Efficacy of TEOAEs and BERA as screening tools for deafness in newborn


  • Dinesh Valse Department of ENT, ESIC Medical College, Kalburgi, Bangalore, Karnataka, India
  • H. K. Nagarathna Department of ENT, Akash Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India




BERA, TEOAE, Deafness, Newborn


Background: Hearing during the first 6 months of life is also considered as crucial for normal acquisition of language. Hence, infants with permanent congenital and early hearing loss identified by 6 months of age and given appropriate and timely support are reported to achieve better language outcomes than those identified later than 6 months of age.

Methods: The study group constituted of 200 ears of 100 neonates (0-28 days) that were randomly selected. The neonates were taken from immunization clinic, newborn nursery, neonatal ward and intensive care unit of our hospital and also those referred from other hospitals.  

Results: There were 4 neonates (8 ears) with high risk factors of hyperbilirubinemia, prematurity and preterm born. These were subjected to Transient Evoked Oto-acoustic Emission (TEOAE) as well as BERA. Out of the 8 ears, 3 ears showed TEOAE fail, one had bilateral and the other had unilateral TEOAE fail. 5 ears passed TEOAE test.

Conclusions: TEOAE cannot completely replace BERA as screening modality for hearing impairment in neonates, however can complement it. 


Mencher GT, Davis AC, De Voe SJ, Bresfor D, Bamford JM. Universal neonatal hearing screening: Past present and future. Am J Audiol. 2001;10(1):3-12.

Finitzo T, Crumley WG. The role of pediatricians in hearing loss: From detection to connection. Pediatr Clin North Am. 1999;46(1):15-34, ix-x.

Ramakalawan TW, Davis AC. The effects of hearing loss and age of intervention on some language metrics in young hearing impaired children. Br J Audiol. 1992;26(2):97-107.

Robinshaw HM. The pattern of development from non communicative behaviour of language by hearing impaired infants. Br J Audiol. 1996;30:177-98.

Mohr PE, Feldman JJ, Dunbar JL, McConkey-Robbins A, Niparko JK, Rittenhouse RK, et al. The societal costs of severe to profound hearing loss in the US. Int J Technol Assess Health Care. 2000;16(4):1120-35.

Culbertson J, Gilbert AM. Children with unilateral sensorineural hearing loss. Cognitive academic and social development. Ear Hear. 1986;7(1):38-42.

Davis JM, Elfenbein J, Schum R, Bentler RA. Effects of mild and moderate hearing impairments on language educational and psychological behavior of children. J Speech Hear Disord. 1986;51(1):53-62.

Bess FH, Dodd Murphy J, Parker RA. Children with minimal sensorineural hearing loss, prevalence. Ear Hear. 1998;19(5):339-54.

Carney AE, Moeller MP. Treatment efficacy Hearing loss in children. J speech Hear Res. 1998;41:361-84.

Yoshinaga Itano C, Sedey AL, Coulter DK, Mehl AL. Language of early and later identified children with hearing loss. Pediatrics. 1998;102(5):1161-71.

Olusanya BO, Luxon LM, Wirz SL. Benefits and challenges of newborn hearing screening for developing countries. Int J Pediatr Otorhinolaryngol. 2004;68(3):287-305.

Erenberg A, Lemons J, Sia C, Trunkel D, Ziring P. Newborn and infant hearing loss: detection and intervention.American Academy of Pediatrics. Task Force on Newborn and Infant Hearing, 1998- 1999. Pediatrics. 1999;103(2):527-30.

Kemp DT. Stimulated acoustic emissions from within the human auditory systems. J Acoust Soc Am. 1978;64(5):1386-91.

Clarke P, Iqbal M, Mitchell S. A comparison of TEOAE and AABR responses for predischarge neonatal hearing screening. Int J Audiol. 2003;42(8):443-7.

Mehl AL, Thomson V. The Colorado newborn hearing screening project, 1992-1999: On the threshold of effect population based newborn hearing screening. Pediatrics. 2002;109:1-8.

Lin H-C, Shu M-T, Lee K-S, Ho G-M, Fu T-Y, Bruna S, et al. Comparison of hearing and screening program between one step with TEOAE and 2 steps with TEOAE & AABR. Laryngoscope. 2005;115(11):1957-62.

Vohr BR, Oh W, Stewart EJ, Bentkover JD, Gabbard S, Lemons J, et al. Comparison of costs and referral rates of 3 universal newborn hearing screening protocols. J Pediatr. 2001;139(2):238-44.

Vohr BR, Carty LM, Moore PE. Letourneau K. The Rhode Island hearing assessment programme: Experience with state wide hearing screening (1993-1996). J Pediatr. 1998;133(3):353-7.

Norton SA, Gorga MP, Widen JE, Folsom RC, Sinniger YS, Conewesson B, et al. Identification of neonatal hearing impairment: Summary and recommendations. Ear Hear. 2000;21(5):529-35.

Hall JW 3rd, Smith SD, Popelka GR. Newborn hearing screening with combined otoacoustic emission and Auditory Brainstem Response. J Am Acad Audiol. 2004;15(6):414-25.

Rhodes MC, Margolis RH, Hirsch JE, Napp AP. Hearing screening in newborn intensive care nursery. Comparison of methods. Otolaryngol Head Neck Surg. 1999;120(6):799-808.

Clemens CJ, Davis SA, Bailex AR. The False positive in universal newborn hearing screening. Pediatrics. 2000;106(1):7.

Dhawan R, Mathur NN. Comparative Evaluation Of Transient Evoked Otoacoustic Emissions And Brainstem Evoked response audiometry As screening modality For hearing Impairment In Neonates. Indian J Otolaryngol Head Neck Surg. 2007;59(1):15–8.

Mehl AL, Thomson V. The Colorado newborn Hearing Project, 1992-1999, On The Thresholds of Effective population based Universal Newborn hearing Screening. Pediatrics. 2002;109(1):7.






Original Research Articles