Effects of exam procedures on transient evoked otoacoustic emissions (TEOAEs) in neonates.

Debris in the ear canal and ear canal collapse in newborns have been shown to interfere with recording transient evoked otoacoustic emissions (TEOAEs). The purpose of this study was to prospectively evaluate the effects of two simple ear canal cleaning procedures on the TEOAE responses of normal newborns. Three hundred and sixteen ears were studied with an initial TEOAE followed randomly by either an otoscopic exam and refit procedure or a probe refit procedure. At the time of each procedure, any superficial debris attached to the otoscope or probe were removed before the second TEOAE was repeated with identical procedures. The study sample consisted of two equal groups of ears (otoscopic exam and refit). Each group initially had equal proportions of ears with no emission, a weak emission, or a robust emission. In the otoscopic group, 12 of 51 (24%) weak emissions converted to robust emissions, 10 of 53 (19%) no emissions converted to robust emissions, and 15 of 53 (28%) no emissions improved to weak emissions. In the refit group, 20 of 50 (40%) weak emissions converted to robust emissions, 13 of 57 (23%) no emissions converted to weak emissions, and 9 of 57 (16%) no emissions improved to weak emissions. Both the otoscopic viewing procedure and the refit procedure were effective in improving the TEOAE response.