[The algorithm for clinical and audiological observation of children born preterm]
I V Savenko1, E S Garbaruk1,2, M Yu Boboshko1
1Laboratory of hearing and speech of Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia.
Insights
Premature infants face high risks of hearing dysfunction, impacting development and quality of life. Early screening and long-term monitoring are crucial for timely diagnosis and intervention to mitigate hearing loss effects.
Area of Science:
- Pediatrics
- Audiology
- Developmental Neuroscience
Background:
- Premature infants are highly susceptible to auditory system dysfunction.
- Hearing impairment in this population can range from conductive to sensorineural hearing loss and auditory neuropathy spectrum disorders (ANSD).
- Consequences include disruptions in auditory, language, communication, emotional, and social skill development, affecting overall quality of life.
Purpose of the Study:
- To present a comprehensive algorithm for the clinical and audiological monitoring of premature children from birth to 10 years old.
- To outline diagnostic and habilitation strategies for children with ANSD.
- To emphasize the importance of multidisciplinary collaboration for early detection and intervention.
Main Methods:
- A two-stage newborn hearing screening within the first 1-2 months of life.
- Diagnostic confirmation by 3 months corrected age.
- Follow-up monitoring schedules tailored to hearing status, with more frequent checks for detected hearing loss and annual checks for normal hearing.
Main Results:
- The proposed algorithm details screening, diagnosis, and monitoring protocols for premature infants up to age 10.
- Specific attention is given to children with ANSD, outlining diagnostic and habilitation pathways.
- The study highlights the necessity of involving otolaryngologists, special education teachers, and speech therapists.
Conclusions:
- Long-term, comprehensive monitoring of auditory function in premature infants is essential.
- Timely and high-quality diagnostic and rehabilitation processes can minimize the negative impact of hearing impairments.
- Early detection and intervention are key to improving developmental outcomes and quality of life for premature children.
Abstract:
Premature babies are at high risk of developing hearing dysfunction, which can affect all levels of the auditory system and disrupt the development of auditory, language, communicative, emotional, and social skills, thus impairing the child's overall quality of life. Hearing impairment in premature infants is presented in transient or intermittent forms of conductive hearing loss, mixed hearing loss, as well as sensorineural hearing loss (SNHL) and auditory neuropathy spectrum disorders (ANSD). Auditory function characteristics include unstable hearing thresholds, the possibility of improvement up to complete normalization, less commonly delayed hearing loss, and the transformation of ANSD into SNHL and vice versa. The article presents a possible algorithm for clinical and audiological monitoring of children born prematurely from birth to 10 years old. It involves a two-stage newborn hearing screening within the first 1-2 months after birth and verification of the diagnosis by the time infants reach 3 months corrected age. If hearing loss are detected, children are examined up to the age of 2 years 3-4 times a year; children with initially verified normal hearing are examined 2-3 times in the first year of life, and then annually. Separately, there is an algorithm for diagnostic and habilitation intervention for children with ANSD. Attention is also drawn to the need to involve otolaryngologists for timely identification of conductive hearing loss and special education teachers, speech therapists for early diagnosis of central auditory processing disorders. Long-term monitoring of all aspects of auditory function in premature babies will allow for timely and high-quality diagnostic and (re)habilitation processes, minimizing the negative impact of hearing impairments.
