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Published on: January 23, 2017
Auditory brainstem response screening for hearing loss in high risk neonates
D R Watson1, R J McClelland, D A Adams
1Department of Otorhinolaryngology, Queen's University, Belfast, UK.
Insights
Auditory Brainstem Response (ABR) screening effectively identifies hearing impairment in at-risk newborns. This method offers high accuracy and can detect hearing loss earlier, reducing average detection age by 7 months.
Area of Science:
- Audiology
- Neonatal Medicine
- Public Health
Background:
- Newborn hearing screening is crucial for early intervention.
- Infants in Special Care Baby Units (SCBU) have a higher risk of hearing impairment.
- Traditional screening methods may have limitations in detecting all types of hearing loss.
Purpose of the Study:
- To evaluate the Auditory Brainstem Response (ABR) as a screening tool for hearing impairment in high-risk newborns.
- To assess the sensitivity and specificity of ABR audiometry in a SCBU population.
- To determine the potential impact of an ABR-based screening program on early detection and cost-effectiveness.
Main Methods:
- A 7-year study involving 417 high-risk newborns in an SCBU.
- Hearing screening using ABR audiometry at birth.
- Analysis of screening results, including pass/fail rates and confirmation of hearing impairment.
Main Results:
- 332 out of 417 infants passed the initial ABR screen at 30 dBnHL.
- 32 infants failed the screen, with 9 confirmed sensorineural hearing impairments.
- An increased incidence of persistent middle ear disease was observed in the failure group.
Conclusions:
- ABR audiometry demonstrates excellent sensitivity and specificity for detecting significant hearing loss in at-risk newborns.
- Implementing an ABR-based screening program can reduce the average age of permanent hearing loss detection by 7 months.
- A targeted ABR screening procedure is a cost-effective approach for early identification of hearing impairment.
Abstract:
The present paper reports the findings of a 7 year study evaluating the use of the auditory brainstem response (ABR) as the basis of a hearing screening procedure in a group of newborns at increased risk of hearing impairment. A Special Care Baby Unit (SCBU) population of 417 infants with diverse clinical backgrounds and treatment histories was tested for hearing impairment at birth using ABR audiometry. Some 332 passed the original screen at 30 dBnHL test level in both ears. Of the failure group, 18 did not survive and 32 had some degree of hearing impairment confirmed, nine of which were sensorineural in origin. An increased incidence of persistent middle ear disease was also noted in the failure group. A detailed operational analysis demonstrates that provided appropriate pass/fail criteria are adopted, the ABR technique offers excellent sensitivity and specificity for the detection of significant hearing loss in the test population. Furthermore, the study establishes that implementation of an ABR-based screening programme could reduce the average age at detection of permanent hearing loss by 7 months. A cost assessment shows that the introduction of such a targetted screening procedure could be done at a reasonable outlay.
