In otoacoustic emission (OAE) testing, distortion product OAEs (DPOAEs) are absent bilaterally in a neonate who passes automated ABR screening. This pattern suggests:

• A Normal hearing
• B Auditory neuropathy spectrum disorder (ANSD) ✓
• C Moderate sensorineural hearing loss
• D Conductive hearing loss due to middle ear effusion

Explanation

Auditory neuropathy spectrum disorder (ANSD) is characterized by absent or abnormal OAEs with normal ABR waveform I (cochlear microphonic), indicating normal outer hair cell function but abnormal neural synchrony. However, the classic ANSD pattern is: present OAEs (cochlear function intact) but absent/abnormal ABR. When DPOAEs are absent but ABR passes, middle ear pathology (effusion) must be excluded. If OAEs are absent and ABR is abnormal, standard SNHL is likely. The question describes absent OAEs with normal ABR — this is the reverse of classic ANSD; this pattern with absent DPOAEs but normal ABR in a neonate most likely reflects middle ear effusion (vernix caseosa) affecting DPOAEs. Rechecking after clearing is appropriate.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.