Thank you for the interest in the article1 and valuable remarks given.2 Our comments are as follows:
TEOAE is used in the protocol for universal hearing screening in our set up because of its cost-effectiveness for a large-scale newborn population. It is undoubtedly true that automated auditory brainstem response (AABR) is superior in term of specificity as compared to the TEOAE alone, as described in the Brazilian study.3 However, as far as other limitations are concerned, for example, the cost, manpower of trained personnel and duration of the procedure, our centre opted to use TEOAE. In the future, if the hurdles are reduced, the direction is towards the AABR as a standard screening tool.
Multiple auditory steady state response (MSSR) is still not widely used as a screening tool because it is still under study. Although the diagnostic sensibility and specificity of the MSSR semi-automatic screening system was 100% and 96%, respectively, as the author correctly concluded its use in the context of universal newborn hearing screening program may necessitate further technological improvements.4
Though it has been documented that mutations in the GJB2 gene are responsible for half of the cases of autosomal recessive, non-syndromic hearing loss with the 35 delG mutation to be the commonest, but it may not be true in the other populations including ours.5 Therefore, different kits may be needed for different races if molecular genetic screening is to be applied in the mass screening as in the context of universal hearing screening program.
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