[Evaluation of Universal Newborn Hearing Screening and follow-up]
Veronika Hall1, Sibylle Brosch1, Thomas Karl Hoffmann2
1Sektion für Phoniatrie & Pädaudiologie, Klinik für Hals-, Nasen- und Ohrenheilkunde, University Hospital Ulm, Germany.
Insights
Universal newborn hearing screening (UNHS) in Germany identifies hearing loss, but follow-up care for affected infants needs improvement. Early diagnosis and intervention are crucial for better outcomes in children with suspected hearing disorders.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Universal newborn hearing screening (UNHS) was implemented in Germany in 2009.
- Limited data exists on follow-up care for infants with suspected hearing loss post-UNHS.
Purpose of the Study:
- To evaluate the follow-up process for children who failed newborn hearing screening in Germany.
- To assess compliance with national guidelines for hearing disorder diagnosis and management.
Main Methods:
- Retrospective analysis of 570 children who failed UNHS between 2009-2016.
- Definition of hearing deficiency: threshold ≥35 dB.
- All children underwent brainstem evoked response audiometry (BERA).
Main Results:
- Permanent hearing disorder identified in 24% of cases; 51% had inner ear loss.
- Delayed diagnosis and therapy occurred, particularly for high-risk infants in peripheral hospitals (only 27% tested immediately with AABR).
- Children tracked by health offices showed earlier presentation but fewer lost to follow-up.
Conclusions:
- Diagnosis was made in 93% during the first examination, with therapy initiated within four months.
- The quality of primary screenings is vital for early problem detection and timely intervention.
- Improving follow-up protocols is essential for optimal management of hearing disorders in newborns.
Background:
Universal newborn hearing screening (UNHS) was established in Germany in 2009. Even compliance was tested in early studies, there is little knowledge regarding the follow-up examination of children with suspected hearing disorder.
Methods:
A retrospective evaluation was performed in 570 cases of children who failed newborn hearing screening for the years between 2009-2016. Hearing deficiency was defined as having a hearing threshold ≥ 35 dB. Compliance with national guidelines was checked. Every child received brainstem evoked response audiometry (BERA).
Results:
Permanent hearing disorder was found in 24 %, of whom about half (51 %) had an inner ear hearing loss (of these in 73 % bilateral). Only 27 % of high risk children born in peripheral hospitals were tested immediately by the envisaged automated auditory brainstem response (AABR) method. They often presented tardy, leading to a delayed diagnosis and therapy. Children tracked by the Bavarian health office presented little earlier but had less cases who were lost to follow-up.
Discussion:
In 93 % a diagnosis was made during first examination and therapy (e. g. prescription of hearing aids) initiated on average within four months age. The rate of deafness corresponded with national averages. The quality of primary screenings is crucial in revealing problems and avoiding delay in dealing with them.
