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Evaluation of hearing loss after failed neonatal hearing screening
Ingrid L Holster1, Lambertus J Hoeve, Marian H Wieringa
1Department of Pediatric Otorhinolaryngology, Sophia Children's Hospital, Rotterdam, The Netherlands. lisanneholster@hotmail.com
The Journal of Pediatrics
|July 21, 2009
Summary
Universal newborn hearing screening identifies more sensorineural hearing loss (SNHL) earlier than behavioral tests. This screening improves early detection and intervention for infant hearing loss, with a higher positive predictive value for SNHL.
Area of Science:
- Pediatrics
- Audiology
- Neonatology
Background:
- Failed universal newborn hearing screening (UNHS) necessitates further evaluation for hearing loss in neonates.
- Previous hearing screening methods, like the Ewing/CAPAS test, had limitations in identifying specific hearing loss types.
Purpose of the Study:
- To evaluate the causes of hearing loss in neonates who failed UNHS.
- To compare the effectiveness of UNHS with the older Ewing/CAPAS behavioral observation test.
Main Methods:
- Audiologic testing and physical examinations were conducted on 340 neonates referred after failed UNHS between 1999 and 2007.
- Data were analyzed to determine hearing loss prevalence and compare screening outcomes.
Main Results:
- 21.2% had normal hearing, 20.3% conductive hearing loss, and 57.9% sensorineural hearing loss (SNHL).
- Neonatal intensive care unit (NICU) referrals had a higher SNHL risk (71%) than well-baby clinic referrals (54%).
- Hearing aids were fitted at a median age of 8 months, and the positive predictive value for SNHL was 54-71%.
Conclusions:
- UNHS identifies less otitis media with effusion compared to the Ewing/CAPAS test (20% vs 59-81%).
- UNHS enables earlier identification and intervention for hearing loss (8 months) versus previous methods (15-18 months).
- The positive predictive value for SNHL has significantly improved with UNHS (54% vs 2%).
