Hearing loss in children in Østfold county 2000-09
Siri Nelson1, Ronny Andersen2, Sven-Harald Anderssen3
1Barneavdelingen Sykehuset Østfold Fredrikstad * Nåværende arbeidssted: Svensedammen Legesenter Drammen.
Insights
Newborn hearing screening using otoacoustic emissions (OAE) effectively identifies congenital hearing loss in neonates. Early diagnosis and treatment initiation before six months improved significantly, aligning with national and international prevalence rates.
Area of Science:
- Audiology
- Neonatal Care
- Public Health
Background:
- Congenital hearing loss affects 1-3 per 1,000 newborns, necessitating early detection.
- Otoacoustic emissions (OAE) are recommended for universal newborn hearing screening.
- Timely intervention before six months of age is crucial for optimal developmental outcomes.
Purpose of the Study:
- To determine the prevalence of congenital hearing loss in a large Norwegian newborn cohort.
- To evaluate the effectiveness of otoacoustic emissions (OAE) as a screening tool.
- To assess changes in the age of diagnosis over a ten-year period.
Main Methods:
- A decade-long prospective study (2000-2009) screened 29,485 neonates in Østfold county using OAE.
- Infants with absent emissions were referred for further audiological evaluation.
- Follow-up data extended to 2013, including cases with initially normal screening but later diagnosed hearing loss.
Main Results:
- A total of 31 neonates (0.11%) were diagnosed with hearing loss via OAE screening.
- The median age of diagnosis decreased from 13 to 6 months, with more cases diagnosed before six months.
- Delayed-onset hearing loss was identified in 10 children (0.03%), with a median diagnosis age of 36 months.
Conclusions:
- The prevalence of hearing loss in the studied cohort aligns with Norwegian and international data.
- Otoacoustic emissions (OAE) proved effective for neonatal hearing screening in a hospital setting.
- The adoption of automated auditory brainstem response audiometry (AABR) reduced the need for invasive testing under anesthesia.
Background:
The Directorate of Health recommends hearing screening of all neonates with the aid of otoacoustic emissions (OAE). The goal is to achieve initiation of treatment before the child is six months old. Congenital hearing loss occurs in 1-3 per 1,000 newborns, and the purpose of this study was to identify the prevalence in a large Norwegian dataset.
Method And Material:
During the period 1 January 2000-31 December 2009, all children who were born in Østfold county, 29,485 neonates in total, were offered hearing screening with the aid of otoacoustic emissions. Those children in whom no emissions were detected were referred to the hearing centre. The dataset also includes children born during the same period who had normal emissions during their neonatal period, but later were diagnosed with hearing loss. The follow-up period of these children lasted until 31 December 2013.
Results:
Altogether 568 children were referred to the hearing centre after screening. Of these, 73 children underwent brainstem response audiometry under anaesthesia, and 31 (0.11%) were diagnosed with hearing loss through absence of emissions at birth. Eleven (35%) of these received their diagnosis before the age of six months. The median age of diagnosis decreased from 13 (7-74) to 6 (3-23) months, while their number increased from nine to 22 from 2000-04 to 2005-09. Hearing loss after normal otoacoustic emissions at the neonatal stage was diagnosed in ten children (0.03%) and the median age of diagnosis among these was 36 (18-86) months. After the introduction of automated auditory brainstem response audiometry (AABR) during sleep, the use of auditory brainstem response audiometry (ABR) under narcosis fell by half.
Interpretation:
The prevalence of hearing loss is equal to other Norwegian and international figures. The age of diagnosis decreased during the period. Otoacoustic emissions appear to be an effective screening method in paediatric wards. The use of automated auditory brainstem response audiometry reduces the need for testing under narcosis.
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