Diagnostic Accuracy of Distortion Product Otoacoustic Emissions (DPOAE) and Transient Evoked Otoacoustic Emissions (TEOAE) in High Risk Newborn: A Comparative Study

Abstract

Introduction: Hearing impairment is one of the commonest congenital disabilities in the world. Early diagnosis is essential to minimize or to prevent the disability. There are many screening methods and protocols for newborn hearing screening. TEOAE has high sensitivity and less time consuming than DPOAE. DPOAE is highly specific but more time consuming than TEOAE. This study aims to compare the accuracy of DPOAE and TEOAE by using ABR evaluation on high risk newborn. Methods: This study was conducted on 1000 high risk newborns admitted to SCBU, CWH (Mandalay). Cases were selected with inclusion and exclusion criteria. The newborns after day 3 were screened with both DPOAE and TEOAE tests on every Monday, Wednesday and Friday. All included newborns underwent ABR confirmation at ENT Department, EENT Hospital (Mandalay). Result: For the 1000 left ears, DPOAE yielded 787 ‘pass’ and 213 ‘refer’. For the 1000 right ears, DPOAE yielded 776 ‘pass’ and 224‘refer’. For the 1000 left ears, 737 had passed TEOAE and 263 were not passed the test. For the 1000 right ears, 752 had passed TEOAE and 248 were referred. Sensitivity of DPOAE is 97.57% and specificity is 95.39%.False positive rate is 4.60% and false negative rate is 2.42%. Sensitivity of TEOAE is 96.49% and specificity is 90.60%. False positive rate is 9.39% and false negative rate is 3.50%. Conclusion: It can be concluded that TEOAEs are useful for universal newborn hearing screening because it has short duration with acceptable accuracy and DPOAEs are useful for high-risk neonates as a hearing screening test because of good correlation between DPOAE and threshold of wave V of ABR.