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Hearing impairment in infants after meningitis: detection by transient evoked otoacoustic emissions
M François1, L Laccourreye, E T Huy
1Department of Otorhinolaryngology Head and Neck Surgery, Hôpital Robert Debré, Paris, France.
Insights
Transient evoked otoacoustic emissions (TEOEs) offer a feasible and cost-effective hearing screening for infants post-meningitis. Absent TEOEs necessitate further audiological tests to precisely diagnose hearing loss.
Area of Science:
- Pediatric Audiology
- Neonatal Infectious Diseases
- Hearing Assessment
Background:
- Meningitis in infants can lead to hearing impairment.
- Early and accurate hearing assessment is crucial for developmental outcomes.
- Current screening methods may have limitations in cost or feasibility.
Purpose of the Study:
- To assess the feasibility of using transient evoked otoacoustic emissions (TEOEs) for infant hearing screening after meningitis.
- To evaluate the cost-effectiveness of TEOEs compared to traditional methods.
- To determine the diagnostic accuracy of TEOEs in identifying hearing deficits.
Main Methods:
- Prospective study involving 39 infants (6-24 months) recovering from purulent meningitis.
- Simultaneous recording of TEOEs and visual reinforcement audiometry (VRA).
- Impedance audiometry and auditory brain-stem responses (ABRs) used for infants with absent TEOEs or abnormal VRA, post-otitis media treatment. Cost analysis performed.
Main Results:
- TEOEs were successfully recorded in most infants with normal VRA findings.
- Absence of TEOEs often correlated with otitis media with effusion.
- Sensorineural hearing loss was identified in 2.6% (bilateral) and 7.7% (unilateral) of patients.
- The TEOE-based protocol was approximately 50% less costly than the previous protocol.
Conclusions:
- Transient evoked otoacoustic emissions (TEOEs) represent a feasible and cost-effective hearing screening tool for infants post-meningitis.
- Absence of TEOEs indicates a need for further audiological evaluation (impedance, ABR) to differentiate hearing loss types and thresholds.
- This approach enhances early detection and management of hearing impairments in this vulnerable population.
Objective:
To evaluate the feasibility and cost-effectiveness of using transient evoked otoacoustic emissions (TEOEs) to assess hearing in infants recovered from meningitis.
Methods:
Recordings of TEOEs and visual reinforcement audiometry (VRA) were performed in a prospective study of 39 children aged 6 to 24 months recovering from a purulent meningitis. Patients with no TEOEs, or whose VRA findings were abnormal, were also tested by impedance audiometry and recording of auditory brain-stem responses (ABRs) after treatment of any secretory otitis media. Costs were compared with those of a previous protocol including VRA, impedance audiometry, and ABR for all children.
Results:
A total of 29 children had TEOEs in both ears and normal VRA findings. Ten children lacked TEOEs in one or both ears; 9 of them had otitis media with effusion. Further examination by VRA and ABR led to the diagnosis of bilateral sensorineural hearing loss in 2.6% (1/39) of patients and unilateral sensorineural hearing loss in 7.7% (3/39) of patients. Cost analysis revealed that this protocol costs about half the previous one.
Conclusion:
Recording TEOEs appears to be a feasible and cost-effective hearing screening test for infants recovered from meningitis. If TEOEs are absent, impedance audiometry, ABR recordings, and audiometric evaluation techniques are needed to distinguish between conductive and sensorineural hearing loss and to assess hearing thresholds precisely.