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Age at diagnosis of paediatric unilateral and bilateral permanent hearing loss in Eastern Switzerland: a
Samuel P Hofmann1,2, Sandro J Stoeckli1, Jochen Rosenfeld1
1Klinik für Hals-Nasen-Ohrenheilkunde, Kantonsspital St. Gallen, Switzerland.
Insights
Early diagnosis of permanent childhood hearing loss is crucial. In Eastern Switzerland, diagnosis age varied, with unilateral and some bilateral cases diagnosed late, highlighting screening gaps.
Area of Science:
- Paediatric Audiology
- Otolaryngology
- Public Health
Background:
- Permanent childhood hearing loss significantly impacts development.
- Early diagnosis and intervention are vital for optimal outcomes.
- Newborn hearing screening programs aim to reduce diagnosis age but show variable success globally.
Purpose of the Study:
- To determine the median age of diagnosis for permanent unilateral and bilateral hearing loss in children in Eastern Switzerland.
Main Methods:
- Retrospective cohort study of children diagnosed between 2014-2019.
- Data collected included hearing loss type, WHO grade, newborn hearing screening status, and referral pathway.
- Primary endpoint was age at diagnosis.
Main Results:
- 107 children were included; overall median diagnosis age was 45.0 months.
- Bilateral hearing loss diagnosed at 25.8 months, unilateral at 63.1 months.
- Children with higher WHO grade bilateral hearing loss and failed newborn screening were diagnosed earlier.
Conclusions:
- Age at diagnosis for paediatric permanent hearing loss in Eastern Switzerland is variable and often delayed.
- Late diagnosis particularly affects unilateral hearing loss and some congenital bilateral cases.
- Findings underscore the need to improve screening and diagnostic pathways.
Study Aim:
Undiagnosed and therefore untreated permanent paediatric hearing loss can have a detrimental impact on a child's speech, language, social and educational development, and quality of life. Therefore, early diagnosis is required for successful treatment with hearing aids to minimise the negative impact of hearing loss. Newborn hearing screening programmes may have decreased the average age at diagnosis of hearing loss worldwide, but outcomes vary widely between countries. In this study, we therefore aimed to assess the median age of children at diagnosis of permanent unilateral and bilateral hearing loss in Eastern Switzerland.
Methods:
In this retrospective cohort study, children born in Eastern Switzerland with permanent hearing loss diagnosed at the Division of Paediatric Audiology at the Cantonal Hospital of St Gallen (the tertiary referral centre for Eastern Switzerland) were included. The study period was from 1 January 2014 to 31 December 2019. The primary endpoint was age at diagnosis of permanent unilateral or bilateral hearing loss. Descriptive data collected were the type and WHO grade of hearing loss, the status of newborn hearing screening and other information such as path of referral and place of residence.
Results:
In total, 107 children with permanent hearing loss were included in this study. Overall, the median age at diagnosis was 45.0 months (interquartile range [IQR] 5.7-74.8). The median age at diagnosis for children with bilateral hearing loss was 25.8 months (IQR 3.6-70.5), compared to 63.1 months (IQR 11.4-88.5) for children with unilateral hearing loss. For children with bilateral hearing loss, the median age at diagnosis was lower with higher WHO grades of hearing loss: 65.6 months (IQR 11.1-131.6) for grade I vs 4.5 months (IQR 2.2-6.0) for grade IV. Children with bilateral hearing loss and a documented failed newborn hearing screen were diagnosed early: median age at diagnosis 4.0 months (IQR 2.2-12.3).
Conclusion:
In conclusion, the age at diagnosis of paediatric permanent hearing loss in our study is variable and, in some cases, late. This applies particularly to bilateral hearing loss that should have been diagnosed by the newborn hearing screen in congenital cases and unilateral hearing loss.
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