Hearing thresholds in four-year-old children with weak or no transient-evoked otoacoustic emissions

Play audiometry is part of the general developmental screening covering 4-year-old children in the city of Malmo (Sweden). In an open study, 10% of the cohort was tested with transient-evoked otoacoustic emissions (TEOAEs), using the IL088 system. The aim was to reveal a hearing loss exceeding 25 dB HL in 4-year-old children. As the first step in determining whether emissions can be used as an efficient method of screening for hearing loss, 295 children were tested with TEOAEs. Audiometry was performed in 160 children. Audiometry was not performed if the TEOAEs were strong (greater than or equal to 10 dB SPL) in both ears. In the group with TEOAEs of 8.8 dB SPL or greater, all ears tested with audiometry had a pure-tone average (PTA) of 25 dB HL or better. Twenty-one percent of the ears had TEOAEs less than or equal to 0 dB SPL. Only 9% of the ears had a hearing threshold exceeding 25 dB HL. (PTA). In conclusion, the number of pathological TEOAE results was much larger than the number of pathological audiograms, making TEOAEs too sensitive to use as a single screening test, but the method may be used as first-line screening.