—Screening auditory status prior to neonatal hospital discharge to identify newborns with severe hearing impairment is an important pediatric care priority. Evoked otoacoustic emission (OAE) testing is a quick noninvasive method. The purpose of this study was to determine the relationship between external auditory canal and middle ear status with click-evoked OAE. It was hypothesized that vernix caseosa, debris in the ear canal, and middle ear fluid contribute to the OAE fail rate.
—All neonates had an initial OAE examination. A second investigator, "blinded" to the results, examined all ears otoscopically, cleaned any obstructing debris, and repeated with a second OAE test.
—All neonates were tested in a designated nursery at a mean age of 43±21 hours.
—Forty-one full-term neonates were prospectively enrolled.
—The ear canals with debris were cleaned under direct vision with a pediatric swab dampened by an alcohol wipe.
—The primary outcome measure was the postcleaning OAE pass rate.
—The preotoscopic examination pass rate of 82 ears was 76%. The OAE pass rate improved to 91% after debris removal.
—The results indicate that the examination and cleaning of the external ear canal are important components of the neonatal screening process.(Arch Otolaryngol Head Neck Surg. 1993;119:276-282)
Chang KW, Vohr BR, Norton SJ, Lekas MD. External and Middle Ear Status Related to Evoked Otoacoustic Emission in Neonates. Arch Otolaryngol Head Neck Surg. 1993;119(3):276-282. doi:10.1001/archotol.1993.01880150024004