Characteristics of normal newborn transient-evoked otoacoustic emissions: Ear asymmetries and sex effects

Transient-evoked otoacoustic emissions (TEOAEs) were recorded from more than 30000 newborns over a six year period. Analysis was performed on all the TEOAEs that passed the bedside universal hearing screen (n = 60431), in order to characterize the normal properties of neonatal TEOAEs and to study ear and sex effects. Short recording times (median = 33 s) were observed in combination with high entire TEOAE level (median = 18.8 dB SPL for an 81.8 dB SPL peak stimulus), and high reproducibility (median = 86%). Signal-to-noise ratio (S/N) of the TEOAE was highly frequency-dependent, being poorer at low frequencies. Prolonged averaging increased median reproducibility to 97%, but the minor S/N-improvement at low frequencies did not justify the longer test time. Highly significant mean lateral asymmetries (right > left) and sex differences (female > male) existed in entire TEOAE level, S/N TEOAE, and in half-octave frequency bands (700-4000 Hz). Mean lateral and sex entire TEOAE level differences were 1.1 dB and 1.3 dB, respectively. Stimulus levels were not affected by ear or sex. Hence, physiological differences at the level of organ of Corti were demonstrated in newborns.