Early Detection Of Hearing Impairment Research Articles

Screening of New-Born through Otoacoustic Emission Device in a Rural Setting for Early Detection of Hearing Impairment - An Observational Study

BACKGROUND
 Hearing is a special sense needed for proper speech, language, mental development and academic performance. The objectives of our study were to screen neonates at rural area with otoacoustic emission device for detecting hearing impairment and develop a comprehensive rehabilitation model for hearing impaired children in rural areas. Hearing loss initial signs are subtle and therefore for early detection routine neonatal hearing screening is the most effective tool. At first otoacoustic emissions are done, failing which neonates undergo BERA as final screening method to identify hearing impairment as a confirmatory test. In a country like India where neonatal hearing tests are not a part of the routine screening program, the chances of missing early detection and possible rehabilitation are large. In this context, the current project envisages to develop a practical and pragmatic screening model for detecting early neonatal hearing impairment using otoacoustic emission technique in a rural sector reaching every door step possible.
 METHODS
 From the government health records collected for a duration of one and half years, all babies delivered in PHC were included for the screening. The babies were screened every Thursday (Immunisation day) with OAE devices by an audiologist at the PHC. The total number of infants screened were 1737. The first screening test done was otoacoustic emission, failing which patient was referred for BERA as a confirmatory test.
 RESULTS
 The total number of babies screened by OAE in our study was 1737. Out of the total infants screened, 1st OAE referrals were 327 babies. All the 327 infants were screened by OAE for the 2nd time, out of which 10 infants were referred for the 2nd consecutive time. 317 infants were passed on 2nd OAE screening. All the 10 infants who were referred for the 2nd time were subjected to BERA at Ramaiah medical Hospital. Out of these 10 infants, BERA showed severe to profound bilateral hearing loss in 7 infants (Confirmed Hearing loss). Other 3 infants had normal BERA reading hence normal hearing. The statistics showed that the overall rate of hearing loss prevalence was 4.03 per thousand.
 CONCLUSIONS
 In order to diagnose hearing loss in neonates, it is critical to identify hearing loss at birth and provide a screening test for it. OAE screening of neonates should be done at the earliest to detect hearing impairment so that hearing and speech rehabilitation can be started at the earliest. It should be done at each & every health care centre on a large-scale basis to cover all the babies.

Prevalence and risk factors of hearing loss in high-risk neonates at a tertiary care hospital in Mumbai

Background: The present study was conducted to assess the prevalence of hearing loss using measurements of otoacoustic emission (OAE) in newborns admitted to NICU and to determine the risk factors predictive of hearing impairment in these newborns. Methods: This was a Prospective observational study conducted among 220 newborns admitted to the NICU over 18 months. Ethical clearance was obtained from the IEC. The sample size was obtained by the universal sampling technique. All candidates underwent hearing assessment in a sound-treated room in the department using a distortion product OAEs (DPOAE) test at the time of discharge. Babies who did not pass the initial screening underwent another OAE test within one month after being discharged. If they failed the test again, they were referred to an otologist for BERA. Results: Of the 226 neonates included in the study, 40 cases (17.7%) failed the initial screening. 29 cases (12.8%) failed the second OAE screening and were subjected to BERA. Risk factors included asphyxia (p≤0.001), mechanical ventilation (p<0.0004), history of ototoxic medication (p=0.004), neonates with hyperbilirubinemia requiring exchange transfusion (p=0.005), low Apgar scores (p≤0.001). Conclusions: A two-stage OAE hearing screening can be a suitable method for early detection of hearing impairment in newborns. This method has shown high prevalence of hearing loss among high-risk neonates but needs to be confirmed with diagnostic BERA. It is crucial to have universal hearing screening to detect the large number of hearing-impaired neonates in the newborn population of our country, including those who are not considered at risk.

Cochlear implantation compliance among minorities at high risk for hearing impairment following universal newborn hearing screening.

