Talk:Hearing test

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Cite this page: Hill, M.A. (2021, June 15) Embryology Hearing test. Retrieved from

10 Most Recent Papers

Note - This sub-heading shows an automated computer PubMed search using the listed sub-heading term. References appear in this list based upon the date of the actual page viewing. Therefore the list of references do not reflect any editorial selection of material based on content or relevance. In comparison, references listed on the content page and discussion page (under the publication year sub-headings) do include editorial selection based upon relevance and availability. (More? Pubmed Most Recent)

Neonatal Hearing Test

<pubmed limit=10>Neonatal Hearing Test</pubmed>

Neonatal Hearing

<pubmed limit=10>Neonatal Hearing</pubmed>


Myelin development, plasticity, and pathology in the auditory system

Dev Neurobiol. 2018 Feb;78(2):80-92. doi: 10.1002/dneu.22538. Epub 2017 Sep 26.

Long P1, Wan G2, Roberts MT1, Corfas G1.


Myelin allows for the rapid and precise timing of action potential propagation along neuronal circuits and is essential for healthy auditory system function. In this article, we discuss what is currently known about myelin in the auditory system with a focus on the timing of myelination during auditory system development, the role of myelin in supporting peripheral and central auditory circuit function, and how various myelin pathologies compromise auditory information processing. Additionally, in keeping with the increasing recognition that myelin is dynamic and is influenced by experience throughout life, we review the growing evidence that auditory sensory deprivation alters myelin along specific segments of the brain's auditory circuit. © 2017 Wiley Periodicals, Inc. Develop Neurobiol 78: 80-92, 2018. KEYWORDS: auditory; circuits; deafness; hearing; myelin PMID: 28925106 PMCID: PMC5773349 DOI: 10.1002/dneu.22538

Development of a Diagnostic Prediction Model for Conductive Conditions in Neonates Using Wideband Acoustic Immittance

Ear Hear. 2018 Mar 3. doi: 10.1097/AUD.0000000000000565. [Epub ahead of print]

Myers J1,1, Kei J1, Aithal S1,1, Aithal V1,1, Driscoll C1, Khan A1, Manuel A1, Joseph A1, Malicka AN1,1.


OBJECTIVES: Wideband acoustic immittance (WAI) is an emerging test of middle-ear function with potential applications for neonates in screening and diagnostic settings. Previous large-scale diagnostic accuracy studies have assessed the performance of WAI against evoked otoacoustic emissions, but further research is needed using a more stringent reference standard. Research into suitable quantitative techniques to analyze the large volume of data produced by WAI is still in its infancy. Prediction models are an attractive method for analysis of multivariate data because they provide individualized probabilities that a subject has the condition. A clinically useful prediction model must accurately discriminate between normal and abnormal cases and be well calibrated (i.e., give accurate predictions). The present study aimed to develop a diagnostic prediction model for detecting conductive conditions in neonates using WAI. A stringent reference standard was created by combining results of high-frequency tympanometry and distortion product otoacoustic emissions. DESIGN: High-frequency tympanometry and distortion product otoacoustic emissions were performed on both ears of 629 healthy neonates to assess outer- and middle-ear function. Wideband absorbance and complex admittance (magnitude and phase) were measured at frequencies ranging from 226 to 8000 Hz in each neonate at ambient pressure using a click stimulus. Results from one ear of each neonate were used to develop the prediction model. WAI results were used as logistic regression predictors to model the probability that an ear had outer/middle-ear dysfunction. WAI variables were modeled both linearly and nonlinearly, to test whether allowing nonlinearity improved model fit and thus calibration. The best-fitting model was validated using the opposite ears and with bootstrap resampling. RESULTS: The best-fitting model used absorbance at 1000 and 2000 Hz, admittance magnitude at 1000 and 2000 Hz, and admittance phase at 1000 and 4000 Hz modeled as nonlinear variables. The model accurately discriminated between normal and abnormal ears, with an area under the receiver-operating characteristic curve (AUC) of 0.88. It effectively generalized to the opposite ears (AUC = 0.90) and with bootstrap resampling (AUC = 0.85). The model was well calibrated, with predicted probabilities aligning closely to observed results. CONCLUSIONS: The developed prediction model accurately discriminated between normal and dysfunctional ears and was well calibrated. The model has potential applications in screening or diagnostic contexts. In a screening context, probabilities could be used to set a referral threshold that is intuitive, easy to apply, and sensitive to the costs associated with true- and false-positive referrals. In a clinical setting, using predicted probabilities in conjunction with graphical displays of WAI could be used for individualized diagnoses. Future research investigating the use of the model in diagnostic or screening settings is warranted. PMID: 29509564 DOI: 10.1097/AUD.0000000000000565


