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Conway RM, Perreault K, Schomer J, Fan CJ, Lucas JC, Babu SC. Rurality Effect on Michigan Newborn Hearing Screening. Laryngoscope 2024; 134:2937-2940. [PMID: 38112396 DOI: 10.1002/lary.31242] [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: 09/24/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Evaluate the effect of rurality on newborn hearing screen outcomes in Michigan. METHODS Patients in the Michigan Department of Health and Human Services (MDHHS) Newborn Hearing Screening database that failed or did not receive their initial screen from 2015 to 2020 were evaluated. Using the U.S. Department of Agriculture Rural-Urban Continuum Codes (RUCC), patients were assigned a 1-9 code based on the population of their zip code, with 1 being the most urban and 9 being the most rural and outcomes between these patients were compared. RESULTS There were 34,928 patients initially identified. Patients that had follow-up testing after a failed NBHS had a slightly higher RUCC than those that did not follow-up, 2.3 versus 2.2, respectively (p < 0.001). There was a significant difference between those that refused screening, with a mean RUCC of 4.2, and those that had a failed initial screen having a mean RUCC of 2.1 (p < 0.001). Similarly, those with equipment failure had a higher mean RUCC, 2.8, compared to those that had screening completed (p < 0.001). CONCLUSIONS More rural areas are more likely to refuse a newborn hearing screen as well as have equipment failure options. There was no difference in rurality scores of those that had a follow-up screen after a failure and those that did not. LEVEL OF EVIDENCE IV Laryngoscope, 134:2937-2940, 2024.
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Affiliation(s)
| | - Kylie Perreault
- Department of Otolaryngology-Head and Neck Surgery, Ascension Macomb-Oakland Hospital, Madison Heights, Michigan, U.S.A
| | - Jason Schomer
- Michigan State University College of Osteopathic Medicine, East Lansing, Michigan, U.S.A
| | - Caleb J Fan
- Michigan Ear Institute, Farmington Hills, Michigan, U.S.A
| | - Jacob C Lucas
- Michigan Ear Institute, Farmington Hills, Michigan, U.S.A
| | - Seilesh C Babu
- Michigan Ear Institute, Farmington Hills, Michigan, U.S.A
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Gómez-Delgado M, Sequi-Sabater JM, Marco-Sabater A, Lora-Martin A, Aparisi-Climent V, Sequi-Canet JM. Neonatal Hearing Rescreening in a Second-Level Hospital: Problems and Solutions. Audiol Res 2023; 13:655-669. [PMID: 37622934 PMCID: PMC10451824 DOI: 10.3390/audiolres13040058] [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: 07/04/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Second-level hospitals face peculiarities that make it difficult to implement hearing rescreening protocols, which is also common in other settings. This study analyzes the hearing rescreening process in these kinds of hospitals. A total of 1130 individuals were included; in this cohort, 61.07% were hospital newborns who failed their first otoacoustic emission test after birth (n = 679) or were unable to perform the test (n = 11), and who were then referred to an outpatient clinic. The remaining 38.93% were individuals born in another hospital with their first test conducted in the outpatient clinic (n = 440). A high number of rescreenings were made outside of the recommended time frame, mainly in children referred from another hospital. There was a high lost-to-follow-up rate, especially regarding otolaryngologist referrals. Neonatal hearing screening at second-level hospitals is difficult because of staffing and time constraints. This results in turnaround times that are longer than recommended, interfering with the timely detection of hearing loss. This is particularly serious in outpatient children with impaired screening. Referral to out-of-town centers leads to unacceptable follow-up loss. Legislative support for all these rescreening issues is necessary. In this article, these findings are discussed and some solutions are proposed.
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Affiliation(s)
- Marta Gómez-Delgado
- Pediatric Department, Francesc de Borja University Hospital, 46702 Gandia, Spain; (M.G.-D.); (A.M.-S.); (A.L.-M.); (V.A.-C.)
| | | | - Ana Marco-Sabater
- Pediatric Department, Francesc de Borja University Hospital, 46702 Gandia, Spain; (M.G.-D.); (A.M.-S.); (A.L.-M.); (V.A.-C.)
| | - Alberto Lora-Martin
- Pediatric Department, Francesc de Borja University Hospital, 46702 Gandia, Spain; (M.G.-D.); (A.M.-S.); (A.L.-M.); (V.A.-C.)
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), 46020 Valencia, Spain
| | - Victor Aparisi-Climent
- Pediatric Department, Francesc de Borja University Hospital, 46702 Gandia, Spain; (M.G.-D.); (A.M.-S.); (A.L.-M.); (V.A.-C.)
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), 46020 Valencia, Spain
| | - Jose Miguel Sequi-Canet
- Pediatric Department, Francesc de Borja University Hospital, 46702 Gandia, Spain; (M.G.-D.); (A.M.-S.); (A.L.-M.); (V.A.-C.)
