Hearing screening using auditory steady state responses obtained by simultaneous air- and bone-conduction stimuli.
OBJECTIVE
Minimising false positives rates is an important goal of universal newborn hearing screening programmes. An adequate way for reaching that goal could be differentiating between transient conductive hearing losses (false positives) and permanent sensorineural hearing impairments (true positives) by means of a methodology that studies electrophysiological responses obtained using both air- and bone-conduction stimuli. Our objective was to evaluate the efficiency of an automated hearing screening test based on auditory steady state responses obtained using simultaneous air- and bone-conduction stimuli.


METHODS
A sample of 80 high risk babies lees than 2 months of born were screened using the automatic screening test. A confirmatory clinical and electrophysiological evaluation was used as the gold standard.


RESULTS
The estimated diagnostic efficiency of this screening test was equivalent (100% sensitivity and 97.7% specificity) to the efficiency reported for otoacoustic emissions and automated auditory brainstem responses. The introduction of bone conduction in the screening reduced the false positive rate from 13.3% to 2.2%. The test duration was 5.3 (± 1.9)min. In 34% of babies only one repetition of the test was needed to raising the result.


CONCLUSIONS
The screening test performed quite well in this initial clinical trial, differentiating transient conductive hearing losses from permanent neurosensory impairments and improving the diagnostic efficiency of auditory steady state responses.
Departamento de Audición y Lenguaje, Centro de Neurociencias de Cuba, La Habana, Cuba. Electronic address: eleina.mijares@cneuro.edu.cu.
Eleina
E
Mijares
Departamento de Neurofisiología, Hospital Pediátrico William Soler, La Habana, Cuba.
Lidia
L
Báez
Departamento de Neurofisiología, Hospital Pediátrico William Soler, La Habana, Cuba.
Licer
L
Cabrera
Departamento de Audición y Lenguaje, Centro de Neurociencias de Cuba, La Habana, Cuba.
María C
MC
Pérez-Abalo
Departamento de Audición y Lenguaje, Centro de Neurociencias de Cuba, La Habana, Cuba.
Alejandro
A
Torres-Fortuny
D000161:Acoustic Stimulation; D000388:Air; D001331:Automation; D001844:Bone Conduction; D016057:Evoked Potentials, Auditory, Brain Stem; D005188:False Negative Reactions; D005189:False Positive Reactions; D006314:Hearing Loss, Conductive / Q000151:congenital / Q000175:diagnosis; D006319:Hearing Loss, Sensorineural / Q000151:congenital / Q000175:diagnosis; D006320:Hearing Tests / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity
Auditory steady state responses; Bone conduction; Cribado auditivo; Estimulación simultánea; Hearing screening; Potenciales evocados auditivos de estado estable; Simultaneous stimulation; Vía ósea