Otoacoustic emissions (OAEs) provide information about the function of the outer hair cells of the cochlea. In high-income countries, infants undergo OAE tests as part of the screening protocols for hearing. However, the cost of the necessary equipment hinders early screening for hearing in low- and middle-income countries, which disproportionately bear the brunt of disabling hearing loss. Here we report the design and clinical testing of a low-cost probe for OAEs. The device, which has a material cost of approximately US$10, uses an off-the-shelf microphone and off-the-shelf earphones connected to a smartphone through a headphone jack. It sends two pure tones through each of the headphone’s earbuds and algorithmically detects the distortion-product OAEs generated by the cochlea and recorded via the microphone. In a clinical study involving 201 paediatric ears across three healthcare sites, the device detected hearing loss with 100% sensitivity and 88.9% specificity, comparable to the performance of a commercial device. Low-cost devices for OAE testing may aid the early detection of hearing loss in resource-constrained settings.

耳声发射 (OAE) 提供有关耳蜗外毛细胞功能的信息。在高收入国家，婴儿接受 OAE 测试作为听力筛查方案的一部分。然而，必要设备的成本阻碍了低收入和中等收入国家的早期听力筛查，这些国家在失能性听力损失中首当其冲。在这里，我们报告了一种低成本 OAE 探针的设计和临床测试。该设备的材料成本约为 10 美元，使用现成的麦克风和通过耳机插孔连接到智能手机的现成耳机。它通过耳机的每个耳塞发送两种纯音，并通过算法检测耳蜗生成并通过麦克风记录的失真产物 OAE。在一项涉及三个医疗机构的 201 名儿童耳朵的临床研究中，该设备以 100% 的灵敏度和 88.9% 的特异性检测听力损失，与商业设备的性能相当。用于 OAE 测试的低成本设备可能有助于在资源有限的环境中及早发现听力损失。