Neonatal Hearing Loss Research Articles

Prevalence of Hearing Loss and Associated Factors among Neonates in Zanzibar

Background: Congenital hearing loss is one of the abnormalities reported at birth. Of 4 000 infants born deaf each year, more than half have a hereditary disorder. Even though it may be hereditary, some children develop hearing loss later in life. Genetic sensorineural deafness (SNHL) includes a range of disorders that affect infants, children and adults with affected individuals presenting with varying degrees of deafness, which may be unilateral or bilateral. About 50% of cases of congenital deafness are genetic with 70% being non-syndromic and the remaining 30% syndromic. Genetic/Congenital hearing loss is differentiated from acquired hearing loss with identification of perinatal conditions such as TORCH infections, Hyperbilirubinemia or trauma. Children who are identified with hearing loss at early stages of life have ended up with improved quality of life. There is paucity of data on congenital hearing loss in Tanzania and thus the aim of this study was to address this gap.
 Methods: Eight months Hospital based, descriptive cross sectional study from May to December 2016 conducted in three hospitals and one health Centre where neonatal hearing screening was done in Zanzibar. Data was collected using a three staged protocol neonatal hearing screening with OAE and AABR, and other information was collected clinically using specialized forms and check list. A total of 600 neonates were recruited and data was analyzed using SPSS program version 21.
 Results: This study enrolled 600 neonates. Among these, 323 (53.8%) were females and 277 (46.2%) were males. Among neonates who underwent 1st OAE, 36.2% failed the test and went for second test. For those who underwent 2nd OAE, 13.8% failed the test and went for AABR. 41.4% of those who went for AABR failed and went for Diagnostic ABR and among these only 3 (25%) failed. Three neonates were diagnosed with hearing loss and they were all males, with bilateral SNHL, making a prevalence of 0.5%. Among those with hearing loss 33.3% had severe SNHL and 66.7% profound SNHL. The most frequent risk factors were ototoxic medications use (11.8%), low APGAR score (11%), family history of child hoodhearing loss(7%) a n d hyperbilirubinemia(2.5%). Hyperbilirubinemia was the only risk factor significantly associated with hearing loss (p=0.001).
 Conclusion: The prevalence of hearing loss in neonates was found to be 0.5% and was more common in males. Hearing loss was bilateral, of sensorineural type and associated with some risk factors like ototoxicity, low APGAR score and hyperbilirubinemia.

Prevalence of hearing loss and associated factors among neonates in Zanzibar

Background: Congenital hearing loss is one of the abnormalities reported at birth. Of 4 000 infants born deaf each year, more than half have a hereditary disorder. Even though it may be hereditary, some children develop hearing loss later in life. Genetic sensorineural deafness (SNHL) includes a range of disorders that affect infants, children and adults with affected individuals presenting with varying degrees of deafness, which may be unilateral or bilateral. About 50% of cases of congenital deafness are genetic with 70% being non-syndromic and the remaining 30% syndromic. Genetic/Congenital hearing loss is differentiated from acquired hearing loss with identification of perinatal conditions such as TORCH infections, Hyperbilirubinemia or trauma. Children who are identified with hearing loss at early stages of life have ended up with improved quality of life. There is paucity of data on congenital hearing loss in Tanzania and thus the aim of this study was to address this gap.
 Methods: Eight months Hospital based, descriptive cross sectional study from May to December 2016 conducted in three hospitals and one health Centre where neonatal hearing screening was done in Zanzibar. Data was collected using a three staged protocol neonatal hearing screening with OAE and AABR, and other information was collected clinically using specialized forms and check list. A total of 600 neonates were recruited and data was analyzed using SPSS program version 21.
 Results: This study enrolled 600 neonates. Among these, 323 (53.8%) were females and 277 (46.2%) were males. Among neonates who underwent 1st OAE, 36.2% failed the test and went for second test. For those who underwent 2nd OAE, 13.8% failed the test and went for AABR. 41.4% of those who went for AABR failed and went for Diagnostic ABR and among these only 3 (25%) failed. Three neonates were diagnosed with hearing loss and they were all males, with bilateral SNHL, making a prevalence of 0.5%. Among those with hearing loss 33.3% had severe SNHL and 66.7% profound SNHL. The most frequent risk factors were ototoxic medications use (11.8%), low APGAR score (11%), family history of childhood hearing loss (7%) and hyperbilirubinemia (2.5%). Hyperbilirubinemia was the only risk factor significantly associated with hearing loss (p=0.001).
 Conclusion: The prevalence of hearing loss in neonates was found to be 0.5% and was more common in males. Hearing loss was bilateral, of sensorineural type and associated with some risk factors like ototoxicity, low APGAR score and hyperbilirubinemia.