The universal newborn hearing screening (UNHS) allows for early detection of hearing impairment (HI). The goal of this current study was to evaluate the impact of cultural background involving consanguineous marriage on newborn HI diagnosed using UNHS, and compliance with hearing rehabilitation. This is a retrospective cohort study that included all children born at a single tertiary medical center between 2011 and 2017 who did not pass the UNHS (oto-acoustic emission and auditory brainstem response), and were diagnosed with HI. The study group included children from consanguineous marriage cultural background which were compared to a control group-all other children. Data were retrieved from the computerized medical charts and included epidemiological, audiological, and pregnancy/delivery-related data, and known risk factors for congenital HI. A total of 238 (196 study and 42 control) neonates were diagnosed with HI. Family history of HI was significantly more prevalent in the study group in mild-severe and profound HI subgroups (p = 0.03 and 0.01, respectively). Study group demonstrated lower rates of cochlear implantation (CI) compliance (p = 0.079), performed at a significantly older age (23 months (IQR 17-36.5) vs. 16 (IQR 12-26) months, p = 0.021). When recommended, bilateral CI compliance was significantly lower in the study group (94.1 vs.48.9%, p < 0.001). UNHS allows for early HI detection among minority populations at higher risk for CI, yet compliance rates remain lower compared with control. Familiarity of families with the importance of early detection and HI risk may result in higher compliance rates for cochlear implantation. Health providers should aim to improve education and communication with this unique group of patients and consider health promotion programs.

Hearing Screening in High-Risk Neonates Using Distortion Product Oto-Acoustic Emission.

The prevalence of hearing loss is 0.09-2.3% in low risk neonates, and 0.3-14.1% in the high-risk population. The treatment requires early identification by neonatal hearing screening and early rehabilitation. OAE (oto-acoustic emission) and ABR (Auditory Brain Response) are the two objective tests used to evaluate hearing loss in neonates. OAE tests the biological response of the cochlea to auditory stimuli. ABR tests the auditory pathway. The aim is to estimate hearing loss in high-risk neonates using the Distortion Product Oto- acoustic emission (DP OAE) and to correlate the associated high-risk factors. This was a cross-sectional study conducted between March 2021 to September 2022. Newborns satisfying the inclusion criteria were included in the study. DP- OAE is performed to screen for hearing loss within 48h of birth. Infants failing the first screening test are then examined for treatable causes and then repeated at 2 weeks. Newborns who fail the second DP-OAE are subjected to ABR for confirmation of hearing loss. A total of 100 high risk neonates underwent hearing screen using DP-OAE. Most common risk factors seen in our study are prematurity (22%), Low birth weight (< 2.5kg) (20%), Neonatal Hyperbilirubinemia (17%), Maternal risk factors (GDM) (14%). Most neonates with prematurity failed the hearing test with significant p-value of 0.05. DP- OAE test can be successfully implemented as newborn hearing screening method, for early detection of hearing impairment to achieve the high quality standard of screening programs.

Type 2 reaction associated sensorineural hearing loss in a drug resistant lepromatous leprosy patient: A case report

Rationale: Leprosy, a chronic granulomatous disease often present clinically as erythema nodosum leprosum, a type 2 reaction. The involvement of cochlear part of audiovestibular system is a rarity. Patient concerns: A 26-year-old male patient with lepromatous leprosy developed bilateral sensorineural hearing loss (SNHL) during type 2 reactional episode. Diagnosis: Recurrent erythema nodosum leprosum in rifampicin-resistant lepromatous leprosy. Interventions: Corticosteroids and second-line multidrug therapy. Outcomes: The patient improved significantly and was further referred for management of psychosocial impact due to sensorineural hearing loss. Lessons: The hearing impairment is a rare complication of type 2 reaction. Any patient with suspected cranial nerve involvement should essentially be screened by tuning fork tests for early detection of hearing impairment and offer timely intervention as required. All high bacteriological index cases should be investigated for antimicrobial resistance in high endemic areas.

