An Analysis of Hearing Screening Results from 616 Preschool Children / 听力学及言语疾病杂志

Objective To explore the feasibility and effectiveness of otoacoustic emission (OAE) in hearing screening for preschool children .Methods A total of 616 preschool children aged 3～6 (mean age 4 .6 years old) were included in this study .All the subjects received transiently evoked otoacoustic emission (TEOAE) test by trained personnel .The children who failed the hearing screening received diagnostic examination in the hearing ex-amination center .Results Of 616 children ,66 (10 .71％ ) failed the hearing screening and 16 children received audi-ological assessment .In these 16 children ,8 had otitis media with effusion (5 with mild conductive hearing loss ) ,5 had impacted cerumen ,3 had normal hearing ,and none had sensorineural hearing loss .Conclusion OAE can be used effectively in the hearing screening for preschool children .But how to improve the referral rate of children who failed the hearing screening needs further discussion .

Comparison of Transient Evoked Otoacoustic Emissions and Distortion Products Otoacoustic Emissions as the Hearing Screening Methods in the Same Population of Normal Newborns / 听力学及言语疾病杂志

Objective To compare the results of TEOAE and DPOAE in the same population of normal newborns, to provide information on choosing appropriate screening tools.Methods A two-steps protocol was taken with the first screening during the first 48 to 72 hours of birth and rescreened from one to two months old if the newborns failed the first screening.For each step of screening, TEOAE and DPOAE were performed simultaneously using AccuScreen hearing screening instrument (Madsen-GN Otometrics, Taastrup, Denmark).A total of 1 062 normal newborns (F/M=508/554) delivered in Peking Union Medical College Hospital were enrolled in this research for the first screening.Infants who failed either TEOAE or DPOAE screening in the first screening were referred to a second screening.Among them, 135 performed both DPOAE and TEOAE in the second step.The newborns who failed the second screening would receive ABR when they were 3 months old.Results In the first screening,the failure rate for TEOAE was 11.0% (117/1 062) and 13.7% (145/1 062) for DPOAE.In the second screening step, the failure rates were 17.8% (24/135) and 20.7% (28/135) for TEOAE and DPOAE, respectively.Chi-square and Fisher's test showed that the failure rates of DPOAE were significant higher than TEOAE for both steps (P<0.001).The agreements between TEOAE and DPOAE were 96.0% and 95.6% for the first and second steps respectively, and the kappa values were 0.817 and 0.857.As to the average time taken to accomplish the screening for one ear, TEOAE was 24±25 s and DPOAE was 40±34 s during the first screening;in the rescreening, TEOAE was 52±41 s and DPOAE was 73±62 s.Paired-t tests showed that the differences between DPOAE and TEOAE testing time were statistically significant (P=0.000) in both screening steps.Finally, 7 newborns (10 ears) were diagnosed conductive hearing loss(except 1 ear was sensorineural hearing loss).Conclusion As a screening tool, TEOAE got lower refer rates and took less time than DPOAE implicating TEOAE a better screening tool for normal neonates.

Role of Active Listening and Listening Effort on Contralateral Suppression of Transient Evoked Otoacousic Emissions

BACKGROUND AND OBJECTIVES: The present study aimed to investigate the effect of active listening and listening effort on the contralateral suppression of transient evoked otoacoustic emissions (CSTEOAEs). SUBJECTS AND METHODS: Twenty eight young adults participated in the study. Transient evoked otoacoustic emissions (TEOAEs) were recorded using ‘linear’ clicks at 60 dB peSPL, in three contralateral noise conditions. In condition 1, TEOAEs were obtained in the presence of white noise in the contralateral ear. While, in condition 2, speech was embedded into white noise at +3, −3, and −9 dB signal-to-noise ratio (SNR) and delivered to the contralateral ear. The SNR was varied to investigate the effect of listening effort on the CSTEOAE. In condition 3, speech was played backwards and embedded into white noise at −3 dB SNR. The conditions 1 and 3 served as passive listening condition and the condition 2 served as active listening condition. In active listening condition, the participants categorized the words in to two groups (e.g., animal and vehicle). RESULTS: CSTEOAE was found to be largest in the presence of white noise, and the amount of CSTEOAE was not significantly different between active and passive listening conditions (condition 2 and 3). Listening effort had an effect on the CSTEOAE, the amount of suppression increased with listening effort, when SNR was decreased from +3 dB to −3 dB. However, when the SNR was further reduced to −9 dB, there was no further increase in the amount of CSTEOAE, instead there was a reduction in the amount of suppression. CONCLUSIONS: The findings of the present study show that listening effort might affect CSTEOAE.

