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Development of a screening service for neonatal ear deformity using neonatal hearing screeners and an information
Lyndsay Fraser1, Nicola Starritt, Louise Melia
1Department of Otolaryngology, Royal Hospital for Sick Children, Dalnair Street, Glasgow G3 8SJ, United Kingdom. LyndsayFraser@doctors.org.uk
Insights
Early detection and splinting of neonatal ear deformities using a screening service is effective. This approach improves outcomes, reduces treatment duration, and avoids psychological distress and corrective surgery.
Area of Science:
- Neonatal care
- Pediatric plastic surgery
- Public health initiatives
Background:
- Early intervention for neonatal ear deformities is crucial for successful treatment.
- Lack of awareness among healthcare personnel often leads to missed opportunities for early splinting.
- A proactive screening service can improve early detection and management.
Purpose of the Study:
- To develop and evaluate a regional screening service for neonatal ear deformities.
- To utilize neonatal hearing screeners for early detection and parental referral.
- To assess the service's acceptability, effectiveness, and cost-efficiency.
Main Methods:
- Information leaflets distributed by neonatal hearing screeners to parents.
- Self-referral system for parents to access a dedicated clinic.
- Assessment of splinting suitability, parent/otolaryngologist ratings, and cost analysis.
Main Results:
- 88 referrals out of 13,403 leaflets distributed; 54 infants suitable for splinting.
- 78% of parents rated splint efficacy as excellent/very good; 96% would recommend the service.
- Early treatment initiation correlated with better surgical outcomes and shorter splinting durations.
Conclusions:
- The developed screening service is acceptable to parents and efficient for early ear deformity correction.
- Routine screening and splinting can prevent the psychological impact of ear deformities.
- Early intervention through screening and splinting can avoid the need for later corrective surgery.
Objectives:
Early splinting of neonatal ear deformities has been proven to be successful but the opportunity to splint is frequently missed due to lack of awareness amongst healthcare personnel. We aimed to develop a regional screening service using neonatal hearing screeners and an information leaflet to allow for the early detection and treatment of such children.
Methods:
We created an information leaflet that was distributed by hearing screeners to all parents in Greater Glasgow at the time of the child's neonatal hearing assessment, with a contact number allowing parents to self refer. All neonates referred were seen at a dedicated clinic within a week and suitability for splints determined. We aimed to assess acceptability of the service, splinting result as rated by parents and otolaryngologist and also costs involved.
Results:
Over a 15 month period, 13,403 leaflets were distributed. 88 babies were referred (0.7%) and 54 were found suitable for splinting. 78% of parents rated the efficacy of splints as either excellent or very good and 96% said they would recommend the service to a friend. Median age at first review was 4 days. We found a weak but statistically significant correlation between age at first review and the surgeon rated outcome from splinting (Spearman's rho=-0.321, p=0.038), with those babies commencing treatment early generally having a better splinting result. We also found that age at first review correlated with duration of splinting required (Spearman's rho=0.357, p=0.008), with younger babies generally requiring shorter splinting times. Cost analysis revealed a saving of £482.76 per child when comparing splint treatment to potential later corrective ear surgery costs.
Conclusions:
Our screening service is both acceptable to parents and efficient in allowing for early correction of ear deformity in the majority of cases. By detecting treatable children early, we propose that the introduction of routine screening and splinting on a wider basis will avoid the psychological burden of ear deformity in childhood and also avoid the need for later corrective surgery.
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