Pitfalls in the Detection of Hearing Loss via Otoacoustic Emissions

Otoacoustic emissions (OAEs) are currently used as a valuable audiological test or as a hearing screening tool. There are many commercially available OAE recording systems that are used both for clinical practice and for research. However, there is little information in the literature comparing their performance in detecting hearing loss. The purpose of this prospective, nonrandomized, and controlled study was to evaluate the screening performance obtained from recent and older versions of the Otometrics Accuscreen OAE screening device in comparison with the Otodynamics ILO-292 OAE system, which has been used as the gold standard. Testing included otoscopic assessment, pure tone audiometry, tympanometry, and transiently evoked OAE (TEOAE) recordings. There was about a 77% agreement between the two versions of the Accuscreen device. Agreement between the two Accuscreen devices and the ILO was approximately 70% for the old and 80% for the new. The newer version of Accuscreen seems to perform better than the old, being more consistent with the reference ILO system and with the audiometry profiles of the tested subjects. In order to set robust standards for OAE evaluation and analysis, additional studies comparing different OAE hearing screening systems are needed.