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Early hearing testing of still critically ill neonates
R D Eavey1, L E Pinto, A R Thornton
1Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.
Archives of Otolaryngology--Head & Neck Surgery
|March 1, 1996
Summary
A new hearing screening technique using auditory brain-stem response in neonatal intensive care units (NICU) identified a high incidence of hearing loss. Early detection is possible even in critically ill infants.
Area of Science:
- Neonatal care
- Audiology
- Pediatric neurology
Background:
- Neonatal intensive care units (NICUs) have a high incidence of hearing loss.
- Early detection of hearing impairment is crucial for developmental outcomes.
- Conventional hearing tests may not be feasible for all NICU patients.
Purpose of the Study:
- To evaluate a novel, portable auditory brain-stem response (ABR) screening technique for early hearing loss detection in NICU patients.
- To determine the incidence and potential causes of hearing loss in this high-risk population.
Main Methods:
- An automated, portable infant hearing screener measuring ABR was utilized at the bedside in a NICU.
- Click stimuli at 40-dB hearing level were applied to each ear.
- Infants were tested early, irrespective of ventilator use, with screening completed before discharge or death.
Main Results:
- Over 15 months, 92 newborns underwent 226 ABR tests.
- A 6% bilateral failure rate was observed in infants discharged alive.
- A 75% bilateral failure rate was noted in infants who died, showing a significant association with mortality (P<.001).
- The overall bilateral failure rate was 21%.
Conclusions:
- Bedside ABR screening is feasible for all NICU infants, regardless of clinical status.
- Early onset of hearing loss suggests NICU treatments were not ototoxic.
- The high failure rate was influenced by including non-survivors, highlighting the need for comprehensive screening.