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Yoshinaga-Itano C, Manchaiah V, Hunnicutt C. Outcomes of Universal Newborn Screening Programs: Systematic Review. J Clin Med 2021; 10:2784. [PMID: 34202909 PMCID: PMC8268039 DOI: 10.3390/jcm10132784] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This systematic review examined the outcomes (age of identification and intervention, developmental outcomes, cost-effectiveness, and adverse effects on parents) of universal newborn hearing screening (UNHS) for children with permanent congenital hearing loss (PCHL). MATERIALS AND METHODS Multiple electronic databases were interrogated in March and April 2020 with further reports identified from article citations and unpublished literature. UNHS reports in English with comparisons of outcomes of infants who were not screened, and infants identified through other hearing screening programs. RESULTS 30 eligible reports from 14 populations with 7,325,138 infants screened through UNHS from 1616 non-duplicate references were included. UNHS results in a lower age of identification, amplification, and the initiation of early intervention services and better language/literacy development. Better speech perception/production were shown in younger, but not in older, children with early identification after UNHS. No significant findings were found for behavior problems and quality of life. UNHS was found to be cost-effective in terms of savings to society. In addition, no significant parental harm was noted as a result of UNHS. CONCLUSIONS In highly developed countries, significantly better outcomes were found for children identified early through UNHS programs. Early language development predicts later literacy and language development.
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Affiliation(s)
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA;
| | - Cynthia Hunnicutt
- Institute of Cognitive Science, University of Colorado Boulder, UCB 594, Boulder, CO 80309, USA;
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202
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Seguya A, Bajunirwe F, Kakande E, Nakku D. Feasibility of establishing an infant hearing screening program and measuring hearing loss among infants at a regional referral hospital in south western Uganda. PLoS One 2021; 16:e0253305. [PMID: 34138954 PMCID: PMC8211292 DOI: 10.1371/journal.pone.0253305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/27/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Despite the high burden of hearing loss (HL) globaly, most countries in resource limited settings lack infant hearing screening programs(IHS) for early HL detection. We examined the feasibility of establishing an IHS program in this setting, and in this pilot program measured the prevalence of infant hearing loss (IHL) and described the characteristics of the infants with HL. Methods We assessed feasibility of establishing an IHS program at a regional referral hospital in south-western Uganda. We recruited infants aged 1 day to 3 months and performed a three-staged screening. At stage 1, we used Transient Evoked Oto-acoustic Emissions (TEOAEs), at stage 2 we repeated TEOAEs for infants who failed TEOAEs at stage 1 and at stage 3, we conducted Automated brainstem responses(ABRs) for those who failed stage 2. IHL was present if they failed an ABR at 35dBHL. Results We screened 401 infants, mean age was 7.2 days (SD = 7.1). 74.6% (299 of 401) passed stage 1, the rest (25.4% or 102 of 401) were referred for stage 2. Of those referred (n = 102), only 34.3% (35 of 102) returned for stage 2 screening. About 14.3% (5/35) failed the repeat TEOAEs in at least one ear. At stage 3, 80% (4 of 5) failed the ABR screening in at least one ear, while 25% (n = 1) failed the test bilaterally. Among the 334 infants that completed the staged screening, the prevalence of IHL was 4/334 or 12 per 1000. Risk factors to IHL were Newborn Special Care Unit (NSCU) admission, gentamycin or oxygen therapy and prematurity. Conclusions IHS program establishment in a resource limited setting is feasible. Preliminary data indicate a high prevalence of IHL. Targeted screening of infants at high risk may be a more realistic and sustainable initial step towards establishing IHS program s in a developing country like Uganda.
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Affiliation(s)
- Amina Seguya
- Department of Ear, Nose and Throat Surgery, Mulago National Referral Hospital, Kampala, Uganda
- * E-mail:
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Elijah Kakande
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Doreen Nakku
- Department of Ear, Nose and Throat Surgery, Mbarara University of Science and Technology, Mbarara, Uganda
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203
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Kanji A, Naudé A. The Impact of Pass/Refer Criteria in the Use of Otoacoustic Emission Technology for Newborn Hearing Screening. Am J Audiol 2021; 30:416-422. [PMID: 34000205 DOI: 10.1044/2021_aja-20-00160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The current study aimed to compare the specificity of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in isolation and in combination, with varying pass/refer criteria for DPOAE technology. Method A longitudinal, repeated-measures design was employed. The current study sample comprised 91 of the initial 325 participants who returned for the repeat screening and diagnostic audiological assessment within a risk-based newborn hearing screening program. Results TEOAE screening had the highest specificity in comparison to DPOAE screening at the initial and repeat screening, irrespective of differences in DPOAE pass/refer criteria. DPOAE screening had a slightly higher specificity, with a three out of six rather than the four out of six frequency pass criteria. Conclusions Pass/refer criteria alone do not influence referral rates and specificity. Instead, consideration of other factors in combination with these criteria is important. More research is required in terms of the sensitivity and specificity of OAE screening technology using repeated-measures and diagnostic audiological evaluation as the gold standard.
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Affiliation(s)
- Amisha Kanji
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Alida Naudé
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, South Africa
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204
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Knowledge and Attitudes of Parents towards Childhood Hearing Loss and Pediatric Hearing Services in Sharjah, United Arab Emirates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126188. [PMID: 34201064 PMCID: PMC8228253 DOI: 10.3390/ijerph18126188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/27/2021] [Accepted: 06/04/2021] [Indexed: 12/02/2022]
Abstract
The successful implementation of pediatric audiology services depends on parental engagement and support. It is essential to analyze the gaps in knowledge level and attitude of the parents in United Arab Emirates (UAE), towards pediatric hearing loss and pediatric audiology services. The present study aimed to assess the knowledge and attitude of parents in Sharjah, UAE.A cross-sectional survey was administered to 295 parents in a tertiary care hospital setting. The self-reported questionnaire consisted of 26 items. 34.2% of the parents ascertaining good knowledge and 65.8% reported poor knowledge regarding the various factors related to the childhood hearing loss. Further, 86.2% of parents reported positive attitudes regarding accessing pediatric audiology services. A significant association was found between age groups, educational status, and knowledge levels. The study highlights the poor knowledge demonstrated by parents in the UAE regarding hearing loss and its associated risk factors. Findings outline the critical need in the region to enhance parental awareness. More health promotion activities and community outreach campaigns are necessary to increase the uptake of pediatric audiology services in the region.
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205
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The use of melatonin for auditory brainstem response audiometry in children with comorbidities. Eur Arch Otorhinolaryngol 2021; 279:2303-2308. [PMID: 34101008 DOI: 10.1007/s00405-021-06923-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE In this study, the efficacy and feasibility of melatonin in young children with and without comorbidities, undergoing auditory brainstem response audiometry (ABR) was evaluated. The aim of this study was primarily to evaluate the use of melatonin for ABR investigations in children with comorbidities. Second, the efficacy of melatonin was evaluated based on several factors like sleep-onset latency, sleep duration, frequency of awakenings as well as adverse events. METHODS Click-induced ABR tests were performed at the outpatient clinic between January, 2018 and August, 2020. Investigations were considered successful when binaural testing was completed. A dose of melatonin depending on age, 5 mg for children younger than 6 years and 10 mg if older than 6 years, was administered after placement of electrodes. RESULTS 131 children were included in this study. 87% of all ABR investigations were performed successfully. Comorbidities such as neurodevelopmental disorders or developmental delays were present in 70% of all children. There was no significant difference in age (p = 0.36) or gender (p = 0.97) between the success and failed group. In addition, comorbidities were equally distributed between both groups. Mean sleep duration was 38 (SD 21) min and sleep-onset latency was 28 (SD 20) min No adverse events were documented. CONCLUSION Melatonin is effective for ABR examinations in infants and children with and without comorbidities. Furthermore, it allows for sequential testing in those at risk for progressive hearing loss. Clear instructions to caregivers and expertise of audiologists are a prerequisite for optimal outcomes.
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206
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Hamzehpour F, Absalan A, Pirasteh E, Sharafi Z, Arbabsarjoo H. Investigating the Effect of Hearing Aid Use on the Balance Status of Children with Severe to Profound Congenital Hearing Loss Using the Pediatric Clinical Test of Sensory Interaction for Balance. J Am Acad Audiol 2021; 32:303-307. [PMID: 34082460 DOI: 10.1055/s-0041-1728754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Since the hearing and vestibular organs are close to each other, the correlation between hearing and balance is one of the principal issues, especially in people with hearing loss. PURPOSE In this study, the effect of the auditory system on human balance performance was investigated by comparing the balance status of hearing-impaired children in the aided and unaided situations. RESEARCH DESIGN In this cross-sectional study a group of children were assigned the task to compare the balance sways in two aided and unaided situations. STUDY SAMPLING A total of 90 children aged 7 to 10 years with severe to profound congenital hearing loss and the healthy vestibular system of both genders served as the research population. DATA COLLECTION AND ANALYSIS After a complete evaluation of the hearing and vestibular system and validation of the hearing aid performance, body sway was recorded using the pediatric clinical test of sensory interaction for balance in aided and unaided situations in the presence of background noise from the speaker. RESULTS According to this study, there was no difference in body sway in aided and unaided situations for conditions 1, 2, and 3. In comparison, in conditions 4, 5, and 6 of the test, there was a statistically significant difference in body sway between aided and unaided situations. However, there was no difference in the sway of the body in aided and unaided situations between girls and boys. CONCLUSION According to this study, hearing aids can improve balance in challenging listening environments.
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Affiliation(s)
- Farzad Hamzehpour
- Department of Audiology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Aghil Absalan
- Department of Audiology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ebrahim Pirasteh
- Department of Audiology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zahra Sharafi
- Department of Audiology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamideh Arbabsarjoo
- Department of Audiology, Zahedan University of Medical Sciences, Zahedan, Iran
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207
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Seguya A, Bajunirwe F, Kakande E, Nakku D. Maternal knowledge on infant hearing loss and acceptability of hearing aids as an intervention at a Referral Hospital in southwestern Uganda. Int J Pediatr Otorhinolaryngol 2021; 145:110722. [PMID: 33933987 DOI: 10.1016/j.ijporl.2021.110722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/15/2021] [Accepted: 04/15/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Infant hearing screening enables early detection and management of hearing loss (HL) so that speech and language development delays are minimized. Parents play a critical role in successful screening and management of Infant Hearing loss (IHL) but there is limited data from resource limited settings on parental knowledge about HL and acceptability of IHL interventions. This study was aimed at exploring the maternal knowledge on the various causes of IHL and their acceptability of hearing aids as an intervention for IHL. METHODS A cross-sectional study was conducted at a referral hospital in southwestern Uganda. A semi-structured questionnaire was used to interview postpartum mothers to assess their knowledge on causes of IHL and acceptability of a hearing aid if prescribed. Logistic regression was used to calculate odds ratio (OR) for the factors associated with hearing aid refusal. RESULTS 401 mothers with a mean age of 25 years (Standard Deviation = 5.6 years) were recruited. Half of the mothers correctly identified at least five causes of IHL. The most well-known causes were measles (63.3%) and a positive family history of HL (61.6%). 60% of mothers held at least one superstitious belief as a cause of IHL. Majority of mothers (86%) would accept a hearing aid as an IHL intervention. Mothers with a positive family history of HL (OR = 0.42, p = 0.04), in middle or higher socioeconomic class (OR = 0.45, p = 0.01) and those with more than 3 antenatal visits in their recent pregnancy (OR = 0.44, p = 0.01) were less likely to refuse a hearing aid while mothers that were either widowed or separated from their spouses (OR = 15.64, p = 0.01) were more likely to refuse a hearing aid. CONCLUSION Although mothers had limited knowledge on some causes of IHL, there was a high acceptability of hearing aids as an intervention for IHL. Marital status, family history of hearing loss, socioeconomic status and antenatal care attendance are factors that could be used to identify mothers that might accept or refuse a hearing aid for their infant. There is need to increase awareness about causes of hearing loss to improve knowledge as well as dispel any non-biological beliefs held by communities.