RISK FACTORS OF HEARING LOSS IN CHILDREN UNDER 10 YEARS OF AGE - A CLINICAL STUDY IN A TERTIARY CARE CENTRE

Background: Hearing impairment in children constitutes a particularly serious obstacle to their optimal development. Early detection of hearing impairment is vital since early intervention including hearing aids and speech therapy can be initiated at the earliest. The aim of the study was to determine the risk factors associated with children with hearing loss and to assess degree of hearing loss using BERA. Materials and methods: 50 patients below 10 years of age attending ENT OPD with h/o hearing loss were taken for the study from January 2021 to January 2022 and were subjected to detailed history taking and clinical examination. Then the patients were subjected to BERA and the results were analysed. Result: The most common risk factor for hearing loss in this study is h/o consanguinity (40%) followed by birth asphyxia(9%) and then hyperbilirubinemia(8%). The other risk factors include h/o ototoxic drug intake(5%), low birth weight(4%), h/o intracranial infections(3%) and family h/o congenital hearing loss(1 %) Conclusion:Newbornscreening is mandatory to identify hearing loss in the prelinguistic period to reduce the burden of handicap in the society. BERA should be carried out as a routine procedure to detect hearing impairment in high risk children and rehabilitative measures should be started as early as possible.

СТАНОВЛЕНИЕ, РАЗВИТИЕ И СОВЕРШЕНСТВОВАНИЕ СИСТЕМЫ АУДИОЛОГИЧЕСКОГО СКРИНИНГА НОВОРОЖДЕННЫХ И ДЕТЕЙ ПЕРВОГО ГОДА ЖИЗНИ В РОССИИ

Early detection of hearing impairment in newborns and children of the first year of life is relevant due to its high prevalence and negative impact on the development of the child. The etiology and epidemiology of this pathology are studied well; there are modern effective methods for diagnosing the auditory system as well as for correcting the lost auditory function. Therefore, the congenital hearing loss complies with all principles of disease screening. Specialists from the National Research Centre for Audiology and Hearing Rehabilitation (NRCAHR, located in Moscow, Russia) together with perinatologists have been systematically implementing a unified system for the early detection of hearing impairment for many years, which is being implemented starting the neonatal period of life. The Program of universal audiological screening of newborns and children of the first year of life was implemented in all Russia regions in 2008 - 2010 based on the NRCAHR methodological developments, and 95% coverage of all newborns was achieved in a few years. This review presents the current state of the abovementioned Program, its legal framework, and the results of the 2020 audiological screening. The issues of further improvement of the system dedicated to enhancing of the efficiency of early detection and rehabilitation of children with congenital and pre-speech hearing loss are considered as well.

Correlation study of FGF23/D-serine in maintenance hemodialysis patients with combined hearing impairment.

Recent studies have reported an association between chronic renal failure and hearing impairment. Yet, the exact mechanism of action is still not fully understood. In this study, we investigated the expression of fibroblast growth factor 23 (FGF23) and D-serine in maintenance hemodialysis (MHD) patients with end-stage renal disease (ESRD) complicated with hearing impairment and further investigated the correlation between FGF23/D-serine and hearing impairment. A total of 90 subjects, including 30 MHD patients complicated with hearing impairment, 30 MHD patients with normal hearing, and 30 controls, were included in this case-control study. Relevant data were obtained by questionnaire survey, audiometric test, enzyme-linked immunosorbent assay (ELISA) to determine FGF23 level, and high-performance liquid chromatography to determine D-serine level. MHD patients showed abnormally high expression of FGF23 and D-serine, where FGF23 and D-serine levels were significantly higher in the group with hearing impairment than in the group with normal hearing and normal controls (all P<0.01). Also, elevated FGF23 and D-serine were identified as risk factors for hearing impairment in ESRD, with ORs of 16.54 (95%CI, 2.75-99.55) and 15.22 (95%CI, 2.59-89.51), respectively. Further Person correlation analysis showed a moderate positive correlation between FGF23 and D-serine (r = 0.683, P<0.001). This study provides potential biomarkers for the early detection of hearing impairment complicated by chronic renal failure, and the reduction of FGF23/D-serine may provide a potential target for the treatment of hearing impairment complicated by chronic renal failure.

