Painless and rapid otoacoustic emission (OAE) and, when needed, ABR tests used to detect permanent hearing loss in newborns at the earliest possible stage.
Indication
- All healthy term newborns (routine screening)
- Infants admitted to the neonatal intensive care unit
- Infants with a family history of hearing loss
- Prenatal infection (CMV, rubella, etc.) or history of high bilirubin
- Low birth weight, prematurity or history of mechanical ventilation
- Craniofacial anomalies (auricle, ear canal, syndromic findings)
Preparation
- A fed, calm and sleepy infant improves test success
- An adequate waiting period is observed so that birth fluid or earwax does not block the canal
- Birth history, medications used and family hearing history are recorded
- A quiet test environment is ensured
How it's performed
- The sleeping infant is placed in an appropriate position
- First-line transient evoked otoacoustic emission (TEOAE) testing is performed
- A small probe is placed in the ear canal; the procedure is painless and non-invasive
- Auditory brainstem response (ABR) testing is performed in infants with borderline OAE results
- All results are recorded as 'pass' or 'refer for re-evaluation'
- Families are given written explanations of the results and the next steps
Post-procedure
- A 'refer' result on the first test does not necessarily mean permanent hearing loss; the test is repeated within 2-4 weeks
- Infants who do not pass on the second attempt are referred for advanced ABR and ENT evaluation
- If a diagnosis is confirmed, hearing aids or rehabilitation are aimed to be initiated before 6 months of age
- Infants with risk factors are advised to undergo follow-up between 24-30 months for late-onset hearing loss
- Speech development is monitored during routine well-child visits
Risks
- Discomfort during the test is uncommon; the procedure is painless
- False-positive results may cause anxiety; confirmatory tests provide clarity
- Late reporting of results may lead to a missed window for early intervention
- The test may need to be repeated due to fluid or earwax in the canal
FAQ
Does the test harm the baby?
No; the screening is completely painless, involves no light or needles, and is completed in a few minutes.
On which day after birth is it performed?
It is generally performed in the first 24-48 hours, before discharge or within the first week.
Should I panic if the first test is not passed?
No; a substantial portion of infants who do not pass the first test have ear canal or middle ear causes and pass on retesting.
What is done if hearing loss is detected?
Early hearing aids or, when needed, cochlear implants and family education are planned; the first 6 months are considered critical for speech development.
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