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The Assessment of Auditory Function in High-Risk Neonates and Infants Using Brainstem-Evoked Response Audiometry
Rashmi P Rajashekhar1, Sunanda Devi Putta1, Aishwarya Kothari1
1Otolaryngology-Head and Neck Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Insights
Early hearing screening using Brainstem-evoked response audiometry (BERA) is crucial for high-risk infants. The study found prematurity as the leading cause of hearing loss, emphasizing the need for timely diagnosis and intervention.
Area of Science:
- Pediatric Audiology
- Neonatal Care
- Developmental Pediatrics
Background:
- Hearing impairment in neonates and infants can significantly impact language, cognitive, and social development.
- Early detection is critical for timely intervention and improved long-term outcomes.
- High-risk neonates are particularly susceptible due to factors like prematurity and low birth weight.
Purpose of the Study:
- To assess the prevalence of hearing impairment in high-risk neonates and infants.
- To identify key risk factors associated with hearing loss in this population.
- To underscore the importance of early auditory screening using Brainstem-evoked response audiometry (BERA).
Main Methods:
- A prospective hospital-based study was conducted in the Otorhinolaryngology department.
- 70 high-risk neonates and infants were enrolled between October 2022 and March 2024.
- Brainstem-evoked response audiometry (BERA) was used for auditory assessment.
Main Results:
- Prematurity was the most prevalent risk factor for hearing impairment.
- Low birth weight (43%), perinatal asphyxia, hyperbilirubinemia, and neonatal sepsis were also significant factors.
- 50% of infants had normal hearing; 23% had mild, and 14% had moderate hearing loss.
Conclusions:
- Early and routine auditory screening with BERA is vital for high-risk neonates and infants.
- Identifying risk factors like prematurity, low birth weight, and hyperbilirubinemia aids in early diagnosis.
- Prompt intervention, including cochlear implants for profound sensorineural hearing loss, is crucial for language development.
Abstract:
Introduction Hearing impairment in neonates and infants is a critical concern due to its potential to impede language acquisition, cognitive development, and overall quality of life. Brainstem-evoked response audiometry (BERA) stands out as a valuable diagnostic tool. The early detection of hearing impairments is paramount in neonatal care. Hearing loss during infancy can impede speech and language development, social interaction, and academic achievement. High-risk neonates, including those born prematurely or with low birth weight, have a heightened susceptibility to hearing impairment due to various factors such as exposure to ototoxic medications, mechanical ventilation, and complications associated with prematurity. Methods A hospital-based prospective study was conducted in the department of otorhinolaryngology; the study focused on high-risk neonates and infants from the outpatient department and inpatient department. The study was conducted from October 2022 to March 2024. A sample size of 70 patients was taken, including high-risk neonates and infants. Healthy term neonates and healthy infants were excluded from the study. Results In the current study, there were 40 males and 30 females. Among the infants surveyed, prematurity was the most prevalent risk factor, followed by perinatal asphyxia. Low birth weight was observed in 43% of cases, while hyperbilirubinemia and neonatal sepsis were the next. Among the 70 infants assessed, 50% were found to have normal hearing. Mild hearing loss was observed in 23% of cases, while 14% had moderate hearing loss. Severe and profound hearing loss were less common. Conclusion Our study highlighted the importance of early and routine auditory screening using BERA in high-risk neonates and infants, revealing a significant prevalence of hearing loss linked to various risk factors such as premature babies, low birth weight, hyperbilirubinemia, neonatal intensive care unit stay, perinatal asphyxia, and ototoxic drugs during pregnancy. Prematurity is the most common risk factor. For language development, early diagnosis and intervention were crucial. If babies have profound sensorineural hearing loss, they can go for a cochlear implant.
