Related Experiment Video
Updated: Jun 6, 2025
Neonatal Murine Cochlear Explant Technique as an In Vitro Screening Tool in Hearing Research
Published on: June 8, 2017
Follow-Up of Neonatal Hearing Screening in the Risk Factor Group for Hearing Loss: Results from a Tertiary Medical
Miriam Geal Dor1,2, Menachem Gross3,4, Cahtia Adelman1,2
1Speech & Hearing Center, Hadassah Hebrew-University Medical Center, Jerusalem 91120, Israel.
Insights
Many children with hearing loss risk factors pass initial screening but require ongoing audiologic follow-up. A refined monitoring protocol is crucial for early detection of hearing impairment in at-risk infants.
Area of Science:
- Pediatrics
- Audiology
- Genetics
Background:
- Universal newborn hearing screening is standard practice.
- Follow-up is recommended for infants with hearing loss risk factors, regardless of initial screening results.
- Clearer guidelines are needed for follow-up testing and frequency in high-risk infants.
Purpose of the Study:
- To assess the effectiveness of the audiologic follow-up program for children with hearing loss risk factors.
- To identify children with hearing loss who passed initial screening.
- To determine optimal follow-up strategies for at-risk infants.
Main Methods:
- Retrospective study of 113,708 births from 2013-2021.
- Focused on 6763 infants identified with hearing loss risk factors.
- Analyzed audiologic test results (ABR, OAE, tympanometry, behavioral audiometry) for 1534 infants.
Main Results:
- 73 out of 6763 (4.7%) at-risk children were diagnosed with hearing loss.
- 19 children diagnosed with hearing loss had passed initial screening.
- Missed diagnoses included familial, progressive, and late-onset hearing loss; causes included CMV, meningitis, and prematurity.
Conclusions:
- A refined protocol for monitoring hearing in high-risk children is essential.
- Specific hearing tests, age-appropriate evaluations, and follow-up duration need standardization.
- Addressing barriers to follow-up and increasing parental involvement are critical.
Introduction:
Universal newborn hearing screening has been successfully implemented in many places around the world, and it is recommended that cases with risk factors for hearing loss be followed-up regardless of hearing screening results. However, there is a need for clarity regarding the recommended rate of follow-up and which tests should be performed. The aim of this study was to assess the audiologic follow-up program for the group with risk factors.
Method:
Our retrospective study involved children of various ages with a risk factor for hearing loss who passed the initial neonatal hearing test but were later diagnosed with hearing loss. Out of 113,708 children born at Hadassah University Medical Center during the years 2013-2021, 6763 were at risk of hearing loss, and their follow-up audiologic test results were studied.
Results:
Audiologic testing including ABR, OAE, tympanometry and behavioral audiometry was performed in 1534 of 6763 (23%) of the risk factor group that returned to the hospital. In total, 73 children (4.7%) were diagnosed with hearing loss, 54 of whom failed the initial screening and 19 who had passed it. Further examination of the children that passed the initial screening and were later diagnosed with a hearing loss revealed that four cases had been missed in screening (one familial mild hearing loss, one familial progressive loss, one premature infant with a high tone loss, and one NICU graduate with CNS involvement). Another nine cases had late-onset hearing loss (three meningitis, five CMV, and one with a mitochondrial disease). An additional six cases were diagnosed late, and the age of onset of the hearing loss was unknown (two intubated, two with hydrocephalus, one with Cerebral Palsy, and one with general developmental delay).
Conclusions:
These results reveal the importance of implementing a refined protocol for monitoring hearing in the high-risk group of children that pass neonatal hearing screening with respect to which hearing tests should be conducted, at what age, and the duration of follow-up. Also, barriers to follow-up must be dealt with, and parents should be more involved in the monitoring process.