Does 3-T fetal MRI induce adverse acoustic effects in the neonate? A preliminary study comparing postnatal auditory test performance of fetuses scanned at 1.5 and 3T.

Fetal MRI at 3T is associated with increased acoustic noise relative to 1.5T. The goal of this study is to determine if there is an increased prevalence of congenital hearing loss in neonates who had a 3-T prenatal MR vs. those who had it at 1.5T. We retrospectively identified all subjects who had 3-T fetal MRI between 2012 and 2016 and also underwent universal neonatal hearing screening within 60days of birth. Fetuses with incomplete hearing screening, magnetic resonance imaging (MRI) studies at both field strengths or fetuses affected by conditions associated with hearing loss were excluded. A random group of controls scanned at 1.5T was identified. Five subjects had repeat same-strength MRIs (one at 3T and four at 1.5T). The pass/fail rate of the transient otoacoustic emissions test and auditory brainstem response test were compared using the Fisher exact test. A logistic regression was performed to assess the effects of other known risk factors for congenital hearing loss. Three hundred forty fetal MRI examinations were performed at 3T, of which 62 met inclusion criteria. A control population of 1.5-T fetal MRI patients was created using the same exclusion criteria, with 62 patients randomly selected from the eligible population. The fail rates of transient otoacoustic emissions test for the 1.5-T and 3-T groups were 9.7% and 6.5%, respectively, and for the auditory brainstem response test were 3.2% and 1.6%, respectively. There was no significant difference in the fail rate of either test between groups (P=0.74 for transient otoacoustic emissions test, and P=0.8 for auditory brainstem response test). The median gestational age of the 3-T group was 30weeks, 1day, significantly higher (P<0.001) than the 1.5-T group (median gestational age: 20weeks, 2days). Our findings suggest that the increase in noise associated with 3T does not increase the rate of clinically detectable hearing abnormalities.

Some Risk Factors for Neonatal Sensorineural hearing Loss in a neonatal Intensive Care Unit

Some Risk Factors for Neonatal Sensorineural hearing Loss in a neonatal Intensive Care Unit

PG - 14: Early Detection of Hearing Loss in Neonates

PG - 14: Early Detection of Hearing Loss in Neonates

Neonatal Screening for Prevalence of Hearing Impairment in Rural Areas.

Hearing is one of the most important sense organs for man. Hearing loss is often associated with delayed speech and language development in young children. Early identification and intervention improves the chance a child gets to lesser delays in development and improving the overall quality of life. To find out the prevalence of hearing loss in neonates in the rural taluka of Maval, Pune, Maharashtra, India. Prospective Non Randomized Clinical Study. The study was carried out between April 2012 and April 2015. A total of 8192 babies were screened across various centers around the Maval area. The babies who had some high risk factors were 1683 in number and babies who had no high risk factors i.e. well babies were 6509. In our study, the overall prevalence of hearing loss in neonates in Maval taluka of Maharashtra was found to be 3.54 per 1000 live births, in normal born neonates (well babies) was 1.689 per 1000 births, in high risk babies was 10.69 per 1000 high risk births. The prevalence of low birth weight neonates, hyperbilirubinemia neonates and neonates with craniofacial abnormalities developing hearing impairment was found to be 5.9, 3.56 and 1.18 per 1000 high risk births respectively. India is the second most populated country in the world with nearly a fifth of the world's population. There is a need for the universal neonatal screening for deafness for earlier detection of deafness and rehabilitation. Level of Evidence: Level IV.

