Otoacoustic Emission (OAE) as a Hearing Screening for Early
Detection in Newborn Baby
Siti Masliana Siregar
1*
, Meizly
Andina
2
1
Department of Ear Nose Throat, University of Muhammadiyah Sumatera Utara, Medan, Indonesia
2
Department of Biochemistry, University of Muhammadiyah Sumatera Utara , Medan, Indonesia
Keywords: Hearing, Screening, Otoacoustic Emission (OAE).
Abstract: A hearing is a necessity for communication between humans. Hearing loss that occurs at preschool age can
affect the development of speech, social, and emotional and may severely impact their academic achievement
in the long run. In the present days, objective hearing can be examined as early as possible using a relatively
safe and easy-to-use tool, and one of them is otoacoustic emission (OAE). It is a descriptive study with a
crossectional design. The research aims to determine hearing disorder in the newborns using OAE. This
research was conducted in Sundari Hospital and Muhammadiyah Hospital in Medan, North Sumatera. Forty-
eight newborn were included in this study. The result indicated that 41.6% of newborns showed bilateral refer,
and 41.67% had a risk factor. The signifies the importance of early hearing screening using OAE in newborns,
even though refers is not an absolute indication of hearing loss, but it was necessary to do follow -ups and
further examinations to them. In conlucion, OAE may be used as a standard tool to detect the hearing
disorder in newborn as early as possible.
1 INTRODUCTION
Hearing loss was often neglected due to par
e
nts
ignorance regarding the possibility of the child
having
a
disorder. Is was not unheard of that these
children m
a
y be considered as autistic or hyperactive
due to
t
he
i
r unruly behavior resulted from the
hearing probl
e
m. Therefore early diagnosis of
hearing loss is
e
ss
e
nt
ial
. Hearing loss detection in
infants is not easy, and it w
a
s commonly found after
the age of two or three. In I
tal
y, 98.2% of 3238
newborns were “pass.” In C
i
pto
Mangunkusumo Hospital Department of
Communi
t
y ENT (1992 - 2006), there were 3087
children found w
it
h severe bilateral neuronal
deafness, most of them w
e
r
e
one to three years old
(43.70%), and 6,41% were under one year old
(Suwento, 2007).
Suleh & Djelantik (1999) in Dr. Hasan S
a
dikin
Hospital Bandung reported the findings of
t
hr
ee
“bilateral refer” case from 212 of newborns. Since
1993, The National Institute of Health in Am
e
r
ica
recommended all newborns to undergo he
a
r
i
ng
examination. Preferably before they leave the
hospi
tal
, the comprehensive hearing function
evaluation
i
s advisable if a child presented as
“refer” before the
a
g
e
of six months (Suardana W,
2008).
Newborn Hearing Screening (NHS)
performed
i
n two groups of individual, universal
newborn (all
i
nf
a
nts) and targeted newborn
(high-risk). Even
t
hough screening should be
performed as a gold standard for hearing screening
in newborns (Suardana, 2008
;
Suwento, 2007), in
order to modern tools to
i
nv
e
s
ti
g
ate
hearing loss,
objective screening can be done as early
a
s possible
using a relatively safe and easy-to-use tool, one of
them is an otoacoustic emission (OAE), which
i
s
currently a standard gold instrument. The purpose of
t
he examination as early as possible is to habituate
he
a
r
i
ng aids as soon as possible to obtain better
i
mprov
e
m
e
nts in language development and the
child's voc
a
bul
a
ry (Zizlavsky, 2008).
An AOE is the first option to detect newborns
hearing disorder to relatively safe, non-invasive,
s
ec
ur
e
, low-cost and objective. (Lee K. J. & Peck J.
E, 2003
;
Suleh S. & Djelantik, 1999). The objective
of
t
his research was to examine hearing by OAE as
an
ea
r
l
y screening of newborn in two hospitals in
Medan, Nor
t
h Sum
ate
r
a
.
114
Siregar, S. and Andina, M.
Otoacoustic Emission (OAE) as a Hearing Screening for Early Detection in Newborn Baby.
DOI: 10.5220/0008789301140116
In Proceedings of the 2nd Syiah Kuala International Conference on Medicine and Health Sciences (SKIC-MHS 2018), pages 114-116
ISBN: 978-989-758-438-1
Copyright
c
2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
2 METHOD
This research was a descriptive observational
s
t
udy, using a cross-sectional design. The research
w
a
s conducted at the Sundari Hospital and
Muhamm
a
diyah Hospital and involved 48 (forty-
eight) newborns. Th
e
samples of this study are all
newborns born w
it
hin January to September 2011,
and fulfilled the fol
l
ow
i
ng inclusion
c
r
ite
r
ia:
a. Age is ranging from 24 hours to seven days
old.
b. Unobstructed ear
ca
na
l
s.
c. No infection in both
ea
rs
The variables evaluated in the examination are
t
he result which is “pass” or “refer,” risk factors,
g
e
nder, and delivery proc
e
ss.