Universal Neonatal Hearing Screening - Experience in a Tertiary Care Hospital in Southern India

Indian Pediatr. 2013 Oct 5. pii: S097475591300554. [Epub ahead of print]

Augustine AM, Jana AK, Kuruvilla KA, Danda S, Lepcha A, Ebenezer J, Paul RR, Tyagi A, Balraj A. Source Department of ENT, Christian Medical College, Vellore; *Department of Neonatology, Christian Medical College, Vellore and **Department of Medical Genetics, Christian Medical College, Vellore, Tamil Nadu, India. Correspondence to: Dr Achamma Balraj, Department of ENT Unit IV, Christian Medical College, Vellore, Tamil Nadu 632 004, India.

Abstract OBJECTIVE: To implement a universal neonatal hearing screening program using automated auditory brainstem response audiometry in a tertiary care set-up and assess the prevalence of neonatal hearing loss. DESIGN: Observational prospective cohort study. SETTING: Tertiary care referral center. PARTICIPANTS: 9448 babies born in the tertiary care hospital over a period of 11 months. INTERVENTION: The neonates were subjected to a two stage sequential screening using the BERAphone. Neonates suspected of hearing loss underwent confirmatory testing using auditory steady state response audiometry and serological testing for TORCH infections and connexin 26 gene. MAIN OUTCOME MEASURES: Feasibility of the screening program, prevalence of neonatal hearing loss and risk factors found in association with neonatal hearing loss. RESULTS: 164 babies were identified as suspected for hearing loss. Among 45 babies who had confirmatory testing, 39 were confirmed to have hearing loss (4.1 per 1000) and were rehabilitated appropriately. 30 babies had one or more risk factors, 6 had evidence of TORCH infection and 1 had connexin 26 gene mutation. CONCLUSION: Universal neonatal hearing screening using BERAphone is a feasible service, vital for early identification and rehabilitation of neonatal hearing loss. The estimated prevalence of confirmed hearing loss was comparable to that in literature. Overcoming the large numbers of loss to follow-up proves to be a challenge in the implementation of such a program.

PMID 24277966

Cost-effectiveness analysis of a national neonatal hearing screening program in China: conditions for the scale-up

PLoS One. 2013;8(1):e51990. doi: 10.1371/journal.pone.0051990. Epub 2013 Jan 16.

Tobe RG, Mori R, Huang L, Xu L, Han D, Shibuya K. Source School of Public Health, Shandong University, Jinan, Shandong Province, China. Abstract BACKGROUND: In 2009, the Chinese Ministry of Health recommended scale-up of routine neonatal hearing screening - previously performed primarily only in select urban hospitals - throughout the entire country. METHODS: A decision analytical model for a simulated population of all live births in china was developed to compare the costs and health effects of five mutually exclusive interventions: 1) universal screening using Otoacoustic Emission (OAE) and Automated Auditory Brainstem Response (AABR); 2) universal OAE; 3) targeted OAE and AABR; 4) targeted OAE; and 5) no screening. Disability-Adjusted Life Years (DALYs) were calculated for health effects. RESULTS AND DISCUSSION: Based on the cost-effectiveness and potential health outcomes, the optimal path for scale-up would be to start with targeted OAE and then expand to universal OAE and universal OAE plus AABR. Accessibility of screening, diagnosis, and intervention services significantly affect decision of the options. CONCLUSION: In conclusion, to achieve cost-effectiveness and best health outcomes of the NHS program, the accessibility of screening, diagnosis, and intervention services should be expanded to reach a larger population. The results are thus expected to be of particular benefit in terms of the 'rolling out' of the national plan.

