Hearing outcomes in children with cleft palate and referred newborn hearing screen
Victoria A Jordan1, James D Sidman
1University of Minnesota Medical School, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, U.S.A.
Insights
Children with cleft palate failing newborn hearing screens may have delayed testing if they have no comorbidities. Permanent hearing loss was only seen in those with additional health conditions.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Genetics
Background:
- Cleft palate is associated with an increased risk of hearing loss.
- Universal newborn hearing screening (UNHS) identifies infants with hearing deficits early.
- Failure of UNHS in infants with cleft palate warrants further investigation.
Purpose of the Study:
- To determine the prevalence of long-term hearing loss in infants with cleft palate who failed their UNHS.
- To identify factors associated with permanent hearing loss in this cohort.
Main Methods:
- Retrospective chart review of infants with cleft palate born between 2002 and 2012.
- Inclusion criteria: failed UNHS and presented to a pediatric otolaryngology practice.
- Data collected: audiology results post-pressure equalization tubes, cleft type, and comorbid conditions.
Main Results:
- Of 317 infants with cleft palate, 89 (28%) failed UNHS.
- Of those who failed, 67 (75%) achieved normal hearing, while 22 (25%) did not have normal results at follow-up.
- Fourteen infants had permanent hearing loss, all of whom had a comorbid condition. Cleft type and comorbidities correlated with hearing outcomes.
Conclusions:
- Infants with cleft palate who fail UNHS may not require immediate diagnostic testing if they have no comorbidities.
- Diagnostic hearing testing can potentially be postponed until after pressure equalization tube placement.
- Comorbid conditions are significant indicators for permanent hearing loss in this population.
Objectives/Hypothesis:
To determine the prevalence of long-term hearing loss in patients with cleft palate who fail their universal newborn hearing screen.
Study Design:
The study is a retrospective chart review from a tertiary pediatric center and tertiary children's hospital.
Methods:
Newborns with cleft palate born between January 2002 and July 2012 were identified from a pediatric otolaryngology practice database. This cohort was then reduced to include only those patients who referred their universal newborn hearing screen. Postpressure equalization tube audiology results, follow-up audiology results, type of cleft, and comorbid conditions were collected for each patient who was both born with a cleft palate and referred their universal newborn hearing screen.
Results:
A total of 317 newborns presented to the pediatric otolaryngology practice for cleft palate, with 89 (28%) having documented referred universal newborn hearing screen. At the time of data collection, 67 (75%) of 89 had normal hearing results, whereas 22 (25%) of 89 did not yet have normal hearing results. Fourteen patients had permanent hearing loss, and all 14 had a comorbid condition. Type of cleft and presence of a comorbid condition were correlated to hearing outcomes.
Conclusions:
Newborns with cleft palate who refer their universal newborn hearing screen could postpone diagnostic hearing testing until after placement of pressure equalization tubes, unless there is a clue to permanent hearing loss such as a comorbid condition.
