Technology choices for newborn hearing screening include evoked otoacoustic emissions (OAE) or automated auditory brainstem response (AABR). Using OAE for newborn screening involves placing a probe with a miniature microphone and speaker into the newborn’s ear canal to stimulate and measure responses from the cochlea within the inner ear. AABR screening involves placement of three small sensors on the infant’s head to measure brainwaves occurring in response to a soft click stimulus presented to the ear. While both OAE and AABR screen for hearing impairment, the AABR screening is the only screening method that screens the entire auditory pathway, from the ear to the brain.

DISADVANTAGE OF OAE

One primary disadvantage of OAE screening is the higher number of newborns who will not pass the screening. Perhaps the biggest disadvantage with OAE screening is that OAE screens only a portion of the hearing pathway, up to the level of the cochlea in the inner ear. While most congenital hearing impairments are due to problems in the inner ear, 15% or more are due to problems involving the auditory nerve, referred to as Auditory Neuropathy Spectrum Disorder or ANSD.

ADVANTAGES OF AABR

In contrast to OAE screening, an Automated Auditory Brainstem Response (AABR) requires a few minutes to prepare the infant for screening, and to measure the responses. AABR screening is performed on an infant who is quiet and relaxed, preferably sleeping. AABR is less susceptible to interference from room noise, can be performed within hours of birth and simultaneous testing of both ears can be achieved. In short, AABR is the technology of choice when early, accurate and proven screening technology is a requirement. Importantly, AABR screening technology has the highest sensitivity and highest specificity as compared to OAE screening. AABR screens the entire auditory pathway and can identify infants with hearing abnormalities within the cochlea and the auditory nerve. In Cyprus, newborn hearing screening with AABR is performed at our Iskele Hearing Center.