Early Detection Of Hearing Loss Research Articles

Newborn and infant hearing screening for early detection of hearing loss in Nairobi, Kenya

Background: Early detection of hearing loss and subsequent intervention leads to better speech, languageand educational outcomes giving way to improved social economic prospects in adult life. This can be achieved through establishing newborn and infant hearing screening programs. Objective: To determine the prevalence of hearing loss in newborns and infants in Nairobi, Kenya. Methods: A cross-sectional pilot study was conducted at the National hospital and at a sub county hospital immunization clinic. A total of 9,963 babies aged 0-3 years, were enrolled in the hearing screening program through convenient sampling over a period of nine months. A case history was administered followed by Distortion Product Oto-acoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) hearing screening. Results: The screening coverage rate was 98.6% (9963/10,104). The referral rate for the initial screen was 3.6% (356/ 9,963), the return rate for follow-up rescreening was 72% (258 babies out of 356) with a lost to follow-up rate of 28% (98/356). The referral rate of the second screen was 10% (26/258). All the 26 babies referred from the second screen returned for diagnostic hearing evaluation and were confirmed with hearing loss, yielding a prevalence of 3/1000. Conclusions: Establishing universal newborn and infant hearing screening programs is essential for early detection and intervention for hearing loss. Data management and efficient follow-up systems are an integral part of achieving diagnostic confirmation of hearing loss and early intervention. Keywords: Hearing screening; newborn; infant; hearing loss; early detection; Kenya.

Early Detection of Hearing Loss among the Elderly.

Age-related hearing loss (ARHL) is a complex communication disorder that affects the cochlea and central auditory pathway. The goal of this study is to characterize this type of hearing loss and to identify non-invasive, inexpensive, and quick tests to detect ARHL among elderly adults, seeking to preserve quality of life and reduce the burden on healthcare systems. An observational, prospective study is conducted with >55-year-old subjects divided into the following groups: normal range (Group A), detected but not treated (Group B), and detected and treated (Group C). During follow-up, Speech Spatial Qualities (SSQ12), and Hearing Handicap Inventory in the Elderly Screening test (HHIE-S) questionnaires were assessed, along with hearing levels (hearing thresholds at 4 kHz were studied in more depth), and a series of tests and questionnaires to assess balance, cognitive level, level of dependence, and depression. A total of 710 patients were included in this study. The duration of hearing loss (11.8 yr. in Group B and 21.0 yr. in Group C) and average time-to-treatment for Group C (14.1 yr.) are both protracted. Both of the used questionnaires show statistically significant differences among the groups, revealing greater handicaps for Group C. Audiometry performed at 4 kHz shows how hearing loss progresses with age, finding differences between men and women. There is a correlation between time-to-treatment in Group C and the cognitive test DSST (-0.26; p = 0.003). HHIE-S, SSQ12, and 4 kHz audiometry are sensitive and feasible tests to implement in screening programs.

Newborn and Infant Hearing Screening for Early Detection of Hearing Loss in Nairobi, Kenya

Background: Early detection of hearing loss and subsequent intervention leads to better speech, language and educational outcomes giving way to improved socioeconomic prospects in adult life. This can be achieved through establishing universal newborn hearing screening (UNHS) programs. The objectives of this study were to assess the feasibility of implementing a UNHS program and to also determine the prevalence of hearing loss in newborns in Nairobi, Kenya.
 Materials And Methods: A cross-sectional pilot study was conducted at the National Hospital and a sub-county hospital immunization clinic. A total of 9,963 babies aged 0-3 years, were enrolled in the hearing screening program through convenient sampling over nine months. A case history was administered followed by Distortion Product Oto-acoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) hearing screening.
 Results: The screening coverage rate was 98.6% (9963/10,104). The referral rate for the initial screen was 3.6% (356/ 9,963), and the return rate for follow-up rescreening was 72% (258 babies out of 356) with a loss to follow-up rate of 28% (98/356). The referral rate of the second screen was 10% (26/258). All 26 babies referred from the second screen returned for diagnostic hearing evaluation and were confirmed to have hearing loss, yielding a prevalence of 3/1000.
 Conclusions: Establishing universal newborn and infant hearing screening programs in Kenya is feasible and essential for early detection and intervention for hearing loss. Data management and efficient follow-up systems are an integral part of achieving diagnostic confirmation of hearing loss and early intervention.