A STUDY TO ASSESS THE PSYCHOSOCIAL PROBLEMS OF HEARING IMPAIRED ADOLESCENTS BETWEEN THE AGE GROUP OF 12 TO 16 YEARS ATTENDING SPECIAL SCHOOL FOR HEARING IMPAIRMENT AT SAONER, NAGPUR, MAHARASHTRA

Hearing is an important part of learning speech and language. It develops child emotional, physical, mental, and spiritual wellbeing. Language is a basic tool for interpersonal relationships and also an act of communication that allows people to exchange ideas and emotions. Most of the children hear from birth. They learn to interact by imitating the sounds but when hearing loss or impairment exists and often goes unnoticed delayed speech and language learning can take place consequently affecting cognitive and behavioral skills. Early detection of hearing impairment is therefore essential, in order to allow more successful intervention and rehabilitation.

PSYCHOSOCIAL PROBLEMS OF HEARING IMPAIRED ADOLESCENTS – A REVIEW

Hearing is an important part of learning speech and language. It develops child emotional, physical, mental, and spiritual wellbeing. Language is a basic tool for interpersonal relationships and also an act of communication that allows people to exchange ideas and emotions. Most of the children hear from birth. They learn to interact by imitating the sounds but when hearing loss or impairment exists and often goes unnoticed delayed speech and language learning can take place consequently affecting cognitive and behavioral skills. Early detection of hearing impairment is therefore essential, in order to allow more successful intervention and rehabilitation.

Neonatal hearing screening in Bulgaria for the period 2016–2019

Newborn hearing screening programmes are expanding worldwide and children are being identified at the earliest possible stage. Universal neonatal hearing screening was officially launched in Bulgaria during autumn in 2015. Despite professional agreement among professionals and relevant institutions on the need for early detection of hearing impairment, little progress has been made in terms of reducing the average age at which this occurs. This fact has provoked our desire to conduct a study to determine how neonatal hearing screening is carried out and the real benefits of its introduction in our country over a period of four years (2016–2019). The full analysis has been published separately and in this paper we will present some of the most important data obtained.

EARLY DETECTION TRAINING OF HEARING DISORDERS IN THE ERA OF THE COVID 19 PANDEMIC FOR HEALTH PERSONNEL AT GENTENG KULON BANYUWANGI HEALTH CENTER, EAST JAVA

The COVID 19 pandemic impacts the early detection of hearing impairment. Socialization is needed in the form of early detection education of hearing loss in the era of the COVID 19 pandemic to health workers in the front line. The purpose of educational activities is to improve the knowledge and skills of health workers to conduct early detection of hearing impairment in the era of the COVID 19 pandemic. The condition of the COVID 19 pandemic changed the interaction pattern between people, including in education and training activities in the field of health. Education with on line means is becoming a common thing to do today. This training activity is conducted on line and off line methods with limited participants. The training for health workers was carried out using an off line method and was attended by 39 participants. The average result of the pre test was 45.20 (+ 15.69), and the average post test was 80.67 (+ 22.73). Comparison of the pre test and post test results with the t-test, the results were significantly different (p &lt; 0.0001). The training with the on line method was attended by 1,145 participants. The results of the average pre test score were 55.30 (+15.61), and the post test average score was 72.82 (+21.61). Comparison of the pre test and post test scores with the t-test results was significantly different (p &lt; 0.0001). On line and off line methods in training activities provide significant results in increasing the knowledge of health workers so that the pandemic does not hinder the implementation of training activities to increase the knowledge of health workers in an effort to improve the quality of life of the community, in this case, hearing.

