Evaluation of 2-Stage Hearing Screening Model in Children

Abstract

Objective: 1) To know the incidence of hearing impairment in children up to the age of 2 years in an apparently healthy urban population in India. 2) To evaluate the efficacy of 2-stage hearing screening using repeat otoacoustic emissions (OAE) and brain stem evoked response audiometry (BERA).

Method: A total of 2579 children up to the age of 2 years were screened in the pediatrics and ENT departments of a tertiary care university hospital for a duration of 1 year. TEOAE’s were used to screen hearing in response to an 80 dB SPL click, whereas DPOAE’s were measured in responses to stimulus condition with L1 = 65 dB SPL and L2 = 50 dB SPL. Those children who failed the initial OAE screening test were rescreened using OAE with similar parameters on a subsequent day. Children who failed the repeat testing by OAE were further subjected to BERA testing for confirmation of hearing loss.

Results: The mean age of children undergoing screening was 4.2 months. A total of 6.14% children failed on the initial OAE screening test, and 32.4% of children who failed the repeat test with OAE were subjected to BERA test. This 2-stage testing by OAEs and BERA was collectively able to pick 0.17% of hearing impaired children in an apparently healthy pediatric population.

Conclusion: The present 2-stage model using OAE and BERA is successful in mass screening for hearing loss. Repeated hearing screening by OAE used in this study is beneficial in decreasing the number of referrals for BERA and hence decrease the cost of screening programme.