Study of sensorineural hearing loss in children with type 1 diabetic mellitus and the corelation with the duration of the disease in a tertiary care center

Background: Annual type 1 diabetes cases in children under the age of 15 are estimated to be around 96,000 worldwide. The pathophysiological explanation for diabetes-related hearing loss is speculative. Usually, hearing loss is bilateral, gradual onset, affecting higher frequencies. It is a well-known entity in type 2 diabetic mellitus. This study aims at knowing the prevalence of hearing loss in children with type 1 diabetic mellitus with respect to duration of diabetic mellitus. Materials and Methods: A hospital-based comparative study was conducted involving 60 diabetic children and 60 healthy (control) children. Brainstem evoked response audiometry test was done in both groups. Reports were compared and prevalence of sensorineural hearing loss in diabetic children and the corelation with the duration of disease were analyzed. Results: The mean age among cases was 11.93±2.9 years and the mean age among controls was 9.08±1.92 years. Among diabetic group, 25 (41.7%) were male, 35 (58.3%) were female. Among non-diabetic group, 33 (55%) were male, 27 (45%) were female. Although none of the diabetic children had hearing loss, the differences in absolute latency waves I, II, III, IV, and V between diabetic group and non-diabetic group in the right ear and waves I and II and III and V between diabetic group and non-diabetic group in the left ear was found to be statistically significant (p<0.05). The difference in interpeak latency values of wave I and wave V between diabetic and non-diabetic group in right ear and between wave I–V and wave III–V in the left ear was found to be statistically strongly significant (p<0.001). This indicates prolonged absolute latency and interpeak latency among diabetics than non-diabetics. Since none of the diabetic children had hearing loss, the corelation of hearing loss with the duration of the disease was unable to obtain. Conclusion: This study stresses on the need for frequent follow-up and hearing evaluation of the type 1 diabetic children for the early detection of hearing loss.

Mothers, Knowledge and Attitude Regarding Early Detection of Hearing Loss among Their Infants in Port Said City.

Mothers, Knowledge and Attitude Regarding Early Detection of Hearing Loss among Their Infants in Port Said City.

Analysis of audiological outcomes of children referred from a universal newborn hearing screening program over 9 years in Beijing, China

Universal newborn hearing screening (UNHS) and audiological diagnosis are crucial for children with congenital hearing loss (HL). The objective of this study was to analyze hearing screening techniques, audiological outcomes and risk factors among children referred from a UNHS program in Beijing. A retrospective analysis was performed in children who were referred to our hospital after failing UNHS during a 9-year period. A series of audiological diagnostic tests were administered to each case, to confirm and determine the type and degree of HL. Risk factors for HL were collected. Of 1839 cases, 53.0% were referred after only transient evoked otoacoustic emission (TEOAE) testing, 46.1% were screened by a combination of TEOAE and automatic auditory brainstem response (AABR) testing, and 1.0% were referred after only AABR testing. HL was confirmed in 55.7% of cases. Ears with screening results that led to referral experienced a more severe degree of HL than those with results that passed. Risk factors for HL were identified in 113 (6.1%) cases. The main risk factors included craniofacial anomalies (2.7%), length of stay in the neonatal intensive care unit longer than 5 days (2.4%) and birth weight less than 1500 g (0.8%). The statistical data showed that age (P < 0.001) and risk factors, including craniofacial anomalies (P < 0.001) and low birth weight (P = 0.048), were associated with the presence of HL. This study suggested that hearing screening plays an important role in the early detection of HL and that children with risk factors should be closely monitored.

