title: The performance of distortion product otoacoustic emissions and automated auditory brainstem response in the same ear of the babies in neonatal unit.
abstract: OBJECTIVE
  To identify the outcomes of hearing screening using different protocols of both Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR) tests in the same ear of the babies in a neonatal unit population.
  
  
  METHODS
  A cross-sectional study was carried out on babies who were admitted into a neonatal unit. By using a formula of single proportion and considering 20% drop out, the number of sample required was 114. The subjects were chosen by using a systematic random sampling. The infants selected were subjected to DPOAE followed by AABR tests screening at the same setting before discharge.
  
  
  RESULTS
  There were 73 newborns (61.6% male and 38.4% female) participated in this study with a total of 146 ears screened. Ototoxic medication was the most common risk factor followed by hyperbilirubinaemia and low birth weight. AABR had higher passing rate (82.9%) as compared to DPOAE (77.4%). The highest passing rate was achieved if the protocol of either passed DPOAE or AABR was used (90.4%). The rate was lower when auditory neuropathy spectrum disorder (ANSD) has been considered (82.9%). Hyperbilirubinaemia, prematurity, craniofacial malformation and ototoxic drugs seem to be the high risk factors for auditory neuropathy.
  
  
  CONCLUSIONS
  AABR has a higher passing rate as compared to DPOAE. However, the use of both instruments in the screening process especially in NICU will be useful to determine the infants with ANSD who may need different approach to management. Therefore, a protocol in which newborns are tested with AABR first and then followed by DPOAE on those who fail the AABR is recommended.
authors: School of Health Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
authors: Siti Noor Hidayah
authors: SN
authors: Abdul Wahid
authors: Mohd Khairi
authors: MK
authors: Md Daud
authors: Dinsuhaimi
authors: D
authors: Sidek
authors: Normastura
authors: N
authors: Abd Rahman
authors: Suzana
authors: S
authors: Mansor
authors: Mohamad Normani
authors: MN
authors: Zakaria
mesh_terms: D001300:Audiometry, Evoked Response / Q000379:methods*; D003430:Cross-Sectional Studies; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*