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The outcomes of an audiological management programme for neonates with hyperbilirubinaemia
Moleboge M Matshete1, Samantha Govender, Sam T Ntuli
1Department Speech-Language Pathology and Audiology, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria. mashudumoleboge@gmail.com.
Insights
Combined hearing tests, including Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAE), improve neonatal hearing loss detection in infants with hyperbilirubinaemia. Monitoring serum bilirubin levels aids in identifying infants needing combined testing.
Area of Science:
- Neonatal audiology
- Pediatric audiology
- Otoacoustic emissions
Background:
- Neonatal hearing loss is linked to hyperbilirubinaemia.
- Otoacoustic Emissions (OAE) and Automated Auditory Brainstem Response (AABR) are crucial for diagnosing hearing loss.
- Combined testing approaches are recommended for early detection.
Purpose of the Study:
- To evaluate a combined OAE and Auditory Brainstem Response (ABR) testing strategy for neonates with hyperbilirubinaemia.
- To assess the relationship between serum bilirubin levels and audiological test outcomes.
Main Methods:
- A cross-sectional study involving 40 neonates (80 ears) in South Africa.
- Neonates underwent hearing screening and diagnostic testing using ABR and/or AABR and DPOAE.
- Comparative analysis of test results and serum bilirubin levels.
Main Results:
- Automated Auditory Brainstem Response (AABR) identified more abnormalities than DPOAEs (p=0.001).
- Neonates with serum bilirubin >10 mg/dL showed abnormal ABR results but passed DPOAE (p=0.001).
- 32.5% of neonates had comorbidities.
Conclusions:
- Combined ABR and DPOAE testing enhances the identification of auditory pathology compared to single tests.
- Serum bilirubin levels can indicate the need for combined audiological testing in neonates.
Background:
Hyperbilirubinaemia is a contributing condition to the prevalence of neonatal hearing loss. Because of its pathophysiology, the use of Otoacoustic Emissions (OAE) and Automated Auditory Brainstem Response (AABR) testing is essential in diagnosing hearing loss. Two-tier screening models are typically used in developing world contexts; however, a combined approach to testing (using both tests) should be used for early detection. Blood serum levels should also be monitored to determine how they impact audiological test results.
Objectives:
To determine the outcomes of using a combined testing approach of both OAE and Auditory Brainstem Response (ABR) for both screening and diagnostic testing of neonates with hyperbilirubinaemia and studying the relationship between the test results and the serum bilirubin levels.
Method:
A cross-sectional, comparative design was utilised. Forty neonates were tested (80 ears). Neonates underwent hearing screening and diagnostic testing (ABR and/or AABR and DPOAE tests). The study was conducted at a hospital in South Africa.
Results:
One-third (32.5%) of the neonates had comorbidities. Screening results indicated that the AABR test could identify more cases of abnormalities than DPOAEs (p = 0.001). Participants with a serum level greater than 10 mg/dL presented with abnormal diagnostic ABR test results while passing the DPOAE test (p 0.001).
Conclusion:
Combined use of ABR and DPOAE testing yielded a greater identification of auditory pathology than using either test alone. Serum bilirubin levels can be used as an indicator for combination testing.Contribution: Combined use of ABR and DPOAE testing leads to greater identification of auditory pathology.
