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Identification of oral clefts as a risk factor for hearing loss during newborn hearing screening

Patricia L Purcell1, Kathleen Cy Sie1,2, Todd C Edwards3

  • 1Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle WA.

Journal of Early Hearing Detection and Intervention
|June 19, 2018
PubMed

Insights

Many children with oral clefts are misclassified as not at-risk for hearing loss. This impacts timely hearing screening and diagnosis for these vulnerable infants.

Area of Science:

  • Pediatric Audiology
  • Craniofacial Anomalies
  • Public Health Surveillance

Background:

  • Children with oral clefts have an increased risk of hearing loss.
  • Newborn hearing screening aims to identify infants at risk early.
  • Accurate classification of risk factors is crucial for appropriate follow-up.

Purpose of the Study:

  • To evaluate the accuracy of hearing loss risk classification for infants with oral clefts.
  • To describe hearing screening and diagnostic outcomes in this population.
  • To identify factors associated with misclassification.

Main Methods:

  • Identified infants with cleft lip and palate or isolated cleft palate using Washington State birth certificates (2008-2013).
  • Cross-referenced birth records with the Early Hearing Detection, Diagnosis and Intervention (EHDDI) database.
  • Employed multivariate logistic regression to analyze associations between classification status and screening outcomes.

Main Results:

  • A significant proportion of infants with oral clefts were not classified as having a craniofacial anomaly in the EHDDI database (only 39%).
  • Misclassification was associated with lower rates of initial hearing screening referral (OR 0.3) and delayed screening (OR 4.4).
  • Of 50 infants with diagnostic results, 50% had hearing loss.

Conclusions:

  • The majority of infants with oral clefts are misclassified regarding hearing loss risk in the EHDDI database.
  • This misclassification can lead to delayed or missed hearing interventions.
  • Improved data accuracy in EHDDI is needed to ensure timely audiological care for infants with oral clefts.
Abstract

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