Otoacoustic Emissions (OAE) Hearing Tests

OAE stands for otoacoustic emissions, the name for the sounds produced by the cochlea. These sounds can be used to test the function of the cochlea (specifically hair cell function) and other parts of the ear, including the auditory nerve.

close-up of baby's ear
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Otoacoustic Emissions Hearing tests are usually performed on newborn babies to detect deafness. The test can also partially estimate hearing sensitivity and test for functional hearing loss. Functional hearing loss is also sometimes referred to as non-organic hearing loss and is a condition where you have symptoms or behaviors of hearing loss but there is nothing actually wrong with your hearing.

Some sources might refer to this as feigned hearing loss but that's probably not completely accurate as this implies that someone is "faking it" and this type of hearing loss has multiple origins that are not always within an individuals control.

Otoacoustic Emissions Hearing tests are commonly used in conjunction with the ABR (Auditory Brainstem Response) hearing test or other hearing tests.

How the Test is Performed

Otoacoustic Emissions Hearing testing is not painful and many babies sleep right through it. Small probes are placed in the ear. One delivers sound and the other is a microphone. If the cochlea is functioning properly it should echo in response to the sound.  There are four types of sounds that the cochlea produces:

  1. Spontaneous acoustic emissions - the cochlea produces these sounds spontaneously (not in response to another sound). These only occur in approximately 40-50 percent of people with normal hearing.
  2. Transient otoacoustic emissions - produced in response to another sound of short duration (transient). Usually clicks or tone-bursts. These are commonly used to evaluate hearing in infants.
  3. Distortion product otoacoustic emissions - produced in response to two simultaneous tones of different frequencies. These are particularly useful in detecting damage to the cochlea early on (for example damage to the cochlea from ototoxicity or noise-induced damage).
  4. Sustained - frequency otoacoustic emissions - produced in response to a continuous tone. These are not typically used in the clinical setting.

Some conditions can cause the absence of OAE's. These include, but are not limited to cysts, external otitis (swimmer's ear for example), stenosis, or abnormal middle ear pressure, a perforated ear drum, otosclerosis, cholesteatoma.

Accuracy of Results

OAE testing cannot definitively diagnose hearing loss or deafness. If you fail OAE testing you will need further hearing tests to determine if there is hearing loss or not.

Sometimes OAE testing is inaccurate because an infant is fussy during the test and sometimes babies have fluid in their ears or other conditions that can cause them to fail the test even though they do not have any permanent hearing loss. Other factors that can cause OAE testing to fail or be inaccurate include:

  • Poor seal around the ear probe
  • Ear wax blockage, especially if it prevents getting a good seal around the ear probe
  • Debris or foreign objects in the ear canal
  • An uncooperative patient
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Otoacoustic Emissions (OAEs). American Speech-Language-Hearing Association [internet].

  2. Akinpelu OV, Peleva E, Funnell WR, Daniel SJ. Otoacoustic emissions in newborn hearing screening: a systematic review of the effects of different protocols on test outcomes. Int J Pediatr Otorhinolaryngol. 2014;78(5):711-7. doi:10.1016/j.ijporl.2014.01.021

  3. Mehta AK, Singh VK. Screening tests for nonorganic hearing lossMed J Armed Forces India. 2000;56(1):79–81. doi:10.1016/S0377-1237(17)30105-3

  4. Cunningham R. Otoacoustic emissions: beyond newborn hearing screening. Audiologyonline.com [internet]. 2011.

Additional Reading
  • Medscape. Otoacoustic Emissions.

  • NDCS. Newborn Hearing Screening.

  • Utah Department of Health. Children With Special Health Care Needs. Otoacoustic Emission Screening.  

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.