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Affiliation(s)
- Amina Seguya
- Department of ENT Surgery, Mulago National Referral Hospital, Kampala, Uganda.
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, Uganda
| | - Elijah Kakande
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Doreen Nakku
- Department of ENT Surgery, Mbarara University of Science and Technology, Uganda
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208
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Connors J, Havranek T, Campbell D. Discharge of Medically Complex Infants and Developmental Follow-up. Pediatr Rev 2021; 42:316-328. [PMID: 34074718 DOI: 10.1542/pir.2020-000638] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
At the time of discharge from the NICU, many infants have ongoing complex medical issues that will require coordinated, multispecialty follow-up. Discharge planning and transfer of care for infants with medical complexity require a multidisciplinary team effort that begins early during the NICU hospitalization. It is critical that the primary care physician is involved in this process because he or she will serve as the chief communicator and coordinator of care after discharge. Although some infants with medical complexity may be followed in specialized multidisciplinary NICU follow-up clinics, these are not universally available. The responsibility then falls to the primary care physician to coordinate with different subspecialties based on the infant's needs. Many infants with medical complexity are technology-dependent at the time of discharge and may require home oxygen, ventilators, monitors, or tube feeding. Prematurity, critical illness, and prolonged NICU hospitalization that lead to medical complexity also increase the risk of neurodevelopmental delay or impairment. As such, these infants will not only require routine developmental surveillance and screening by the primary care physician but also should be followed longitudinally by a neurodevelopmental specialist, either a developmental-behavioral pediatrician or a neonatologist with experience in neurodevelopmental assessment.
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Affiliation(s)
- Jillian Connors
- Division of Neonatology, Children's Hospital at Montefiore, Bronx, NY.,Albert Einstein College of Medicine, Bronx, NY
| | - Tomas Havranek
- Division of Neonatology, Children's Hospital at Montefiore, Bronx, NY.,Albert Einstein College of Medicine, Bronx, NY
| | - Deborah Campbell
- Division of Neonatology, Children's Hospital at Montefiore, Bronx, NY.,Albert Einstein College of Medicine, Bronx, NY
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209
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Bermudez BEBV, de Souza do Amaral ME, da Silva Gomes C, Novadzki IM, de Oliveira CM. Respiratory and otolaryngological disorders in Down syndrome from one center in Brazil. Am J Med Genet A 2021; 185:2356-2360. [PMID: 34047053 DOI: 10.1002/ajmg.a.62244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/14/2021] [Accepted: 03/14/2021] [Indexed: 11/08/2022]
Abstract
Down syndrome (DS) is the most common chromosomal condition. Anatomical and functional variations in the upper and lower airways are component manifestations of the syndrome and increase the risk of various medical problems. The objective of this study was to determine the prevalence of otorhinolaryngological and respiratory diseases in a DS outpatient clinic over a 3-year period. Medical records data from 1207 patients were retrospectively reviewed. Newborn Hearing Screening was positive in 7.1% of patients. Brainstem auditory evoked potential was performed in 1101 children and showed a hearing loss of 19.8% in the first year. It was positive in 21% of 1021 exams. Audiometry was altered in 64 of 994 exams (6.4%), showing a conductive loss in 90%. Adenotonsillectomy was performed in 308 (25.5%) patients, and 169 (14.0%) required serous otitis ventilation tubes. Asthma was observed in 140 (11.6%) patients, and allergic rhinitis in 544 (56.6%). There were hospitalizations for invasive infection in 480 (39.8%) children, and two (0.2%) patients had severe septicemia from pulmonary focus. Five (0.4%) infants had laryngotracheomalacia, and one patient had anomalous right tracheal bronchus. Recognizing the prevalence of respiratory and otorhinolaryngological disorders in patients with DS allows the promotion of optimal follow-up and early treatment, preventing the development of sequelae.
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Affiliation(s)
- Beatriz Elizabeth Bagatin Veleda Bermudez
- Down Syndrome Outpatient Clinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Department of Integrated Medicine, Federal University of Paraná, Curitiba, Brazil
| | | | - Charles da Silva Gomes
- Down Syndrome Outpatient Clinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Iolanda Maria Novadzki
- Down Syndrome Outpatient Clinic, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Camila Maciel de Oliveira
- Department of Integrated Medicine, Federal University of Paraná, Curitiba, Brazil.,Global Co-creation Lab, MIT, Cambridge, Massachusetts, USA
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210
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Denoyelle F, Rouillon I, Alvin F, Parodi M, Couloigner V, Loundon N, Garabédian N. [Neonatal hearing screening]. Med Sci (Paris) 2021; 37:519-527. [PMID: 34003098 DOI: 10.1051/medsci/2021064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Neonatal hearing screening has been developped in a large number of countries. The rational to build such nationwide programs is robust. The prevalence of hearing impairment of various etiologies is high (1/1,000), diagnosis of hearing impairment in infants is uneasy and is made most of the time after the age of 18 months when treatment is less efficient and, last, appropriate test to screen for hearing impairment are available: Otoacoustic Emission and Auditory Evoked Potential. In France the screening is organised at the regional level. The organization of such a program is complexe. Midwifes and nurses should be trained to informed the parents and to perform the test. If the test is abnormal the infant will be oriented to a specialzed department of pediatrics for appropriate diagnosis and treatment.
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Affiliation(s)
- Françoise Denoyelle
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Necker-Enfants malades, 149 rue de Sèvres, 75015 Paris, France
| | - Isabelle Rouillon
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Necker-Enfants malades, 149 rue de Sèvres, 75015 Paris, France
| | - Fiona Alvin
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Necker-Enfants malades, 149 rue de Sèvres, 75015 Paris, France
| | - Marine Parodi
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Necker-Enfants malades, 149 rue de Sèvres, 75015 Paris, France
| | - Vincent Couloigner
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Necker-Enfants malades, 149 rue de Sèvres, 75015 Paris, France
| | - Natalie Loundon
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Necker-Enfants malades, 149 rue de Sèvres, 75015 Paris, France
| | - Noël Garabédian
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, Hôpital Necker-Enfants malades, 149 rue de Sèvres, 75015 Paris, France
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211
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Jiang Y, Samuel OW, Zhang H, Chen S, Li G. Towards effective assessment of normal hearing function from ABR using a time-variant sweep-tone stimulus approach. Physiol Meas 2021; 42. [PMID: 33238252 DOI: 10.1088/1361-6579/abcdf2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/25/2020] [Indexed: 11/12/2022]
Abstract
Objective. The auditory brainstem response (ABR) audiometry is a means of assessing the functional status of the auditory neural pathway in the clinic. The conventional click ABR test lacks good neural synchrony and it mainly evaluates high-frequency hearing while the common tone-burst ABR test only detects hearing loss of a certain frequency at a time. Additionally, the existing chirp stimuli are designed based on average data of cochlear characteristics, ignoring individual differences amongst subjects.Approach. Therefore, this study designed a new stimulus approach based on a sweep-tone concept with a time variant and spectrum characteristics that could be customized based on an individual's cochlear characteristics. To validate the efficiency of the proposed method, we compared its performance with the click and tone-bursts using ABR recordings from 11 normal-hearing adults.Main results. Experimental results showed that the proposed sweep-tone ABR achieved a higher amplitude compared with those elicited by the click and tone-bursts. When the stimulus level or rate was varied, the sweep-tone ABR consistently elicited a larger response than the corresponding click ABR. Moreover, the sweep-tone ABR appeared earlier than the click ABR under the same conditions. Specifically, the mean wave V peak-to-peak amplitude of the sweep-tone ABR was 1.3 times that of the click ABR at 70 dB nHL (normal hearing level) and a rate of 20 s-1, in which the former saved 40% of test time.Significance. In summary, the proposed sweep-tone approach is found to be more efficient than the traditional click and tone-burst in eliciting ABR.
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Affiliation(s)
- Yanbing Jiang
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, People's Republic of China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, People's Republic of China.,Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen, People's Republic of China
| | - Oluwarotimi Williams Samuel
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, People's Republic of China.,Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen, People's Republic of China
| | - Haoshi Zhang
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, People's Republic of China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, People's Republic of China.,Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen, People's Republic of China
| | - Shixiong Chen
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, People's Republic of China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, People's Republic of China.,Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen, People's Republic of China
| | - Guanglin Li
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen, People's Republic of China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, People's Republic of China.,Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen, People's Republic of China
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212
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Malesci R, Burattini E, Franze A, Auletta G, Laria C, Errichiello M, Toscano F, Monzillo C, Marciano E. Targeted Audiological Surveillance Program in Campania, Italy. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2214-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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213
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Trudeau S, Anne S, Otteson T, Hopkins B, Georgopoulos R, Wentland C. Diagnosis and patterns of hearing loss in children with severe developmental delay. Am J Otolaryngol 2021; 42:102923. [PMID: 33486206 DOI: 10.1016/j.amjoto.2021.102923] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION & OBJECTIVE Children with cognitive delay often experience challenges with obtaining hearing thresholds through behavioral audiometry (BA). This necessitates sedated Auditory Brainstem Response (sABR) testing. This study aimed to evaluate diagnostic and hearing patterns in children with Down Syndrome (DS), Autism Spectrum Disorder (ASD), Global Developmental delay (GDD), and Cerebral Palsy (CP) who were unable to complete reliable BA testing due to severe cognitive delay. METHODS Retrospective chart review on a cohort of children aged 0.5-18 years with a diagnosis of DS, ASD, GDD, or CP who underwent sABR due to unsuccessful BA testing. This was performed at a tertiary care institution from 2014 to 2019. Testing patterns and audiometric data were collected. RESULTS Across 15 DS, 39 ASD, 10 GDD, and 11 CP patients, the average time from first nondiagnostic BA to sABR ranged from 8.6 months (in GDD) to 21.8 months (in DS). The average number of BAs performed before sABR ranged from 1.6 (in ASD and GDD) to 2.7 (in DS). Hearing loss (HL) was diagnosed in 10%, 13%, 36% and 46% of patients with GDD, ASD, CP and DS respectively. Up to 75% of the HL was sensorineural (in CP patients). CONCLUSION In children with significant cognitive delays, a high incidence of HL (especially SNHL) was identified, therefore high suspicion for HL should be held in these patients. Multiple unsuccessful BAs contribute to prolonged time to diagnosis and treatment, thus prompt sABR should be performed in patients whose severe cognitive delay inhibits reliable testing with BA.
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Affiliation(s)
- Stephen Trudeau
- Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Samantha Anne
- Cleveland Clinic Foundation Head & Neck Institute, Cleveland, OH, United States of America
| | - Todd Otteson
- University Hospitals Department of Otolaryngology - Head & Neck Surgery, Cleveland, OH, United States of America
| | - Brandon Hopkins
- Cleveland Clinic Foundation Head & Neck Institute, Cleveland, OH, United States of America
| | - Rachael Georgopoulos
- Cleveland Clinic Foundation Head & Neck Institute, Cleveland, OH, United States of America
| | - Carissa Wentland
- University Hospitals Department of Otolaryngology - Head & Neck Surgery, Cleveland, OH, United States of America.
