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Published on: October 26, 2019
Conductive hearing loss in preterm infants with bronchopulmonary dysplasia
1Department of Neonatology, and Growth and Development Unit, Mater Misericordiae Public Hospitals, South Brisbane, Queensland, Australia. pgray@mater.org.au
Insights
Preterm infants with bronchopulmonary dysplasia (BPD) face a higher risk of persistent conductive hearing loss. Early auditory brainstem response (ABR) tests before discharge do not predict this risk accurately.
Area of Science:
- Neonatal Medicine
- Audiology
- Pediatric Otolaryngology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants.
- Hearing impairment is a potential complication in preterm infants, but specific risks associated with BPD require further investigation.
Purpose of the Study:
- To assess the risk of conductive hearing loss in preterm infants diagnosed with bronchopulmonary dysplasia (BPD).
- To compare hearing outcomes in infants with BPD to matched preterm controls.
Main Methods:
- A cohort of 78 preterm infants with BPD (26-33 weeks gestation) and 78 matched controls underwent auditory brainstem response (ABR) testing before hospital discharge.
- Visual reinforcement orientation audiometry (VROA) and impedance audiometry were performed at 8-12 months corrected age.
- Infants with persistent audiological abnormalities were referred for specialist evaluation.
Main Results:
- Infants with BPD exhibited a significantly higher incidence of ABR abnormalities (22% vs. 9%, P=0.028).
- Persistent abnormalities were more frequent in the BPD group on VROA and impedance testing.
- 22.1% of infants with BPD required surgical intervention for conductive dysfunction, compared to 7.7% of controls (P=0.03).
Conclusions:
- Preterm infants with BPD are at increased risk for developing persistent conductive hearing loss by late infancy.
- Auditory brainstem response (ABR) testing at hospital discharge is insufficient for predicting later conductive hearing issues.
- Routine audiological evaluations are recommended for infants with BPD towards the end of their first year of life.
Objective:
To determine the risk of conductive hearing loss in preterm infants with bronchopulmonary dysplasia (BPD) and preterm controls.
Methodology:
The study population consisted of 78 infants with BPD of 26-33 weeks gestation and 78 controls of similar gestational age matched for broad-based birthweight categories. An auditory brainstem response (ABR) audiology was performed shortly before hospital discharge. Visual reinforcement orientation audiometry (VROA) and impedance audiometry were performed at 8-12 months corrected for prematurity. Infants with persistent audiological abnormalities were referred for evaluation to paediatric ENT surgeons.
Results:
Infants with BPD had a significantly higher rate of ABR abnormalities (BPD: 22%, controls: 9%; P = 0.028). On VROA and impedance audiometry, the infants with BPD also had a higher rate of persistent abnormalities. Following ENT assessment, 22.1% of infants with BPD and 7.7% of controls had persistent conductive dysfunction requiring myringotomy and grommet tube insertion (P = 0.03). Most of these infants had normal ABR audiometry at hospital discharge.
Conclusions:
Preterm infants with BPD are at high risk of persistent conductive hearing loss late in the first year of life compared to controls. An ABR audiology conducted at the time of hospital discharge does not predict accurately later conductive hearing problems. Infants with BPD should have routine audiological evaluation toward the end of the first year of life.
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