Risk factors for failure in the newborn hearing screen test in very preterm twins

We aimed to identify prenatal and postnatal risk factors associated with abnormal newborn hearing screen (NHS) results and subsequently confirmed sensorineural hearing loss (SNHL) in preterm twin neonates. Electronic medical records of 159 twin neonates who were born alive after ≤32 weeks were retrospectively reviewed for hearing loss in both ears. Histopathologic examination of the placenta was performed and clinical data, including method of conception and factors specific to twins, were retrieved from a computerized perinatal database. The main outcome measure was failure to pass the NHS test. The generalized estimation equations model was used for twins. Thirty-two neonates (20.1%) had a "refer" result, and, on the confirmation test, permanent SNHL was identified in 4.4% (7/159) of all neonates. Neonates who had a "refer" result on the NHS test were more likely to be of lower birth weight, more likely to have been conceived with the use of invitro fertilization (IVF), and more likely to have higher rates of intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia. However, monochorionic placentation, death of the co-twin, or being born first was not associated with a "refer" result on the NHS test. Multivariable logistic regression revealed that conception after IVF and the presence of IVH were the only variables to be statistically significantly associated with "refer" on the NHS test. No parameters studied were found to be significantly different between the SNHL and no SNHL groups, probably because of the relatively small number of cases of SNHL. In preterm twin newborns, IVF and the presence of IVH were independently associated with an increased risk of abnormal NHS results, whereas the factors specific to twins were not associated with abnormal NHS results.

Population-based cross-sectional study to assess newborn hearing screening program in central Germany

ObjectivesEarly diagnosis of congenital hearing loss is fundamental to minimize the negative consequences on the speech development. To lower the age at diagnosis and at intervention in hearing impaired children, not only universal newborn hearing screening (NHS) but also tracking is considered essential. The aim of the study was to evaluate the first six years after implementation of the population based newborn hearing screening program in Saxony-Anhalt, one German Federal State. MethodsThe cross-sectional cohort study consisted of three cohort samples. Overall 102,301 infants born between January 2010 and December 2015 were included. NHS protocol was developed as dual target group protocol with two sub-protocols. The screening technique included Transient Evoked Otoacoustic Emissions (TEOAE) and Automated Auditory Brainstem Response (AABR) test. Newborns were assigned to the sub-protocols according to their audiological risk factors. Additionally, to evaluate the quality of NHS and tracking (false-negative screening) we were analysing data from a cohort of hearing impaired children diagnosed up to the age of three years. We calculated quality indicators and compared them with international guidelines. Results101,102 (98.8%) infants were screened. The prevalence of bilateral neonatal hearing loss was 2.32 per 1,000 newborns. The median age was two days at first screening, three month at diagnostic testing, and four month at intervention onset. 2.6% infants were lost to follow-up. 56.3% had a final diagnosis of bilateral sensorineural hearing loss. The sensitivity of 0.85 (KI 95%: 0.76-0.91) and a specificity of 0.84 (KI 95%: 0.84–0.85) was calculated for the NHS program. ConclusionThe analysis of benchmarks and outcomes of NHS demonstrated that the program reaches its main goal to identify the hearing impaired newborns in a timely manner.

Risk Factors for Hearing Loss and Its Prevalence in Neonates Older than 6 Months with History of Hospitalization in Intensive Care Unit.