ENT examination was mandatory for all
t
he samples. The sample was examined by Oto Read
t
ool TEOAE, Interacoustics Denmark. All newborns
under seven days old underwent ears, nose and
oropharynx examinations using
e
ndos
c
ope.
Children with anatomical abnormalities
w
e
r
e
excluded from OAE examination, and every
newborn who had normal anatomy was next
evaluated for OAE. The interpretation of OAE is
either “pass” or
“
r
e
f
e
r.”
The data was presented in four tables to show
t
h
e
number of newborns with “pass” or “refer”
results, r
i
sk factors, delivery type, and g
e
nder.
3 RESULTS
The result conducted in 48 of newborns, wher
ea
s
qualification of inclusion criteria. Table 1. Indicate
20 of newborns (41.66%) showed bilateral refer. In
c
ontr
a
s
t
to other centers as reported by Suardana &
W
i
r
a
nadh
a
(2007) at Sanglah Hospital Denpasar,
obtained refer
i
n 18.41% samples from 831 of
newborns in period M
a
y 2006 - May 2007. Wijana
(2008) at Melinda Hospi
tal
Bandung reported that
the pass results were obtained
i
n 613 infants
(88.84%) and referrals in 77
i
nf
a
nts (11.16%) on the
first examination. After one month
t
he examination
repeated and only 31 infants w
e
r
e
controlled
(40.26%), 46 infants drop out for the s
ec
ond
examination (59.74%), the results are two bilateral
r
e
f
e
r and 29 bilateral passes. In another study
reported by Khairi et al. (2005), at Universiti Sains
Hospi
tal
Malaysia, were found 5 of infants (1.28%)
with r
e
f
e
rr
al
results from 392 of subj
ect
s.
Table 1: Distribution of OAE results
OAE Result
Amount
Percentage
Bilateral Pass
12
25
Bilateral Refer
20
41.66
Unilateral
Pass/Refer
16
33.33
Total
48
100
There is almost no difference amount among male
and female; it is shown in Table 2, the distribution of
gender newborns. It is relevant to Khairi et al.
(2005) in Malaysia, found 45.4% is female, and
54.4% is male. Meanwhile, Mashari (1997) in
Yogyakarta obtained 51.07% of male and 48.93% of
female.
Table 2: Distribution of gender newborns
Gender
Amount
Percentage
Male
26
54.17
Female
22
45.83
Total
28
100
The American Academy of Pediatrics Joint
Committee on Hearing (1995) investigate no-risk
f
act
or newborn has bilateral deafness as many as 1
to 3 newborn per 1000 birth, and found as many as
2 to 4 newborns in intensive care unit. It showed
41.66% bilateral refer, whereas 58.33% of the risk
f
act
or.
Table 3. Showed 41.67% of newborns have a
r
i
sk factor, in the literature describe many risk
factors such as low birth weight (LBW), antenatal
infection, g
e
ne
tic
, anatomy abnormalities, and
ototoxicity drugs consumption. Some literature
described the higher r
i
sk of hearing disorder is
low birth weight; it provoked asphyxia or acidosis
induce metabolic dysfunction;
it
correlated to affect
the auditory system (Reardon W,1997).
The hearing screening in newborns both risk or
no risk factor should be evaluated, in Israel, the
NHSP (Newborn Hearing Screening Program)
coverage 98.7% approximately 179.000 live births
per year for 2014- 2016 and average referral rates
were under 3% (W
a
ss
e
r J et al., 2019). Despite
AABR (Automated Audi
t
ory Brainstem Response)
more effective than OAE
t
o screened hearing
disorder, but AOE easier to use
t
han AABR. Ngui et
al. (2019) in Malaysia reported the pass rate in
AABR (67.9%) was higher than DPOAE (Distortion
Product Otoacoustic Emission) (50.1%) from 722
non-risk factors (1444
ea
rs).
Otoacoustic Emission (OAE) as a Hearing Screening for Early Detection in Newborn Baby
115
Table 3: Distribution of Risk Factor
Amount
Percentage
20
41.67
28
58.33
48
100
The type of delivery majority found in S
ecti
o
Caesarea (SC) is 58.33% of total samples; it is seen
i
n the table. 4. Since spinal or epidural anesthesia
used
t
o Sectio Caesarea, it is safer than vacuum
extraction. Th
e
vacuum extraction correlates
asphyxia of the newborn due to birth prolonged
ti
m
e
.
Table 4: Distribution of Delivery type
Type of Delivery
Amount
Percentage
Spontaneous
Labor (SL)
18
37.50
Section Cesaria
(SC)
28
58.33
SL + Extraction
Vacum
2
4.17
Total
48
100
4 CONCLUSIONS
The research was conducted in 48 of newborns
t
o
determine hearing disorder by using OAE, OAE is
t
he easy-to-use tool to examined hearing as early as
poss
i
bl
e
in newborns. Bilateral refers in OAE is not
a
bsolut
e
value to conclude hearing loss, a re-
evaluation should be performed after 3 and six
months using Brain S
te
m Evoked Auditory
(BERA) as a preventive effort of hearing loss as
early as poss
i
bl
e
.
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