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The Case for Incorporation of Wideband Immittance Testing in Newborn and Infant Hearing Screening: Practical and Theoretical Considerations, in partnership with Seminars in Hearing

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1.  Which of the following factors is responsible for a reported 78-96% of all referred cases who failed newborn hearing screening at birth? Sensitivity of screening tests to noisy acoustic environment in newborn nursery settings. Electrical interference by medical equipment in hospital settings. Newborns are non-compliant during testing resulting in high myogenic noise. Ear canals and middle ears are obstructed by vernix, fluid, and residual tissue in the first days of life.

2.  Why is the ability to perform wideband immittance testing without pressurization of newborn ear canals advantageous over traditional tympanometry? Pressure-induced collapse and expansion of immature newborn ear canal walls introduces error to tympanometry measures. Perforation of tympanic membranes is not a common occurrence in newborn ears. Negative middle ear pressure is not a common occurrence in newborn ears. Wideband immittance apparatus can be calibrated using simpler procedures compared to tympanometry.

3.  Which of the following is true about wideband power absorbance? A measure that represents the proportion of acoustic power in a broadband test signal that is reflected at the tympanic membrane across a wide range of frequencies. It provides estimates of admittance over a wide range of frequencies. A measure that represents the proportion of acoustic power in a broadband test signal that is absorbed through the middle ear over a wide range of frequencies. It provides estimates of impedance over a wide range of frequencies.

4.  What referral/recommendation is appropriate for a 2-day-old newborn who failed OAE screening and had normal wideband absorbance outcomes in both ears? Referral to outpatient re-screening in 2-4 weeks. Observe and monitor for progressive hearing loss, obtain diagnostic testing by 9 months of age. Follow up with pediatrician doctor for further evaluation. Direct referral to diagnostic ABR evaluation due to increased risk of sensorineural hearing loss.

5.  Which of the following is a sign that probe tip placement is not well-fitted in the ear canal with a good air seal? Wideband absorbance doesn’t show a prominent middle-frequency peak. Wideband absorbance exhibits abnormally high values at low frequencies. Wideband absorbance shows negative values around 4000 Hz. A minor peak in absorbance appears between 250-500 Hz.