• M C Rhodes, R H Margolis, J E Hirsch, and A P Napp.
• Northland ENT Associates, Duluth; the Department of Otolaryngology, University of Minnesota, Minneapolis, USA.
• Otolaryngol Head Neck Surg. 1999 Jun 1;120(6):799-808.

AbstractPatients in the neonatal intensive care unit were tested by hearing screening tests including auditory brain stem response (ABR), transient and distortion-product otoacoustic emissions (TEOAEs and DPOAEs), and acoustic stapedius 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 produced pass rates of about 90%. The most efficient combination was DPOAEs followed by ABR. Pass rates tended to decrease with age. Of patients who failed 226-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 failed the 1000-Hz tympanogram failed all hearing tests. Many ears were abnormal by pneumatic otoscopy but passed hearing tests, suggesting that the usual ear examination criteria may not apply to infants.

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