EHDI Services should be accessible! caregivers’ expectations of EHDI services in South Africa

ABSTRACT Progress of Early Hearing Detection and Intervention (EHDI) services within the South African context lags behind that made by high-income countries internationally. Implementation of EHDI services in this context faces many challenges that underscore the need to ensure contextualized intervention approaches that meet the needs of South Africa’s linguistically and culturally diverse population. The aim of the current study was to describe caregivers’ expectations of EHDI services, and to evaluate the success and/or failure of the EHDI services in relation to these expectations. To achieve this aim, in-person, telephonic and videoconferencing narrative interviews were conducted with nine caregivers of children who are Deaf-or-Hard-of-Hearing (DHH), and analysed through reflexive thematic analysis. The following themes and sub-themes emerged from the narrative interviews: (1) expectations of the EHDI process (‘early detection of hearing loss and ‘EHDI should be accessible’), and (2) expectations for the outcomes of EHDI services (‘age-appropriate acquisition of spoken language’, ‘mainstream education’, and ‘further education and independence’). These themes speak to concerns with the entire EHDI process from detection to intervention, including continuity of care. In order to ensure effective and sustainable EHDI services within the South African context; caregivers’ expectations should be used to inform service provision and to guide best practice. Furthermore, these findings suggest a need to implement wide spread, integrated, and inter-disciplinary EHDI services that are linguistically and culturally responsive and relevant; with caregivers and families forming a crucial part of the programmes.

A study of otoacoustic emission and brainstem evoked response audiometry as audiological assessment modalities for early detection of hearing loss in children

Background: Aim of the research was to study the incidence of hearing loss in high risk children up to 5 years age and determine the common etiological factors associated with it. Methods: Total 140 neonates falling under the norms of inclusion criteria and the children brought by parents with suspicion of having impaired hearing were subjected to thorough history taking and clinical examination followed by audiological examination in the form of otoacoustic emission (OAE) and brainstem evoked response audiometry (BERA). Those showing REFER or FAIL were subjected to BERA. Results were documented accordingly and analysed for identifying the common risk factors and degree of hearing loss. Results: Maximum number of subjects with hearing loss were in the age group of 25-36 months age. Most common risk factor found was Consanguinity and most common postnatal risk factor was found to be hyperbilirubinemia. When compared to BERA, sensitivity of DPOAE was 97.59%, and the specificity was 92.98%. Conclusions: Universal hearing screening of neonates at birth in the form of DPOAE and followed by BERA can reduce the average age of diagnosis of hearing loss and therefore, can provide an opportunity to initiate an appropriate rehabilitative program.

Parental Perspectives on Communication from Health Care Providers following a Newborn Diagnosis of Congenital Cytomegalovirus Infection: A Secondary Analysis of a Qualitative Study.

The study objective was to identify communication messages that parents of children diagnosed with congenital cytomegalovirus (cCMV) infection reported as essential and helpful. We performed a secondary analysis of focus groups and interviews conducted with 41 parents of children with cCMV who had enrolled in a long-term follow-up cCMV study at an academic medical center. Three groups of parents who had children with cCMV participated in the study: parents with children symptomatic at birth, parents with children asymptomatic at birth who later developed sensorineural hearing loss, and parents with children asymptomatic at birth who remained asymptomatic into adulthood. Using a health marketing approach, we identified six general themes from the focus group sessions: initial diagnosis, likely health outcome(s), comfort and coping, symptom watch, resources, and prevention. Receiving the initial diagnosis was shocking for many parents, and they wanted to know how their child would or could be affected. They valued access to the information, follow-up visits for early detection of hearing loss and other developmental delays, and support from other parents. Parents wished to obtain this information from their pediatrician but felt that experts offered more up-to-date knowledge about prognosis, monitoring, and treatment. With more U.S. states implementing cCMV screening strategies which would lead to more infant diagnoses, it will be necessary for providers to meet parents' expectations and communication needs.

Assessment of Hearing Impairment in Sick Newborns: A Prospective Observational Study.

