Title: 'Evaluating Wideband Reflectance Versus Tympanometry as a Reliable Diagnostic Indicator for Identifying Middle Ear Dysfunction in Newborn Hearing Screening Protocols'
Track: 2 - Audiological Services
Keyword(s): Neonate, Tympanometry, Wideband Reflectance, Hearing Loss
Learning Objectives:
  1. Discuss evidence to support effective newborn hearing screening protocols
  2. Assess diagnostic implications for use of tympanometry versus wideband reflectance in accurately identifying middle ear dysfunction


Between 1 to 3 per 1000 well-babies and 2 to 4 per 1000 neonatal intensive care unit newborns are born with significant hearing loss. The 2007 position statement of the Joint Committee of Infant Health recommends that newborns have their hearing screened by 1 month of age, and if hearing loss is identified, evaluated by a physician and fit with appropriate amplification by 3 months of age, followed by access to early intervention services by 6 months of age. In the United States, newborn hearing screening techniques vary between otoacoustic emission testing and auditory brainstem response testing. Studies have suggested that there is a relationship between external and middle ear status and hearing screening results. In a study completed at the University of California-Irvine, 90 neonate ears with middle ear dysfunction resulted in 5 percent fail rate on ABR screening and 77 percent fail rate on otoacoustic emission screening. Given the significant amount of ears which do not pass initial hearing screenings due to middle ear dysfunction it is important to differentiate ears with middle ear dysfunction, from ears with neural hearing loss. High frequency tympanometry is a widely used diagnostic test for identifying tympanic membrane mobility in neonate ears with suspected middle ear dysfunction. Wideband reflectance is a newer diagnostic measure that evaluates power reflectance across a range of frequencies and can also provide information about middle ear status. A critical review of the literature will evaluate the clinical implications of using wideband reflectance in comparison with tympanometry as a diagnostic indicator of middle ear dysfunction in neonates. The poster will present a suggested modification in screening protocols for the newborn hearing screening. This information has the potential to be useful in promoting discussion about the clinical uses for wideband reflectance within the field of pediatric diagnostic audiology.
Presentation: Poster_KatieSoltys_1598.pdf

Handouts: Handout is not Available
CART: CART Transcription is not Available
Katie Soltys - Primary Presenter
University of Iowa
     Credentials: M.A.
      Doctor of Audiology candidate at the University of Iowa. Currently completing her fourth year externship at Boys Town National Research Hospital in Omaha, NE.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Lenore Holte - Author
Univ of Iowa Communication Sciences and Disorders
     Credentials: PhD CCC-A
      Lenore Holte, PhD, CCC-A, is a Clinical Professor in the Department of Communication Sciences and Disorders and the Department of Pediatrics and serves as director of speech-language-pathology and audiology services at the Center for Disabilities and Development. She also provides audiological technical assistance to the Iowa Early Hearing Detection and Intervention (EHDI) program. Dr. Holte's professional background is primarily in pediatric audiology, newborn hearing screening and hearing assessment of individuals with disabilities. Her role in the OCHL study includes recruitment of families through cooperation with the Iowa EHDI team and development and conduct of test protocols