Outcomes and Efficacy of Newborn Hearing Screening: Strengths and Weaknesses (Success or Failure?) (original) (raw)
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Universal neonatal audiological screening: experience of the University Hospital of Pisa
Italian Journal of Pediatrics, 2011
The early identification of pre-lingual deafness is necessary to minimize the consequences of hearing impairment on the future communication skills of a baby. According to the most recent international guidelines the deafness diagnosis must occur before the age of three months and the prosthetic-rehabilitative treatment with a traditional hearing aid should start within the first six months. When a Cochlear implant becomes necessary, the treatment should start between the age of 12 months and 18 months. The only way to diagnose the problem early is the implementation of universal neonatal audiological screening programs. Transient evoked otoacoustic emissions (TEOAE) is the most adequate test because it's accurate, economic and of simple execution. Automatic auditory brainstem response (AABR) is necessary to identify patients with auditory neuropathy but it is also important to reduce the number of false-positives.The 20-30% of infant hearing impairment is represented by progressive or late-onset hearing loss (HL) so it's also necessary to establish an audiological follow up program, especially in infants at risk. From November 2005 all neonates born in the University hospital of Pisa undergo newborn hearing screening. From 2008 the screening program follows the guidelines for the execution of the audiological screening in Tuscany which have been formulated by our group according to the 2007 JCIH Position Statement and adaptated to our regional reality by a multidisciplinary effort. From November 2005 to April 2009 8113 neonates born in the Neonatal Unit of Santa Chiara Hospital (Pisa) have undergone newborn hearing screening. 7621 neonates (93.9%) without risk factors executed only the TEOAE test. 492 (6.1%) neonates had audiological risk factors and thus underwent TEOAE and AABR. 84 patients (1,04%) failed both TEOAE and AABR tests. 78 of them underwent further investigations. 44 patients resulted falsepositives (the 0,54% of the screened newborns). 34 neonates (4,2 ‰) had a final diagnosis of hearing impairment. 8 patients (0.99 ‰) had unilateral hearing loss (HL). 26 patients (3,2 ‰) had bilateral hearing impairment. In our screening program the percentage of false-positives was quite low (0.54%) while the incidence of bilateral HL (3.2 ‰) is a little higher than that found in literature reports. In most of our patients premature birth or neonatal suffering represent the main cause of HL.
Making universal newborn hearing screening a success
International Journal of Pediatric Otorhinolaryngology, 2006
Objective: Following a long period of pilot study, Iaso maternity hospital established a universal newborn hearing screening program based on transiently evoked otoacoustic emissions (TEOAEs). The aim of this study is to present the improvement of outcome measures of this program, comparing the results of two groups of newborns screened successively. Methods: We analyzed data from two groups of full-term newborns screened at our setting. The first group included all newborns born and screened during the initial 3 years of application of the program and the second group included all newborns born and screened during the next 2 years. TEOAEs were performed during the first days after birth. All newborns who failed the initial test underwent repeat testing with TEOAEs before hospital discharge. Newborns with absence of otoacoustic emissions were referred to follow-up test after 1 month. Results were compared between the two groups. Results: The first group included 22,195 newborns-examined during 3 years and the second group included 25,032 newborns-examined during 2 years, due to reduction of * Corresponding author. Present address: 23 Achaion Street -Ag. Paraskevi, GR-15343 Athens, Greece. Tel.: +30 210 600 4683;
Newborn hearing screening: what are we missing?
Bangladesh Medical Research Council Bulletin, 2014
The objectives of the study were to demonstrate hearing status in newborns at first screening by Transient Evoked Otoacoustic Emissions and to find out the relationship between abnormal hearing screening and known risk factors. This study was conducted in the department of neonatology of Bangabandhu Sheikh Mujib Medical University in collaboration with department of otolaryngology and department of obstetrics and gynaecology. This prospective observational study included a cohort of 168 neonates from Neonatal Intensive Care Unit and neonatal Nursery (Minimal care unit). All were screened for hearing impairment using Transient Evoked Otoacoustic Emissions in out-patient department of otolaryngology by a trained audiologist before discharge from hospital. Risk factors analysed were according to the criteria of American Academy of Pediatrics. Of the total neonates screened, Refer rate was 32.7% irrespective of presence or absence of risk factors. Small for gestational age, in-utero inf...
PLOS ONE, 2016
Objectives To determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICU Materials and Methods It examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital's institutional review board (13MMHISO23). Results The screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference.