PMID 23341887


Incidence and clinical value of prolonged I-V interval in NICU infants after failing neonatal hearing screening

Eur Arch Otorhinolaryngol. 2011 Apr;268(4):501-5. Epub 2010 Nov 11.

Coenraad S, Hoeve LJ, Goedegebure A. Source Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical Center, Dr. Molewaterplein 60, SP-1455, 3015 GJ, Rotterdam, The Netherlands.


Infants admitted to neonatal intensive care units (NICUs) have a higher incidence of perinatal complications and delayed maturational processes. Parameters of the auditory brainstem response (ABR) were analyzed to study the prevalence of delayed auditory maturation or neural pathology. The prevalence of prolonged I-V interval as a measure of delayed maturation and the correlation with ABR thresholds were investigated. All infants admitted to the NICU Sophia Children's Hospital between 2004 and 2009 who had been referred for ABR measurement after failing neonatal hearing screening with automated auditory brainstem response (AABR) were included. The ABR parameters were retrospectively analyzed. Between 2004 and 2009, 103 infants were included: 46 girls and 57 boys. In 58.3% (60 infants) of our population, the I-V interval was recordable in at least one ear at first diagnostic ABR measurement. In 4.9%, the I-V interval was severely prolonged. The median ABR threshold of infants with a normal or mildly prolonged I-V interval was 50 dB. The median ABR threshold of infants with a severely prolonged I-V interval was 30 dB. In conclusion, in case both peak I and V were measurable, we found only a limited (4.9%) incidence of severely prolonged I-V interval (≥0.8 ms) in this high-risk NICU population. A mild delay in maturation is a more probable explanation than major audiologic or neural pathology, as ABR thresholds were near normal in these infants.

PMID 21069370

The influence of epidural anesthesia on new-born hearing screening: A pilot study

J Pharm Bioallied Sci. 2011 Jan;3(1):135-41.

Khoza-Shangase K, Joubert K. Source Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa. Abstract OBJECTIVE: The main aim was to establish if epidural anesthesia had an influence on new-born hearing screening results in newborns born via elective Cesarean section in healthy pregnancies. Specific objectives included determining screening results in a group of newborns born to mothers who had undergone epidural anesthesia during Cesarean section childbirth (experimental group); and comparing the findings with those of a group of newborns born to mothers who had undergone natural delivery without epidural anesthesia (comparison group); while establishing if the time of screening following delivery had any effect on the overall screening results.

MATERIALS AND METHODS: The above objectives were achieved through the use of a prospective quasi-experimental repeated measures design with a comparison group, where 40 newborns (20 in the experimental and 20 in the comparison group) were screened at three different times through transient otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) measures. All participants were screened while resting quietly in open bassinets in an empty new-born nursery. For both test measures, the results were recorded as either pass or refer. Data were analyzed through both descriptive and inferential statistics.

RESULTS: Findings indicated that hearing screening earlier than four hours after birth, for both the experimental and comparison groups yielded more false positive findings than testing conducted after 24 hours. An index of suspicion in relation to the influence of epidural anesthesia on Automated Auditory Brainstem Response (AABR), when conducted less than four hours after birth, was raised, as statistically significant findings (P<0.05) were obtained.

CONCLUSIONS: The findings have implications for timing of screening where universal newborn hearing screening is being implemented.