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Deaf Children of Hearing Parents Have Age-Level Vocabulary Growth When Exposed to American Sign Language by 6 Months of Age. J Pediatr 2021; 232:229-236. [PMID: 33482219 PMCID: PMC8085057 DOI: 10.1016/j.jpeds.2021.01.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/08/2021] [Accepted: 01/13/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine whether children who are deaf or hard of hearing who have hearing parents can develop age-level vocabulary skills when they have early exposure to a sign language. STUDY DESIGN This cross-sectional study of vocabulary size included 78 children who are deaf or hard of hearing between 8 and 68 months of age who were learning American Sign Language (ASL) and had hearing parents. Children who were exposed to ASL before 6 months of age or between 6 and 36 months of age were compared with a reference sample of 104 deaf and hard of hearing children who have parents who are deaf and sign. RESULTS Deaf and hard of hearing children with hearing parents who were exposed to ASL in the first 6 months of life had age-expected receptive and expressive vocabulary growth. Children who had a short delay in ASL exposure had relatively smaller expressive but not receptive vocabulary sizes, and made rapid gains. CONCLUSIONS Although hearing parents generally learn ASL alongside their children who are deaf, their children can develop age-expected vocabulary skills when exposed to ASL during infancy. Children who are deaf with hearing parents can predictably and consistently develop age-level vocabularies at rates similar to native signers; early vocabulary skills are robust predictors of development across domains.
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Trepiccione F, Walsh SB, Ariceta G, Boyer O, Emma F, Camilla R, Ferraro PM, Haffner D, Konrad M, Levtchenko E, Lopez-Garcia SC, Santos F, Stabouli S, Szczepanska M, Tasic V, Topaloglu R, Vargas-Poussou R, Wlodkowski T, Bockenhauer D. Distal Renal Tubular Acidosis: ERKNet/ESPN Clinical Practice Points. Nephrol Dial Transplant 2021; 36:1585-1596. [PMID: 33914889 DOI: 10.1093/ndt/gfab171] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Indexed: 12/15/2022] Open
Abstract
Distal renal tubular acidosis (dRTA) is characterised by an impaired ability of the distal tubule to excrete acid, leading to metabolic acidosis. Associated complications include bone disease, growth failure, urolithiasis and hypokalaemia. Due to its rarity, there is a limited evidence to guide diagnosis and management, however, available data strongly suggest that metabolic control of the acidosis by alkali supplementation can halt or revert almost all complications. Despite this, cohort studies show that adequate metabolic control is present in only about half of patients, highlighting problems with treatment provision or adherence. With these clinical practice points the authors, part of the working groups tubulopathies in the European Rare Kidney Disease Reference network (ERKnet) and inherited kidney diseases of the European Society for Paediatric Nephrology (ESPN) aim to provide guidance for the management of patients with dRTA to facilitate adequate treatment and establish an initial best practice standard against which treatment of patients can be audited.
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Affiliation(s)
- Francesco Trepiccione
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Steven B Walsh
- Department of Renal Medicine, University College London, UK
| | - Gema Ariceta
- Division of Pediatric Nephrology. Hospital Universitario Vall d' Hebron. Universitat Autonoma de Barcelona. Barcelona, Spain
| | - Olivia Boyer
- Pediatric Nephrology, Necker Hospital, APHP, MARHEA, Imagine Institute, Paris University, Paris, France
| | - Francesco Emma
- Division of Nephrology, Bambino Gesu Children's Hospital - IRCCS, Rome, Italy
| | - Roberta Camilla
- Nephrology, Dialysis, Transplantation, Regina Margherita University Hospital, Turin, Italy
| | - Pietro Manuel Ferraro
- U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School Children's Hospital, Hannover, Germany
| | - Martin Konrad
- Department of General Pediatrics, University Children's Hospital, Muenster, Germany
| | - Elena Levtchenko
- Division of Pediatric Nephrology, University Hospitals Leuven; Department of Development & Regeneration, Katholieke Universiteit Leuven, Belgium
| | - Sergio Camilo Lopez-Garcia
- Department of Renal Medicine, University College London, UK.,Renal Unit, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Fernando Santos
- Department of Pediatrics, Hospital Universitario Central de Asturias and Área de Pediatría, Dpto. de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Stella Stabouli
- 1st Department of Pediatrics, Aristotle University, Thessaloniki, Greece
| | | | - Velibor Tasic
- University Children's Hospital, Medical School, Skopje, Macedonia
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rosa Vargas-Poussou
- Department of Genetics, Centre de Références MARHEA, Hôpital Européen Georges Pompidou Assistance Publique Hôpitaux de Paris, Paris France
| | - Tanja Wlodkowski
- Department of Paediatric Nephrology, University Children's Hospital, Heidelberg, Germany
| | - Detlef Bockenhauer
- Department of General Pediatrics, University Children's Hospital, Muenster, Germany.,Division of Pediatric Nephrology, University Hospitals Leuven; Department of Development & Regeneration, Katholieke Universiteit Leuven, Belgium
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216
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Meagher SP, Carlson BL, Elrod MG. Behaviors Interfering with Audiometry Associated with Eventual Diagnosis of Autism. J Autism Dev Disord 2021; 51:849-854. [PMID: 32056116 DOI: 10.1007/s10803-020-04385-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Children referred for audiology evaluation due to speech and language delays represent a neurodevelopmentally high-risk group. The audiology evaluation is a behaviorally-challenging encounter early in the diagnostic process. We assessed interfering behaviors (IB) that complicated completion of audiometry as predictors of autism spectrum disorder (ASD) diagnosis. This retrospective cohort study using the Military Health System electronic medical record included 296 children aged 18 to 71 months. Children who displayed IB had increased odds of receiving an ASD diagnosis compared to those who did not (OR = 5.6, 95% CI 2.6-12.1). Interfering behaviors had a high specificity (81%) and negative predictive value (94%) for ASD. The audiology evaluation may represent an opportunity early in the diagnostic process to stratify risk for ASD.
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Affiliation(s)
- Sean P Meagher
- Department of Pediatrics, Wilford Hall Ambulatory Surgical Center, 1100 Wilford Hall Loop, Joint Base San Antonio-Lackland, San Antonio, TX, USA.
| | - Betsy L Carlson
- Department of Surgery, Madigan Army Medical Center, 9040 Jackson Ave, Joint Base Lewis-McChord, Tacoma, WA, USA
| | - Marilisa G Elrod
- Department of Pediatrics, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA, USA
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217
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Palma S, Ciorba A, Nascimbeni L, Pecovela M, Negossi L, Pelucchi S, Stagi P, Genovese E. Hearing Loss in Children: Clinical-Epidemiological Data from Two Different Provinces of the Same Region. Audiol Res 2021; 11:192-199. [PMID: 33922429 PMCID: PMC8167747 DOI: 10.3390/audiolres11020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/16/2021] [Accepted: 04/21/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In many countries, neonatal hearing screening programs (NHS) have been available for many years; however, because of the presence of hearing loss at late onset, early hearing detection programs (EHDP) have been implemented. The aim of this study was to evaluate all cases of infantile hearing loss under the care of two different provinces of a regional health service since the introduction of NHS. METHODS Clinical data (the presence of audiological risk factors, age at which children are placed under the care of health service, entity of hearing loss, treatment, and exposure to bilingualism) were retrospectively collected during the period from 1 January 2012 to 31 December 2018, starting from the IT management system used in all of the regional neuropsychiatric services. RESULTS In total, 124 children were included-116 cases failed the screening, 1 case had an untraceable result, and 7 cases (5.6%) had hearing screening that passed. Most of the children were placed under the care of a neuropsychiatric infantile and adolescence (NPIA) service within the first year of life. The main differences across the two provinces concerned the percentages of audiological risk factors and the number of unilateral hearing loss cases. CONCLUSION In order to plan and manage hearing rehabilitation programs for children in the best way, it is very important to know the local clinical-epidemiological features of the population.
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Affiliation(s)
- Silvia Palma
- Audiology, Primary Care Unit, 41121 Modena, MO, Italy
| | - Andrea Ciorba
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Cona, FE, Italy; (A.C.); (L.N.); (S.P.)
| | - Laura Nascimbeni
- Child and Adolescent Mental Health Service AUSL, 41121 Modena, MO, Italy; (L.N.); (M.P.); (P.S.)
| | - Mariachiara Pecovela
- Child and Adolescent Mental Health Service AUSL, 41121 Modena, MO, Italy; (L.N.); (M.P.); (P.S.)
| | - Laura Negossi
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Cona, FE, Italy; (A.C.); (L.N.); (S.P.)
| | - Stefano Pelucchi
- ENT & Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, 44124 Cona, FE, Italy; (A.C.); (L.N.); (S.P.)
| | - Paolo Stagi
- Child and Adolescent Mental Health Service AUSL, 41121 Modena, MO, Italy; (L.N.); (M.P.); (P.S.)
| | - Elisabetta Genovese
- Audiology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, 41121 Modena, MO, Italy;
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218
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Early Prelingual Auditory Development of Infants and Toddlers With Unilateral Hearing Loss. Otol Neurotol 2021; 41:654-0. [PMID: 32604328 DOI: 10.1097/mao.0000000000002584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess the influence of congenital and permanent unilateral hearing loss (UHL) on early prelingual auditory development (EPLAD) of infants and toddlers. STUDY DESIGN A cross-sectional and case-controlled design. SETTING Tertiary referral center. PATIENTS Sixty-five young children (median with interquartile ranges: 4.4 [3.3, 7.7] mo) with UHL, 70 children (6.0 [3.8, 9.0] mo) with bilateral normal hearing (BNH) and 32 children (5.8 [3.9, 12.1] mo) with bilateral mild hearing loss (BMHL) were enrolled and grouped. Children with UHL were further grouped according to the severity of impairment and the ear that was impaired. INTERVENTIONS Children involved were assessed by the 9-item Infant-toddler Meaningful Auditory Integration Scale (ITMAIS). MAIN OUTCOME MEASURES 1) EPLAD assessed by ITMAIS, 2) functions of sound detection, sound discrimination and identification and preverbal vocalization assessed by dividing ITMAIS into three sections, 3) trajectories of EPLAD estimated by ITMAIS. RESULTS Compared with BNH, children with UHL lagged behind in the function of sound discrimination and identification, preverbal vocalization, as well as trajectory of EPLAD. Children with severe to profound UHL exhibited more severe EPLAD handicaps than children with mild to moderate losses. The auditory functions and EPLAD trajectory of children with UHL were similar to those with BMHL. CONCLUSIONS Children with congenital and permanent UHL demonstrate delays in EPLAD, which are evident soon after birth before initial development of speech and language. The ITMAIS is an appropriate tool to identify these delays both in children with unilateral and bilateral hearing impairment.
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Audiological Findings in Children Suspected to Have Been Exposed to the Zika Virus in the Intrauterine Period. Otol Neurotol 2021; 41:e848-e853. [PMID: 32569146 DOI: 10.1097/mao.0000000000002704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate auditory manifestations in children born to mothers who had exanthema during pregnancy, suspected to have been exposed to the Zika virus (ZIKV). STUDY DESIGN Prospective observational. SETTING Tertiary referral center. PATIENTS Children born in Rio de Janeiro, Brazil, between April 2016 and September 2017, who were referred for newborn hearing screening (NHS). INTERVENTION The NHS was performed by the automated brainstem auditory-evoked potential test at an intensity of 30 dBHL (decibels Hearing Level) with the result presented as "PASS/FAIL." A follow-up test was performed 6 months after the first examination. MAIN OUTCOME MEASURES Hearing outcomes by audiological assessment. RESULTS Ninety-eight children were recruited and 78 underwent the NHS test. In the first evaluation, the FAIL NHS result was observed in 4 of the 78 children. Three were diagnosed with sensorineural hearing loss and one had conductive loss. Including the first and second evaluation, the frequency of audiological alterations was 5.1%. Of the four children diagnosed with hearing loss, two were carriers of ZIKV, one had suspected ZIKV infection, and one was asymptomatic with confirmed exposure to the virus. There was no progression of hearing loss or other hearing abnormality in the children by the time of the second evaluation. The group of nonexposed children (negative quantitative reverse transcription polymerase chain reaction for ZIKV) showed no hearing loss. CONCLUSION Uni or bilateral sensorineural hearing loss was diagnosed in asymptomatic children at birth. These observations highlight the importance of periodic follow-up of patients with congenital Zika syndrome to better understand their long-term auditory clinical outcome.