Pure tone threshoIds and Otoacoustic Emissions in PCI Patients without Hearing Loss CompIaints / 听力学及言语疾病杂志

Objective To study the audiometry and otoacoustic emissions in patients with posterior circulation ischemia(PCI) .Methods Forty patients treated by neurologists were selected as the experimental group who re_ceived pure tone audiometry ,tympanometry ,otoacoustic emissions (OAE) and distortion products otoacoustic emis_sions (DPOAE) examinations .Thirty healthy objects were chosen as the control group .The data from the PCI groups and the control group were compared using the SPSS 14 .0 software .ResuIts The difference in pure tone thresholds across 125 to 8 000 Hz between the PCI group and the control group was not statistically significant (P>0 .05) .In the PCI patients ,the prevalence of TEOAE was only 47 .5% ,significantly different from that of in the control group .The prevalence of DPOAE at 0 .5~8 kHz were between 57 .9% ~77 .6% in PCI patients ,and the amplitudes of DPOAE were reduced significantly (P<0 .05) .ConcIusion Cochlear damages can occur to patients with PCI ,especially in the high frequency range .These results suggest that OAE can be used as an important diag_nostic test for patients with PCI ,and might be helpful for the location diagnosis of PCI .

The Analysis of Neonates Hearing Screening in Neonatal Intensive Care Unit / 听力学及言语疾病杂志

Objective To analyze the hearing screening results of infants in neonatal intensive care unit (NICU).Methods TEOAEs was used to screen 3 130 newborns in the NICU between January 2008 and January 2009.102 NICU infants initially failed TEOAE screening were followed up with sedated ABR testing.Results Of the 3 130 subjects,513 infants(709 ears) failed TEOAE.102 subjects(156 ears) had experienced ABR,in which 79 cases(130 ears,83.33%) were diagnosed as hearing loss with mild hearing loss in 38 ears,moderate in 55 ears,serere in 16 ears,and perfound in 6 ears.Infants with pneumonic diseases,hyperbilirubinemia and prematurity in the NICU were at significant risk of sensorineural hearing loss.Conclusion The data indicates that NICU neonates have a high incidence of abnormal hearing status.Pneumonic diseases,hyperbilirubinemia and prematurity are the high risk factors in the NICU population.

Results and Cost-Effectiveness of Newborn Hearing Screening Program in Ajou University Hospital / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is estimated that more than 2 in every 1,000 neonates suffers from hearing loss. Early detection with appropriate rehabilitation of congenital hearing loss can reduce the adverse developmental consequences such as language delays, and behavior and attention deficits. The purpose of this study is to evaluate our newborn hearing screening program using the combined transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR), and to estimate the cost-effectiveness of our program. MATERIALS AND METHOD: 6,634 infants (5,918 well babies and 716 NICU babies) underwent the newborn hearing screening program at Ajou University Hospital for 4 years. Initially well babies were screened with TEOAEs, and those failing the TEOAEs were tested with the rescreening program. Neonates failing the TEOAE rescreening and the NICU babies were examined with ABR. The cost included personnel, fringe benefits, supplies, equipment and overhead. RESULTS: 660 (11%) out of 5,918 well babies failed the initial TEOAE screening and 27 (0.46%) babies failed the TEOAE rescreening. Eleven babies (0.16%), 3 of the well babies and 8 of the NICU babies, were confirmed to have hearing loss of more than 60 dB. We detected four deaf babies out of these eleven. From the four deaf babies, we confirmed a connexin 26-related deafness and an enlarged vestibular aqueduct syndrome. It cost $6 to screen one infant and $3,700 to detect one infant with hearing loss. CONCLUSION: We could detect 11 babies (0.16%) with hearing loss out of 6,634 neonates during the 4 years. Considering the benefits of early identification and rehabilitation of congenital hearing loss, the cost for the newborn hearing screen program is affordable. The newborn hearing screen should be extended as a national health program.

