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Failed newborn hearing screens as presentation for otitis media with effusion in the newborn population
Ryan T Boone1, Charles M Bower, Patti F Martin
1Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 West Markham, MS 543, Little Rock, AR 72205-7199, USA.
Insights
Middle ear effusion (OME) is a frequent cause of failed newborn hearing screenings. While OME often resolves, some infants require intervention for accurate hearing assessments, and sensorineural hearing loss (SNHL) may still be present.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Neonatal Care
Background:
- Newborn hearing screening is crucial for early detection of hearing impairment.
- Infants failing initial screenings require further audiological and otolaryngological evaluation.
- Middle ear disease, particularly otitis media with effusion (OME), can transiently affect hearing test results.
Purpose of the Study:
- To determine the prevalence of middle ear disease in infants with failed newborn hearing screenings.
- To analyze the audiological outcomes of infants diagnosed with or without middle ear disease after an initial failed hearing screen.
Main Methods:
- Retrospective chart review of 76 infants referred for failed otoacoustic emissions (OAEs) and otolaryngology evaluation.
- Data collected included audiological test results (ABR) and middle ear status.
- Follow-up assessed OME resolution and need for surgical intervention (tympanostomy tubes).
Main Results:
- Otitis media with effusion (OME) was diagnosed in 64.5% of infants with failed hearing screens.
- Auditory Brainstem Response (ABR) confirmed hearing loss in 78.9% of infants without OME.
- While 65.3% of OME cases resolved spontaneously, 34.7% required tympanostomy tubes for further testing.
- Sensorineural hearing loss (SNHL) was identified in 11% of infants after OME resolution.
Conclusions:
- OME is a significant and common reason for failed infant hearing screenings.
- Evaluation for OME is essential before proceeding with definitive hearing diagnostic testing.
- While most OME resolves, a substantial minority of infants need intervention for accurate audiological assessment.
- Sensorineural hearing loss (SNHL) can be present independently or concurrently with OME, necessitating thorough follow-up.
Objectives:
Evaluate the prevalence of middle ear disease in infants failing a newborn hearing screening program. Review the outcomes of those infants diagnosed with or without middle ear disease after failed hearing screen.
Design:
Retrospective chart review of 76 patients referred to a tertiary care institution for evaluation of a failed newborn hearing screening test.
Setting:
Arkansas Children's Hospital, Little Rock, Arkansas.
Results:
Seventy-six patients were referred for failed OAEs and complete otolaryngology evaluation. Mean age at the time of referral was 3 months (0.25 years) old. OME was identified in 64.5% of the patients. ABR confirmed a suspected hearing loss in 15 patients (78.9%) without middle ear disease. Effusion resolved without surgical intervention in 65.3% of infants, while 17 (34.7%) of the infants required tubes. SNHL was subsequently identified in 11% of infants after resolution of the effusion.
Conclusions:
OME is a common cause of failed infant hearing screens, and should be looked for prior to definitive diagnostic hearing testing. OME resolves in the majority of infants, but tube insertion is necessary to allow for diagnostic testing in nearly one third of infants. The majority of infants without OME had SNHL confirmed. SNHL was also identified in 11% of infants with OME after resolution of the effusion.
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