Undiagnosed neonatal hearing loss causes severe language, cognitive, and behavioral problems in children. Sick newborns who spend 48 hours in the neonatal intensive care unit (NICU) have a 10- to 20-fold increased risk of permanent hearing loss.The aim of this study is to identify hearing impairment in high-risk sick newborns who spend at least 48 hours in the NICU. The present prospective observational study was conducted at a single center.All sick neonates admitted to the NICU for a minimum of 48 hours at the JK Lon Hospital, Zanana Hospital, and Mahila Chikitsalaya, Sawai Man Singh (SMS) Medical College, Jaipur,Rajasthan, India, from June 2017 to May 2018 were considered eligible for the study.The primary outcome was the assessment of hearing loss of high-risk newborns using otoacoustic emissions at the time of discharge, six weeks of age, and automated auditory brainstem response (AABR) at three months of chronological age. The secondary outcome was to analyze the association of hearing loss with different risk factors in high-risk neonates. A total of 150 infants who had one or more risk factors were studied, 60 were female and 90 were male. No statistically significant difference in hearing loss was observed based on birth weight, sex, and gestational age.The firstdistortion-product otoacoustic emission(DPOAE) screening was done on infants at the time of discharge from the NICU. Eighty-three infants (55.33%) had "refer" on the first DPOAE and the remaining 67 (44.67%) were passed results at the time of discharge.At six weeks of life, on repeat screening with a second DPOAE test, 36% "refer"on the first screen had a"refer"result on the second DPOAE. However, 4.4% "pass" on the first screen turned out to be"refer"on the second screen. These 33 infants who had"refer"results on the second screen were subjected to testing.At 10 weeks of life, AABR wasperformedon 33 infants. Eleven infants out of 33 had sensorineural hearing loss (SNHL) on AABR. Hearing impairment with the DPOAE test was observed with risk factors neonatal hyperbilirubinemia (NHH), hypoxic ischemic encephalopathy (HIE), and very low birth weight (VLBW) and was statistically significant among all risk factors.But, no such association (between hearing impairment and risk factors) was observed with the AABR test. In our study, we found that the duration of mechanical ventilation in mean days 7.67±6.24 had statistically significant SNHL compared to the lesser duration of mechanical ventilation (p<0.001). Two-stage DPOAEdone prior to AABR is helpful in the early detection of hearing loss.

Development of Social-Pragmatic Understanding in Children With Congenital Hearing Loss and Typical Hearing Between the Ages of 4 and 6 Years.

This prospective longitudinal study aimed to explore (a) the development of social-pragmatic understanding of children with bilateral hearing aids (BiHAs), bilateral cochlear implants (BiCIs), and typical hearing (TH) between the ages of 4 and 6 years and (b) group differences between children with BiHAs, BiCIs, and TH. The Pragma test was used for a comprehensive assessment of social-pragmatic understanding of a total of 86 children: 19 children with BiHAs, 22 children with BiCIs, and 45 children with TH. The Pragma test requires answering socially and contextually demanding questions and explaining the right answers. The explanation tasks are targeted at studying the participant's own awareness of the inferencing process. The children in this study were assessed yearly at the ages of 4, 5, and 6 years. The participants with BiHAs, BiCIs, and TH showed significant development in their social-pragmatic understanding between the ages of 4 and 6 years, but most children with hearing loss (HL) still did not meet age expectations at the age of 6 years. Children with BiHAs and BiCIs both showed large-scale inferential difficulties, including utilizing theory of mind, utilizing verbal and visual information, and understanding conversational norms and emotions in context. Children with BiHAs and BiCIs are at risk of delays in social-pragmatic understanding despite early detection of HL, early amplification, and cochlear implantation. Therefore, the social-pragmatic abilities of children with HL should be assessed regularly, and the children with HL should have early access to social-pragmatic interventions where utilizing contextual information is practiced comprehensively.

A comparison of otoacoustic emissions examination results as early hearing screening in normal and infants at risk of hearing loss

Link of Video Abstract: https://youtu.be/fvbkSDEVY3Q Background: A child's ability to speak must be supported by a good hearing function. With early detection of hearing loss, it is hoped that intervention can be made promptly, thus improving the quality of life (QOL) of children with hearing loss at birth. The purpose of this study was to compare the otoacoustic emissions (OAE) examination results in infants with and without risk. Method: The OAE examination was conducted on 60 newborns with and without risk factors in the nursery room and ORL-HNS outpatient unit. For all the newborns aged &gt; 24 hours and before being discharged from the hospital with inclusion criteria, the OAE examinations were performed and repeated when they were 1 and 2 months old. Furthermore, the comparison of OAE results on newborns with and without risk factors aged &gt; 24 hours, 1 month, and 2 months were statistically analyzed. Results: A Friedman statistical analysis test was then conducted to examine the correlation between the results of the first, second, and third OAE examinations. The first, second, and third OAE examination results of newborns with and without risk factors were compared, significant differences were found with a p-value of 0.0111 (p &lt; 0.05). Conclusion: The newborn hearing screening using OAE should be performed for all newborns (Universal Newborn Hearing Screening) and serially to minimize the number of higher referrals to health facilities to improve an individual's quality of life in the future.

