A study of hearing evaluation for neonate with hyperbilirubinemia using otoacoustic emission and brainstem auditory evoked response

Background: Jaundice is a common condition in newborns, and while most cases are benign, high serum bilirubin levels can lead to kernicterus, causing severe complications like bilirubin encephalopathy and hearing loss. Early detection through routine screening is essential to prevent such complications. One effective screening method is otoacoustic emission (OAE), followed by brain stem auditory evoked response (BERA), to assess hearing loss in neonates with hyperbilirubinemia. This study aimed to determine the incidence of hearing abnormalities in neonates with hyperbilirubinemia, correlate high bilirubin levels with OAE and BERA abnormalities, and evaluate OAE as a mass screening tool for sensorineural hearing loss. Methods: After institutional ethics approval, 105 neonates meeting inclusion criteria were enrolled. A standard case record was maintained, and OAE testing was conducted before hospital discharge. Infants who failed OAE screening underwent BERA, which was considered the gold standard for diagnosis. Results: Results showed abnormal OAE in 6 infants and abnormal BERA in 9 infants out of 105 tested. Conclusions: These findings indicate that OAE is a useful, cost-effective, and quick screening tool for detecting hearing loss in neonates. Since OAE is non-invasive and less time-consuming than BERA, it can be used as an initial screening method. Infants failing OAE screening can then undergo BERA for further evaluation. This study supports the use of OAE for mass screening, ensuring early intervention through hearing aids and infant stimulation, thereby promoting normal language development in affected infants.