Patient:  H.G.

Age: 13 months

I reviewed this very interesting case with the engineers at Intelligent Hearing Systems and with upper level management of Pediatrix.  This baby passed a hearing screening administered by Pediatrix with the Intelligent Hearing Systems screener, using a 30 dB nHL click.  The baby passed the neonatal screening, but has a diagnosis of right unilateral ear canal atresia.  The audiologist reports that the canal may be extremely stenotic rather than atresic, but she cannot determine.  She is recommending amplification.

The infant hearing screener would not have conducted otoscopic inspection, that is beyond the scope of practice for a screener.  The screening system uses a supra-aural cup type earphone, rather than going into the ear canal.  The screening testing is automated.  It uses computer algorithms to determine if a response is present, but there is also a waveform that can be reviewed.  The engineers obtained the waveform and data from the original screening, and are confident that, at least at that test date, there was a response present.

The data will need close inspection. The audiologist has made helpful notes on the stimulus conditions on the side.

• Review the findings and complete the table below of the lowest intensity eliciting  a response.  The table notes the correction factor used by this audiologist in converting from lowest level eliciting a response to hearing threshold estimates.
• Provide a general critique of the testing.
• Suggest reasons for the discrepancy – passed screening and hearing loss on diagnostic testing.