Hearing loss is one of the most important disabilities in neonates. Delay in the detection of hearing loss leads to impaired development and may prevent the acquisition of speech. We aimed to determine the risk factors associated with hearing loss in neonatal patients aged more than 6 months with a history of hospitalization in Neonatal Intensive Care Unit (NICU). In this case-control study, screening for hearing loss was carried out on 325 neonates aged 6-12 months referred to Pediatric Neurology Office of Vali-e-Asr Hospital, Tehran, Iran up to 2011. Hearing loss was confirmed using Auditory Brainstem Response screening test (ABR). The prevalence of mildly and moderately hearing loss in neonates was determined as 3.6%. The most significant risk factors for hearing loss in neonates were neonatal icterus associated with phototherapy, respiratory distress syndrome (RDS) and lower Apgar score. It seems to quantitative auditory system screening using ABR is necessary for all neonates; because rehabilitation support such as speech therapy and hearing training in this age period is more effective than older ages.

Normal neonatal hearing screening did not preclude sensorineural hearing loss in two-year-old very preterm infants.

Very preterm infants are at risk of neonatal hearing loss. However, it is unknown whether infants with a normal neonatal hearing screening result risk sensorineural hearing loss (SNHL) at a later age. This cohort study was conducted at the Erasmus Medical University Center Rotterdam, the Netherlands, on 77 very preterm infants born between October 2005 and September 2008. All infants underwent auditory brainstem response audiometry during neonatal hearing screening and at two years of corrected age. The frequency of SNHL in infants with a normal neonatal hearing screening was analysed and the risk factors associated with newly diagnosed SNHL in these infants were examined. We found that 3.9% (3/77) of the very preterm infants showed permanent hearing loss during their neonatal hearing screening. In addition, a relatively high prevalence of newly diagnosed SNHL (4.3%) was found in three of the 70 infants followed up at the age of two. The total prevalence rate of permanent hearing loss in the cohort was approximately 8%. A normal outcome of neonatal hearing screening did not guarantee normal hearing at two years of age in this very preterm cohort and paediatricians should be alert to the possibility of late-onset SNHL.

Monitoring neonates for ototoxicity

Objectives: Neonates admitted to the neonatal intensive care unit (NICU) are at greater risk of permanent hearing loss compared to infants in well mother and baby units. Several factors have been associated with this increased prevalence of hearing loss, including congenital infections (e.g. cytomegalovirus or syphilis), ototoxic drugs (such as aminoglycoside or glycopeptide antibiotics), low birth weight, hypoxia and length of stay. The aetiology of this increased prevalence of hearing loss remains poorly understood. Design: Here we review current practice and discuss the feasibility of designing improved ototoxicity screening and monitoring protocols to better identify acquired, drug-induced hearing loss in NICU neonates. Study sample: A review of published literature. Conclusions: We conclude that current audiological screening or monitoring protocols for neonates are not designed to adequately detect early onset of ototoxicity. This paper offers a detailed review of evidence-based research, and offers recommendations for developing and implementing an ototoxicity monitoring protocol for young infants, before and after discharge from the hospital.

The association among prematurity, cochlear hyperintensity, and hearing loss.

Background Prematurity is a major risk factor for neonatal hearing loss. Recent advancements in magnetic resonance imaging (MRI) have made it possible to evaluate structural details of the membranous labyrinths in premature infants that have heretofore been inaccessible. Objective We compared the prevalence of abnormal cochlear signal intensity in premature and term neonates and evaluated for a potential link with hearing loss. Materials and methods We retrospectively reviewed 148 consecutive MR exams performed in premature (< 37 weeks' gestation) and term neonates performed over a 30-month period. Cochlear signal alteration was evaluated on three-dimensional T1-weighted imaging (T1WI) sequences. Each patient's electronic medical record was reviewed to document demographics, symptomatology, physical exam findings, and potential medical variables that could contribute to cochlear signal alteration. Results Cochlear hyperintensity on T1WI was present in 6.8% patients ( n = 10) overall, but was much more common in preterm than term patients (12.2% (9 of 74) vs. 1.4% (1 of 74), respectively; p value < 0.05; Fisher's exact test). Overall, 14.9% ( n = 15) of the patients with hearing test results failed the screening Auditory Brainstem Response exam. However, failure was much more common among patients with cochlear hyperintensity on T1W1 than those with normal findings (56% (5 of 9) vs. 11% (10 of 92), respectively; p value < 0.01; Fisher's exact test). Conclusion Cochlear hyperintensity on T1WI is more common in preterm than term neonates, and potentially associated with hearing loss. Cochleae should be closely scrutinized in all premature infants; signal alterations should prompt further diagnostic inquiry and possible early otolaryngology referral.