Neonatal Hearing Screening: The Importance of the Study of Risk Indicators for Hearing Loss
Journal of Otolaryngology-ENT Research, 2017
Objective: to analyze the frequency of risk indicators for hearing loss and its influence on the increase number of refer cases. Methodology: The study was carried out in a public hospital with a sample of 796 infants who participated in the neonatal hearing screening program by transient evoked otoacoustic emission (TEOAE). Results: 132 (16%) newborn had some risk indicators for hearing loss. NICU stay, low Apgar score, mechanical ventilation, lower birth weight less than 1500g and use of ototoxic drugs were the most frequenty risk indicators. A total of 51 (6%) newborns refer in the TEOAE test in at least one ear, and among them, 16 (31%) had a risk indicator for hearing loss. There was a statistically significant relationship between the refer rates in TEOAE with the following risk indicators: craniofacial malformation, genetic syndrome and birth weight less than 1500g. Conclusion: The NICU stay, low Apgar score, mechanical ventilation, birth weight less than 1500g and use of ototoxic drugs were the risk indicators most frequenty in this sample and the main risk indicator associated with refer in the TEOAE teste were craniofacial malformations, genetic syndromes and birth weight less than 1500g.
Newborn Hearing Screening: Overview
2009
B ackground Hearing is fundamental to speech and communication. Hearing loss in children can result in delayed speech and language development, social and emotional problems, and educational failure. Early detection of hearing loss, even as early as the newborn period, will lead to early intervention and reduction of hearing loss handicap. Bilateral hearing loss occurs in approximately 1 to 3 per 1,000 newborns in the well-baby nursery population which is more common than other existing disease screening programs such as phenylketonuria (10 per 100,000 births) or hypothyroidism (25 per 100,000 births). Furthermore, the number of newborns with hearing loss identified in the newborn intensive care unit (NICU) is 10 – 20 times higher than in the general well-baby population. In the past, only infants at risk for hearing loss were screened. Actually, about 50% of infants with permanent congenital hearing loss do not have any known risk factors. Therefore hearing screening among the high...
Newborn Hearing Screening and Early Diagnostic in the NICU
BioMed Research International, 2014
The aim was to describe the outcome of neonatal hearing screening (NHS) and audiological diagnosis in neonates in the NICU. The sample was divided into Group I: neonates who underwent NHS in one step and Group II: neonates who underwent a test and retest NHS. NHS procedure was automated auditory brainstem response. NHS was performed in 82.1% of surviving neonates. For GI, referral rate was 18.6% and false-positive was 62.2% (normal hearing in the diagnostic stage). In GII, with retest, referral rate dropped to 4.1% and false-positive to 12.5%. Sensorineural hearing loss was found in 13.2% of infants and conductive in 26.4% of cases. There was one case of auditory neuropathy spectrum (1.9%). Dropout rate in whole process was 21.7% for GI and 24.03% for GII. We concluded that it was not possible to perform universal NHS in the studied sample or, in many cases, to apply it within the first month of life. Retest reduced failure and false-positive rate and did not increase evasion, indic...
Success rate of newborn and follow-up screening of hearing using otoacoustic emissions
International journal of pediatric otorhinolaryngology, 2006
During the last 6 years, and after a long period of pilot study, a universal newborn hearing screening program based on otoacoustic emissions is implemented in Iaso Maternity Hospital. Our purpose is to present the success rate of otoacoustic emission testing on discharge from the hospital and 1 month later. All full-term newborns who were screened during a period of 2 years and failed testing after one or more sessions of transiently evoked otoacoustic emissions, on discharge from the hospital, were included in the study. These newborns were retested approximately 1 month after discharge. Twenty-five thousand and thirty-two newborns were examined in total. We found 534 (2.1%) 'refer' cases. Only 223 of them (41.8%) returned to retest in follow-up after 1 month. From the rescreening, 59 (2.3 per thousand) newborns failed in the test again and were referred for diagnostic audiological evaluation. The rate of referrals was small, but efforts should be made to decrease it furth...
Neonatal Audiologic Screening and Test Procedures
1989
This paper provides guidelines for neonatal audiologic screening. Hearing tests that measure behavioral responses, and those that measure physiological changes of body function in response to a stimulus, are discussed. The paper is intended to rectify inadequate means of identifying and testing infants considered as high risks for hearing loss. The information presented indicates the existence of viable methods of determining the hearing acuity of an infant. D.scussion emphasizes that early identification of hearing problems is of paramount importance for the prevention of unnecessary delays in a child's ability to communicate and interact with the world. Specific strategies for early identification are offered. (RH)