title: A two-step scenario for hearing assessment with otoacoustic emissions at compensated middle ear pressure (in children 1-7 years old).
abstract: OBJECTIVE
  Otoacoustic emissions (OAEs) are widely used for assessing congenital and early-acquired sensorineural hearing loss in young children. Middle ear pathology has a negative effect on the presence of OAEs. In this study we investigated whether measuring OAEs at compensated middle ear pressure (CMEP) resulted in a higher pass rate than at ambient pressure. Secondly, we analysed the influence of 12 different pass definitions on the pass rates.
  
  
  METHODS
  One hundred and eleven children (age 1-7 years, mean 4 years and 5 months) were measured twice in one session: first at ambient pressure and then at CMEP.
  
  
  RESULTS
  The study showed a higher pass rate of OAEs at CMEP than at ambient pressure. A two-step scenario reduced the number of fails by 18-26%, depending on the pass/fail definition used.
  
  
  CONCLUSIONS
  Measuring OAEs at CMEP results in higher pass rates. Secondly, pass/fail definitions have a large influence on pass rates and this issue deserves further attention. Further studies must be done, before this method is readily applicable to universal neonatal screening.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Maastricht, The Netherlands. jhof@skno.azm.nl
authors.forename: J R
authors.initials: JR
authors.lastname: Hof
authors.forename: P van
authors.initials: Pv
authors.lastname: Dijk
authors.forename: M N
authors.initials: MN
authors.lastname: Chenault
authors.forename: L J C
authors.initials: LJ
authors.lastname: Anteunis
mesh_terms: D000158:Acoustic Impedance Tests / Q000379:methods*; D001299:Audiometry; D001309:Auditory Threshold / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004432:Ear, Middle / Q000503:physiopathology*; D006314:Hearing Loss, Conductive / Q000503:physiopathology; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D011312:Pressure