Abstract
Both distortion product otoacoustic emission (DPOAE) and automated auditory brainstem response (AABR) are widely used to screen newborn hearing. AABR is considered to have high accuracy and give very few false-negative errors (sensitivity of nearly 100%), but theoretically both tests may fail to identify congenital hearing loss. A small number of hearing-impaired infants may be missed because they have low-frequency hearing loss, and auditory neuropathy cannot be detected by DPOAE screening. We investigated the profiles of false negatives in these screening procedures. Thirteen cases passing DPOAE screening had serious hearing loss: 9 with auditory neuropathy, 2 with cochlear nerve deficiency, 1 with a brainstem disorder, and 1 with moderate hearing loss. Three cases passing AABR screening had serious hearing loss: 1 with unilateral profound hearing loss and 2 with inner ear anomaly (Mondini dysplasia). The false-negative error in newborn hearing screening must be kept to a minimum because it may be associated with delayed development and socioeconomic consequences. If only one ear fails the initial screening test, an audiologic assessment of both ears is recommended. ABR screening is preferred for infants admitted to the NICU who are at risk of neural hearing loss.
