Scholarlink

<p>Hearing loss in neonates affects language development and subsequently the quality of life. The need for early detection and rehabilitation of hearing loss requires quick screening modalities. Hearing loss in neonates, especially those in high-risk groups (e.g.,Neonatal Intensive Care Unit graduates), is often underdiagnosed and can significantly affect speech, language, and cognitive development. Early detection using appropriate screening tools such as Distortion Product Otoacoustic Emissions (DPOAE) and Brainstem Evoked Response Audiometry (BERA) is vital. However, the reliability of OAE alone in this group is questionable, especially in conditions like Auditory Neuropathy Spectrum Disorder (ANSD). </p><p>The present study was undertaken to evaluate the diagnostic accuracy of Distortion Product Otoacoustic Emissions (DPOAE) in comparison to Brainstem Evoked Response Audiometry (BERA) for the detection of hearing loss in neonates with high-risk factors, and to assess the association between specific risk factors and hearing outcomes. A prospective observational study was conducted over one year in a tertiary care hospital. One hundred high-risk neonates with predefined clinical risk factors (e.g., prematurity, low birth weight, hyperbilirubinemia, craniofacial anomalies, genetic syndromes) were enrolled. Regardless of the DPOAE result, all neonates were subsequently subjected to BERA testing on the same day using standard click stimuli under natural sleep. BERA waveforms were interpreted by a trained audiologist to determine hearing thresholds and identify any abnormalities, including features suggestive of auditory neuropathy. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of DPOAE were calculated against BERA as the reference standard. Of the 200 ears tested, DPOAE showed a “Pass” in 69% and “Refer” in 31%. BERA confirmed hearing loss in 16 ears, of which 4 were attributed to ANSD and 12 to other causes. The diagnostic performance of DPOAE in the study showed sensitivity of 75%, specificity of 72.8%, PPV of 19.4%, NPV of 97.1%, and overall diagnostic accuracy of 73%. Notably, 4 ears had normal DPOAE but abnormal BERA findings, indicative of ANSD. No statistically significant association was found between individual risk factors and hearing loss. </p><p>DPOAE, although a convenient screening tool, may miss neural hearing deficits such as ANSD. A combination of DPOAE and BERA enhances diagnostic accuracy and should be adopted for screening high-risk neonates to ensure timely diagnosis and intervention. Hearing loss in high-risk neonates can be missed if just one modality is used for screening, hence DPOAE along with BERA should be used as a combined tool.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Comparative Evaluation of Diagnostic Modalities for Hearing Loss in High-Risk Neonates: A Prospective Observational Study

  • 期刊论文

  • 发表日期：

    2026年3月7日

查看全文
  • Daamini Bapat,
  • Praveen Kumar Rathore,
  • Ravi Meher,
  • Ajay Kumar,
  • Raman Sharma

摘要

Hearing loss in neonates affects language development and subsequently the quality of life. The need for early detection and rehabilitation of hearing loss requires quick screening modalities. Hearing loss in neonates, especially those in high-risk groups (e.g.,Neonatal Intensive Care Unit graduates), is often underdiagnosed and can significantly affect speech, language, and cognitive development. Early detection using appropriate screening tools such as Distortion Product Otoacoustic Emissions (DPOAE) and Brainstem Evoked Response Audiometry (BERA) is vital. However, the reliability of OAE alone in this group is questionable, especially in conditions like Auditory Neuropathy Spectrum Disorder (ANSD).

The present study was undertaken to evaluate the diagnostic accuracy of Distortion Product Otoacoustic Emissions (DPOAE) in comparison to Brainstem Evoked Response Audiometry (BERA) for the detection of hearing loss in neonates with high-risk factors, and to assess the association between specific risk factors and hearing outcomes. A prospective observational study was conducted over one year in a tertiary care hospital. One hundred high-risk neonates with predefined clinical risk factors (e.g., prematurity, low birth weight, hyperbilirubinemia, craniofacial anomalies, genetic syndromes) were enrolled. Regardless of the DPOAE result, all neonates were subsequently subjected to BERA testing on the same day using standard click stimuli under natural sleep. BERA waveforms were interpreted by a trained audiologist to determine hearing thresholds and identify any abnormalities, including features suggestive of auditory neuropathy. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of DPOAE were calculated against BERA as the reference standard. Of the 200 ears tested, DPOAE showed a “Pass” in 69% and “Refer” in 31%. BERA confirmed hearing loss in 16 ears, of which 4 were attributed to ANSD and 12 to other causes. The diagnostic performance of DPOAE in the study showed sensitivity of 75%, specificity of 72.8%, PPV of 19.4%, NPV of 97.1%, and overall diagnostic accuracy of 73%. Notably, 4 ears had normal DPOAE but abnormal BERA findings, indicative of ANSD. No statistically significant association was found between individual risk factors and hearing loss.

DPOAE, although a convenient screening tool, may miss neural hearing deficits such as ANSD. A combination of DPOAE and BERA enhances diagnostic accuracy and should be adopted for screening high-risk neonates to ensure timely diagnosis and intervention. Hearing loss in high-risk neonates can be missed if just one modality is used for screening, hence DPOAE along with BERA should be used as a combined tool.