Prevelance of Hearing Loss and Factors Association in Chronic Kidney Disease Patients.

Aim: Chronic kidney disease (CKD) is becoming a great concern, especially in developing countries and SNHL among patients with CKD is considerably higher than general population. So, current study aims evaluation and assessment of degree of hearing loss in chronic kidney disease patients using pure tone audiogram and correlation of hearing loss with its contributing factors. Materials and methods:70 patients with CKD were included in this prospective observational cross sectional study performed in tertiary care hospital. A detailed history; general physical, otological examination, blood investigation was done.CKD staging was done using KDIGO guidelines and hearing assessment using pure tone audiometry. Hearing loss association with CKD and contributing factors were studied. Result: Out of 70 participants, SNHL was seen in twenty one participants. Hearing loss was present in 3 out of 22 participants of CKD-3; 6 out of 12 participants of CKD-4 and 12 out of 15 participants of stage CKD-5. A statistically significant association of hearing loss was found with CKD stage, albuminuria, hemodialysis, hypertension and other factors. Discussion: Since hearing impairment may well have a negative impact on the social function of an affected individual, the use of pure tone audiogram to monitor CKD patients should be considered as a routine procedure. Patients with CKD would benefit from early detection of hearing loss which will allow for early rehabilitative measures to be taken.

Importance of congenital cytomegalovirus in the neonatal hearing screening program

IntroductionIn newborns, hearing loss secondary to congenital Cytomegalovirus (CMVc) infection, despite its low prevalence, can cause a serious problem in the personal development and social integration of patients. Therefore, it is important to include the determination of CMV DNA as a neonatal screening tool. Materials and methodsWe have carried out a 5-year retrospective study, by describing the CMVc in the Autonomous Community of the Basque Country in newborns who did not pass the hearing screening in the early hearing loss detection program. The times of detection, confirmation (incidence) and intervention (treatment) are described. ResultsOf 18,782 subjects studied, 58 (three per thousand live births) presented hearing loss. Of these, CMVc is guaranteed in four patients (one woman and three men). The mean time to hearing screening was 6.5 days (SD: ±3.69) and to detect CMV by polymerase chain reaction (PCR) in urine and saliva was 4.2 days (SD: ± 3.94). Time to confirm hearing loss by BAEP and audiological intervention 2.2 (SD: ±0.957) and 5 months (SD: ±3.741), respectively. Four hearing aid adaptations and one cochlear implant were performed. Discussion and conclusionNeonatal hearing screening has established itself as a good public health program. The determination of viral DNA allows an early, specific and interdisciplinary diagnosis and treatment, in which otorhinolaryngology plays a fundamental role. Our study highlights the importance of including CMV PCR as a universal screening tool.

Optimized concurrent hearing and genetic screening in Beijing, China: A cross-sectional study.

Concurrent screening has been proven to provide a comprehensive approach for management of congenital deafness and prevention of ototoxicity. The SLC26A4 gene is associated with late-onset hearing loss and is of great clinical concern. For much earlier detection of newborns with deafness-causing mutations in the SLC26A4 gene, the Beijing Municipal Government launched a chip for optimized genetic screening of 15 variants of 4 genes causing deafness based on a chip to screen for 9 variants of 4 genes, and 6 variants of the SLC26A4 gene have now been added. To ascertain the advantage of a screening chip including 15 variants of 4 genes, the trends in concurrent hearing and genetic screening were analyzed in 2019 and 2020. Subjects were 76,460 newborns who underwent concurrent hearing and genetic screening at 24 maternal and child care centers in Beijing from January 2019 to December 2020. Hearing screening was conducted using transiently evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAE), or the automated auditory brainstem response (AABR). Dried blood spots were collected for genetic testing and 15 variants of 4 genes, namely GJB2, SLC26A4, mtDNA 12S rRNA, and GJB3, were screened for using a DNA microarray platform. The initial referral rate for hearing screening decreased from 3.60% (1,502/41,690) in 2019 to 3.23% (1,124/34,770) in 2020, and the total referral rate for hearing screening dropped form 0.57% (236/41,690) in 2019 to 0.54% (187/34,770) in 2020, indicating the reduced false positive rate of newborn hearing screening and policies to prevent hearing loss conducted by the Beijing Municipal Government have had a significant effect. Positivity according to genetic screening was similar in 2019 (4.970%, 2,072/41,690) and 2020 (4.863%,1,691/34,770), and the most frequent mutant alleles were c.235 del C in the GJB2 gene, followed by c.919-2 A > G in the SLC26A4 gene, and c.299 del AT in the GJB2 gene. In this cohort study, 71.43% (5/7) of newborns with 2 variants of the SLC26A4 gene were screened for newly added mutations, and 28.57% (2/7) of newborns with 2 variants of the SLC26A4 gene passed hearing screening, suggesting that a screening chip including 15 variants of 4 genes was superior at early detection of hearing loss, and especially in early identification of newborns with deafness-causing mutations in the SLC26A4 gene. These findings have clinical significance.

