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UBC Theses and Dissertations

A novel screening protocol for the differentiation of type of hearing loss in neonatal intensive care unit (NICU) infants Millman, Tara Pamela


Objective: The current screening protocol of the British Columbia Early Hearing Program for neonatal intensive care unit infants is unable to differentiate between conductive and sensorineural hearing losses at the time of detection. A critical need exists for developing standardized screening procedures for differentiating conductive, sensory, and neural loss in early infancy to provide an appropriate course of intervention and to avoid later consequences on health and the development of speech and language. Design: The current study examined a novel protocol for the hearing screening of neonatal intensive care unit (NICU) infants that involved the measures of 1000 Hz tympanometry, transient evoked otoacoustic emissions (TEOAE), and ipsilateral broadband middle-ear muscle reflex (MEMR) at a 1 kHz probe tone frequency. The GN Otometrics Accuscreen device was used for automated auditory brainstem response (AABR) and TEOAE screening and the GN Otometrics Otoflex diagnostic immittance meter recorded 1000 Hz tympanometry and the MEMR. A total of 90 infants (180 ears) from the NICU of the Royal University Hospital in Saskatoon, Saskatchewan was recruited, of which 78 infants (143 ears) met the inclusion criteria. The participants mean chronological age was 31.38 days. The novel protocol was examined for three components: 1) if it generated equivalent results with the current two-stage AABR hearing screening protocol for NICU infants; 2) for testing length; and 3) for challenges encountered during testing. Results: Results revealed that 70.6% of infants passed both the current AABR and novel protocols. TEOAE accounted for most of the referrals for infants who passed the current AABR screening protocol and referred on the novel protocol (70%) and for infants who referred on both protocols (83.3%). Conclusion: The novel protocol might provide more information regarding the reason for a screening referral, including the identification of middle-ear dysfunction and the detection of mild hearing impairment.

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