PMID 21430964

Overview of newborn hearing screening activities in Latin America

Rev Panam Salud Publica. 2011 Mar;29(3):145-52.

Gerner de Garcia B, Gaffney C, Chacon S, Gaffney M. Source Educational Foundations and Research, Gallaudet University, Washington, DC, USA. Abstract OBJECTIVE: Ascertain the status of early hearing detection and intervention services in Latin America.

METHODS: Between June and November 2007, Gallaudet University, in collaboration with the U.S. Centers for Disease Control and Prevention Early Hearing Detection and Intervention Diversity Committee, disseminated a survey to 11 Latin American countries. It included questions about newborn hearing screening (NHS) procedures, the availability of intervention services for infants with hearing loss, and challenges in identifying infants with hearing loss. In addition, a literature review was conducted to help identify the status of NHS efforts in Latin America.

RESULTS: Six countries (Chile, Costa Rica, Guatemala, Mexico, Panama, and Uruguay) and one U.S. territory (Puerto Rico) responded to the survey. Responses indicated that efforts to identify infants with hearing loss vary within and across countries in Latin America. In some countries, activities have been implemented at a national level; in others, activities have been implemented at a single hospital or region within a country. Common barriers to implementation of NHS programs include a lack of funding, screening and diagnostic equipment, public awareness, and personnel qualified to work with infants and young children.

CONCLUSIONS: In spite of several barriers, NHS programs have been implemented in at least some facilities and regions in Latin America. Additional efforts are needed to expand NHS activities in Latin America.

PMID 21484013

Incidence and Pattern of Hearing Impairment in Children with ≤ 800 Gram Birth Weight in British Columbia, Canada

Acta Paediatr. 2011 Aug 8. doi: 10.1111/j.1651-2227.2011.02437.x. [Epub ahead of print]

Synnes AR, Anson S, Baum J, Usher L. Source Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada Child and Family Research Institute, Vancouver, BC, Canada Neonatal Follow-Up Program, Children's & Women's Health Centre of British Columbia, Vancouver, BC, Canada Audiology and Speech Sciences, University of British Columbia, Vancouver, BC, Canada.


Aim:  Evaluate changes over time in the characteristics of permanent hearing impairment (HI) in extremely low birth weight (ELBW < 800 grams) children. Methods:  Data from sequential visits up to 5 years of age assessing hearing and other neurodevelopmental outcomes was extracted from a cohort of ELBW subjects born 1983-2006 at a single Canadian site. Trends in HI incidence, severity, and association with other impairments were analyzed in three 8 year epochs. Results:  Fifty of 586 ELBW children had a HI. HI rates increased from 5% in epoch 1 to 7% in epoch 2 to 13% in epoch 3 (p= 0.01). Mild HI decreased from 78% in epoch 1 to 35% in epoch 3 (p =0.03). Median age at diagnosis decreased from 13 to 8 months. Comorbidities were more common in HI children than non HI children: cerebral palsy (40% vs 14%, p <0.0001)), cognitive (38% vs 12%, p <0.0001) and visual impairments (16% vs 6%, p=0.009). Conclusion:  The incidence and severity of hearing impairment in a cohort of extremely low birth weight children increased significantly from 5% to 13% (p= 0.01) over a 24 year period. Comorbidities were common. Potentially modifiable causes are explored.

Acta Paediatrica © 2011 Foundation Acta Paediatrica.

PMID 21824192

The use of transient evoked otoacoustic emissions as a hearing screen following grommet insertion

J Laryngol Otol. 2011 Jul;125(7):692-5. Epub 2011 Apr 27.

Dale OT, McCann LJ, Thio D, Wells SC, Drysdale AJ. Source ENT Department, Musgrove Park Hospital, Taunton, UK.

Abstract OBJECTIVE: This study aimed to evaluate the sensitivity of transient evoked otoacoustic emission testing as a screening tool for hearing loss in children, after grommet insertion.

