Absent or Elevated Middle Ear Muscle Reflexes in the Presence of Normal Otoacoustic Emissions: A Universal Finding in 136 Cases of Auditory Neuropathy/Dys-synchrony

2005 ◽  
Vol 16 (08) ◽  
pp. 546-553 ◽  
Author(s):  
Charles I. Berlin ◽  
Linda J. Hood ◽  
Thierry Morlet ◽  
Diane Wilensky ◽  
Patti St. John ◽  
...  
Keyword(s):  
Middle Ear ◽  
Otoacoustic Emissions ◽  
Hearing Screening ◽  
Auditory Neuropathy ◽  
The Other ◽  
Frequency Bands ◽  
Behavioral Audiogram ◽  
Muscle Reflex ◽  
Muscle Reflexes

We extracted a subpopulation of 136 patients (from our database of 257 AN/AD subjects) in whom middle ear muscle reflexes had been measured. None showed normal reflexes at all frequencies tested. Only three subjects showed any reflexes at 95 dB HL or below, but never at both 1 and 2 kHz in both ears whether ipsilaterally or contralaterally elicited. All the other reflex measures in these remaining 133 patients were either absent or observed above 100 dB HL, which is incongruous with their normal otoacoustic emissions throughout the frequency bands.Therefore, we urge colleagues to test ipsilateral middle ear muscle reflex at least at 1 kHz and 2 kHz in any perinatal hearing screening that depends solely on otoacoustic emissions. If the emissions are present and the reflexes are absent or elevated, an ABR may be required to properly intervene, because the management of AN/AD patients often differs drastically from what the behavioral audiogram or the ABR suggest.

Newborn Hearing Screening with Combined Otoacoustic Emissions and Auditory Brainstem Responses

2004 ◽  
Vol 15 (06) ◽  
pp. 414-425 ◽  
Author(s):  
James W. Hall ◽  
Steven D. Smith ◽  
Gerald R. Popelka
Keyword(s):  
Auditory Brainstem Response ◽  
Otoacoustic Emissions ◽  
Auditory Brainstem ◽  
Hearing Screening ◽  
Auditory Neuropathy ◽  
Diagnostic Evaluation ◽  
Auditory Brainstem Responses ◽  
Conductive Loss ◽  
Brainstem Response ◽  
Screening Measures

Accurate assessment of neonatal hearing screening performance is impossible without knowledge of the true status of hearing, a prohibitive requirement that necessitates a complete diagnostic evaluation on all babies screened. The purpose of this study was to circumvent this limitation by integrating two types of screening measures obtained near simultaneously on every baby. Peripheral auditory function was defined by otoacoustic emission results. A complete diagnostic evaluation was performed on every baby who received a "Refer" outcome for auditory brainstem response screening. The integrated results for auditory brainstem response screening in an unselected group of 300 newborns estimated sensitivity at 100%, specificity at 99.7%, overall referral rate at 2.0%, and a positive predictive value of 83.3%. Conductive loss associated with amniotic fluid in the middle ear can persist several weeks after birth; conductive loss can produce a "Refer" outcome for auditory brainstem response screening; and auditory neuropathy can be detected with screening measures. Prevalence results were consistent with the published literature. The implications of this study are that otoacoustic emissions and auditory brainstem measures provide much more information than either alone and that both are needed for a comprehensive hearing screening program.

External and middle ear effects on infant hearing screening test results

2000 ◽  
Vol 122 (4) ◽  
pp. 477-481 ◽  
Author(s):  
Karen Jo Doyle ◽  
Paula Rodgers ◽  
Sharon Fujikawa ◽  
Erin Newman
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Otoacoustic Emissions ◽  
Hearing Screening ◽  
Pass Rates ◽  
Auditory Brain Stem Response ◽  
Membrane Cleaning ◽  
Auditory Brain Stem ◽  
Newborn Hearing ◽  
Otoscopic Examination