Newborn Hearing Screening: 3 Years of Experience

PURPOSE: Hearing loss is one of the most common major abnormalities present at birth, which has an incidence of 1 to 3 per 1,000 newborn infants in the well-baby nursery population, and 2 to 4 per 1,000 infants in the intensive care unit population each year. If early undetected, will impede speech and language. The purpose of this study was to confirm in prevalence of neonatal hearing loss and to establish a common screening method adjusted to our country and to emphasize the importance of early detection. MATERIALS AND METHODS: TEOAE (transient evoked otoacoustic emission) were performed in 5,512 newborn infants in the well-baby nursery. The tests were performed daily until the infant had passed. Failed infants were followed at the outpatient clinic for re-tests. ABRs were performed for the confirmation of hearing loss those who had failed 3 TEOAE tests. RESULTS: The average test durations for right and left TEOAE were 67+/-50 sec and 72+/-56 sec respectively. There was no difference in test durations of the first TEOAE between before 24 hours and after 24 hours of life. 89% of tested infants passed during admission and the rest were followed at the outpatient clinic for the further studies. Eight infants were diagnosed with hearing loss on ABR. Overall time spent for the diagnosis of hearing loss was less than 3 months. CONCLUSION: TEOAE is a simple and useful screening method for the identification of hearing loss in infants. TEOAE must be necessary to universal screening of all infants.

TEOAE as a Newborn Hearing Screening / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hearing impairment is a common congenital disability of the newborn, which has an incidence of 1.5 to 3 per 1,000 infants each year. The identification of this problem is difficult and many of these children are not identified until 2-3 years of age if not screened at birth. The purpose of this study is to establish a common screening method adjusted to our country and to emphasize the importance of early diagnosis of neonatal hearing loss. MATERIALS AND METHODS: TEOAE were performed in 1,459 infants from March to December, 1998 at Ajou university hospital. The tests were performed daily until discharge if the infant had failed the first test, and were followed at the outpatient clinic. Hearing loss was confirmed by ABR. RESULTS: The average test time of TEOAE was 102.6 seconds. Test time after 24 hours of birth was shorter than before 24 hours, and was shorter in female compared to male infants. Pass rate after 24 hours was higher than before 24 hours and 86% of tested infants passed during admission. Thirty-one out of 213 infants failed to follow-up at the outpatient clinic. Two were diagnosed with unilateral hearing loss on ABR. CONCLUSION: TEOAE is a simple and useful screening method for the identification of hearing loss in infants.

Property of TEOAE and the Influence of Stimulus Intensity on Its Spectrum in Hearing - Normal Youngers / 听力学及言语疾病杂志

Transient Evoked otoacoustic emissions(TEOAE) in 25 hearing- normal youngers was analysed to study its basic character and the influences of different stimulus intensities on the amplitude and the power spectrum which may be useful to identify the hearing-loss subjects as the standardline. We find that the average amplitude of TEOAE is 5.97, 9.22, 12. 76 dB SPL under three intensities,the frequencies of the spectrum distribute from 0 to 6 000 Hz. The two maximal values are located in 1 025 Hz and 1 513 Hz seper-ately. The amplitude of TEOAE increases with the stimulus tone's growth. We conclude that it's necessary to consider completely when evaluating the patient's hearing function by TEOAE's power spectrum on account of its incontinuity and decrease in high frequency.

Transient Evoked Otoacoustic Emission in China Rural Primary School Children Hearing Screening / 听力学及言语疾病杂志

Objective To investigate the clinical meaning and feasibility of transient evoked otoacoustic emission (TEOAE) in China rural primary school children hearing screening.Methods TEOAE was recorded with Madsen Celesta 503 in 317 (634 ears) primary school children,then the results were compared with gold standard test group,including otoscopy, pure tone audiometry and tympanogram.Results In 317 (634 ears) pupils, the presence of TEOAE was 94.64% (600/634); the presence of gold standard was 94.48% (599/634). The consistency rate was (96.69?0.71)%; sensitivity (Sen) was 0.69?0.078;specificity (Spe)=0.98?0.0052, the false positive rate (FPR), that was ?, was 0.31; ? = 0.02; Youden's index J = 0.67?0.078, LR_+=34.5, LR_-=0.32, PV_+=0.71(71%),PV_-=0.98(98.%),AZ=0.8.Conclusion The TEOAE test is simple, quick, harmless, sensitive and objective. It can be used in hearing screening program in rural primary school children.