METHOD: A prospective study was conducted of 48 children (91 ears) aged three to 16 years who had undergone grommet insertion for glue ear. At post-operative review, pure tone audiometry was performed followed by transient evoked otoacoustic emission testing. Outcomes for both tests, in each ear, were compared.

RESULTS: The pure tone audiometry threshold was ≤ 20 dB in 85 ears (93.4 per cent), 25 dB in two ears (2.2 per cent) and ≥ 30 dB in four ears (4.4 per cent). Transient evoked otoacoustic emissions were detected in 69 ears (75.8 per cent). The sensitivity of transient evoked otoacoustic emission testing for detecting hearing loss was 100 per cent for ≥ 30 dB loss but only 66.7 per cent for ≥ 25 dB loss.

CONCLUSION: Transient evoked otoacoustic emission testing offers a sensitive means of detecting hearing loss of ≥ 30 dB following grommet insertion in children. However, the use of such testing as a screening tool may miss some cases of mild hearing loss.

PMID 21524331


Auditory Brainstem Evoked Response: response patterns of full-term and premature infants

Braz J Otorhinolaryngol. 2010 Nov-Dec;76(6):729-38.

Casali RL, Santos MF. Source Center for Pediatric Studies, Campinas State University, Brazil.


Auditory Brainstem Response (ABR) is important for the early diagnosis of hearing impairment in infants.

AIM: To compare ABR responses in full-term and premature infants; gender and ear were taken into account.

METHODS: A cross-sectional prospective cohort study was carried out. We evaluated 36 full-term and 30 premature infants that had passed the Transient Otoacoustic Emissions test, had type A tympanometric curves, and had no risk factor for hearing loss besides prematurity. The evaluations were done from the time of hospital discharge to the third month of life, and consisted of a clinical history, acoustic immittance testing and ABR evaluation.

RESULTS: The comparison of absolute and interpeak wave I, III and V latencies in right and left ears revealed a statistically significant difference at the interpeak I-III. There was no significant gender differences in the comparison of results. Significant difference in wave I, III and V absolute latencies at 80 dB and in wave V at 60 db and 20 db were observed in a comparison of absolute and interpeak latencies between full-term and premature infants. An inverse correlation was found between age and absolute latencies.

CONCLUSIONS: The maturity of the auditory system influences ABR responses in infants. To avoid misinterpretation of results, gestational age must be taken into account in the analysis of ABR in pediatric population.

PMID 21180941


Critical analysis of three newborn hearing screening protocols

Pro Fono. 2009 Jul-Sep;21(3):201-6.

Freitas VS, Alvarenga Kde F, Bevilacqua MC, Martinez MA, Costa OA. Source Departamento de Fonoaudiologia da Faculdade de Odontologia de Bauru - Universidade de São Paulo. Abstract BACKGROUND: having knowledge about the validity of procedures for newborn hearing screening (NHS) is fundamental, once the purpose of these programs is to identify all newborns with hearing loss at an acceptable cost. AIM: to estimate the specificity and the false-positive rate of NHS protocols using transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR). METHOD: participants were 200 newborns who were submitted to a hearing screening test between March and July 2006. Three protocols were analyzed: protocol 1, NHS was carried out in two steps using TEOAE; protocol 2, NHS was carried out in two steps using AABR; and protocol 3, NHS was carried out in one step, using the two procedures - testing with TEOAE followed by a retest with AABR for all the newborns who did not pass the TEOAE testing. RESULTS: although there was no statistically significant difference when comparing the referral rates to audiological diagnosis obtained in protocols using TEOAE and AABR, the protocol using TEOAE referred four times more newborns. Protocol 3 presented the highest referral rate, with a statistically significant difference when compared to protocols 1 and 2. CONCLUSIONS: the false-positive rate and consequently specificity were better for the protocol using AABR, followed respectively by the protocol using TEOAE and using both TEOAE and AABR.