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Al-Balas HI, Nuseir A, Zaitoun M, Al-Balas M, Khamees A, Al-Balas H. The effects of mode of delivery, maternal age, birth weight, gender and family history on screening hearing results: A cross sectional study. Ann Med Surg (Lond) 2021; 64:102236. [PMID: 33868678 PMCID: PMC8040126 DOI: 10.1016/j.amsu.2021.102236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Congenital 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. Methods A 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. Results A 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. Conclusion Our 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. Hearing impairment is a stressful condition that disturbs family quality of life. Early detection of hearing impairment can make a difference in child development. Otoacoustic test emission is a screening test with considerable reliability. Early Otoacoustic test can have false negative results in specific condition. Postpone the first phase of hearing screening decrease the family stress.
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Affiliation(s)
| | - Amjad Nuseir
- Department of Special Surgery, Faculty of Medicine, Jordan University of Science and Technology, Jordan
| | - Maha Zaitoun
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Jordan
| | - Mahmoud Al-Balas
- Department of General and Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | | | - Hamzeh Al-Balas
- Department of General and Special Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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Performance and characteristics of the Newborn Hearing Screening Program in Campania region (Italy) between 2013 and 2019. Eur Arch Otorhinolaryngol 2021; 279:1221-1231. [PMID: 33768315 PMCID: PMC8897375 DOI: 10.1007/s00405-021-06748-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/11/2021] [Indexed: 11/06/2022]
Abstract
Purpose Universal newborn hearing screening (UNHS) in the first month of life is crucial for facilitating both early hearing detection and intervention (EHDI) of significant permanent hearing impairment (PHI). In Campania region, UNHS has been introduced in 2003 by the Regional Council Resolution and started on January 2007. The aim of this paper is to update a previous article describing the performance of the program since its implementation in the period between 2013 and 2019. Methods A longitudinal retrospective study was carried at the Regional Reference Center III on 350,178 babies born in the analysis period. The paper reports the main results of overall coverage, referral rate, lost-to-follow-up rate,yield for PHI and shall determine various risk factor associations with hearing impairment Results In Campania region, 318,878 newborns were enrolled at I level, with a coverage rate of 91.06%, 301,818 (86.18%) Well Infant Nurseries (WIN) and 17,060 (5.35%) Neonatal Intensive Care Unit (NICU) babies. PHI was identified in 413 children, 288 (69.73%) bilaterally and 125 (30.26%) unilaterally. The overall cumulative incidence rate of PHI was 1.29 per 1000 live-born infants (95% CI 1.17–1.42) with a quite steady tendency during the whole study period. Conclusions This study confirms the feasibility and effectiveness of UNHS in Campania region also in a setting with major socioeconomic and health organization restrictions.The program meets quality benchmarks to evaluate the progress of UNHS. Nowadays, it is possible to achieve an early diagnosis of all types of HL avoiding the consequences of hearing deprivation.
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Faistauer M, Lang Silva A, Félix TM, Todeschini de Souza L, Bohn R, Selaimen da Costa S, Petersen Schmidt Rosito L. Etiology of early hearing loss in Brazilian children. Braz J Otorhinolaryngol 2021; 88 Suppl 1:S33-S41. [PMID: 33839059 PMCID: PMC9734262 DOI: 10.1016/j.bjorl.2021.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/22/2021] [Accepted: 02/28/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Hearing loss etiology depends on the population studied as well as on the ethnicity and the socio-economic condition of the analyzed region. Etiological diagnosis contributes to the improvement of preventive measures and to the early identification of this deficiency. OBJECTIVE To identify the etiological factors of hearing loss and its prevalence in a tertiary hospital in southern Brazil, to verify the frequency of mutations in GJB2 and GJB6 genes, and to correlate the degree of hearing loss with the etiological factors of deafness. METHODS This prevalence study involved 140 children with bilateral sensorineural or mixed hearing loss. Medical history, physical examination, audiometry, and evoked auditory brainstem response were conducted. Imaging and genetic examinations were also performed. RESULTS Etiologies and their prevalence were as follows: (a) indeterminate causes, 31.4%; (b) conditions related to neonatal period, 22.1%; (c) genetic, 22.1%; (d) auditory neuropathy, 10%; (e) other factors (cortical malformation, intracranial hemorrhage, and internal ear malformations), 7.9% and (f) congenital infections, 6.4%. Within the genetic cases, ten homozygous and seven heterozygotes of the 35delG mutation were identified, besides two cases of rare variants of GJB2: p.Try172* and p.Arg184Pro. One case with homozygosis of del(GJB6-D13S1830) was found. Regarding severity of hearing loss, in 78.6% of the cases the degree of hearing loss was profound and there were no significant differences when comparing between etiologies. CONCLUSION The number of indeterminate etiologies is still high and congenital CMV infection may be a possible cause of undiagnosed etiology for hearing loss. The predominance of etiologies related to neonatal conditions and infectious causes are characteristic of developing countries. The most prevalent mutation was 35delG, the main GJB2 gene, probably because of the European influence in the genotype of our population.
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Affiliation(s)
- Marina Faistauer
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, RS, Brazil
| | - Alice Lang Silva
- Hospital de Clínicas de Porto Alegre, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Oftalmologia e Otorrinolaringologia, Porto Alegre, RS, Brazil.
| | - Têmis Maria Félix
- Hospital de Clínicas de Porto Alegre, Departamento de Genética, Porto Alegre, RS, Brazil
| | | | - Renata Bohn
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, RS, Brazil
| | - Sady Selaimen da Costa
- Hospital de Clínicas de Porto Alegre, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Oftalmologia e Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Letícia Petersen Schmidt Rosito
- Hospital de Clínicas de Porto Alegre, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Oftalmologia e Otorrinolaringologia, Porto Alegre, RS, Brazil
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Schickinger-Fischer B. [Early detection of unilateral connatal hearing loss via newborn hearing screening and the implementation of the SAV-concept 2017 in lower Austria and Burgenland]. Wien Med Wochenschr 2021; 172:14-19. [PMID: 33738629 DOI: 10.1007/s10354-021-00835-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent studies showed the benefit or even need of hearing aids or cochlear implants in children with unilateral hearing loss to improve localization abilities and speech intelligibility. Therefore, the Audiology working group of the Austrian ENT society adopted the SAV-concept in 2017 (Screening Abklärung Versorgung von konnatalen Hörstörungen - Konzeptpapier 2017 AG Audiologie) to establish methods for testing, the mode of testing both ears, the desired schedule for the screening process and the subsequent therapy. METHODS The screening data were collected via questionnaires sent to all maternity and neonatal wards in different districts by responsible persons of the Austrian ENT society. Data on the implementation of the SAV concept were evaluated retrospectively based on the responses for the regions of Lower Austria and Burgenland. RESULTS The feedback, the implementation and responsibility for the screening program in respect of method and schedule differs throughout the federal states of Austria as well as in hospitals of state health organizations. CONCLUSION Austria in comparison to other European countries is missing a central documentation and tracking system via a governmental screening coordination office as the data are not generally transferred to a common birth register. Therefore, different timetables and organization for the universal new born hearing screening in the federal states as well as in state organizations were found causing a delayed diagnosis and treatment of children with unilateral hearing loss.
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Bussé AML, Mackey AR, Hoeve HLJ, Goedegebure A, Carr G, Uhlén IM, Simonsz HJ. Assessment of hearing screening programmes across 47 countries or regions I: provision of newborn hearing screening. Int J Audiol 2021; 60:821-830. [PMID: 33688794 DOI: 10.1080/14992027.2021.1886350] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Newborn hearing screening (NHS) varies regarding number and type of tests, location, age, professionals and funding. We compared the provision of existing screening programmes. DESIGN A questionnaire containing nine domains: demography, administration, existing screening, coverage, tests, diagnosis, treatment, cost and adverse effects, was presented to hearing screening experts. Responses were verified. Clusters were identified based on number of screening steps and use of OAE or aABR, either for all infants or for well and high-risk infants (dual-protocol). STUDY SAMPLE Fifty-two experts completed the questionnaire sufficiently: 40 European countries, Russia, Malawi, Rwanda, India and China. RESULTS It took considerable effort to find experts for all countries with sufficient time and knowledge. Data essential for evaluation are often not collected. Infants are first screened in maternity wards in most countries. Human development index and health expenditure were high among countries with dual protocols, three screening steps, including aABR, and low among countries without NHS and countries using OAE for all infants. Nationwide implementation of NHS took 6 years, on average. CONCLUSION The extent and complexity of NHS programmes are primarily related to health expenditure and HDI. Data collection should be improved to facilitate comparison of NHS programmes across borders.
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Affiliation(s)
- Andrea M L Bussé
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Hans L J Hoeve
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gwen Carr
- Independent consultant in Early Hearing Detection, Intervention and Family Centered Practice, London, UK
| | | | - Huibert J Simonsz
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Mackey AR, Bussé AML, Hoeve HLJ, Goedegebure A, Carr G, Simonsz HJ, Uhlén IM. Assessment of hearing screening programmes across 47 countries or regions II: coverage, referral, follow-up and detection rates from newborn hearing screening. Int J Audiol 2021; 60:831-840. [PMID: 33686919 DOI: 10.1080/14992027.2021.1886351] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To assess the performance of newborn hearing screening (NHS) programmes, through selected quality measures and their relationship to protocol design. DESIGN NHS coverage, referral, follow-up and detection rates were aggregated. Referral rates were compared to age at screening step 1, number of steps, and test method: OAE or aABR. STUDY SAMPLE A questionnaire on existing hearing screening was completed by experts from countries in Europe, plus Russia, Malawi, Rwanda, India and China. RESULTS Out of 47 countries or regions, NHS coverage rates were reported from 26, referral rates from 23, follow up from 12 and detection rates from 13. Median coverage rate for step 1 was 96%. Referral rate from step 1 was 6-22% where screening may be performed <24 h from birth, 2-15% for >24 h, and 4% for >72 h. Referral rates to diagnostic assessment averaged 2.1% after one to two steps using OAE only, 1.7% after two steps including aABR, and 0.8% after three to four steps including aABR. Median detection rate for bilateral permanent hearing impairment ≥40dB was 1 per 1000 infants. CONCLUSION Referral rates were related to age, test method and number of screening steps. Quality measures were not available for many NHS programmes.
