Abstract
The early identification of pre-lingual deafness is necessary to minimize the consequences of hearing impairment on the future communication skills of a baby. According to the most recent international guidelines the deafness diagnosis must occur before the age of three months and the prosthetic-rehabilitative treatment with a traditional hearing aid should start within the first six months. When a Cochlear implant becomes necessary, the treatment should start between the age of 12 months and 18 months. The only way to diagnose the problem early is the implementation of universal neonatal audiological screening programs. Transient evoked otoacoustic emissions (TEOAE) is the most adequate test because it's accurate, economic and of simple execution. Automatic auditory brainstem response (AABR) is necessary to identify patients with auditory neuropathy but it is also important to reduce the number of false-positives.The 20-30% of infant hearing impairment is represented by progressive or late-onset hearing loss (HL) so it's also necessary to establish an audiological follow up program, especially in infants at risk.From November 2005 all neonates born in the University hospital of Pisa undergo newborn hearing screening. From 2008 the screening program follows the guidelines for the execution of the audiological screening in Tuscany which have been formulated by our group according to the 2007 JCIH Position Statement and adaptated to our regional reality by a multidisciplinary effort. From November 2005 to April 2009 8113 neonates born in the Neonatal Unit of Santa Chiara Hospital (Pisa) have undergone newborn hearing screening. 7621 neonates (93.9%) without risk factors executed only the TEOAE test. 492 (6.1%) neonates had audiological risk factors and thus underwent TEOAE and AABR. 84 patients (1,04%) failed both TEOAE and AABR tests. 78 of them underwent further investigations. 44 patients resulted falsepositives (the 0,54% of the screened newborns). 34 neonates (4,2 ‰) had a final diagnosis of hearing impairment. 8 patients (0.99 ‰) had unilateral hearing loss (HL). 26 patients (3,2 ‰) had bilateral hearing impairment.In our screening program the percentage of false-positives was quite low (0.54%) while the incidence of bilateral HL (3.2 ‰) is a little higher than that found in literature reports. In most of our patients premature birth or neonatal suffering represent the main cause of HL.
Highlights
According to the most recent international guidelines the deafness diagnosis must occur before the age of
The most important international guidelines suggest the execution of a universal screening program and screening tests should be done on all neonates and on those presenting increased risk factors [5,6,7,22], as only about half of the babies suffering from permanent hearing conditions present increased risk factors [22,23,24,25,26,27,28]
They execute the test (TEOAE or Automatic auditory brainstem response (AABR) depending on the presence or absence of auditory risk factors) before the discharge from hospital or within 2 weeks from birth
Summary
The identification and the early diagnosis of pre-lingual deafness is necessary to prevent or minimize the serious consequences of hearing impairment on language development and on the future communication skills of a baby [1,2,3,4,5,6,7].According to the most recent international guidelines the deafness diagnosis must occur before the age ofThe aim of such programs is to identify hearing impairments present at birth, overall medium and severe (bilateral, >= 40 dB HTL between 0.5 and 4 KHz) [15,16,17,18,19,20,21,6,7].The most important international guidelines suggest the execution of a universal screening program and screening tests should be done on all neonates and on those presenting increased risk factors [5,6,7,22], as only about half of the babies suffering from permanent hearing conditions present increased risk factors [22,23,24,25,26,27,28]. in Italy neonates without risk factors are tested at around 8 months of age with the use of the Boel test. According to the most recent international guidelines the deafness diagnosis must occur before the age of. The aim of such programs is to identify hearing impairments present at birth, overall medium and severe (bilateral, >= 40 dB HTL between 0.5 and 4 KHz) [15,16,17,18,19,20,21,6,7]. In the absence of a screening program, the average delay in the diagnosis ranges between 18 months and 24 months Such delay might cause a decreased effectiveness of the rehabilitation therapy and irreparable consequences for the patient [7,12,13,14,29,30]
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