
authors.lastname: Newman
mesh_terms: D002571:Cerumen; D016057:Evoked Potentials, Auditory, Brain Stem; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening; D010034:Otitis Media with Effusion / Q000503:physiopathology*; D017084:Otoacoustic Emissions, Spontaneous; D014432:Tympanic Membrane / Q000502:physiology