Infant hearing screening with distortion product otoacoustic emissions in the intermediate care nursery

This study investigated the performance of distortion product otoacoustic emissions (DPOAE) as a hearing screening tool for hearing impairment in the intermediate neonatal intensive care nursery (NICU) population and environment. The focus of the study was to evaluate the specificity of DPOAE. Forty infants admitted to the intermediate NICU were tested at bedside. Thirty-two of the forty infants were at risk for hearing impairment. DPOAE results were compared with a gold standard, auditory brainstem response (ABR) threshold.; DPOAE were analyzed from 1000 through 8000 Hz. The responses were further analyzed by octave and by groups of octaves. The pass/fail results of these analyses were compared with ABR results. A repeatable wave V at 35 dB nHL was required to pass the ABR. Two of the forty infants failed ABR, yielding a 5% failure rate. When DPOAE from 1000 through 8000 Hz were compared to ABR, specificity was 34.2%. Excluding data for the highest octave and analyzing DPOAE from 1000 through 4000 Hz increased the specificity to 86.8%. Analyzing only the second octave of DPOAE (2000 through 4000 Hz) further increased the specificity to 97.3%. This analysis, however, also yielded one apparent false negative screening outcome. Repeatability analysis of DPOAE showed low repeatability between consecutive runs on the same infant. Analysis of test time indicated that test time was shorter for DPOAE than for ABR screening.; The results of this study indicate that interpretable DPOAE data, with a failure rate as low as 5%, can be recorded for a 1000 through 4000 Hz frequency region in the intermediate NICU population and environment. In this setting, DPOAE screening is likely to be quicker than ABR screening. DPOAE have much potential for implementation as an acceptable method of infant hearing screening.