An exploratory study of nurses' knowledge, skill, and training requirements for newborn hearing screening in a public-sector program in South India

BackgroundA pilot newborn hearing screening (NHS) program was established at 11 Corporation Maternity Hospitals in Chennai, a city in South India, to aid in the early detection of hearing loss. Nurses were trained how to screen newborns using both otoacoustic emissions (OAEs) and automated auditory brainstem responses (AABRs). The purpose of this qualitative study was to explore nurses’ perceptions of the NHS program and the challenges they faced in implementing it.Material and methodsSemi-structured interviews were conducted with 11 nurses, one from each hospital, who performed NHS in Corporation Maternity Hospitals. Interviews were conducted using guides and probes developed and validated by experts.ResultsFour general themes that covered the nurses’ responses were identified: their understanding of NHS and skills in its execution; gaps in their understanding of the NHS program, constraints faced in implementing the screening program, and additional needs for support.ConclusionsAddressing gaps in training needs, providing full documentation, and overcoming poor adherence to NHS protocols would help the program grow. The lessons learnt are also transferable to programs conducted in similar low–middle income countries.

Trajectory of hearing loss in children with unilateral hearing loss.

The aim of this study was to quantify the amount of deterioration in hearing and to document the trajectory of hearing loss in early identified children with unilateral hearing loss (UHL). We also examined whether clinical characteristics were associated with the likelihood of having progressive hearing loss. As part of the Mild and Unilateral Hearing Loss Study, we followed a population-based cohort of 177 children diagnosed with UHL from 2003 to 2018. We applied linear mixed models to examine hearing trends over time including the average amount of change in hearing. Logistic regression models were used to examine the relationship between age and severity at diagnosis, etiology, and the likelihood of progressive loss and amount of deterioration in hearing. The median age of the children at diagnosis was 4.1 months (IQR 2.1, 53.9) and follow-up time was 58.9 months (35.6, 92.0). Average hearing loss in the impaired ear was 58.8 dB HL (SD 28.5). Over the 16-year period, 47.5% (84/177) of children showed deterioration in hearing in one or both ears from their initial diagnostic assessment to most recent assessment including 21 (11.9%) who developed bilateral hearing loss. Average deterioration in the impaired ear ranged from 27 to 31 dB with little variation across frequencies. Deterioration resulted in a change in category of severity for 67.5% (52/77) of the children. Analysis for children who were followed for at least 8 years showed that most lost a significant amount of hearing rapidly in the first 4 years, with the decrease stabilizing and showing a plateau in the last 4 years. Age and severity at diagnosis were not significantly associated with progressive/stable loss after adjusting for time since diagnosis. Etiologic factors (ENT external/middle ear anomalies, inner ear anomalies, syndromic hearing loss, hereditary/genetic) were found to be positively associated with stable hearing loss. Almost half of children with UHL are at risk for deterioration in hearing in one or both ears. Most deterioration occurs within the first 4 years following diagnosis. Most children did not experience sudden "large" drops in hearing but more gradual decrease over time. These results suggest that careful monitoring of UHL especially in the early years is important to ensure optimal benefit from early hearing loss detection.

