What is the interpretation of an Otoacoustic Emissions (OAE) test for hearing screening that shows present results on the right side and minimal to absent results on the left side?

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From the Guidelines

The otoacoustic emissions (OAE) test results showing "present right and minimal to absent left" indicate a significant asymmetry in hearing function, suggesting potential hearing loss in the left ear that warrants further evaluation with a comprehensive hearing test (audiogram) as recommended by the clinical practice guideline for age-related hearing loss 1. The OAE test measures sounds produced by the inner ear's outer hair cells when responding to stimuli, which are detectable in individuals with normal hearing up to mild hearing loss.

  • The asymmetric results suggest that while the right ear's cochlear function is intact, the left ear shows signs of dysfunction that could indicate hearing loss ranging from moderate to profound.
  • This finding is consistent with the guideline's key action statement (KAS 5) that recommends evaluating and treating patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing 1.
  • The cause of the hearing loss could be conductive (involving the outer or middle ear), sensorineural (involving the inner ear or auditory nerve), or mixed, and depending on the cause and severity, treatment options might include medical intervention, hearing aids, or other assistive devices.
  • Early intervention is important, especially in children, as undetected hearing loss can affect speech and language development, and clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life, as recommended by KAS 6 1.
  • Furthermore, clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing, as recommended by KAS 11 1, and consider offering appropriately fit amplification to patients with age-related hearing loss, as recommended by KAS 8 1.

From the Research

Otoacoustic Emissions Test Results

  • The results of an Otoacoustic emissions test for hearing screen showing present right and minimal to absent left can be indicative of potential hearing loss or damage in the left ear 2, 3, 4.
  • Otoacoustic emissions (OAE) are sounds produced by the inner ear as a response to sound stimulation, and their presence or absence can be used to assess hearing function 3.
  • A systematic review comparing OAE with audiometry in monitoring hearing loss after long-term noise exposure found that OAE could not reliably detect threshold shifts at individual level, but may be useful in predicting future hearing loss 2.

Comparison with Audiometry

  • Studies have compared the effectiveness of OAE with pure-tone audiometry in early diagnosis of hearing loss, with some finding that OAE may be more effective in detecting hearing loss, particularly in men 3.
  • However, another study found that pure-tone average hearing thresholds generally predicted self-reported hearing slightly better than did OAE measures, and that adding OAE as predictors did not improve the prediction of self-reported hearing 4.

Interpretation of Results

  • The presence of OAE in the right ear and minimal to absent OAE in the left ear may indicate a difference in hearing function between the two ears, with potential hearing loss or damage in the left ear 2, 3, 4.
  • Further testing, such as pure-tone audiometry, may be necessary to confirm the results and determine the extent of any hearing loss or damage 2, 3, 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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