Performance of two hearing screening protocols in the NICU

Area of Science:

• Neonatal care
• Audiology
• Public health

Background:

• Neonatal intensive care units (NICUs) house infants at high risk for hearing impairment.
• Early detection of hearing loss is crucial for timely intervention and improved outcomes.
• Implementing effective hearing screening programs in NICU settings is essential.

Purpose of the Study:

• To report the successful implementation of a novel two-step hearing screening protocol for NICU infants.
• To evaluate the efficacy of Distortion Product Otoacoustic Emissions (DPOAE) and automated Auditory Brainstem Response (AABR) in identifying hearing loss.
• To establish a baseline for potential universal hearing screening in China.

Main Methods:

• A two-stage screening process was employed: initial screening with DPOAE and AABR, followed by diagnostic evaluation at two months.
• Diagnostic work-up included otoscopy, middle ear impedance, and click-evoked ABR for referred infants.
• The study involved 200 NICU infants at Shanghai Children's Medical Center.

Main Results:

• Twenty-nine infants (14.5%) were initially referred by DPOAE screening; nine (4.5%) by DPOAE-AABR screening.
• Six infants (3%) were diagnosed with significant hearing loss based on click-evoked ABR at two months.
• No infants referred by DPOAE but passing AABR were found to have hearing loss, indicating high specificity.

Conclusions:

• The implemented two-step screening protocol is effective for identifying hearing loss in high-risk NICU infants.
• This program demonstrates the feasibility of advanced hearing screening in a Chinese NICU setting.
• The study supports the potential for expanding universal hearing screening programs in the People's Republic of China.