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Affiliation(s)
| | - Andrea M L Bussé
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hans L J Hoeve
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gwen Carr
- Early Hearing Detection, Intervention and Family Centered Practice, London, UK
| | - Huibert J Simonsz
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Zika-related adverse outcomes in a cohort of pregnant women with rash in Pernambuco, Brazil. PLoS Negl Trop Dis 2021; 15:e0009216. [PMID: 33684110 PMCID: PMC7971861 DOI: 10.1371/journal.pntd.0009216] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/18/2021] [Accepted: 02/07/2021] [Indexed: 11/20/2022] Open
Abstract
Background While Zika virus (ZIKV) is now widely recognized as a teratogen, the frequency and full spectrum of adverse outcomes of congenital ZIKV infection remains incompletely understood. Methods Participants in the MERG cohort of pregnant women with rash, recruited from the surveillance system from December/2015-June/2017. Exposure definition was based on a combination of longitudinal data from molecular, serologic (IgM and IgG3) and plaque reduction neutralization tests for ZIKV. Children were evaluated by a team of clinical specialists and by transfontanelle ultrasound and were classified as having microcephaly and/or other signs/symptoms consistent with congenital Zika syndrome (CZS). Risks of adverse outcomes were quantified according to the relative evidence of a ZIKV infection in pregnancy. Findings 376 women had confirmed and suspected exposure to ZIKV. Among evaluable children born to these mothers, 20% presented with an adverse outcome compatible with exposure to ZIKV during pregnancy. The absolute risk of microcephaly was 2.9% (11/376), of calcifications and/or ventriculomegaly was 7.2% (13/180), of additional neurologic alterations was 5.3% (13/245), of ophthalmologic abnormalities was 7% (15/214), and of dysphagia was 1.8% (4/226). Less than 1% of the children experienced abnormalities across all of the domains simultaneously. Interpretation: Although approximately one-fifth of children with confirmed and suspected exposure to ZIKV in pregnancy presented with at least one abnormality compatible with CZS, the manifestations presented more frequently in isolation than in combination. Due to the rare nature of some outcomes and the possibility of later manifestations, large scale individual participant data meta-analysis and the long-term evaluation of children are imperative to identify the full spectrum of this syndrome and to plan actions to reduce damages. The ability to meaningfully quantify the absolute and relative risks of Congenital Zika Syndrome is contingent on the accurate identification of ZIKV infections in pregnant women and the long-term follow-up of children at risk. This study builds on the evidence base on ZIKV in pregnancy by not only examining pregnancy and birth outcomes, but also considering later onset manifestations of Congenital Zika Syndrome, conducting a deep and standardized investigation of infant outcomes. In addition, it used unprecedented repeated testing and the use of multiple diagnostic platforms, including qRT-PCR, IgM and IgG3 ELISAs, and PRNTs to identify ZIKV cases. The absolute risk of microcephaly was 2.9%, of calcifications and/or ventriculomegaly was 7.2%, of additional neurologic alterations was 5.3%, of ophthalmologic abnormalities was 7% and of dysphagia was 1.8%. The manifestations presented more frequently in isolation than in combination (i.e., less than 1% of the children experienced abnormalities across all of the domains simultaneously). Although approximately one-fifth of children with confirmed and suspected exposure to ZIKV in pregnancy presented with at least one abnormality compatible with CZS, the manifestations presented more frequently in isolation than in combination
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227
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Beswick R, McHugh L, Clark JE. Integrating congenital cytomegalovirus screening within a newborn hearing screening program: Is it worthwhile? Int J Pediatr Otorhinolaryngol 2021; 142:110594. [PMID: 33422993 DOI: 10.1016/j.ijporl.2020.110594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of the present study was to review the potential impacts and barriers to upscaling a pilot congenital Cytomegalovirus (cCMV) screening program into a state-wide permanent universal newborn hearing screening (UNHS) program. DESIGN This study reviewed the outcomes of the cCMV screening program pilot operating at three maternity hospitals to standard state-wide laboratory notifications in Queensland, Australia between August 2014 to April 2018. Stakeholder interviews were also conducted to inform state-wide program implementation. RESULTS Of the 485 infants tested for CMV on a saliva swab at the pilot sites, 4 (0.8%) returned a positive result. Review of the state-wide laboratory infant CMV PCR notifications for the same time-period revealed more than half of infants with cCMV (63.7%) would not have been detected under a state-wide targeted screening program as they either passed newborn hearing screening, were deceased, symptomatic, or were born <34 weeks gestational age. Barriers to state-wide program implementation included program-level factors (timing of the cCMV screen, funding, cross-agency communication, workforce and training) and community-level factors (low public cCMV awareness and prevalence). CONCLUSIONS Although cCMV screening alongside UNHS is achievable, a number of barriers need to be addressed prior to state-wide program implementation.
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Affiliation(s)
- Rachael Beswick
- Children's Health Queensland Hospital and Health Service, Queensland, PO Box 930, Nundah, Queensland, 4012, Australia.
| | - Lauren McHugh
- Children's Health Queensland Hospital and Health Service, Queensland, PO Box 930, Nundah, Queensland, 4012, Australia
| | - Julia E Clark
- Children's Health Queensland Hospital and Health Service, Queensland, PO Box 930, Nundah, Queensland, 4012, Australia; School of Clinical Medicine, Children's Health Queensland Clinical Unit, 501 Stanley Street, PO Box 3474, South Brisbane, QLD, 4101, Australia
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228
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Birdsey B, Joseph L. Plurality of perspective: Doctor-parents of deaf children in a low-to middle-income country. Int J Pediatr Otorhinolaryngol 2021; 142:110610. [PMID: 33477015 DOI: 10.1016/j.ijporl.2021.110610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Pediatric deafness is an important consideration in neurodevelopment. Early identification and intervention are major factors in seeing that deaf children reach their full potential. Often, it is the medical professionals who themselves have limited knowledge about hearing loss or the consequences of delayed language acquisition. These knowledge gaps can negatively influence the timeous and holistic care that children with hearing loss require. With a dual experiential expertise gained through both parenting children with disabling hearing loss and being medical doctors, the purpose of this study was to better understand the field of pediatric hearing loss through doctors' insights gained as parents. STUDY DESIGN Interpretative Phenomenological Analysis was the approach used for this qualitative enquiry. Five South African participants with children between the ages of two and ten years, were selected using purposive sampling and an in-depth semi-structured interview used as the data instrument. Thereafter, three levels of thematic analysis were conducted. RESULTS Generally, doctors have limited knowledge of pediatric deafness. Perceptions towards deafness are typically through a medical-model lens, while appreciation of Universal Newborn Hearing Screening is lacking. Through exploring the various gains of parenting a deaf child, participants acknowledged the power of the lived experience in changing their own practice as both parents and practitioners. CONCLUSION Doctors need to know more about pediatric deafness. The pathway of care from identification to intervention in South Africa needs revision. Exposure to the lived experience is a powerful means of enabling expert insights to influence such change in a practical and meaningful way.
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Affiliation(s)
- Bianca Birdsey
- Department of Pediatrics and Child Health, 1 Jan Smuts Avenue, Braamfontein 2000, Johannesburg, South Africa.
| | - Lavanithum Joseph
- Discipline of Audiology, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000, South Africa.
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Qian ZJ, Chang KW, Ahmad IN, Tribble MS, Cheng AG. Use of Diagnostic Testing and Intervention for Sensorineural Hearing Loss in US Children From 2008 to 2018. JAMA Otolaryngol Head Neck Surg 2021; 147:253-260. [PMID: 33377936 PMCID: PMC7774052 DOI: 10.1001/jamaoto.2020.5030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/05/2020] [Indexed: 12/30/2022]
Abstract
Importance Early detection and intervention of pediatric hearing loss is critical for language development and academic achievement. However, variations in the diagnostic workup and management of pediatric sensorineural hearing loss (SNHL) exist. Objective To identify patient and clinician factors that are associated with variation in practice on a national level. Design, Setting, and Participants This cross-sectional study used the Optum claims database to identify 53 711 unique children with SNHL between January 1, 2008, and December 31, 2018. Main Outcomes and Measures National use rates and mean costs for diagnostic modalities (electrocardiogram, cytomegalovirus testing, magnetic resonance imaging, computed tomography, and genetic testing) and interventions (speech-language pathology, billed hearing aid services, and cochlear implant surgery) were reported. The associations of age, sex, SNHL laterality, clinician type, race/ethnicity, and household income with diagnostic workup and intervention use were measured in multivariable analyses. Results Of 53 711 patients, 23 735 (44.2%) were girls, 2934 (5.5%) were Asian, 3797 (7.1%) were Black, 5626 (10.5%) were Hispanic, 33 441 (62.3%) were White, and the mean (SD) age was 7.3 (5.3) years. Of all patients, 32 200 (60.0%) were seen by general otolaryngologists, while 7573 (14.10%) were seen by pediatric otolaryngologists. Diagnostic workup was received by 14 647 patients (27.3%), while 13 482 (25.1%) received intervention. Use of genetic testing increased (odds ratio, 1.22 per year; 95% CI, 1.20-1.24), whereas use of computed tomography decreased (odds ratio, 0.93 per year; 95% CI, 0.92-0.94) during the study period. After adjusting for relevant covariables, children who were seen by pediatric otolaryngologists and geneticists had the highest odds of receiving workup and intervention. Additionally, racial/ethnic and economic disparities were observed in the use of most modalities of diagnostic workup and intervention for pediatric SNHL. Conclusions and Relevance This cross-sectional study identified factors associated with disparities in the diagnostic workup and intervention of pediatric SNHL, thus highlighting the need for increased education and standardization in the management of this common sensory disorder.
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Affiliation(s)
- Z. Jason Qian
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Kay W. Chang
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Iram N. Ahmad
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Melissa S. Tribble
- Pediatric Audiology, Lucile Packard Children’s Hospital, Palo Alto, California
| | - Alan G. Cheng
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
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230
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Pitathawatchai P, Chaichulee S, Kirtsreesakul V. Robust machine learning method for imputing missing values in audiograms collected in children. Int J Audiol 2021; 61:66-77. [PMID: 33641573 DOI: 10.1080/14992027.2021.1884909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the accuracy and reliability of a machine learning (ML) algorithm for predicting the full audiograms of hearing-impaired children relative to the common approach (CA). DESIGN Retrospective study. STUDY SAMPLE There were 206 audiograms included from 206 children with sensorineural hearing loss. Nested cross-validation was used for evaluating the performance of the CA and ML. Six audiogram prediction simulations were performed in which either one or two thresholds across 0.5-4 kHz from complete audiograms in the dataset were labelled. Missing thresholds at the remaining frequencies were then predicted using the CA and ML in each simulation. The accuracy of the ML algorithm was determined by comparing the median average absolute threshold differences between the CA and ML using Wilcoxon signed-rank test. The reliability between runs of the ML was also assessed with Cronbach's alphas. RESULTS The median average absolute threshold differences in ML (5-8 dBHL) were statistically significantly lower than those in CA (6.25-10 dBHL) in all six simulations (p value < 0.05). The ML algorithm was also found to be reliable to predict the audiograms in all six simulations (α > 0.9). CONCLUSION Using the ML to predict the children's audiograms was reliable and more accurate than using the CA.
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Affiliation(s)
- Pittayapon Pitathawatchai
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Sitthichok Chaichulee
- Institute of Biomedical Engineering, Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Virat Kirtsreesakul
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
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Plyler E, Harkrider AW, Little JP. Three Cases of Recovery from Sensorineural Hearing Loss in the First Year of Life: Implications for Monitoring and Management. J Am Acad Audiol 2021; 32:54-68. [PMID: 33588509 DOI: 10.1055/s-0040-1719129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Three infants with different risk factors, behavioral and physiologic audiometric histories, and diagnoses were fit with amplification between 3 and 8 months of age. Two of the three met criteria for cochlear implantation. PURPOSE This article aims to heighten awareness of the rare possibility of recovery from sensorineural hearing loss in infants with varying histories and emphasize the importance of a full diagnostic test battery in all infants diagnosed with sensorineural hearing loss every 3 months until objective and subjective thresholds are stable to ensure appropriate intervention. RESEARCH DESIGN Case reports. RESULTS All three infants demonstrated improvement or full recovery of hearing and cochlear function by approximately 12 months old. Their change in hearing was discovered due to frequent follow-up and/or caregiver report. One of these infants was tentatively scheduled to have cochlear implant surgery 2 months later. CONCLUSION Appropriate early intervention for infants with hearing loss is critical to ensure maximum accessibility to speech and language cues. The Federal Drug Administration approves cochlear implantation in infants as young as 12 months. When providing audiometric management of infants with sensorineural hearing loss, it is imperative to conduct a full diagnostic test battery every 3 months (including tympanometric, acoustic reflex, and otoacoustic emission measurement) until objective and subjective thresholds are stable. There was no apparent pattern of factors to predict that the infants highlighted in these cases would recover. Discussion among pediatric audiologists and otologists and comparison of data from clinics across the U.S. is needed to identify predictive patterns and determine appropriate, consistent monitoring of infants with sensorineural hearing loss.
