Ear-canal acoustic admittance and reflectance effects in human neonates. I. Predictions of otoacoustic emission and auditory brainstem responses.

This report describes the extent to which ear-canal acoustic admittance and energy reflectance (YR) in human neonates (1) predict otoacoustic emission (OAE) levels and auditory brainstem response (ABR) latencies, and (2) classify OAE and ABR responses as present or absent. Analyses are reported on a subset of ears in which hearing screening measurements were obtained previously [Norton et al., Ear. Hear. 21, 348-356 (2000a)]. Tests on 1405 ears included YR, distortion-product OAEs, transient-evoked OAEs, and ABR. Principal components analysis reduced the 33 YR variables to 5-7 factors. OAE levels decreased and ABR latencies increased with increasing high-frequency energy reflectance. Up to 28% of the variance in OAE levels and 12% of the variance in ABR wave-V latencies were explained by these factors. Thus, the YR response indirectly encodes information on inter-ear variations in forward and reverse middle-ear transmission. The YR factors classify OAEs with an area under the relative operating characteristic (ROC) curve as high as 0.79, suggesting that middle-ear dysfunction is partly responsible for the inability to record OAEs in some ears. The YR factors classified ABR responses less well, with ROC areas of 0.64 for predicting wave-V latency and 0.56 for predicting Fsp.