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Paeds Casesinvestigations-procedures-and-technology

Paeds Cases · investigations-procedures-and-technology

Interpret a referred newborn hearing screen — OSCE

OSCE investigation-interpretation and counselling station: a 5-week-old infant referred on the newborn hearing screen. Interpret the diagnostic audiogram, tympanogram, otoacoustic emissions and auditory brainstem response together, recognise the OAE-present-ABR-absent pattern of auditory neuropathy spectrum disorder, explain the 1-3-6 milestones, and counsel the anxious parents.

investigation interpretation and counselling station3 min readVerification in progress

Target exams

RACP DCEMRCPCH ClinicalRCPSC PediatricsABP General Pediatrics
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Study tools

Target exams

RACP DCEMRCPCH ClinicalRCPSC PediatricsABP General Pediatrics
Prompt
A 5-week-old infant is brought to the paediatric audiology clinic by anxious parents after the newborn hearing screen referred on the right ear. The diagnostic testing shows robustly present otoacoustic emissions at all frequencies on both ears, a normal type A tympanogram on the left and a normal type A on the right, and an auditory brainstem response on the right that shows no reproducible wave V even at high stimulus levels with a preserved cochlear microphonic. You are the paediatric registrar asked to interpret the results and to counsel the family.

Candidate brief

You have this station to interpret a set of paediatric hearing-test results and to counsel the parents of a 5-week-old infant referred on the newborn hearing screen. Read the four tests together — the audiogram, the tympanogram, the otoacoustic emissions and the auditory brainstem response — identify the pattern they produce, explain the diagnosis and the next steps in plain language, and demonstrate that you understand why an OAE-only screen can miss the diagnosis and what the 1-3-6 timeline means for this family. [11] [2]

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References4ShowHide
  1. [1]Harlor AD Jr, Bower C Hearing assessment in infants and children: recommendations beyond neonatal screening Pediatrics, 2009.PMID 19786460
  2. [11]Santarelli R, Scimemi P, Cama E, Domínguez-Ruiz M, et al Preservation of Distortion Product Otoacoustic Emissions in OTOF-Related Hearing Impairment Ear Hear, 2024.PMID 37677959
  3. [3]Gellrich D, Eder K, Echternach M, Gröger M, et al A Comparison of 226- and 1000-Hz Probe Tone Tympanometry With Myringotomy Findings in Infants Am J Audiol, 2024.PMID 39413047
  4. [2]Awad R, Oropeza J, Uhler KM Meeting the Joint Committee on Infant Hearing Standards in a Large Metropolitan Children's Hospital: Barriers and Next Steps Am J Audiol, 2019.PMID 31084570
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