While new born hearing screening the which oae should be done and the frequency range
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OAE in Newborn Hearing Screening
Which OAE to Use
For universal newborn hearing screening (UNHS), automated Transient Evoked OAE (TEOAE) is the recommended first-line test. Both TEOAE and DPOAE can be used, but TEOAE is preferred because:
- It is quick and minimally invasive
- Consumable costs are low
- It requires no judgement from the screener (automated pass/fail algorithm)
- It can be performed on sleeping neonates in the maternity unit before discharge
Scott-Brown's Otorhinolaryngology, Vol 2, p. 4589
Frequency Range
| OAE Type | Frequency Range Tested |
|---|---|
| TEOAE | 0.4 kHz to 6 kHz (most clinically useful energy: 1-4 kHz) |
| DPOAE | Frequency-specific; typically tested at 1-8 kHz (f2 frequencies) |
TEOAE is elicited by a brief click stimulus and produces a cochlear echo spanning 0.4-6 kHz. The response amplitude decreases as frequency increases. The latency is 5-20 ms in humans.
Cummings Otolaryngology, p. 512
How TEOAEs Are Interpreted in Screening
A TEOAE result is considered a pass when:
- Response amplitude (after noise subtraction) is ≥ 4 dB above background noise
- Waveform is reproducible in at least 3 octave bands
Scott-Brown's Otorhinolaryngology, Vol 2, p. 2519
Screening Protocol (Typical Two-Stage)
- Stage 1: TEOAE - done on all well newborns (up to 2 attempts)
- Pass in both ears = screen pass, no further action
- Fail = proceed to Stage 2
- Stage 2: AABR (Automated Auditory Brainstem Response) - if TEOAE fails
- NICU/SCBU babies (>48 hours) go directly to both TEOAE + AABR, since they are at risk for auditory neuropathy, which OAE alone will miss
Important limitation: OAE screening (TEOAE alone) will miss auditory neuropathy spectrum disorder (ANSD), because OAEs reflect outer hair cell function, not neural integrity. This is why AABR is mandatory for high-risk neonates.
Scott-Brown's Otorhinolaryngology, Vol 2, p. 4589; Cummings Otolaryngology, Key Points
Quick Summary
| Parameter | Answer |
|---|---|
| Preferred OAE for screening | TEOAE (Transient Evoked OAE) |
| Stimulus used | Brief click (80-86 dB SPL) |
| Frequency range | 0.4-6 kHz (clinically: 1-4 kHz) |
| Pass criterion | ≥ 4 dB SNR in ≥ 3 octave bands |
| Misses | Auditory neuropathy (ANSD) |
| Follow-up test if TEOAE fails | AABR |
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