In a 2-stage neonatal hearing screening protocol, if an infant fails the first-stage screening with an otoacoustic emissions test, an automated auditory brainstem response (ABR) test is performed. The purpose of this study was to estimate the rate of hearing loss detected by first-stage otoacoustic emissions test but missed by second-stage automated ABR testing.

Maintaining balance is a complex process involving intricate coordination of multiple sensory, motor and biomechanical components. 1 The position of the body relative to gravity and spatial surroundings is sensed by central integration of visual, vestibular and somatosensory inputs. Hearing provides spatial acoustic information and may contribute to the ability of maintaining postural balance, supplementary to those visual, vestibular and somatosensory inputs. It would therefore follow that balance may be disturbed in subjects suffering from hearing loss. Computerised dynamic posturography (CDP), the sensory organisation test (SOT) and the motor control test (MCT) are validated tools for the evaluation of the vestibular, visual and somatosensory systems. 2 By manipulating specific sensory inputs, these tests are able to evaluate the effective use of the sensory systems in retaining balance as well as measure overall balance and stability. The direct association between the middle ear pathologies and balance has long been recognised and well-researched. The aim of this study was to determine whether a conductive hearing loss (CHL) with no underlying pathology could potentially influence postural stability and, if so, to investigate the possible pathophysiology. | ME THODSThis study was approved by the Tel Aviv Medical Center institutional review board (0157-13-TLV). Healthy volunteers were recruited into the study after providing informed consent. They all underwent audiometric testing before and after their ear canals were sealed with earplugs (EAR classic super-fit 30™, Aearo company, Indianapolis, Indiana, USA), to induce a CHL. A CDP battery test (Equitest system,

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