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Implementation of neonatal screening for hearing impairment: influence on pediatric otitis media surgery in The
W Lok1, M N Chenault, L J C Anteunis
1Department of Otorhinolaryngology, Albert Schweitzer Hospital, Zwijndrecht, The Netherlands. w.lok@asz.nl
Insights
Shifting hearing impairment screening from 9 months to the neonatal period in the Netherlands did not reduce ventilation tube insertions for otitis media. However, adenoidectomy rates declined, suggesting a link between screening timing and otitis media treatment.
Area of Science:
- Pediatrics
- Otolaryngology
- Public Health
Background:
- Historically, hearing impairment screening in the Netherlands occurred at 9 months.
- Otitis media prevalence peaks at 9 months, potentially linking this screening age to treatment decisions.
- Recent policy changes moved hearing impairment screening to the neonatal period.
Purpose of the Study:
- To evaluate the impact of shifting hearing impairment screening from 9 months to the neonatal period on otitis media treatments.
- To assess changes in ventilation tube placement and adenoidectomy rates in children aged 0-2 years.
Main Methods:
- Utilized national birth rate data.
- Analyzed data on hearing impairment screening timing (9 months vs. neonatal).
- Examined treatment data for otitis media, specifically ventilation tube placement and adenoidectomy, in children aged 0-2 years in the Netherlands.
Main Results:
- The percentage of children receiving ventilation tubes did not decrease post-neonatal screening implementation; in fact, more children were treated at a younger age.
- A decline in adenoidectomy rates was observed.
- A slight but statistically significant increase in odds for tube placement occurred in children aged 0-23 months.
Conclusions:
- Neonatal hearing impairment screening appears associated with otitis media treatment patterns.
- A notable increase in tube placement was observed in infants aged 6-11 months after neonatal screening implementation.
- A statistically significant decline in adenoidectomy rates was observed concurrently with the shift in screening policy.
Objective:
Screening for hearing impairment in the Netherlands took place at the age of 9 months for many years but was recently moved to the neonatal period. Since otitis media has its highest prevalence at the age of 9 months, it might be that screening for hearing impairment at this age is linked to treatment of otitis media. We were interested in what the impact would be on the number of children treated with ventilation tubes or adenoidectomy when they were no longer screened at the age of 9 months.
Methods:
National birth rates, data regarding screening for hearing impairment at the age of 9 months and at the neonatal period, as well as data regarding adenoidectomy and tube placement were used to study treatment of otitis media in children aged 0-2 years in the Netherlands.
Results:
The percentage of children treated with ventilation tubes after implementation of neonatal screening for hearing impairment did not decline (OR 1.198-1.112), and more children were treated at a younger age. The number of children treated with adenoidectomy did however decline (OR 0.724-0.890).
Conclusion:
There seems to be an association between the implementation of neonatal screening for hearing impairment and the treatment of otitis media. During the whole studied period there was a slight but statistical significant increase in the odds for tube placement in all children aged 0-23 months. After implementation of the neonatal screen there was a distinct increase in the number of children aged 6-11 months treated with tubes. In the same period a statistical significant decline in the odds of undergoing adenoidectomy was observed.
