DPOAE vs TEOAE: Which to Choose?

This video provides an overview of the advantages and the disadvantages of using distortion product OAE (DPOAE) or transient evoked OAE (TEOAE) assessments. You can read the full transcript below.

DPOAE and TEOAE similarities

Let's start by emphasizing that the interpretation of the test result is the same with both types of OAE measurements.

In a screening program, the OAE device will produce either a pass or a refer test result. With a pass, the chance of having a hearing loss that requires immediate intervention is very small and we will refer. Not much can be said about the hearing and thus no conclusions can be made. Further investigation is needed in these cases.

There are many other similarities between TEOAE and DPOAE.

• They both perform well between 1.5 to 4 kHz.
• They are both limited at testing frequencies of 500 Hz and below.
• The sensitivity and specificity of DPOAE and TEOAE are considered similar and are for most people not a reason for preferring one over the other.

DPOAE and TEOAE differences

Let’s now look at the differences.

1. Frequency

DPOAE performs better above 4 kHz and TEOAE performs better between 0.5 to 1.5 kHz. However, these differences are less relevant for newborn hearing screening because most programs screen at frequencies from 1.5 to 4 kHz. However, if the equipment of the newborn hearing screening program is also used for the follow-up diagnostic assessment, one might take some of these aspects into consideration.

2. Test speed

TEOAE is said to be somewhat faster in obtaining a result in quiet test environments because it measures a wide range of frequencies at once, whereas DPOAE measures frequencies sequentially. However, modern DPOAE equipment is fast compared to older generations, rendering any speed differences between the techniques less relevant nowadays.

3. Test environment

In noisy environments, DPOAE will perform better and will still obtain otoacoustic emissions, while TEOAE on some occasions cannot. Still, a quiet environment gives by far the best performance for both screening methods.

4. Reputation

Lastly, the most used argument to choose one OAE method over another within a newborn hearing screening program is based on reputation. New implementations are typically based on existing programs and on the experiences shared by those running such programs.