Evaluation of Hearing in High-risk Neonates and Children at a Tertiary Care Hospital through Otoacoustic Emissions and Auditory Brainstem Responses: A Prospective Study and Literature Review

Abstract

Objective: To evaluate otoacoustic emissions (OAE) and auditory brainstem responses (ABR) for screening hearing impairment among high-risk neonates and children and to assess sensitivity, and positive and negative predictive values of OAE in comparison with ABR.

Methods: A total of 76 children were screened including high-risk neonates and children. OAE and ABR were done simultaneously on all the study participants.

Results:  The prevalence of hearing loss among the study population was 21.05% (high-risk NICU graduates 13.6 %; high-risk children 31.25%). Among the high-risk NICU graduates, risk factors that were significantly associated with hearing loss were birth weight less than 1500g, meningitis, mechanical ventilation for more than 3 days, and TORCH infections. Among high-risk children, factors significantly associated with hearing loss were ototoxic drugs, meningoencephalitis and cerebral palsy with global developmental delay. OAE and ABR tests used simultaneously to screen high-risk study populations showed that OAE has good specificity and is thereby comparable to ABR. The overall sensitivity and specificity of OAE in comparison to ABR were 62.50% and 93.33% respectively.

Conclusion: TEOAE was found to be a simple, non-invasive, short-duration, cost-effective method and suitable for hearing screening in high risk children. However, all high-risk newborns should be screened with ABR to detect hearing loss as OAE has less sensitivity.