PMID 19838565


Detection of perinatal cytomegalovirus infection and sensorineural hearing loss in belgian infants by measurement of automated auditory brainstem response

J Clin Microbiol. 2008 Nov;46(11):3564-8. Epub 2008 Sep 3.

Verbeeck J, Van Kerschaver E, Wollants E, Beuselinck K, Stappaerts L, Van Ranst M. Source Laboratory of Clinical Virology, Rega Institute for Medical Research, Minderbroedersstraat 10, BE-3000 Leuven, Belgium.


Since auditory disability causes serious problems in the development of speech and in the total development of a child, it is crucial to diagnose possible hearing impairment as soon as possible after birth. This study evaluates the neonatal hearing screening program in Flanders, Belgium. The auditory ability of 118,438 babies was tested using the automated auditory brainstem response. We selected 194 babies with indicative hearing impairment and 332 matched controls to investigate the association between the presence of human cytomegalovirus (HCMV) in urine samples and sensorineural hearing loss and to analyze the sensibility and specificity of a cell culture assay and a quantitative PCR detection method. Our results indicate that significantly more babies with confirmed hearing impairment were HCMV positive after birth. Further, based on the results of our study, babies with HCMV viral loads above 4.5 log copies/ml urine seem to be 1.4 times more likely to have confirmed hearing impairment. Our follow-up study suggests that the hearing impairment of children infected with HCMV after birth is less likely to improve than that of HCMV-negative infants. Our results confirm that the presence of HCMV before or shortly after birth influences the outcome of hearing impairment.

PMID 18768656

Unbound bilirubin concentration is associated with abnormal automated auditory brainstem response for jaundiced newborns

Pediatrics. 2008 May;121(5):976-8. doi: 10.1542/peds.2007-2297.

Ahlfors CE, Parker AE. Source Department of Pediatrics, Division of Neonatology, California Pacific Medical Center, San Francisco, California, USA.

Abstract OBJECTIVE: This study was conducted to determine whether incidental jaundice affects automated auditory brainstem response results. METHODS: We reviewed the medical charts of jaundiced newborns of > or = 34 weeks of gestation who underwent automated auditory brainstem response testing within 4 hours of plasma total bilirubin concentration and unbound bilirubin concentration measurements. We tested the hypothesis that the likelihood of abnormal automated auditory brainstem response results would increase as total bilirubin and unbound bilirubin concentrations increased. RESULTS: Forty-four infants with proximate total bilirubin concentration, unbound bilirubin concentration, and automated auditory brainstem response measurements were identified, and 4 (9%) had bilateral refer automated auditory brainstem response results. The mean total bilirubin concentration of 21.4 mg/dL (SD: 4.0 mg/dL; range: 14.4-29.5 mg/dL) for the 40 infants with bilateral pass automated auditory brainstem response results was not significantly different from that of 23.0 mg/dL (range: 14.9-33.1 mg/dL) for the 4 infants with bilateral refer automated auditory brainstem response results. However, the mean unbound bilirubin concentration of 1.32 microg/dL (range: 0.22-2.99 microg/dL) for the 40 infants with bilateral pass results was significantly lower than the mean of 2.62 microg/dL (range: 0.88-4.41 microg/dL) for the 4 infants with bilateral refer results. Logistic regression showed that increasing unbound bilirubin concentrations but not increasing total bilirubin concentrations were associated with of bilateral refer automated auditory brainstem response results. CONCLUSIONS: The probability of bilateral refer automated auditory brainstem response results increases significantly with increasing unbound bilirubin concentrations but not with increasing total bilirubin concentrations. Because unbound bilirubin concentrations are also more closely correlated with bilirubin neurotoxicity than are total bilirubin concentrations, bilateral refer automated auditory brainstem response results for jaundiced newborns may indicate increased risk of bilirubin neurotoxicity, in addition to the possibility of congenital deafness. PMID 18450902