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[Hearing screening in newborn infants. Comparative studies and cost analysis with different instruments]
1Klinik für Kommunikationsstörungen, Johannes Gutenberg-Universität Mainz.
Insights
Newborn hearing screening is crucial. A two-step approach using Transient Evoked Otoacoustic Emissions (TEOAE) and Brainstem Evoked Response Audiometry (BERA) is recommended for effective infant hearing assessment.
Area of Science:
- Neonatal care
- Audiology
- Public health
Background:
- Newborn screening examinations are essential.
- General hearing screening for newborns is not yet widely implemented globally.
Purpose of the Study:
- To evaluate the effectiveness of different hearing screening methods in newborns.
- To compare the costs of one-step versus two-step newborn hearing screening protocols.
Main Methods:
- 100 newborns (200 ears) were screened on their third day of life.
- Transient Evoked Otoacoustic Emissions (TEOAE) using ECHOSCREEN and ILO-88 were employed.
- Brainstem Evoked Response Audiometry (BERA) using ALGO PORTABLE or EVOFLASH was conducted on 100 ears as a comparative method.
Main Results:
- 4.5% of ears screened with ECHOSCREEN showed abnormalities due to earwax.
- No abnormalities were detected with the ALGO-system.
- The EVOFLASH system identified seven ears (4 children) with abnormalities.
- Cost analysis indicated that two-step screenings (TEOAE and BERA) are cost-effective.
Conclusions:
- A two-step screening approach combining TEOAE and BERA devices is recommended for newborn hearing assessment.
- This combined method offers a reliable and potentially cost-effective strategy for early detection of hearing impairment in infants.
Background:
The necessity of screening examinations in newborns today cannot be denied. Up to now, it has only been achieved in a few countries to introduce a general hearing screening for newborns.
Methods:
We examined 100 newborns (200 ears) at their third day of life. All ears were evaluated with the TEOAE-screening-device ECHOSCREEN. In addition, we carried out BERA screening examinations with the ALGO PORTABLE or with the EVOFLASH on 100 of these 200 ears. As a reference method, we utilized TEOAE-examinations with the ILO-88 for all ears.
Results:
4.5% of the 200 ears examined with the ECHOSCREEN were conspicuous due to accumulation of earwax problems. With the ALGO-system, none of the ears was conspicuous. Among the 100 ears examined with the EVOFLASH we found negative results with seven ears (4 children). These findings will be discussed in detail. Furthermore, we analyzed the costs for one-step- and two-step-screenings. Costs for a one-step-screening of both ears would be DM 14.27 with Echoscreen, DM 44.69 with ALGO, DM 32.19 with Evoflash for one patient including material and personnel costs. Costs for a two-step-screening would be DM 16.28 with Echoscreen and ALGO, DM 15.72 with Echoscreen and Evoflash, calculated per child on the basis of 812,173 newborn children in the year 1997 in Germany.
Conclusion:
On the basis of all these results, we recommend a two-step-screening with TEOAE and BERA-devices.