Assessing school readiness in children with cochlear implants using an Arabic language-based test

ABSTRACT The Jeddah Institute for Speech and Hearing- School Readiness Screening Test (JISH-SRST), an Arabic language-based test, was used to assess 33 children with cochlear implants (CCIs) aged 5;0–6;11 (years; months) compared to age-and gender-matched children with typical hearing (CTH). The main objectives of the study were to compare the spoken language performance of CCIs to that of CTH and to determine if there is a relationship between their language performance and the variables of gender, implant age, and chronological age. Results showed that CTH outperformed CCIs (p < .05) on all JISH-SRST subtests. Despite using spoken language to communicate, CCIs exhibited significant delays in a variety of language skills, with their weakest performance on tasks requiring the development of proper syntax and morphology skills. In general, both groups performed better in receptive language than expressive language. While gender did not have significant effects on language performance, implant age and chronological age did. Clinical implications of the findings include the significance of implementing a newborn hearing screening system for early detection of hearing loss and early cochlear implantation before age two, providing intensive speech therapy services that target complex language skills until school age and throughout the elementary years of school, and training classroom teachers to work effectively with CCIs. This will improve their communication experiences and school readiness outcomes. The findings may have ramifications for multiple stakeholders in Jordan in the health and education sectors.

Importancia del citomegalovirus congénito en el programa de cribado auditivo neonatal

IntroductionIn newborns, hearing loss secondary to congenital cytomegalovirus (CMVc) infection, despite its low prevalence, can cause a serious problem in the personal development and social integration of patients. Therefore, it is important to include the determination of CMV DNA as a neonatal screening tool. Materials and methodsWe have carried out a 5-year retrospective study, by describing the CMVc in the Autonomous Community of the Basque Country (Spain) in newborns who did not pass the hearing screening in the early hearing loss detection program. The times of detection, confirmation (incidence) and intervention (treatment) are described. ResultsOf 18,782 subjects studied, 58 (3 per 1,000 live births) presented hearing loss. Of these, CMVc is guaranteed in 4patients (one woman and 3men). The mean time to hearing screening was 6.5 days (SD: ±3.69) and to detect CMV by polymerase chain reaction in urine and saliva was 4.2 days (SD: ±3.94). Time to confirm hearing loss by BAEP and audiological intervention 2.2 (SD: ±0.957) and 5 months (SD: ±3.741), respectively. Four hearing aid adaptations and one cochlear implant were performed. Discussion and conclusionNeonatal hearing screening has established itself as a good public health program. The determination of viral DNA allows an early, specific and interdisciplinary diagnosis and treatment, in which otorhinolaryngology plays a fundamental role. Our study highlights the importance of including CMV polymerase chain reaction as a universal screening tool.

Early detection and monitoring of hearing loss in vestibular migraine: Extended high-frequency hearing.

Vestibular migraine (VM) presents mainly with recurrent vestibular symptoms and migraine. A great number of patients with VM have cochlea symptoms such as tinnitus, hearing loss. A cross-sectional study was conducted on patients with definite VM (dVM) and probable VM (pVM) who met the diagnostic criteria. Auditory-vestibular tests and psychological assessments were performed. Logistic regression was used to evaluate the predictive effect of EHF pure tone audiometry (PTA) for standard frequency (SF) hearing loss. Fifteen patients with pVM and 22 patients with dVM were recruited. Overall, the two most vertigo types were vestibulo-visual symptoms (83.78%) and internal vertigo (54.05%). A vertigo attack persisted for <5 min in approximately 57% of patients, compared with 5 min to 72 h in 43%, and lasted longer than 72 h in 8%. Approximately 87% of patients had psychological disorders. Most patients with VM (92%) suffered from some degree of EHF hearing impairment, and 68% had SF hearing loss, which is substantially higher than their complaints (43%). Moreover, the mean EHF hearing threshold cutoff value (57 dB HL) worked well in predicting SF hearing loss (area under curve, AUC, 0.827), outperforming distortion product optoacoustic emission (AUC, 0.748). VM has a wide range of clinical manifestations. Hearing loss had a considerably higher rate compared to actual complaints. Moreover, patients with VM tended to have bilateral EHF and high-frequency hearing loss. The effectiveness of the mean EHF hearing threshold cutoff value in predicting hearing loss supported its use in the early detection of hearing loss and monitoring disease progression.