Targeted versus Universal Neonatal Hearing Screening in a Single Egyptian Center

Safaa S Imam,Hesham M Taha,Helbees E Bishoy,Rania A El-Farrash

doi:10.1155/2013/574937

Abstract

Aim. To compare targeted neonatal hearing screening (TNHS) and universal neonatal hearing screening (UNHS) since many developing countries, including Egypt, implement selective screening for high-risk neonates. Methods. 150 neonates were assessed; 50 full terms consecutively admitted to the well-baby nursery and 100 neonates consecutively admitted to neonatal intensive care unit (NICU), Ain Shams University. Patients were further subdivided into high-risk group which included 50 neonates with multiple risk factors for hearing loss and low risk group which included 50 neonates with only one risk factor. Transient evoked otoacoustic emissions (TEOAEs) were used for hearing screening. Auditory brain response (ABR) was performed 3 months later for failed TEOAEs. Results. The most frequent risk factor was consanguinity (46%). In the well-baby population, 16% failed TEOAEs. In the NICU, 30% of the low risk and 38% of the high risk groups failed TEOAEs. Regarding ABR, failed results were 12%, 10%, and 8% in the high-risk, low-risk, and healthy groups, respectively. Conclusion. The use of TNHS would have missed 8% of neonates from the well-baby group who actually had PCHL (permanent congenital hearing loss). The use of UNHS would identify all cases with PCHL, allowing for early intervention and follow-up.

Highlights

Significant hearing loss is one of the most frequent congenital diseases present at birth occurring in about 1 to 3 of every 1,000 healthy neonates and 2 to 4 of every 100 neonates in the neonatal intensive care unit (NICU) population [1, 2], the prevalence of hearing loss varies because of differences in criteria for defining hearing impairment, the age group surveyed, and the testing methods used.Many etiological factors may result in severe hearing loss in neonates
The results of Transient Evoked Otoacoustic Emissions (TEOAEs) were interpreted according to the Rhode Island criteria [8]; pass: response is 3 dB or more in at least 4 frequency bands, partial pass: positive response in at least 2 frequency bands, and fail: no response is present in any frequency band
Retesting was done for infants before hospital discharge, and those with failed or partial pass response in one or both ears for the second time were considered as failed screening and referred for diagnostic Auditory brain response (ABR)

Summary

Introduction

Many etiological factors may result in severe hearing loss in neonates. Genetic causes account for at least 50 to 60 percent of childhood hearing loss. Environmental causes of hearing loss includes, for example, rubella embryopathy, prematurity, bacterial meningitis, and head trauma [3]. The initial signs of hearing loss are very subtle, and systematic neonatal hearing screening is the most effective means of early detection. The early identification of congenital hearing loss is necessary to minimize the consequences of hearing impairment on the future communication skills of a baby [4, 5]

Methods

Results

Conclusion