Screening Programs for Hearing Assessment in Newborns and Children
Zafar Mahmood1, Muhammad Razzaq Dogar2, Abdul Waheed3
1Otolaryngology, Liaquat College of Medicine and Dentistry, Darul Sehat Hospital, Karachi, PAK.
Insights
Newborn hearing loss screening using otoacoustic emission (OAE) and brainstem evoked response audiometry (BERA) is crucial for early detection. Implementing these programs in Pakistan can help identify and manage hearing impairment in infants effectively.
Area of Science:
- Pediatric Audiology
- Neonatal Screening
- Otoacoustic Emissions
- Auditory Brainstem Response
Background:
- Hearing loss is a significant concern in pediatric populations.
- Early detection and intervention are critical for speech and language development.
- Otoacoustic Emission (OAE) and Brainstem Evoked Response Audiometry (BERA) are objective measures for assessing infant hearing.
Purpose of the Study:
- To determine the incidence of hearing loss in children using OAE and BERA.
- To identify potential etiological factors contributing to pediatric hearing loss.
- To evaluate the effectiveness of OAE and BERA screening in a Pakistani population.
Main Methods:
- A retrospective observational study of 108 newborns and children was conducted.
- Initial screening utilized Otoacoustic Emissions (OAE) and/or Auditory Brainstem Response (ABR).
- Children with suspected hearing loss underwent diagnostic Brainstem Evoked Response Audiometry (BERA) for confirmation.
Main Results:
- Out of 108 cases, 12 showed hearing loss on OAE screening.
- Further BERA testing confirmed hearing loss in 7 out of these 12 cases.
- Of the 7 with confirmed hearing loss, 5 had cochlear deafness and 2 had retrocochlear deafness.
Conclusions:
- OAE hearing screening and diagnostic BERA are effective in identifying pediatric hearing loss.
- Implementing widespread screening programs in Pakistan is recommended for early detection.
- Early assessment of newborn hearing is vital to prevent long-term auditory problems.
Abstract:
Objective In this study, we aimed to assess the incidence of hearing loss in the pediatric population through otoacoustic emission (OAE) and brainstem evoked response audiometry (BERA) and to analyze the possible etiological factors responsible for it. Material and methods A retrospective observational study was conducted in the Otolaryngology (ENT) and Gynecology and Obstetrics Departments at the Jinnah Postgraduate Medical Centre and National Institute of Child Health in Karachi, Pakistan between July 2019 and October 2019. The convenient sampling technique was used to select the patients. The final sample size consisting of newborns and children was 108. Initially, screening procedures were undertaken for newborns to detect permanent or fluctuating, bilateral or unilateral, and sensory or conductive hearing loss, averaging 30-40 dB or more in the frequency region, which indicated potential issues related to speech recognition (approximately 500-4,000 Hz). The screening of newborns involved the use of non-invasive, objective physiologic measures that included OAEs and/or auditory brainstem response (ABR). The children with hearing impairment then underwent BERA; thereafter, further investigations were performed to confirm the defects found on BERA testing. Results Of the 108 cases, 96 had normal hearing on OAE screening, and 12 were found to have hearing loss on the OAE test. Further testing was carried out on BERA for 12 cases that had been detected to have hearing loss on OAE, and BERA showed normal hearing for five cases whereas seven were found to have hearing loss. Of the seven patients with hearing loss on the BERA test, five were diagnosed with cochlear deafness, and two had retrocochlear deafness. Conclusion Our present study concludes that in order to avoid any hearing problems in infants, OAE hearing screening and diagnostic BERA screening programs should be carried out in all the hospitals of Pakistan to assess newborn hearing at an early age.
