UNIVERSAL NEONATAL HEARING SCREENING (NEWBORN HEARING SCREENING): OTOACOUSTIC EMISSIONS (OAE) PROTOCOLS

Abstract

Universal Newborn Hearing Screening (UNHS), popularly known as the "Hearing Test," is a fundamental public health strategy aimed at the early detection of congenital hearing loss, whose prevalence is estimated at 1 to 2 cases per 1,000 live births. This study is a narrative literature review that synthesizes the evidence on the use of the Otoacoustic Emissions (OAE) protocol in UNHS. OAE is the first-line tool in newborn screening due to its practicality and high sensitivity, assessing the integrity of the outer hair cells of the cochlea. However, its main limitation is the inability to detect auditory neuropathies or late-onset hearing loss, highlighting the need for complementary protocols, such as Auditory Brainstem Response (ABR/BERA), especially in at-risk populations. The modernization of Universal Newborn Hearing Screening (UNHS) requires integration with the surveillance of congenital infections, such as Congenital Cytomegalovirus (cCMV), which can cause progressive or late-onset hearing loss, even in asymptomatic newborns who initially "pass" the test. Additionally, genetic investigation is crucial, accounting for more than half of hearing loss cases, aiding in prognosis and the indication of interventions such as cochlear implants and pharmacological therapies (e.g., valganciclovir for cCMV). It is concluded that the effectiveness of UNHS depends on an integrated care system that combines OAE (Otoacoustic Emissions) with etiological evaluation and continuous multidisciplinary follow-up, aiming at early intervention and minimization of developmental impairments.