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[Screening program for selection of hearing loss in newborn infants instituted by the European Community]
B Arnold1, K Schorn, M Stecker
1Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Ludwig-Maximilians-Universität München.
Insights
Early identification of hearing impairment in children is crucial. This study evaluated 1202 children, finding that transiently evoked otoacoustic emissions (TEOAE) combined with auditory brainstem response (ABR) effectively screened for hearing loss, despite some false positives.
Area of Science:
- Pediatric audiology
- Clinical research
- Hearing science
Background:
- Early identification of hearing impairment in children is a significant clinical challenge.
- Over half of the 1202 evaluated children had risk factors for hearing loss.
- Referrals came primarily from pediatricians (52%) and parents (40%).
Purpose of the Study:
- To assess the hearing sensitivity of 1202 newborns, infants, and children.
- To evaluate the effectiveness of various audiological tests for early hearing impairment detection.
Main Methods:
- Transiently evoked otoacoustic emissions (TEOAE)
- Impedance audiometry
- Auropalpebral reflex
- Behavioral observation audiometry
- Auditory brainstem response (ABR)
Main Results:
- TEOAEs were recorded in 378 children bilaterally and 151 unilaterally.
- Auditory brainstem response (ABR) detected absence of TEOAEs in 155 children bilaterally and 16 unilaterally.
- A high rate of false positives in TEOAE screening was attributed to middle ear dysfunction in 76% of cases, particularly after procedures like adenotomy and paracentesis.
Conclusions:
- TEOAEs are a valuable tool for hearing screening in children.
- Auditory brainstem response (ABR) is essential for confirming TEOAE results and identifying hearing loss.
- Middle ear dysfunction can lead to false positive TEOAE results, necessitating further investigation with ABR.
Abstract:
Early identification of hearing impairment in children poses a major problem for clinical research and development. In the last two years we determined the hearing sensitivity of 1202 newborns, small infants and children. 52.4% of the children exhibited risk factors for hearing impairment in their medical history. The majority of children was referred to our department by pediatricians (52%), who first suspected hearing impairment, 40% by parents, 3.5% by otolaryngologists, 3% by educators, and 1.5% by general practitioners. The following examinations were performed: transiently evoked otoacoustic emissions (TEOAE), impedance audiometry, auropalpebralreflex, behavioral observation audiometry, and, if necessary, auditory brain stem response (ABR) with air and bone-conducted clicks as well as frequency-following responses at 500 Hz tone burst. In 378 children TEOAE were recorded on both sides, in 151 at least on one side. These results were confirmed by the other techniques. Only three children presented false negative results of TEOAE on one side. Two of these children had a middle ear effusion and a threshold of 35 dB, one had retrocochlear hearing loss. The absence of TEOAE in both ears in 155 children as well as in one ear in 16 children was detected by ABR. Seventy-seven patients showed no response on both sides, 25 on one side, although a hearing impairment more than 25 dB could not be verified by ABR. This high number of false positive results is explained in 77 cases (76%) by a middle ear dysfunction during the recording of TEOAE, when ABR was performed following adenotomy and paracentesis.(ABSTRACT TRUNCATED AT 250 WORDS)