Early Detection of Hearing Impairment Using Dpoae in High Risk Military Personnel

Background: The present study aimed for early detection of hearing impairment in high risk military personnel. Material and Methods: A multicentric cross-sectional study was conducted at a tertiary ENT center of a zonal Military Hospital, from Aug 2025 to Aug 2026. The study included 600 male participants, comprising 300 noise-exposed armed forces personnel and 300 civilian controls without occupational noise exposure. All participants underwent Distortion Product Otoacoustic Emissions (DPOAE) and Pure Tone Audiometry (PTA) after providing informed consent and meeting the study's inclusion and exclusion criteria. Results: The majority of participants in both groups were 25–30 years of age, with a mean age of 30.81 years among cases and 29.34 years among controls. Among cases, the mean duration of noise exposure was 10.07 years, with 31% exposed for 6–10 years. DPOAE screening showed significantly fewer PASS results in cases than controls in both the left ear (70.66% vs. 91.33%) and right ear (60.33% vs. 91.66%). On pure tone audiometry, 76% of cases had sensorineural hearing loss (SNHL), compared with 23.33% of controls (p < 0.0001), with right-sided SNHL being the most common finding among cases. A significant association was observed between DPOAE REFER results and PTA-confirmed SNHL in both ears (p < 0.005). Compared with PTA, DPOAE demonstrated a sensitivity of 67.98%, specificity of 77.77%, positive predictive value of 90.64%, negative predictive value of 43.41%, and an overall diagnostic accuracy of 70.33% for detecting noise-induced hearing loss. Conclusion: Otoacoustic emissions (OAEs) can detect early outer hair cell damage before changes appear on pure tone audiometry, making them useful for early screening. Hearing loss is most pronounced at 3–6 kHz and usually progresses rapidly during the first 10 years of noise exposure before stabilizing.

Keywords: Hearing Impairment, DPOAE, Early Detection, Military Personnel.