Neonatal Transient Evoked Otoacoustic Emissions Screening: How Many Stimuli Are Enough?

The present study examined the effect of stimulus number on two pass criteria in neonatal transient evoked otoacoustic emission (TEOAE) screening. Participants were 25 normal, full-term neonates (mean age = 2.7 days, SD = 1.3), with normal peripheral auditory function in both ears. The Otodynamics ILO88 (Quickscreen) program was used and the TEOAE spectrum was analysed after the presentation of 10, 50, 100 and 260 stimuli. Two pass criteria were used: Criterion 1 - whole wave reproducibility (WWR) ≥ 60%, and Criterion 2 - SNR ≥ 3 dB for all three frequency bands centered at 2.4, 3.2 and 4.0 kHz. The results revealed that the number of stimuli used to achieve a "Pass" status depended on the pass criterion and the activity state of neonates. Although the use of an initial minimum stimulus number of 50 in neonatal TEOAE screening is justified, clinicians should continue testing if necessary until a set of predetermined stopping criteria are satisfied.