Transitory evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) outcomes from a three-stage newborn hearing screening protocol.

Objective: Comparison of the efficacy of Transitory Evoked Otoacoustic Emissions (TEOAEs) and Distortion Product Otoacoustic Emissions (DPOAEs) in a neonatal hearing screening protocol, based on a three-stage strategy. Methods: In the first stage, a hearing screening using both evoked emissions was conducted in 3,480 neonates from March 2006 through January 2012. Both TEOAEs and DPOAEs were recorded. Neonates, who did not undergo the test before being discharged, were examined within 30 days at a scheduled appointment. Follow-up of the referred newborns (second-stage screening) was performed as an outpatient re-screening, within a month. The third-stage evaluation, i.e., the diagnostic testing, included a clinical otolaryngological examination, high-frequency tympanometry at 1,000 Hz and Auditory Brainstem Response (ABR) measurements. Results: A total of 3,480 (97%) newborns (n = 1,765 males) out of 3,595 infants were enrolled in the study. In the first-stage evaluation, 8.9 % of the infants were referred according to TEOAEs, while the percentage of the referred infants for DPOAEs was 25.7 %. At this initial assessment stage, the specificity of TEOAES and DPOAEs were determined as 92% and 75%, while positive predictive values (PPV) were 3.8 % and 1.3 %, respectively. In the second stage of evaluation, the specificity of TEOAES and DPOAEs were 86 % and 76 %, while the PPV increased to 18 % and 15 %, respectively. Conclusions: With a lower follow-up rate, TEOAEs testing was significantly easier to perform and more reliable compared to the DPOAEs test. Hippokratia 2016, 20(2): 104-109