Auditory screening in neonates by means of transient evoked otoacoustic emissions: A report of 2,842 recordings

The principal goal of-an early identification program is to identify hearin g impairment present at birth, in order to effect appropriate intervention as early as possible. Although recent research provides some evidence for t he value of transient evoked otoacoustic emissions (TEOAEs) in neonate hear ing screening, data are needed from large-scale clinical evaluations about the value of using TEOAEs for screening not only high-risk but also healthy neonates. A cohort of 1,421 neonates (2,842 ears) from the well-baby nurse ry was screened with TEOAEs in a 2-stage process. Neonates were referred fr om the first test prior to being discharged from the hospital. Those who fa iled were rescreened before the end of the first month. Those who did not p ass the second-stage TEOAE screening were referred for diagnostic audiologi cal evaluation for confirmation of hearing loss. Neonates transferred to a neonatal intensive care unit were not included in this study. Two neonates with bilateral sensorineural hearing loss of >40 dB hearing level were iden tified from this cohort. This study demonstrates the feasibility and the li mitations of using TEOAEs as a universal hearing screening tool for all neo nates. It confirms that the prevalence of hearing impairment in neonates ha s to be taken into account, even in a group of children without high-risk c riteria. In France, a prevalence of 1.4 per 1,000 would represent 1,000 dea f children born every year, with reference to about 700,000 births per year . This study suggests that such universal screening programs would substant ially increase the rate of early-identified infants with significant hearin g impairment.