Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report
CPT4 code
Name of the Procedure:
Distortion Product Evoked Otoacoustic Emissions (DPOAE); Limited Evaluation or Transient Evoked Otoacoustic Emissions (TEOAE), with Interpretation and Report
Summary
This procedure involves evaluating the function of the inner ear (cochlea) by measuring otoacoustic emissions (OAEs). The test can confirm the presence or absence of a hearing disorder by assessing the response to sound stimuli in 3-6 different frequencies.
Purpose
Medical Condition or Problem It Addresses:
The procedure helps to identify hearing impairments, especially in individuals who may not be able to communicate or respond to traditional hearing tests, such as infants or those with cognitive disabilities.
Goals or Expected Outcomes:
The main goal is to determine whether the inner ear's outer hair cells are functioning correctly, which is crucial for normal hearing. The results can help diagnose hearing loss and guide appropriate treatment.
Indications
Specific Symptoms or Conditions:
- Newborn hearing screening
- Hearing loss in siblings or family history of congenital hearing loss
- Unexplained speech delay or behavioral issues in children
- Monitoring ototoxicity in patients on certain medications
Patient Criteria:
- Infants and young children
- Patients with developmental disabilities
- Adults when behavioral tests are inconclusive
Preparation
Pre-Procedure Instructions:
- No special preparation is usually needed.
- Ears should be free of excessive wax, which might need to be cleaned before the test.
Diagnostic Tests Beforehand:
- A visual inspection of the ear canal and tympanic membrane to ensure there is no blockage.
Procedure Description
- The patient lies still in a quiet room.
- A probe is placed in the ear canal; this probe contains a speaker and a microphone.
- Sound stimuli (clicks or tones) are played through the speaker.
- The microphone measures the echoes (emissions) that come back from the inner ear.
- Data is recorded and analyzed by a computer.
- Audiologist interprets the results and prepares a report.
Tools and Equipment:
- OAE probe
- Audiometer and specialized computer software
Anesthesia or Sedation:
- Not required, the test is non-invasive and painless.
Duration
Approximately 10-30 minutes.
Setting
Typically performed in:
- Outpatient clinics
- Audiology or ENT offices
- Hospitals (especially in neonatal units)
Personnel
- Audiologists are the primary healthcare professionals performing and interpreting this test.
Risks and Complications
Common Risks:
- None, the procedure is entirely safe.
Rare Risks:
- Minor discomfort if the ear probe is not correctly placed.
Management of Complications:
- Adjusting the probe or ensuring the ear canal is clear.
Benefits
Expected Benefits:
- Reliable detection of hearing issues.
- Quick intervention and management if hearing loss is detected.
- Appropriate referrals to specialists if needed.
Realization of Benefits:
- Usually immediately after the procedure, based on the report's findings.
Recovery
Post-Procedure Care:
- No specific post-procedure care is required.
Recovery Time:
- Immediate return to normal activities.
Follow-up:
- Based on the results, further diagnostic tests or follow-up appointments may be recommended.
Alternatives
Other Treatment Options:
- Behavioral hearing tests
- Auditory Brainstem Response (ABR) testing
Pros and Cons of Alternatives:
- Behavioral hearing tests require the patient’s active participation, which may not be feasible for all demographics.
- ABR testing might require sedation in young children and is more complex.
Patient Experience
During the Procedure:
- The patient might hear sounds (clicks or tones) but it's otherwise non-invasive.
- No pain is involved and the environment is typically relaxed.
Pain Management and Comfort Measures:
- No pain management needed.
- Patients are kept comfortable and calm during the procedure, especially infants who might be wrapped or held gently to minimize movement.