Otoacoustic emissions (OAEs) are absent in a newborn hearing screen. Which conclusion is most appropriate?

• A The child definitely has sensorineural hearing loss at the cochlear level
• B The child has a central auditory processing disorder
• C The result is always artifactual and should be repeated only after 6 months
• D Outer hair cell function is likely impaired; confirmation with ABR is required ✓

Explanation

OAEs assess outer hair cell (OHC) integrity in the cochlea; absent OAEs indicate impaired OHC function, which can result from cochlear hearing loss, middle ear effusion, or debris in the external canal. An absent OAE screen is not diagnostic of a specific type or severity of hearing loss — it triggers a refer result, and ABR (AABR or diagnostic ABR) is required to confirm the type and degree of hearing loss, as well as to identify auditory neuropathy spectrum disorder where OAEs may be present but ABR abnormal.

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

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Written and medically reviewed by the StethoPrep medical team.