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Hearing screening: agreement among behavioral and objective methods

PURPOSE: to check the agreement among the obtained results in hearing screening through the observation of behavioral responses and the transient evoked otoacoustic emissions. METHOD: a double-blind study was carried out with 139 infants attended in Neonatal Hearing Screening service of Santa Maria University Hospital. Different examiners evaluated the presence of eye blink reflex and transient evoked otoacoustic emissions. RESULTS: among the 139 evaluated infants, 123 showed eye blink reflex and otoacoustic emissions; 10 showed only otoacoustic emissions; and 3 failed in both tests. Sixteen infants should be re-evaluated. Nine did not come back to repeat the tests. Seven children were re-evaluated, two passed in both tests; five maintained the failed status and they were referred to evaluation on Auditory Response Audiometry. Two children showed otoacoustic emissions, but did not have eye blink reflex. In the evaluation of Auditory Response Audiometry, one manifested normal hearing and the other showed acute hearing loss. One child who did not evidence otoacoustic emissions, but manifested eye blink reflex, had compatible Auditory Response Audiometry with moderate hearing loss in both ears. The infant who failed in both test showed severe bilateral hearing loss in the evaluation of Auditory Response Audiometry. CONCLUSION: even though the otoacoustic emissions are present, the absence of eye blink reflex should be considered a reason to evaluate the Auditory Response Audiometry, and this can be sign of auditory neuropathy. Considering that the analysis of otoacoustic emissions and the evaluation of eye blink reflex are complement procedures. The apparent disagreement among some results can show different types of hearing disorder.

Hearing; Neonatal Screening; Early Diagnosis; Child


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