This study investigated the relationship between external and middle ear factors and hearing screening results by automated auditory brain stem response (ABR) and transient-evoked otoacoustic emissions (EOAEs). The ears of 200 healthy new-borns aged 5 to 48 hours underwent screening by ABR and EOAE, followed by otoscopic examination. The pass rates for ABR and EOAE were 91% and 58.5%, respectively. On otoscopic examination, 28% (112/400) ears had occluding vernix obscuring the view of the tympanic membrane. Cleaning of vernix was successfully performed in all but 2 ears that had occluding vernix. Cleaning of vernix significantly increased the pass rates of all 400 ears for ABR and EOAE to 96% and 69%. Decreased tympanic membrane mobility was found in 22.7% (90/396) of ears that were evaluated otoscopically. Decreased tympanic membrane mobility had a significant effect on EOAE screening; only 33.4% of ears passed EOAE testing. Decreased tympanic membrane mobility did not significantly affect pass rates for ABR screening; 95% of these ears passed the automated ABR screen. Implications for newborn hearing screening are discussed.

Neonatal Hearing Screening with Otoscopy, Auditory Brain Stem Response, and Otoacoustic Emissions

1997 ◽  
Vol 116 (6) ◽  
pp. 597-603 ◽  
Author(s):  
Karen Jo Doyle ◽  
Barbara Burggraaff ◽  
Sharon Fujikawa ◽  
Ju Kim ◽  
Carol J. Macarthur
Keyword(s):  
Brain Stem ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Otoacoustic Emissions ◽  
Hearing Screening ◽  
Pass Rates ◽  
Auditory Brain Stem Response ◽  
Auditory Brain Stem ◽  
Brain Stem Response ◽  
Otoscopic Examination

A study was performed to investigate the relationship between external and middle ear factors and hearing screening results by auditory brain stem response (ABR) and transient evoked otoacoustic emissions (EOAEs). The ears of 200 well newborns aged 5 hours to 48 hours underwent screening by ABR and EOAEs, followed by otoscopic examination. The pass rates for ABR and EOAE screening were 88.5% and 79%, respectively. On otoscopic examination, 13% (53 of 400) ears had occluding vernix obscuring the view of the tympanic membrane. Cleaning of vernix was attempted in ears that failed ABR or EOAE screening. Seventeen ears that failed ABR were cleaned, and 12 (71%) of them passed repeat ABR. Thirty-three ears that failed EOAE screening were cleaned, and 22 (67%) of them passed repeat emissions testing. Cleaning vernix increased the pass rates for ABR and EOAE screening to 91.5% and 84%, respectively. Decreased tympanic membrane mobility was found in 9% of ears that could be evaluated otoscopically. Increased failure rates for both ABR and EOAE screening were found in infant ears with decreased tympanic membrane mobility, but significance testing could not be performed because of inadequate sample size. Prevalence of occluding external canal vernix and middle ear effusion as a function of increasing infant age were studied. Implications for newborn hearing screening are discussed.

Identification of Otitis Media with Effusion in Children

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 190-195 ◽  
Author(s):  
Erdem I. Cantekin ◽  
Sylvan E. Stool ◽  
Charles D. Bluestone ◽  
Quinter C. Beery ◽  
Thomas J. Fria ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Diagnostic Method ◽  
Otitis Media With Effusion ◽  
Diagnostic Value ◽  
The Other ◽  
Other Hand ◽  
Muscle Reflex

In an effort to establish the diagnostic value of otoscopy, tympanometry, and the middle ear (ME) muscle reflex in the identification of otitis media with effusion (OME), the diagnostic findings by these three methods were compared with the findings at myringotomy in 333 children (599 ears). The study showed that even experienced clinicians had some difficulty in identifying those ears with effusion (sensitivity) and had even greater difficulty in making a diagnosis of those ears without an effusion (specificity). However, tympanometry, employing patterns that have been validated with myringotomy findings, was found to be more accurate. On the other hand, assessment of the ME muscle reflex as a diagnostic method was unacceptable due to an extremely low specificity (52%). An algorithm derived from the combination of the three methods had highest sensitivity (97%) and specificity (90%).

