Newborn Auditory Screening with Automated ABR, Transient Evoked Otoacoustic Emissions TEOAEs and Conventional ABR

Abstract

The aim of this study is to validate automated ABR (AABR) with ALGO2e, using conventional signal-averaged ABR, and to compare AABR with transient evoked otoacoustic emissions (TEOAE) for a universal hearing screening. As our purpose of this screening is to identify neonates with a bilateral, permanent hearing loss, we regarded bilateral fail as “fail”.
49 full-term neonates were tested by hearing screening test, including AABR, TEOAE and conventional ABR. Successful screening in the nursery without sedation was achieved for 100% of infants by AABR, but for 97.9% by TEOAE. The specificity of AABR was 97.9% and that of TEOAE was 93.6%. We could not evaluate the sensitivity, because neonates with bilateral hearing loss were not identified in this study. The mean test duration of AABR was 6min. 27sec. and that of TEOAE was 12min. 36sec. Because of its high sensitivity and its short test duration, AABR was more suitable for newborn hearing screening than TEOAE and conventional ABR. But, if one-month-old infants are tested in a quiet room at health examination when there is no influence of debris in the ear canal and middle ear fluid, TEOAE will be suitable, too.
On comparison of AABR with cnnventional ABR, a unilateral referral ear of AABR failed conventional ABR on the same side, too. But one neonate who referred AABR passed conventional ABR. The results indicate that further analysis on the sensitivity is needed, and AABR is somewhat reliable, but there may be false-positive cases.