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Affiliation(s)
- Erin Plyler
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee
| | - Ashley W Harkrider
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee
| | - John P Little
- Children's Ear, Nose and Throat Specialists, Children's Hospital, Knoxville, Tennessee
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232
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Orzan E, Pizzamiglio G, Gregori M, Marchi R, Torelli L, Muzzi E. Correlation of cochlear aperture stenosis with cochlear nerve deficiency in congenital unilateral hearing loss and prognostic relevance for cochlear implantation. Sci Rep 2021; 11:3338. [PMID: 33558599 PMCID: PMC7870947 DOI: 10.1038/s41598-021-82818-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 01/25/2021] [Indexed: 12/22/2022] Open
Abstract
The use of neonatal hearing screening has enabled the identification of congenital unilateral sensorineural hearing loss (USNHL) immediately after birth, and today there are several intervention options available to minimize potential adverse effects of this disease, including cochlear implantation. This study aims to analyze the characteristics of the inner ear of a homogeneous group of congenital non-syndromic USNHL to highlight the features of the inner ear, which can help in clinical, surgical, and rehabilitative decision-making. A retrospective chart review was carried out at a tertiary referral center. Systematic diagnostic work-up and rigorous inclusion-exclusion criteria were applied to 126 children with unilateral hearing impairment, leading to a selection of 39 strictly congenital and non-syndromic USNHL cases, undergoing computed tomography (CT) and magnetic resonance (MR) imaging studies. The frequency and type of malformations of the inner ear in USNHL and unaffected contralateral ears were assessed, with an in-depth analysis of the deficiency of the cochlear nerve (CND), the internal auditory canal (IAC) and the cochlear aperture (CA). Inner ear anomalies were found in 18 out of 39 (46%) of the USNHL patients. In 1 subject, the anomalies were bilateral, and the CND resulted in the predominant identified defect (78% of our abnormal case series), frequently associated with CA stenosis. Only 3 out of 14 children with CND presented stenosis of the IAC. CND and CA stenosis (and to a much lesser extent IAC stenosis) are a frequent association within congenital and non-syndromic USNHL that could represent a distinct pathological entity affecting otherwise healthy infants. In the context of a diagnostic work-up, the evaluation with CT and MRI measurements should take place in a shared decision-making setting with thorough counseling. Both imaging techniques have proven useful in differentiating the cases that will most likely benefit from the cochlear implant, from those with potentially poor implant performance.
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Affiliation(s)
- Eva Orzan
- Otorhinolaryngology and Audiology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giulia Pizzamiglio
- Otorhinolaryngology and Audiology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy.
| | - Massimo Gregori
- Radiology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Raffaella Marchi
- Otorhinolaryngology and Audiology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Lucio Torelli
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Enrico Muzzi
- Otorhinolaryngology and Audiology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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233
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Palma S, Roversi MF, Alberici MP, Negri M, Chiossi C, Berardi A, Genovese E. Newborn hearing screening programme based on an integrated hospital and community care system. Results of the first 4 years of activity. Int J Pediatr Otorhinolaryngol 2021; 141:110554. [PMID: 33341716 DOI: 10.1016/j.ijporl.2020.110554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Since January 2012, babies born in the province of Modena, Italy, have routinely undergone hearing testing as part of a two-stage screening programme. Newborn hearing screening (NHS) has been based on an integrated hospital and community care system and this study aims to assess screening coverage, referral rates, the prevalence, type and extent of hearing loss several years into the programme. Data were collected from January 1, 2012 to December 31, 2015. Coverage was over 99% in all five facilities of the province. The ratio of "fails of the screening" to the total number of infants tested varied over the period from 1.2% to 0.9% in the third level facility, and from 0.8% to 0.4% in the other four. Although hearing loss was mainly associated with dysmorphic\syndromic diseases or a family history of hearing loss, some 23% of cases were identified with no known risk factors. We highlight the importance of the NHSP and the need for strong support from healthcare administrators to ensure high coverage. This is especially true since although the prevalence of hearing loss was higher among infants with audiological risk factors, several cases of hearing loss were found in newborns with no known risk factors.
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Affiliation(s)
| | - Maria Federica Roversi
- Paediatric Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | | | | | | | - Alberto Berardi
- Paediatric Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | - Elisabetta Genovese
- Audiology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
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234
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Anastasio ART, Yamamoto AY, Massuda ET, Manfredi AKS, Cavalcante JMS, Lopes BCP, Aragon DC, Boppana S, Fowler KB, Britt WJ, Mussi-Pinhata MM. Comprehensive evaluation of risk factors for neonatal hearing loss in a large Brazilian cohort. J Perinatol 2021; 41:315-323. [PMID: 32884104 DOI: 10.1038/s41372-020-00807-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/17/2020] [Accepted: 08/27/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To determine the incidence and risk factors of hearing loss (HL) in Brazilian neonates. STUDY DESIGN 11,900 neonates were screened for hearing and congenital CMV (cCMV). Low and high-risk babies who did not pass their hearing screening and infants with cCMV were scheduled for a diagnostic audiologic evaluation. RESULTS The incidence of HL was 2 per 1000 live-born infants (95% CI: 1-3). HL was higher in high-risk neonates than in low risk babies (18.6 vs. 0.3/1000 live births, respectively). Among infants exposed to isolated risk factors, association of HL with craniofacial abnormalities/syndromes (RR = 24.47; 95% CI: 5.9-100.9) and cCMV (RR = 9.54; 95% CI: 3.3-27.7) were observed. HL was 20 to 100-fold more likely in neonates exposed to ototoxic drugs in combination with cCMV or craniofacial/congenital anomalies. CONCLUSIONS Strategies for the prevention of cCMV and exposure to ototoxic drugs may decrease the incidence of HL in this population.
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Affiliation(s)
- Adriana R T Anastasio
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
| | - Aparecida Y Yamamoto
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Eduardo T Massuda
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School-University of São Paulo, São Paulo, Brazil
| | - Alessandra K S Manfredi
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Juliana M S Cavalcante
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Bruno C P Lopes
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School-University of São Paulo, São Paulo, Brazil
| | - Davi C Aragon
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Suresh Boppana
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Karen B Fowler
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - William J Britt
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Marisa M Mussi-Pinhata
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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235
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Khoza-Shangase K, Kanji A, Ismail F. What are the current practices employed by audiologists in early hearing detection and intervention in the South African healthcare context? Int J Pediatr Otorhinolaryngol 2021; 141:110587. [PMID: 33360694 DOI: 10.1016/j.ijporl.2020.110587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/18/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Universal access to early hearing detection and intervention (EHDI) forms part of the audiology community's goal. Evidence on current practices employed by South African audiologists in EHDI in order to ensure this universal access and success for children with hearing impairment is therefore required, hence this study. METHODS A quantitative survey research methodology with a cross-sectional design was employed. An online survey was completed by 49 qualified audiologists and dually qualified speech therapists and audiologists. Data were analysed using descriptive statistics. RESULTS Results identified gaps in the implementation of EHDI within the South African context. A total of 83.7% of the participants were involved in newborn hearing screening (NHS), with over half adopting the targeted screening approach instead of universal NHS services (UNHS). Capacity versus Demand challenges play a significant role in the lack of successful implementation of NHS with over 60% of the audiologists in the sample reporting that NHS is and should only be conducted by audiologists only; with minimal evidence of task shifting found. No standardised screening protocol was found, with challenges around budget allocation for EHDI revealed. CONCLUSIONS Although progress has been noted, a) gaps between public and private healthcare sector resources allocations and availability, b) limited contextually responsive strategic planning, as well as c) lack of translation of knowledge, policies and guidelines into practice, are glaring areas that require attention by the South African audiology community.
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Affiliation(s)
- Katijah Khoza-Shangase
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
| | - Amisha Kanji
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
| | - Fatima Ismail
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
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236
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Alenazi A, Derraugh G, Levesque M, Morris MI, Shawyer AC, Lum Min SA, Keijzer R. The prevalence of hearing loss in children with congenital diaphragmatic hernia: A longitudinal population-based study. J Pediatr Surg 2021; 56:226-229. [PMID: 33004187 DOI: 10.1016/j.jpedsurg.2020.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/06/2020] [Accepted: 08/01/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The true prevalence of hearing loss among children with congenital diaphragmatic hernia (CDH) is unknown, with some studies reporting rates up to 60%. PURPOSE The purpose of this study was to determine the prevalence of hearing loss among children with CDH and compare it to age-matched controls. METHODS We used population-based datasets to compare the number of hearing loss diagnoses in children younger than 10 years-of-age born between 1992 and 2009 with CDH to date-of-birth matched controls without CDH. Factors associated with CDH disease severity were analyzed to determine their effect on the prevalence of hearing loss. A sensitivity analysis was performed to determine if selection bias of improved care over the course of the study affected hearing loss in CDH patients. The prevalences of hearing loss were compared using Fisher's exact tests and statistical significance was defined as p < 0.05. RESULTS A total of 529 children, 38 CDH cases and their 491 date-of-birth matched controls, met the inclusion criteria. Hearing loss was found in 7 children with CDH (18.4%) compared to 26 (5.3%) controls; the risk ratio (RR) of hearing loss was 3.48 (95%CI = 1.61-7.49, p = 0.006). There was no association between CDH disease severity and hearing loss. CONCLUSIONS CDH is associated with hearing loss compared to the general population. Our results suggest that congenital factors may contribute to hearing loss in CDH more than perinatal exposures. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Abdullah Alenazi
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba
| | - Gabrielle Derraugh
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba
| | - Mathew Levesque
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba
| | - Melanie I Morris
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba
| | - Anna C Shawyer
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba
| | - Suyin A Lum Min
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba
| | - Richard Keijzer
- Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba.
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Chorath K, Garza L, Tarriela A, Luu N, Rajasekaran K, Moreira A. Clinical practice guidelines on newborn hearing screening: A systematic quality appraisal using the AGREE II instrument. Int J Pediatr Otorhinolaryngol 2021; 141:110504. [PMID: 33229031 DOI: 10.1016/j.ijporl.2020.110504] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Several guidelines and consensus statements have been produced and disseminated for the detection and management of newborn hearing loss. However, to date, the quality and methodologic rigor of these screening and management protocols have not been appraised. OBJECTIVE To identify and evaluate existing guidelines and consensus statements for the detection and management of neonatal hearing loss. METHODS A comprehensive search of EMBASE, MEDLINE/PubMed, SCOPUS and grey literature sources was conducted until August 2020. The quality of these guidelines was assessed by four independent reviewers using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II). Domain scores were considered satisfactory quality if they scored >60%, and intraclass correlation coefficients (ICC) were calculated to assess agreement among the appraisers. RESULTS Twelve guidelines were assessed for critical evaluation. Only two guidelines were classified as 'high quality', and the remaining were 'average' or 'low quality'. The 'Scope and Purpose' domain achieved the highest mean score (91.3% ± 5.8%), and lowest was 'Rigor of Development' (35.8% ± 19.1%). ICC analysis showed good to very good agreement across all domains (0.63-0.95). CONCLUSION These findings highlight the variability in methodologic quality of guidelines and consensus statement for the detection and management of neonatal hearing loss. These results may help to improve the reporting of future guidelines and guide the selection and use of these guidelines in clinical practice.