Розвиток соціальної компетентності у дітей із синдромом Дауна і порушеним слухом

The article analyses the theoretical aspects of the problem of socialisation of children with Down syndrome and hearing impairments, providing them with comprehensive psychological and pedagogical assistance and developing their social competence. An important task is to analyse the problem of early manifestation, psychological support and the development of social competencies in children with Down syndrome and hearing impairment. The authors of the article state that the problem of organising medical and psychological support for children of early age with Down syndrome, monitoring their health status and psychomotor development is becoming more and more relevant, which is connected with the crucial importance of the first decades of life of a child with such a disorder for their further development and adaptation in society. The article dsells upon the concept of “social competenceˮ in children with Down syndrome and hearing impairment. Common to almost all definitions of competence is understanding it as a child's ability or readiness to cope with various social tasks, which in turn depends on the acquired knowledge, abilities and skills needed to perform a certain job. Therefore, the acquisition of knowledge, skills and abilities are not the result of acquiring knowledge, but an intermediate mandatory goal, though not the main component of the educational result. The importance of hearing development in the early stages after cochlear implantation and the corresponding remedial developmental work have been clarified. It is vitally important to stimulate the cognitive development of children with Down syndrome, especially at preschool age, because language development is the cornerstone of a child's healthy and fulfilling life, which specialists and teachers strive for, which in turn will form the child's high social competences. Thus, the identified problem is important, since the main conditions for effective psychological support and development of a child with Down syndrome and impaired hearing are early detection of hearing impairment, timely hearing prosthesis and cochlear implant adjustment, as well as the creation of an educational space conducive to successful learning and full-fledged personal development. The impact of hearing loss in children with Down syndrome has serious consequences for the further development and formation of the child's social competences. It is known that hearing loss leads to many developmental problems, including: delayed or absent speech development, impaired communication skills, problems with reading, writing and other skills, low academic performance, social isolation, etc. Keywords: children with Down syndrome, hearing impairment, cochlear implantation, remedial and developmental work, social competencies.

Role of Otoacoustic Emission Test in Early Diagnosis of Hearing Impairment in Infants.

Hearing impairment is most common congenital dissorder and undiagnosed hearing loss can cause disorder in speech, language with delay in social and emotional developments. Early detection of Hearing Impairment in Infants and too access the relationship between selected risk factor and hearing loss. Neonates age upto 15days randomly selected from pediatric and obstetrics and gynaecology department, born during this period were screened by OAE before their discharge from the hospital and after stabilizing high risk neonates. Informed consent of neonates parent/guardian was obtained before babies were subjected to OAE. A total of 400 neonates were screened for hearing loss by otoacoustic emission. Out of that 18 (4.5%) neonates failed the test in initial screening and were asked for follow up screening. Two neonates were lost to follow up. Out of 16 neonates, 2 (12.5%) neonate failed the test on follow up screening by otoacoustic emission and was referred for BERA. Neonates were classified as low and high risk basis of risk factors present. Out of 76 neonates having high risk of hearing loss, 16 failed the test. Similarly out of 324 neonates with low risk of hearing loss, only one neonate failed the test. Chi square analysis has revealed highly significant results (p < 0.001). Late identification of hearing loss presents a significant public health concern. However, without screening, children with hearing loss are usually not identified until 2years of age, which results in significant delays in voice communication, language communication, social, cognitive, and emotional development. In contrast, early recognition, and intervention prior to 3months of historic period has a significant positive impact on development.

Investigating Hearing Function in Pediatric Patients with Renal Dysfunction: In Pursuit of Preventive Audiology Outcomes.

Chronic kidney is being increasingly recognized as a global health problem with effects that have implications for both mortality and morbidity; with hearing loss being one of the effects that has an impact on quality of life. This study aimed to describe hearing function in a group of children with chronic renal dysfunction receiving treatment in an academic hospital in Johannesburg, South Africa. One hundred children between the ages 5 and 18years (mean age 11.68) were included in the study. A cross-sectional, descriptive, quantitative research design was employed. All participants underwent a case history interview and an audiological examination which included otoscopy, immittance testing, pure tone audiometry including extended high frequency testing up to 16kHz as well as diagnostic distortion product otoacoustic emission testing. A medical record review was also done. Both descriptive and inferential statistics were used to analyze the collected data. Results revealed that there was a high prevalence of hearing loss in this group. The most common hearing loss was a low and high to ultrahigh frequency mild sensorineural hearing loss. No relationship between the severity of hearing loss and the severity of renal dysfunction, or the duration of renal dysfunction and the duration of treatment was found. However, a relationship between the severity of hearing loss and certain treatments was found. These were v hemodialysis and the use of ototoxic medication such as loop diuretics, tuberculosis medication, and antimalarial medication. Current findings highlight the importance of extended high frequency audiometry as well as diagnostic distortion product otoacoustic emission testing for early detection of hearing impairment, in pursuit of preventive audiology outcomes, in ototoxic monitoring in this population.

