EVALUATION OF AUTOMATED AUDITORY BRAINSTEM RESPONSE AND OTO ACOUSTIC EMISSIONS IN NEONATAL HEARING SCREENING IN NICU NEONATES VERSUS WELL BORN NEONATES

Document Type : Original Article

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Abstract

Background: Universal neonatal hearing screening (UNHS) has been implemented in countries all over the world to detect neonates with congenital hearing loss early and provide appropriate intervention in time. Therefore, it is extremely important to find a convenient and effective screening protocol to identify precisely all newborns with hearing loss. This study mainly explored the effectiveness of ATEOAEs and AABR as first screening tool in risky and non-risky neonates.
Aim of the work: To compare performing time, referral rates, sensitivity and specificity of ATEOAEs and AABR as a screening tool in Neonatal Intensive Care Unit (NICU) and Well-Infant Nursery (WIN) and to identify obstacles against each screening tool.
Patient and Methods:510 neonates were recruited from Neonatal Intensive Care Unit (NICU) and Obstetrics & Gynecology maternity hospital in Ain Shams University Hospital. All neonates were screened by Automated Transient Evoked Oto-Acoustic Emissions (ATEOAEs) and Automated Auditory Brain stem Response (AABR) tests in first hearing screening, and those failed any test were scheduled for retest after one week. Failed neonates were assessed by diagnostic ABR. The results of ATEOAEs and AABR were compared among the NICU and Well Born Neonates (WBN) groups. The time spent on screening by each tool was recorded, validity and referral rates were calculated.
Results: AABR resulted in more pass and less refer outcome, with highly statistically significant difference in referral rates between ATEOAEs & AABR after first and second screening tests in both well born and NICU groups (P<0.001). As regards the total test time (including setting time plus the actual testing time), AABR test had significantly shorter total test time compared to ATEOAEs for both well born and NICU neonates. AABR was more valid than ATEOAEs in neonatal hearing screening in NICU neonates with higher sensitivity and specificity.
Conclusions: AABR is more sensitive and specific than ATEOAEs in diagnosis of hearing loss in NICU neonates, and with the newly developed technologies (BERAphone), screening test is cost effective than ATEOAEs due to significantly lower referral rate. So AABR is the screening test of choice for high risk NICU neonates.

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Ain Shams Medical Journal
Volume 73, Issue 3
September 2022
Pages 557-569

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