Causes and Considerations for Failed OAE Testing
Primary Causes: Outer and Middle Ear Dysfunction
- Debris in the ear canal is the leading cause of OAE failure, accounting for the majority of false-positive results 1, 2, 3, 4, 5
- OAEs are particularly sensitive to middle ear effusions because the acoustic signal must travel through the middle ear space in both directions 6
- Both OAE and ABR technologies are affected by middle ear dysfunction, as these transient conditions prevent sound transmission to the cochlea 1, 2, 3, 4, 5
Secondary Causes and Risk Factors
- Motion artifacts interfere with test results, requiring the infant to be relatively inactive during testing 6
- The acoustic and electrical environment must be suitable for testing 1, 2, 4, 5
- Repeated screening increases the likelihood of obtaining a pass outcome by chance alone when statistical probability is used for pass/fail decisions 1, 2, 3, 4, 5
True Hearing Loss (Less Common in Initial Failures)
- OAE testing will miss mild or isolated frequency region losses 1, 2, 3, 4, 5
- OAE cannot detect auditory neuropathy/dyssynchrony because OAEs are generated within the cochlea and do not assess neural function 1, 2, 3, 4, 5
- Neural conduction disorders affecting the eighth nerve or auditory brainstem pathway will not be detected by OAE testing 1, 2, 3, 4, 5