Identification of hearing loss in newborns by transient otoacoustic emissions

Objective: More than 90% of congenital hearing loss cases are of cochlear origin. There are two methods for newborn hearing screening: the transient otoacoustic emission (TEOAE) or auditory brainstem response (ABR) screening. When TEOAE is used for hearing screening patients, newborn with a neural hearing loss are not discovered. Materials: In the present study TEOAEs were obtained from 3048 newborns from both ears in patients with and without risk factors for hearing loss in the history. All newborns who did not pass TEOAE in the 2nd screening (uni or bilaterally) underwent additional audiologic tests. Results: In the first screening 150 (4.5%) of the newborns newborn did not pass the screening and 30 (0.98%) did not pass in the second screening. In nine newborns with unilateral absent TEOAE and in two newborns a deafness was confirmed, with one side cochlear and on the other side retrocochlear. Both patients received cochlear implants before the 2nd year of age. In 21 newborns with absent TEOAE bilaterally, five had moderate sensorineural hearing loss bilaterally and in nine patients profound hearing loss (90-100 dB) or deafness was confirmed. Of 3048 newborns there were 1355 with a risk of hearing loss and in 12 (0.88%) newborns bilateral hearing loss or deafness was confirmed; of the 1663 newborns without risk of hearing loss in the history, in four (0.24%) newborn deafness or bilateral sensorineural hearing loss in the range of 45-65 dB were confirmed. Conclusion: When the newborn has an absent TEOAE uni or bilaterally, we need to inform the parents and to recommend additional screening and other audiologic tests to confirm or exclude hearing loss. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.