The effects of mode of delivery, maternal age, birth weight, gender and family history on screening hearing results: A cross sectional study

IntroductionCongenital hearing impairment is one of the principal issues that make distress to families especially those with a family history of hearing problems. Early detection of hearing impairment can make a difference regarding cognitive, attention, learning, speech, and social and emotional development of babies. Otoacoustic test emission is a very common screening test that can be used to pick up early cases and relieve family stress. We tried to evaluate the factors that may disrupt our results regarding the OAE test. MethodsA cross-sectional study included infants who were admitted to the nursery unit alone. Infants who were admitted to the NICU unit, infants with craniofacial anomalies, infants with vernix in the external auditory canal, and Infants with Stigmata associated with a syndrome known to include a sensorineural hearing loss were excluded from the study. Both transient evoked otoacoustic emissions (TEOAE) with distortion product otoacoustic emissions (DPOAE) Screening tests were performed by the same professional audiologist experienced in neonatal screening. ResultsA total of 1413 newborns (733 males and 680 females) were included in the study. Among them, 1368 babies (96.8%) passed the first OAE in both ears, while 45 babies (3.2%) didn't pass the first OAE in one or both ears.Significant correlations between the female gender and family history of congenital hearing loss with failure of the first OAE test results. Moreover, vaginal delivery (VD) infants had a 1.5-fold higher failure rates of first OAE test screening results in comparison to caesarian delivery (CD) infants. ConclusionOur study demonstrated higher failure rates of the first OAE in female infants, vaginal delivery infants, and infants with a family history of hearing impairment. It is recommended to postpone the first phase of hearing screening for those infants until the first scheduled vaccine appointment to achieve higher compliance attendance, and decrease family stress associated with false-negative results of the test.

Tinnitus Is Associated With Extended High-frequency Hearing Loss and Hidden High-frequency Damage in Young Patients.

Objectives:To analyze the results of extended high-frequency (EHF) and high-frequency hearing tests in young patients with tinnitus who show normal response in conventional pure-tone audiometry (PTA), and to explore the correlation between tinnitus and hearing loss (HL).Study Design:A case–control study.Setting:A Tertiary Eye Ear Nose & Throat Hospital of China.Participants:Patients with tinnitus, aged 18 to 35 years old, and with normal conventional PTA (125 Hz–8 kHz) were enrolled in the tinnitus group. Volunteers without tinnitus of the same age were enrolled in the control group.Main Outcome Measures:The incidence of EHF-HL and the hearing thresholds at each frequency, as well as the distribution of maximum HL frequency and edge frequency in all participants were compared.Results:In total, 28 cases (43 ears) were enrolled in the tinnitus group and 34 cases (68 ears) in the control group. The incidence of EHF-HL, average hearing threshold of each frequency ranging from 4 to 16 kHz, and the maximum hearing threshold were significantly higher in the tinnitus group. The edge frequency in the tinnitus group was lower than that in the control group (10.4 ± 3.1 kHz versus 12.3 ± 2.5 kHz, p = 0.010). The dominant tinnitus pitch in cases whose EHF was impaired was positively correlated with the hearing-level loudness of tinnitus (r = 0.627, p < 0.001).Conclusion:Patients with tinnitus and normal hearing in conventional PTA showed signs of EHF-HL and hidden damage in the high-frequencies more easily. EHF hearing tests and the follow-up of HF hearing tests are recommended to facilitate early detection of hearing impairment for timely intervention.

