Hearing screening in the newborn intensive care nursery: Comparison of methods

Patients in the neonatal intensive care unit were tested by hearing screeni ng tests including auditory brain stem response (ABR), transient and distor tion-product otoacoustic emissions (TEOAEs and DPOAEs), and acoustic staped ius reflex (ASR), and by middle ear function tests including multifrequency tympanometry and pneumatic otoscopy, Pass rates on hearing tests were 75% to 89%. TEOAEs produced the lowest pass rate, and DPOAEs the highest. TEOAE , DPOAE, or ASR testing followed by ABR testing of initial failures produce d pass rates of about 90%, The most efficient combination was DPOAEs follow ed by ABR, Pass rates tended to decrease with age, Of patients who failed 2 26-Hz and 678-Hz tympanometry, 30% to 67% passed hearing tests, suggesting a high false-positive rate for these immittance tests, The 3 ears that fail ed the 1000-Hz tympanogram failed all hearing tests. Many ears were abnorma l by pneumatic otoscopy but passed hearing tests, suggesting that the usual ear examination criteria may not apply to infants.