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Affiliation(s)
- Kevin Chorath
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA.
| | - Luis Garza
- Department of Pediatrics, University of Texas Health-San Antonio, San Antonio, TX, USA
| | - Aina Tarriela
- Department of Pediatrics, University of Texas Health-San Antonio, San Antonio, TX, USA
| | - Neil Luu
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, PA, USA
| | - Alvaro Moreira
- Department of Pediatrics, University of Texas Health-San Antonio, San Antonio, TX, USA
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238
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Conte G, Casale S, Caschera L, Lo Russo FM, Paolella C, Cinnante C, Berardino FD, Zanetti D, Stocchetti D, Scola E, Bassi L, Triulzi F. Assessment of the Membranous Labyrinth in Infants Using a Heavily T2-weighted 3D FLAIR Sequence without Contrast Agent Administration. AJNR Am J Neuroradiol 2021; 42:377-381. [PMID: 33509916 DOI: 10.3174/ajnr.a6876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/01/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Imaging is fundamental to assessing the acoustic pathway in infants with congenital deafness. We describe our depiction of the membranous labyrinth in infants using the heavily T2-weighted 3D FLAIR sequence without a contrast agent. MATERIALS AND METHODS We retrospectively reviewed 10 infants (20 ears) (median term equivalent age: 2 weeks; IQR: 1-5 weeks) who had undergone brain MR imaging including a noncontrast heavily T2-weighted 3D FLAIR scan of the temporal bone. For each ear, 3 observers analyzed, in consensus, the saccule, the utricle, and the 3 ampullae, assessing the visibility (score 0, not appreciable; score 1, visible without well-defined boundaries; score 2, visible with well-defined boundaries) and morphology ("expected" or "unexpected" compared with adults). The heavily T2-weighted 3D FLAIR sequence was scored for overall quality (score 0, inadequate; score 1, adequate but with the presence of image degradation; score 2, adequate). RESULTS Six (60%) MR examinations were considered adequate (score 1 or 2). The saccule was visible in 10 ears (83.3%) with an expected morphology in 9 ears (90%). In 1 ear of an infant with congenital deafness, the saccule showed an unexpected morphology. The utricle was visible as expected in 12 ears (100%). The lateral ampulla was visible in 5 ears (41.6%), the superior ampulla was visible in 6 ears (50.0%), and the posterior ampulla was visible in 6 ears (50.0%), always with expected morphology (100%). CONCLUSIONS MR imaging can depict the membranous labyrinth in infants using heavily T2-weighted 3D FLAIR without an injected contrast agent, but the sequence acquisition time reduces its feasibility in infants undergoing MR studies during natural sleep.
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Affiliation(s)
- G Conte
- From the Neuroradiology Unit (G.C., S.C., L.C., F.M.L.R., C.C., D.S., E.S., F.T.)
| | - S Casale
- From the Neuroradiology Unit (G.C., S.C., L.C., F.M.L.R., C.C., D.S., E.S., F.T.)
| | - L Caschera
- From the Neuroradiology Unit (G.C., S.C., L.C., F.M.L.R., C.C., D.S., E.S., F.T.)
| | - F M Lo Russo
- From the Neuroradiology Unit (G.C., S.C., L.C., F.M.L.R., C.C., D.S., E.S., F.T.)
| | - C Paolella
- Department of Advanced Biomedical Sciences (C.P.), University of Naples "Federico II," Naples, Italy
| | - C Cinnante
- From the Neuroradiology Unit (G.C., S.C., L.C., F.M.L.R., C.C., D.S., E.S., F.T.)
| | | | | | - D Stocchetti
- From the Neuroradiology Unit (G.C., S.C., L.C., F.M.L.R., C.C., D.S., E.S., F.T.)
| | - E Scola
- From the Neuroradiology Unit (G.C., S.C., L.C., F.M.L.R., C.C., D.S., E.S., F.T.)
| | - L Bassi
- NICU (L.B.), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy
| | - F Triulzi
- From the Neuroradiology Unit (G.C., S.C., L.C., F.M.L.R., C.C., D.S., E.S., F.T.).,Department of Pathophysiology and Transplantation (F.T.), University of Milan, Milan, Italy
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239
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Bezuidenhout JK, Khoza-Shangase K, De Maayer T, Strehlau R. Outcomes of newborn hearing screening at an academic secondary level hospital in Johannesburg, South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2021; 68:e1-e8. [PMID: 33567828 PMCID: PMC7876983 DOI: 10.4102/sajcd.v68i1.741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The Health Professions Council of South Africa (HPCSA) issued early hearing detection and intervention guidelines, which has universal newborn hearing screening (UNHS) as one of the important goals. Despite established evidence of the importance of UNHS globally, there has been no mandated formalised and standardised implementation as yet in South Africa. OBJECTIVES The aim of this study was to describe the outcomes of newborn hearing screening (NHS) in an academic secondary level hospital in Johannesburg, South Africa. METHODS This was a prospective non-experimental feasibility study over a 3-month period, involving conducting hearing screening of 121 neonates. Audiologists conducted a risk factor assessment, otoscopic examinations and distortion product otoacoustic emissions (DPOAEs) screening on each neonate, with follow-up appointments for re-screening and diagnostic audiological assessments for all neonates with refer findings. Data were analysed using STATA intercooled version 11©, through both descriptive and inferential statistics (Fisher's exact test), with significance established where p-values less than 0.05 were considered statistically significant. RESULTS Of the 121 neonates screened, the majority (75%) were screened in the first 24 h of life. A high refer rate (47%) of the total sample was found on DPOAE screening. No maternal or neonatal risk factors were found to be significantly associated with refer findings. CONCLUSION Findings contribute towards the existing evidence base that raises implications for successful implementation of NHS programmes in public healthcare in South Africa. Screening protocols need to consider the timing of screening, the measures and procedures adopted in the screening protocols, as well as the follow-up strategies.
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Affiliation(s)
- Jacqueline K Bezuidenhout
- Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
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Al-Shawi YA, Alrawaf FK, Al-Gazlan NS, Al-Qahtani MM, Almuhawas FA. Relationship between proximity to a cochlear implant center and early presentation in children with congenital hearing loss. Saudi Med J 2021; 41:314-317. [PMID: 32114606 PMCID: PMC7841559 DOI: 10.15537/smj.2020.3.24918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To determine whether distance from a cochlear implant (CI) center can influences the ages of presentation and intervention for CI, which thus may influence CI outcomes in Saudi Arabia. Methods: This study comprised a retrospective crosssectional analysis of 221 patients who presented to the CI committee between March 2016 and March 2018 at King Abdullah Ear Specialist Center, Riyadh, Saudi Arabia. Through phone interviews and patients’ files, age at suspicion, audiology testing, diagnosis, hearing aid fitting, and CI discussion were recorded for prelingually deaf children; additionally, demographic information were recorded. Patients were divided into 3 groups based on the distance between their place of residence and the nearest CI center (residing within 200 km, 200-500 km, and >500 km). Results: Patients living within 200 km showed the youngest mean age for all tested checkpoints; however, there were no statistically significant differences among the groups. Conclusion: In Saudi Arabia, distance from CI center does not have a significant effect on age of presentation for CI intervention.
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Affiliation(s)
- Yazeed A Al-Shawi
- Department of Otolaryngology and Head and Neck Surgery, King Abdullah Ear Specialist Center, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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241
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Savarirayan R, Tunkel DE, Sterni LM, Bober MB, Cho TJ, Goldberg MJ, Hoover-Fong J, Irving M, Kamps SE, Mackenzie WG, Raggio C, Spencer SA, Bompadre V, White KK. Best practice guidelines in managing the craniofacial aspects of skeletal dysplasia. Orphanet J Rare Dis 2021; 16:31. [PMID: 33446226 PMCID: PMC7809733 DOI: 10.1186/s13023-021-01678-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/05/2021] [Indexed: 02/08/2023] Open
Abstract
Background Recognition and appropriate management of the craniofacial manifestations of patients with skeletal dysplasia are challenging, due to the rarity of these conditions, and dearth of literature to support evidence-based clinical decision making. Methods Using the Delphi method, an international, multi-disciplinary group of individuals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, best practice guidelines in the management of craniofacial aspects of these patients. Results After a comprehensive literature review, 23 initial statements were generated and critically discussed, with subsequent development of a list of 22 best practice guidelines after a second round voting. Conclusions The guidelines are presented and discussed to provide context and assistance for clinicians in their decision making in this important and challenging component of care for patients with skeletal dysplasia, in order standardize care and improve outcomes.
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Affiliation(s)
- Ravi Savarirayan
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, University of Melbourne, Parkville, VIC, 3052, Australia. .,Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
| | - David E Tunkel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laura M Sterni
- Eudowwod Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael B Bober
- Division of Orthogenetics - Nemours/ A.I. duPont Hospital for Children, Wilmington, DE, USA
| | - Tae-Joon Cho
- Division of Pediatric Orthopaedics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Michael J Goldberg
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Julie Hoover-Fong
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Melita Irving
- Department of Clinical Genetics Guy's, St Thomas NHS, London, UK
| | - Shawn E Kamps
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - William G Mackenzie
- Department of Orthopedic Surgery - Nemours/ A.I. duPont Hospital for Children, Wilmington, DE, USA
| | - Cathleen Raggio
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Samantha A Spencer
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Viviana Bompadre
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Klane K White
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
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242
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Didoné DD, Oliveira LS, Durante AS, de Almeida K, Garcia MV, Riesgo RDS, Sleifer P. Cortical auditory-evoked potential as a biomarker of central auditory maturation in term and preterm infants during the first 3 months. Clinics (Sao Paulo) 2021; 76:e2944. [PMID: 34669874 PMCID: PMC8491591 DOI: 10.6061/clinics/2021/e2944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To analyze central auditory maturation in term and preterm infants during the first 3 months of life by comparing the latency and amplitude of cortical auditory-evoked potential at different frequencies. METHODS In this study, 17 term and 18 preterm infants were examined; all had tested positive on the neonatal hearing screening test. Cortical auditory potential was investigated during the first and third months of life. The response of the cortical auditory-evoked potential was investigated at frequencies of 500, 1000, 2000, and 4000 Hz. The latency and amplitude of the cortical response were automatically detected and manually analyzed by three researchers with experience in electrophysiology. The results were compared using analysis of variance and the Bonferroni test. A significance level of 5% was used for all analyses. RESULTS Latency values of cortical auditory-evoked potential in the first month of birth were significantly higher than those in the third month, and latency values of the preterm group were higher than those of the term group, regardless of the frequency and time of evaluation. In general, the latency of the cortical auditory-evoked potential was higher at high frequencies. Amplitude values in the third month of life were significantly higher than those in the first month for term and preterm infants. CONCLUSION Central auditory maturation was observed in both groups but with different results between those born at term and preterm, with latencies of cortical auditory-evoked potential higher for the preterm group and at high frequencies.
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Affiliation(s)
- Dayane Domeneghini Didoné
- Programa de Pos-Graduacao em Saude da Crianca e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, BR
- Corresponding author. E-mail:
| | | | | | - Kátia de Almeida
- Faculdade de Ciencias Medicas, Santa Casa de Sao Paulo, (FCMSCSP), Sao Paulo, SP, BR
| | | | - Rudimar dos Santos Riesgo
- Programa de Pos-Graduacao em Saude da Crianca e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, BR
| | - Pricila Sleifer
- Departamento de Saude e Comunicacao Humana, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, BR
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243
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McCarthy M, Leigh G, Arthur-Kelly M. Practitioners' Self-Assessment of Family-Centered Practice in Telepractice Versus In-Person Early Intervention. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:46-57. [PMID: 33006612 DOI: 10.1093/deafed/enaa028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/06/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
For infants and young children who are identified as deaf or hard of hearing (DHH), best practice principles indicate the provision of family-centered early intervention (FCEI). However, factors such as geographical inaccessibility and workforce shortages can limit families' access to FCEI in their local area. One strategy for overcoming these barriers is telepractice-a method of connecting families and practitioners using synchronous, two-way audiovisual technologies. This study compared the self-assessed use of family-centered practices by a group of practitioners delivering FCEI through telepractice with that of a similar group delivering FCEI in-person. A sample of 38 practitioners (15 telepractice and 23 in-person) from two early intervention programs for children who are DHH completed a self-assessment tool: the Measures of Processes of Care for Service Providers. Results indicated that there were no significant differences between telepractice and in-person sessions with regard to practitioners' self-assessment of their use of family-centered practices.