Wideband Power Reflectance and Power Transmittance as Tools for Assessing Middle-Ear Function

2008 ◽  
Vol 18 (2) ◽  
pp. 44-57 ◽  
Author(s):  
Patricia S. Jeng ◽  
Jont B. Allen ◽  
Judi A. Lapsley Miller ◽  
Harry Levitt
Keyword(s):  
Middle Ear ◽  
Otoacoustic Emissions ◽  
Power Flow ◽  
Acoustic Power ◽  
Hearing Screening ◽  
Flow Measurements ◽  
Case Examples ◽  
Screening Programs ◽  
Adults And Children ◽  
Infants And Young Children

Abstract Hearing screening programs using otoacoustic emissions can have high false positive rates, due to temporary middle-ear and outer-ear disorders. This is especially the case for newborns, infants, and young children. Standard tympanometry is limited, uncomfortable, and unreliable in young ears. By incorporating wideband acoustic power flow measurements into hearing screening (using the same equipment), middle-ear and outer-ear disorders can be detected, thus allowing for rescreening rather than more expensive audiological referrals. Wideband acoustic power flow is described in detail and four case examples are provided for adults and children.

scholarly journals Hearing screening in schoolchildren: accuracy of different criteria used to analyze transient evoked otoacoustic emissions

Revista CEFAC ◽  
2021 ◽  
Vol 23 (6) ◽  
Author(s):  
Aryelly Dayane da Silva Nunes-Araújo ◽  
Sheila Andreoli Balen ◽  
Antonio Pereira Junior ◽  
Isabelle Ribeiro Barbosa
Keyword(s):  
Otoacoustic Emissions ◽  
Signal To Noise Ratio ◽  
Hearing Screening ◽  
Northeastern Brazil ◽  
Signal To Noise ◽  
Frequency Bands ◽  
Transient Evoked Otoacoustic Emissions ◽  
Criterion A ◽  
Noise Ratio ◽  
Transient Emissions

ABSTRACT Purpose: to compare the accuracy of different criteria used to analyze transient evoked otoacoustic emissions in schoolchildren. Methods: an accuracy study, where an audiological assessment (audiometry, logoaudiometry, tympanometry) and transient emissions were performed with 70 schoolchildren, from the first to the fifth grade of a municipal school, in Northeastern Brazil (6-14 years, 9.9 ± 2 years), with four criteria, all with signal-to-noise ratio ≥ 3 dB, being: criterion A, in all frequency bands; B, in three consecutive frequency bands; C, in three of the five non-consecutive frequency bands; D, in 2, 3 and 4 kHz. Sensitivity, specificity, accuracy and predictive values with their respective confidence intervals of 95% were analyzed. Results: criterion A showed higher sensitivity (92.31%, 95% CI: 67-98%) and lower specificity (17.35%, 95% CI: 10-29%); criterion C higher specificity (84.21%, 95% CI: 72-91%) and higher positive predictive value (52.63%; 95% CI: 51.63-54.63). Accuracy was 82.85% (95% CI 78.23-87.47) in criterion C and 70% (95% CI: 65.38-74.62) in criterion B. Conclusion: criterion C, signal-to-noise ratio ≥ 3dB in three non-consecutive frequency bands, showed the best accuracy, being considered the best choice as a criterion for the isolated use of transient emissions as a hearing screening procedure, in schoolchildren.

STUDYING THE ATTITUDES OF THE STUDENTS OF SPECIALTY "MIDWIFE" CONCERNING PERFORMING UNIVERSAL NEONATAL HEARING SCREENING

2019 ◽  
pp. 146-152
Author(s):  
Anka Nestorova ◽  
Darina A. Ivanova
Keyword(s):  
Otoacoustic Emissions ◽  
Professional Competence ◽  
Acoustic Stimulation ◽  
Hearing Screening ◽  
Impaired Hearing ◽  
Study Materials ◽  
Neonatal Hearing Screening ◽  
Screening Study ◽  
Students Attitudes ◽  
Universal Neonatal Hearing Screening

Hearing is one of the five human senses and represents the ability to perceive sounds through the hearing system. The presence of normal auditory perception is one of the prerequisites for the emergence and development of speech in children. Conducting neonatal auditory screening is part of the early neonatal screening and incorporates examining infant’s hearing shortly after birth. A screening device is used that emits very low sounds with the help of simultaneous "otoacoustic emissions" from the inner ear of this acoustic stimulation. The latest researches show that in one or two in a thousand births the child has congenital deafness or impaired hearing. Aim: To acquaint midwifery students with the implementation of universal neonatal hearing screening using information from the Trakia Electronic University. Materials and Methods: The conducted survey allows us to study students' attitudes towards the audio screening. Study materials are accessible via the Internet in our e-university. The use of digital and multimedia materials is a way of enhancing the students' professional competence and the effectiveness of the learning process.

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