Title: 'Conductive Hearing Loss Diagnosis in Newborn Hearing Screening Follow-up Using Wideband Immittance'
Track: 2 - Audiological Services
Keyword(s): Diagnosis, middle ear, conductive hearing loss
Learning Objectives:
  1. List middle ear problems that may affect newborn screening.
  2. Define wideband immittance testing and how it differs from traditional tympanometry
  3. Discuss wideband immittance results in transient and permanent conductive hearing loss


Newborn hearing screening (NHS) referrals may be caused by transient or permanent middle ear conditions. A major challenge in achieving diagnosis by age 3 months is determining if the referral is due to temporary or permanent hearing loss. Wideband acoustic immittance (WAI)provides a more thorough analysis of middle ear function than standard tympanometry by testing across a broad frequency range using click stimuli rather than pure tones. Goals: This study was designed to assess whether WAI improves accuracy of detecting transient and permanent conductive hearing loss. Methods: Infants were enrolled from well-baby and NICU nurseries in a clinical trial. Well newborns were tested with the newborn hearing screening protocol of Stage I screening with transient evoked otoacoustic emission (TEOAE) and Stage II screening with automated auditory brainstem response (AABR) if TEOAE was referred. NICU newborns were tested with TEOAE or DPOAE and automated or diagnostic ABR. All infants were tested with WAI at birth and follow-up (1 and 9 months). Infants who attended a follow-up diagnostic evaluation were also assessed with toneburst air and bone conduction ABR, DPOAE and the wideband acoustic test battery. Results: 41 cases of conductive hearing loss were diagnosed, including several cases of permanent conductive hearing loss. The wideband test battery effectively diagnosed infants who referred on Stage I or II screening due to temporary middle ear problems, or who had permanent conductive hearing loss, as determined by the diagnostic ABR. Results will be discussed relative to screening and diagnostic applications of the WB test.
Presentation: Tuesday_Stopher_1100_LisaHunter_1629.pdf

Handouts: Handout is not Available
CART: Topical Session 5- 1629.docx
Lisa Hunter - Primary Presenter
Cincinnati Children's Hospital
     Credentials: PhD
      Lisa Hunter is Scientific Director of Audiology and Professor at Cincinnati Children's Hospital Medical Center and the University of Cincinnati. She collaborates on a number of funded studies including evaluating physiologic factors associated with risks for hearing loss and understanding mechanisms for improved follow-up with newborn hearing screening in high risk famlies. She is a faculty with the Leadership Education in Neurodevelopmental and related Disabilities at Cincinnati Children's Hospital Medical Center.

Financial - Receives Speaker for Teaching and speaking from Interacoustics, Inc.  

Nonfinancial - No relevant nonfinancial relationship exist.
Douglas Keefe - Author
Boystown National Research Center
     Credentials: PhD
      Douglas Keefe, Ph.D. is a Senior Scientist at Boystown National Research Hospital. Dr. Keefe is an acoustical physicist who has worked in hearing research, musical acoustics and related signal processing, acoustics and vibration fields.
Patrick Feeney - Author
National Center for Rehabilitative Audiology Research, Portland OR
     Credentials: Ph.D.
      Dr. Feeney is the Director of the National Center on Rehabilitative Auditory Research at the Portland Veteran's Administration. His research interests involve the evaluation of peripheral auditory function, hearing screening, and central auditory function in aging.