Universal Hearing Screening in Newborns Using Otoacoustic Emissions and Brainstem Evoked Response in Eastern Uttar Pradesh.

The objectives were to determine the incidence of hearing impairment in a standardized population of neonates and to determine the significance of association of epidemiological and risk factors with neonatal hearing loss. A cohort of 600 newborns was selected for study and divided into two groups-525 in 'No Risk' group and remaining 75 in 'At Risk' group. The study protocol was carried out in three steps: (a) Screening of Hearing Loss with TOAE, done from 36h after birth to 28days of life, (b) Re-screening of hearing loss in newborns (of 4-12weeks of age), who were tested positive for hearing loss in the first screening, done with DPOAE, (c) Confirmation of hearing loss with BERA, in those who were tested positive in both the first and second screening. In the study the incidence of hearing impairment in 600 infants screened was 6.67 per 1000 screened; 3.81 per 1000 screened in the Not at Risk group and 26.67 per 1000 screened in At Risk group. In At Risk group, admitted to the NICU, severe birth asphyxia and hyperbilirubinemia were found to be major risk factors. Loss to follow up was more in Not at Risk group and False Positive cases with TEOAE were more than DPOAE. BERA was found to be must for confirmation of hearing loss. Neonatal Hearing Screening of only At Risk population is likely to miss some hearing loss. Universal Hearing Screening should be the preferred strategy. Good follow up in the 'At Risk' group suggests that initial interventions in NICU had sensitized the parents for the possibility of hearing loss. This study recommends the introduction of two stage neonatal screening-rescreening protocol, using OAE and BERA, in the country in phased manner.

Outcomes of Newborn Hearing Screening Program: A Hospital Based Study.

Hearing loss is hidden disability and second most common congenital pathology. Prevention, early identification and early intervention of hearing loss can prevent further disability in development of speech, language, cognition and other developmental domains. The prevalence of congenital hearing loss has been estimated to be 1.2-5.7 per thousand in neonates. In these contexts, the aim of study was to determine outcomes of neonates hearing screening program in Hospital. It is a clinical cross-sectional study which was conducted in tertiary care centre from 8th July, 2015 to 31th May, 2016. Total no of 2254 cases were screened. Details case history including high risk register, Pediatric Audiometry, Otoacoustic Emission tests were performed followed brainstem evoked response audiometry. The Prevalence of hearing loss among high risk babies confirmation by BERA was 8.8% per 1000 babies and 16 cases were recommended for Cochlear Implant. The screening protocol with objective test i.e. Distortion Product Otoacoustic Emission and confirmation by Brainstem Evoked Response Audiometry is very useful tool in early identification of congenital hearing loss in neonates. Hence, the results of this study will be used to initiate universal newborn hearing screening in other hospitals. Moreover, this study highlights the relevance of neonatal hearing screening in other states of India and country where this screening is not performed routinely in all hospitals and creating awareness to identify neonatal risk factors associated with hearing loss and understand the importance of early identification and early intervention and among health care professionals.

Cochlear implants in children: A cross-sectional investigation on the influence of geographic location in Saudi Arabia.