Hearing Affection in High Risk Neonates

Background: Hearing impairment in children is a hidden disability. By the time, it is recognized usually at 2:3 years. The child’s speech and language ability will be irreversibly affected. Early detection of hearing impairment and timely intervention can give better consequences. Objectives: Identification of the most significant risk factors for hearing impairment in high risk neonates hospitalized at our Neonatal Intensive Care Unit (NICU) and to assess the sensitivity of hearing screening tests. Patients and methods: This study was carried out on newborns with risk factor of hearing loss admitted to NICU of Pediatric Department, Zagazig University Hospital from December 2017 to December 2018 using both transient evoked otoacoustic emissions (TEOAE) and Auditory Brainstem Response (ABR) tests in Audiology Unit, Zagazig University Hospital. Number of the studied neonates was 58 high risk neonates. Results: Of the criteria that studied neonates was chosen according to it, exposure to ototoxic medications was the most common risk factor (82.8%) followed by assisted ventilation > 5 days (77.6%), prematurity (62.1%), LBW (56.9%), septicemia (50%), perinatal asphyxia (13.8%). There were statistical significant relationship between auditory brainstem response and ototoxic medications in the studied neonates. Vancomycin and meropenem were significant risk factors of hearing loss. Conclusion: Prematurity, Low birth weight, Septicemia, Perinatal asphyxia and Administration of vancomycin and meropenem were significant risk factors of hearing impairment in our studied neonates by ABR test.

Early detection of hearing impairment in type 2 diabetic patients

Background: Hearing impairment is an under-recognized complication of type 2 diabetic patients. Exploring an appropriate technique and method to detect early hearing impairment in diabetic patients is the key to good hearing care.Objectives: The objectives of this study are to evaluate the application effects of extended high-frequency audiometry and distortion product otoacoustic emissions in early detection of hearing impairment in diabetic patients.Materials and methods: The study recruited 65 type 2 diabetic patients with normal hearing thresholds detected by conventional PTA, and 60 control subjects. All subjects completed detailed medical history questionnaires and underwent ENT (Ear, Nose and Throat) physical examinations and laboratory tests. Then they underwent the conventional pure tone audiometry (PTA) tests, extended high frequency audiometry (HFA) and distortion product of otoacoustic emissions (DPOAEs). Audiologic data and the related risk factors of audiology were analyzed.Results: Of 65 diabetic patients, 41 patients (63.1%) suffered from high frequency hearing loss detected by HFA and 58 patients (89.2%) suffered from cochlear dysfunction detected by DPOAEs. The incidence of high frequency hearing loss was 38%, 83.3% and 42.3% at the age of 30–39, 40–49 and 50–59 years, respectively. The factors of age (p = .00) and disease duration (p = .00) were related with the high frequency hearing threshold, while the factor of glycosylated hemoglobin (HbA1c) (p = .716) had no relationship with it.Conclusions and significance: There can be cochlear dysfunction and high frequency hearing loss in diabetic patients with normal hearing thresholds of conventional frequencies. The examinations of HFA and DPOAEs are of great importance for early diagnosis of hearing loss in type 2 diabetic patients.

Study of hearing impairment among “At risk” neonates by screening with OAE

Background: Hearing is one of the very important five senses. Normal speech and language development depend upon a child’s ability to hear spoken language. Universal hearing screening is implemented in many developed countries. However, neither universal screening, nor high risk screening, exists in India. In India various studies have been conducted to detect the hearing loss on high risk neonates. Screening only the high-risk neonates can detect 50% of babies with hearing loss. Hence a mandatory hearing screening is needed to detect all such babies. Methods: A cross sectional study of 75 “At risk” babies were done. Babies underwent hearing screening after 48 hours of birth or before discharge from hospital using DPOAE test as the first level of screening. Babies who got “Refer” results were subjected to repeat testing with DPOAE after one month. Babies who got “Refer” results in the second screening test were referred for diagnostic test BERA to assess hearing loss. Data was analysed by appropriate statistical methodology. Results: Incidence of hearing loss among at risk babies is 2.6 % (2/75). Both babies who had hearing loss had multiple risk factors and had bilateral hearing loss. Common risk factors observed are NICU care &gt; 5 days 100% (2/2), Ventilated baby 50% (1/2), Preterm 100% (2/2), low birth weight 50% (1/2), jaundice requiring phototherapy 100% (2/2). Conclusion: Hearing loss is more common in “At risk” babies. Major risk factors are NICU admission, Preterm, LBW, Ventilated babies, and jaundice. It is necessary to implement neonatal hearing screening of at least “At risk” neonates in our country to secure normal, social and holistic development of the child. Two–stage DPOAE/BERA hearing screening is an efficient and cost-effective method for early detection of hearing impairment on a large scale.