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Affiliation(s)
- Melissa McCarthy
- Royal Institute for Deaf and Blind Children Renwick Centre, Macquarie University, Sydney, Australia
- University of Newcastle Faculty of Education and Arts, Callaghan, Australia
| | - Greg Leigh
- Royal Institute for Deaf and Blind Children Renwick Centre, Macquarie University, Sydney, Australia
- HEARing Cooperative Research Centre, Melbourne, Australia
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244
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Sheng H, Zhou Q, Wang Q, Yu Y, Liu L, Liang M, Zhou X, Wu H, Tang X, Huang Z. Comparison of Two-Step Transient Evoked Otoacoustic Emissions and One-Step Automated Auditory Brainstem Response for Universal Newborn Hearing Screening Programs in Remote Areas of China. Front Pediatr 2021; 9:655625. [PMID: 34055691 PMCID: PMC8160434 DOI: 10.3389/fped.2021.655625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: To compare the hearing screening results of two-step transient evoked otoacoustic emissions (TEOAE) and one-step automatic auditory brainstem response (AABR) in non-risk newborns, and to explore a more suitable hearing screening protocol for infants discharged within 48 h after birth in remote areas of China. Methods: To analyze the age effect on pass rate for hearing screening, 2005 newborns were divided into three groups according to screening time after birth: <24, 24-48, and 48-72 h. All subjects received TEOAE + AABR test as first hearing screen, and those who failed in any test were rescreened with TEOAE + AABR at 6 weeks after birth. The first screening results of AABR and TEOAE were compared among the three groups. The results of two-step TEOAE screening and one-step AABR screening were compared for newborns who were discharged within 48 h. The time spent on screening was recorded for TEOAE and AABR. Results: The pass rate of TEOAE and AABR increased significantly with the increase of first screening time (P < 0.05), and the false positive rate decreased significantly with the increase of first screening time (P < 0.05). The failure rate of first screening of AABR within 48 h was 7.31%, which was significantly lower than that of TEOAE (9.93%) (P < 0.05). The average time spent on AABR was 12.51 ± 6.36 min, which was significantly higher than that of TEOAE (4.05 ± 1.56 min, P < 0.05). The failure rate of TEOAE two-step screening was 1.59%, which was significantly lower than one-step AABR. Conclusions: Compared with TEOAE, AABR screening within 48 h after birth can reduce the failure rate and false positive rate of first screening. However, compared with TEOAE two-step screening, one-step AABR screening has higher referral rate for audiological diagnosis. In remote areas of China, especially in hospitals with high delivery rate, one-step AABR screening is not feasible, and two-step TEOAE screening protocol is still applicable to UNHS screening as more and more infants discharged within 48 h after birth.
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Affiliation(s)
- Haibin Sheng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qian Zhou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qixuan Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yun Yu
- Department of Otolaryngology-Head and Neck Surgery, Liuzhou Maternal and Child Health Care Hospital, Liuzhou, China
| | - Lihua Liu
- Department of Otolaryngology-Head and Neck Surgery, Liuzhou Maternal and Child Health Care Hospital, Liuzhou, China
| | - Meie Liang
- Department of Otolaryngology-Head and Neck Surgery, Liuzhou Maternal and Child Health Care Hospital, Liuzhou, China
| | - Xueyan Zhou
- Department of Otolaryngology-Head and Neck Surgery, Liuzhou Maternal and Child Health Care Hospital, Liuzhou, China
| | - Hao Wu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Xiangrong Tang
- Department of Otolaryngology-Head and Neck Surgery, Liuzhou Maternal and Child Health Care Hospital, Liuzhou, China
| | - Zhiwu Huang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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245
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Belcher R, Virgin F, Duis J, Wootten C. Genetic and Non-genetic Workup for Pediatric Congenital Hearing Loss. Front Pediatr 2021; 9:536730. [PMID: 33829002 PMCID: PMC8020033 DOI: 10.3389/fped.2021.536730] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 02/25/2021] [Indexed: 01/06/2023] Open
Abstract
Hearing loss is one of the most common concerns for presentation for a geneticist. Presentation prior to the age of one (congenital hearing loss), profound sensorineural hearing loss (SNHL), and bilateral hearing loss are sensitive and should raise concern for genetic causes of hearing loss and prompt referral for genetic testing. Genetic testing particularly in this instance offers the opportunity for anticipatory guidance including possible course of the hearing loss over time and also connection and evaluation for additional congenital anomalies that may be associated with an underlying syndrome vs. isolated genetic hearing loss.
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Affiliation(s)
- Ryan Belcher
- Division of Pediatric Otolaryngology, Vanderbilt Department of Otolaryngology - Head and Neck Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN, United States
| | - Frank Virgin
- Division of Pediatric Otolaryngology, Vanderbilt Department of Otolaryngology - Head and Neck Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN, United States
| | - Jessica Duis
- Division of Pediatric Otolaryngology, Vanderbilt Department of Otolaryngology - Head and Neck Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN, United States
| | - Christopher Wootten
- Division of Pediatric Otolaryngology, Vanderbilt Department of Otolaryngology - Head and Neck Surgery, Monroe Carell Jr. Children's Hospital, Nashville, TN, United States
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246
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Zaitoun M, Rawashdeh M, AlQudah S, ALMohammad H, Nuseir A, Al-tamimi F. Knowledge and Practice of Hearing Screening and Hearing Loss Management among Ear, Nose, and Throat Physicians in Jordan. Int Arch Otorhinolaryngol 2021; 25:e98-e107. [PMID: 33542759 PMCID: PMC7851363 DOI: 10.1055/s-0040-1709112] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/25/2020] [Indexed: 10/27/2022] Open
Abstract
Introduction One of the main factors that affect the early diagnosis and intervention of hearing loss is inadequate knowledge by the health care workers. Ear, nose, and throat (ENT) specialists are the main source of information about hearing loss and its management in most developing countries, such as Jordan. Objective The purpose of the present study is to explore the level of knowledge and the practice of hearing screening and hearing loss management for children among ENT physicians in Jordan as an example of health care providers in developing countries of the Middle East. Methods This was a cross-sectional study, adapting a questionnaire of knowledge and the practice of hearing screening and hearing loss management for children. The questionnaire consisted of 2 sections with 20 questions. A total of 40 ENT physicians completed the questionnaire. Results The majority of the respondents acknowledged the importance of hearing screening for children; however, there was limited knowledge regarding hearing loss management and testing. Only 10 of the ENT physicians believed that a referral to an audiologist is warranted, and the majority of the respondents were not aware that a child with a confirmed permanent hearing loss should be referred to a speech pathologist or to a rehabilitation center. Managing unilateral and mild sensorineural hearing loss (SNHL) was another area about which ENT physicians have limited knowledge. Conclusion There is a strong need for professional intervention programs, providing the latest updates and standardizations in the field of audiology and pediatric rehabilitation for ENT physicians.
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Affiliation(s)
- Maha Zaitoun
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Rawashdeh
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Safa AlQudah
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Hana' ALMohammad
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Amjad Nuseir
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Feda Al-tamimi
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Kamenov K, Chadha S. Methodological quality of clinical guidelines for universal newborn hearing screening. Dev Med Child Neurol 2021; 63:16-21. [PMID: 32981050 DOI: 10.1111/dmcn.14694] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 01/10/2023]
Abstract
AIM To review existing guidelines for universal newborn hearing screening (UNHS), identify those that provide comprehensive and clear recommendations on the subject, and provide a brief overview. METHOD A scoping literature review was performed in PubMed, the Guidelines International Network library, and national guideline databases to identify guidelines on newborn hearing screening developed or updated between 2004 and 2019. The quality of the guidelines was checked with the Checklist for the Quality Assessment of Guidelines (AGREE II). RESULTS Six guidelines met all the inclusion criteria. All six were based on the 1-3-6 benchmark (screening completed by 1mo, audiological diagnosis by 3mo, enrolment in early intervention by 6mo). However, the guidelines varied in terms of their recommendations for the application of screening methods, role of health professionals in the screening process, and quality. Based on the AGREE II score, flexibility, adaptability, and foundation role for all other guidelines, the 2019 guidelines of the Joint Committee on Infant Hearing position statement were identified as the most appropriate to be recommended for adaptation by countries or programmes. INTERPRETATION The diversity in the existing guidance can be confusing for countries and institutions that are planning to develop universal hearing screening programmes. As more countries and organizations develop their newborn hearing screening programmes, they will need examples to emulate. This review provides an evaluation of the quality, comprehensiveness, and applicability of existing clinical guidelines that can serve as a facilitator for countries, institutions, or organizations in their planning and implementation of a UNHS programme.
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Affiliation(s)
- Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Shelly Chadha
- Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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Spivak L. Evaluation of guidelines for universal newborn hearing screening programs. Dev Med Child Neurol 2021; 63:7. [PMID: 33058144 DOI: 10.1111/dmcn.14706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Lynn Spivak
- Queens College Division of Social Sciences - Linguistics and Communication Disorders, Flushing, NY, USA
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Purcell PL, Deep NL, Waltzman SB, Roland JT, Cushing SL, Papsin BC, Gordon KA. Cochlear Implantation in Infants: Why and How. Trends Hear 2021; 25:23312165211031751. [PMID: 34281434 PMCID: PMC8295935 DOI: 10.1177/23312165211031751] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/22/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. It can be more challenging to confirm CI candidacy in infants; therefore, a multidisciplinary approach, including objective audiometric testing, is recommended to not only confirm the diagnosis but also to counsel families regarding expectations and long-term management. Surgeons performing CI surgery in young children should consider both the anesthetic risks of surgery in infancy and the ways in which mastoid anatomy may differ between infants and older children or adults. Multiple studies have found CI surgery in infants can be performed safely and effectively. This article reviews current evidence regarding indications for implantation in children younger than 12 months of age and discusses perioperative considerations and surgical technique.
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Affiliation(s)
- Patricia L. Purcell
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicholas L. Deep
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Susan B. Waltzman
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - J. Thomas Roland
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Sharon L. Cushing
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Blake C. Papsin
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen A. Gordon
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Monitoring of the auditory pathway maturation after early intervention during the first year of life in infants with sensorineural hearing loss. Eur Arch Otorhinolaryngol 2020; 278:4187-4197. [PMID: 33336301 PMCID: PMC8486705 DOI: 10.1007/s00405-020-06498-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022]
Abstract
Purpose The objective of this study was to investigate the auditory pathway maturation monitored by auditory brainstem responses (ABR) in infants with hearing loss during the first year of life. ABR were used to estimate hearing thresholds and the effect of early intervention strategies using hearing aids (HA). Methods Click-evoked ABRs were measured in 102 infants aged from 0 to 12 months to determine their individual auditory threshold. Early therapy intervention was recommended before 12 months of age and analyzed. To evaluate the effect of hearing amplification on auditory maturation, different subgroups of infants with moderate hearing loss were analyzed and the auditory pathway maturation was determined based on IPL I–V shortening. Results Overall, 110 ears (54.0% of 204 ears) with mild to profound HL showed threshold changes of 10 dB up to 60 dB in the follow-up ABR testing. HA were prescribed at the age of 3.8 ± 3.9 months. Cochlear implantation (CI) was performed in cases of repeated profound HL at the age of 9.9 months ± 4.5 months. A significant shortening of IPL I–V in all subgroups of infants (with and without risk factors) who received HA was shown and assumed auditory pathway maturation. Conclusion An early intervention using optimally fitted HA influenced auditory pathway maturation and may lead to improvements of hearing thresholds during the first year of life in infants. This study underscores the importance of not only providing HAs to infants, but also controlling for hearing threshold changes ensuring that HAs provide the optimal level of intervention or CI is indicated.
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