INTRODUCTION:The role of the family in detecting a child's hearing difficulty and the age at which an implantation is done have been identified as strong predictors of the outcomes of pediatric cochlear implantation. In the absence of screening programs for hearing loss in Saudi neonates, the family's role is of paramount importance. The aim of this study was to investigate the influence of geographic location on the course of identification, examination, and cochlear implantation in children in Saudi Arabia.MATERIALS AND METHODS:Pediatric patients who had received either unilateral or bilateral cochlear implantation at King Abdulaziz University Hospital in Riyadh, Saudi Arabia, between January 1, 2012, and December 31, 2014, were surveyed.RESULTS:A total of 156 pediatric patients have had a cochlear implant between January 1, 2012, and December 31, 2014. The one-way analysis of variance test to compare the means of the independent sample groups in various geographic zones showed that with a hundred percent access to primary health care, the geographic location of the population had an influence on the detection of hearing loss but not on the cochlear implantation.CONCLUSION:This study found that the geographic location of the population has an influence on the time of detection of hearing loss in children but not on the time of cochlear implantation. Raising parental awareness of the importance of early detection of hearing loss is necessary. Further research is also required to define the role of factors such as the income and the educational level of parents on the early detection of neonatal hearing loss.

Neonatal screening for hearing loss and its risk factors at a tertiary hospital; A : Prospective Cross sectional study.

Background Hearing loss is one of the commonest childhood disabilities with a huge burden in developing countries like India. Detecting and rehabilitating neonates with hearing impairment is a healthcare priority. Prevalence of hearing impairment among neonates is high. Early identification and early rehabilitation is the key in addressing this disability. Behavioral observation audiometry is a dependable screening tool compared to Auditory Brainstem Response.Objectives 1. To screen neonates for hearing impairment using behavioral observation audiometry 2.To confirm hearing impairment using Auditory Brainstem Response among screen positive neonatesMethodology A cross sectional study was conducted among 160 randomly selected neonates. A questionnaire was administered followed by free field testing of Behavioral Observation Audiometry was done on all neonates. Risk factors for neonatal hearing loss was assessed among all neonates.Results The prevalence of hearing impairment on screening with BOA was found to be 2.5 . Risk factors for hearing impairment are more prevalent in our study. 27.5 of the neonates were born preterm being the most common risk factor followed by hyperbilirubinaemia 21.9 low birth weight 13.13 NICU admissions 9.4 and vaginal discharge in mothers during antenatal period being 6.9.Conclusions Prevalence of hearing impairment among newborns and its risk factors are high among normal newborns. Hence there is a need for a routine neonatal hearing screening program.

Risk factors for hearing loss in neonates

Background An estimated 6 of 1,000 children with live birthssuffer from permanent hearing loss at birth or the neonatal period.At least 90% of cases occur in developing countries. Hearing lossshould be diagnosed as early as possible so that intervention canbe done before the age of 6 months.Objective To determine risk factors for hearing loss inneonates.Methods We performed a case-control study involving 100neonates with and without hearing loss who were born atSanglah Hospital, Denpasar from November 2012 to February2013. Subjects were consisted of 2 groups, those with hearingloss (case group of 50 subjects) and without hearing loss (controlgroup of 50 subjects). The groups were matched for gender andbirth weight. We assessed the following risk factors for hearingloss: severe neonatal asphyxia, hyperbilirubinemia, meningitis,history of aminoglycoside therapy, and mechanical ventilationby Chi-square analysis. The results were presented as odds ratioand its corresponding 95% confidence intervals.Results Seventy percent of neonates with hearing loss had historyof aminoglycoside therapy. Multivariable analysis revealed thataminoglycoside therapy of 14 days or more was a significant riskfactor for hearing loss (OR 2.7; 95%CI 1.1 to 6.8; P=0.040).There were no statistically significant associations betweenhearing loss and severe asphyxia, hyperbilirubinemia, meningitis,or mechanical ventilation.Conclusion 􀀤􀁐􀁌􀁑􀁒􀁊􀁏􀁜􀁆􀁒􀁖􀁌􀁇􀁈􀀃􀁗􀁋􀁈􀁕􀁄􀁓􀁜􀀃􀁉􀁒􀁕􀀃􀂕􀀃􀀔􀀗􀀃􀁇􀁄􀁜􀁖􀀃􀁚􀁄􀁖􀀃􀁌􀁇􀁈􀁑􀁗􀁌􀁉􀁌􀁈􀁇􀀃as a risk factor for hearing loss in neonates. [

