Evaluation of otoacoustic emissions and auditory brainstem responses for hearing screening of high risk infants

Aim: The objective of the present study is the assessment of otoacoustic emissions (OAEs) and auditory brainstem responses (ABRs) for hearing screening of high risk infants. Study Design: Prospective, hospital-based. Materials and Methods: Distortion product OAEs (DPOAEs) and brainstem evoked response audiometry (BERA) recordings were obtained for 30 controls and 100 infants with one or more high risk factors, in a sound treated room and the results were interpreted. ABR peak latencies, amplitudes, and waveform morphology in high risk infants were compared with those in control group. DPOAE as screening test was evaluated in terms of various parameters with BERA/ABR taken as gold standard. Results: Absolute latencies of Wave I and Wave V and interpeak latency of I-V were significantly prolonged in high risk group as compared to control group. The most common causes to contribute significantly for hearing impairment were found to be hyperbilirubinemia, birth asphyxia, meningitis/septicemia. DPOAE when compared with ABR taken as gold standard showed that sensitivity of the test was 87.7% (74.5%-94.9%) and specificity was 74.5% (60.0%-85.2%). Positive predictive value was 76.7% (63.2%-86.6%) and negative predictive value of the test was 86% (71.9%-94.3%). Positive likelihood ratio was 0.29 (0.18-0.46) and negative likelihood ratio was 6.08 (2.82-13.09). Conclusion: ABR/BERA, though highly reliable, is a tedious and time consuming test. DPOAE is a simple and rapid test with relatively higher acceptability but low sensitivity and specificity; therefore, limits its role as independent screening test. DPOAE-ABR test series is an effective way to screen all the high risk infants at the earliest.