Hearing loss in high risk neonates

Objective: To determine the incidence and risk factors associated with hearing loss in high risk neonates. Design: Descriptive cross sectional study. Setting: Level II NICU of a tertiary care hospital. Participants: 280 high risk infants were screened. Intervention: All high-risk babies were initially screened with both transient evoked otoacoustic emissions (TOAE) and Auditory brainstem response (ABR). Outcome variables: Primary: to determine the incidence of auditory neuropathy in high risk infants; Secondary: risk factors in those babies identified with hearing loss. Results: Incidence of hearing loss was 17.8 per 1000 screened (95% C.I is 0.24% - 3.32%), with bilateral hearing loss seen in 14.2 per 1000 babies. Highest incidence of hearing loss was seen is in infants with intracranial haemorrhage and meningitis (50%) followed by in decreasing orders craniofacial anomalies (20%), intrauterine congenital infections (11.11%), culture positive sepsis including meningitis (8.88%), birth weight less than 1.5 kg (7.14%), preterm < 33 weeks (4.34%), severe birth asphyxia (4%), use of ototoxic medications for more than 5 days (3.03%). The risk of hearing loss is higher with higher number of risk factors. With a single risk factor being present, it is only 0.66%, whereas with five risk factors, the incidence was 33.3%. Conclusion: There is a high incidence of hearing loss in at-risk infants. Hearing loss is commoner when risk factors such as intracranial haemorrhage or meningitis are present and with presence of multiple risk factors. This would justify the need to routinely screen all high risk infants, so that rehabilitative measures can be initiated at the earliest.

Delayed Diagnosis of Childhood Deafness: The Value of False Negatives in the Programme for Early Detection of Neonatal Hearing Loss

IntroductionDespite its importance, the existence of false negatives (patients who are told they hear well, but they have some degree of hipacusia) is rarely evaluated in programmes for early detection of hearing loss. The aim of this study is to determine the variables that can lead to a delayed diagnosis, especially the existence of false negatives and the lack of registration of risk factors. MethodsA retrospective study of prevalence has been carried out, in which the medical records of children diagnosed with sensorineural hearing loss born within 2005 and 2012 in the health centres of study have been analysed. ResultsOf the 32 children with sensorineural hearing loss, 16 passed the OAE, 12 did not passed the OAE, and in four they were not carried out. Of the children who passed the OAE, 57% have severe hearing loss. 66% of children with hearing loss presented a risk factor for hearing loss at birth, being the most frecuent family history of hearing loss, but only 7% of those with family history of hearing loss were included in the risk group. ConclusionsThe results of the study indicate that the late diagnosis of hearing loss is related to the presence of false negatives to the OAE and the non-registration of risk factors.

High Frequency Tympanometry (1000 Hz) in Young Infants and Its Comparison With Otoacoustic Emissions, Otomicroscopy and 226 Hz Tympanometry

Introduction and objectiveIn the first 6 months of life, 226Hz tympanometry is considered an ineffective procedure for the diagnosis of otitis media with effusion. With the introduction of universal hearing screening, the use of high frequency 1000Hz (1kHz) tympanometry has been recommended. To optimise the diagnosis of neonatal hearing loss, we present this comparison, from the clinical point of view, of the results of 226Hz and 1kHz tympanometry in infants. Materials and methodsWe designed a prospective study of 100 children under 9 months of age proceeding from our hearing screening programme. We compare the result of tympanometry with binocular microscopy and transient evoked otoacoustic emissions. ResultsThe application of transient otoacoustic emissions, otomicroscopy and 226Hz and 1kHz tympanometry has shown its usefulness in the management of otitis media with effusion of young infants, with a similar effectiveness between the 4 tests. ConclusionThe joint use of otomicroscopy, transient otoacoustic emissions and 226Hz and 1kHz tympanometry, has allowed us to diagnose otitis media with effusion in young infants more accurately than each test separately. We recommend initial use of 1kHz tympanometry, at least in children younger than 7 months, but in the presence of hearing loss or an unclear result, 226Hz tympanometry is a good diagnostic complement.