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Zhou X, Wang L, Jin F, Guo Y, Zhou Y, Zhang X, Zhang Y, Ni X, Li W, Liu H. The prevalence and risk factors for congenital hearing loss in neonates: A birth cohort study based on CHALLENGE study. Int J Pediatr Otorhinolaryngol 2022; 162:111308. [PMID: 36116180 DOI: 10.1016/j.ijporl.2022.111308] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 06/30/2022] [Accepted: 08/31/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVES To determine the prevalence and risk factors of congenital hearing loss (HL) in neonates based on China Longitudinal Environmental, Genetic, and Economic Cohort (CHALLENGE cohort). METHODS Maternal and neonatal data were collected based on the CHALLENGE cohort study from July 2018 to September 2020. Total 7287 neonates underwent the universal newborn hearing screening (UNHS). Babies who did not pass the initial screening and the rescreening were given the formal audiological diagnosis for possible HL. The data was analyzed to find out the prevalence and risk factors for congenital HL in this cohort study. RESULTS The prevalence of congenital HL was 3.43‰, and temporary HL was 0.07‰ (5 neonates). The statistical data showed that risk factors, including craniofacial anomalies, neonatal intensive care unit (NICU) admission, family history and advanced maternal age (AMA), could be associated with congenital HL. Additionally, exchange transfusion, assisted ventilation and NICU admission, these three factors could be associated with congenital sensorineural HL (SNHL). Risk factors including craniofacial anomalies, NICU admission, family history and AMA might be contributed to congenital conductive HL(CHL). CONCLUSION There were several common risk factors could be contributed to congenital HL, which were consistent with previous studies. However, some risk factors were no longer causing congenital HL due to the improvement of medical treatment and prenatal care. This study has not only helped explain the status quo of the prevalence of congenital HL in China but also laid foundation for future studies.
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Affiliation(s)
- Xin Zhou
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Liming Wang
- Department of Otolaryngology, Beijing Miyun Hospital, Capital Medical University, Beijing, China.
| | - Feng Jin
- Shunyi Maternal and Children's Hospital of Beijing Children's Hospital. Center of Genetics and Reproduction, Beijing, China.
| | - Ying Guo
- Royal National Ear, Nose, Throat & Eastman Dental Hospitals. London, United Kingdom.
| | - Yi Zhou
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Xiaofen Zhang
- Shunyi Maternal and Children's Hospital of Beijing Children's Hospital. Center of Genetics and Reproduction, Beijing, China.
| | - Yawei Zhang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Xin Ni
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Wei Li
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, MOE Key Laboratory of Major Diseases in Children, Genetics and Birth Defects Control Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Haihong Liu
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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Abstract
Hearing loss is one of the most common congenital defects in infancy; it increases speech and language delays and adversely affects academic achievement and socialemotional development. The risk of hearing loss in premature infants is higher than that in normal newborns, and because of the fragility of the auditory nervous system, it is more vulnerable to different risk factors. The hearing screening guidelines in current use were proposed by the American Academy of Pediatrics and updated in 2007, but there are no uniform guidelines for hearing screening in preterm infants. This review focuses on the risk factors related to hearing loss in premature infants, hearing screening strategies, and reasons for failure. The aim is to provide a more comprehensive understanding of hearing development in preterm infants to achieve early detection and early intervention. At the same time, attention should be paid to delayed auditory maturation in preterm infants to avoid excessive intervention. KEY POINTS: · Hearing loss is very common in infancy, especially in premature infants.. · Genetic factors, infection, hyperbilirubinemia, drugs, and noise are the main causes.. · We should pay attention to the delayed hearing maturity of premature infants and avoid excessive intervention..
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Affiliation(s)
- Xiaodan Zhu
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Department of Perinatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
| | - Xiaoping Lei
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Department of Perinatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
| | - Wenbin Dong
- Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Department of Perinatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
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Our newborn hearing screening results. North Clin Istanb 2021; 8:167-171. [PMID: 33851081 PMCID: PMC8039115 DOI: 10.14744/nci.2021.30806] [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: 11/30/2020] [Accepted: 01/29/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: The aim of the study was to evaluate the results of neonatal hearing screening in our hospital with the help of literature and to question and reveal the risk factors to gain healthy individuals and to raise awareness for all health workers and the public who are interested in this subject. METHODS: A total of 16,388 newborn infants were evaluated between October 2009 and January 2018. All newborns were screened with transient evoked otoacoustic emissions (TEOAEs) test. Risk factors were investigated. The test repetition and auditory brainstem response (ABR) measurements were performed on newborns who could not pass the TEOAE test and the newborns in the risky group after 15 days. RESULTS: A total of 116 newborns (0.7%) were suspected to have hearing loss. Twenty-seven newborns (0.16%) were found to be in intensive care unit. Twelve newborns (0.07%) had permanent hearing loss. Then, in order: 9 newborns (0.05%) had received phototherapy and 7 newborns (0.04%) were born to consanguineous marriages. In addition, 3 newborns (0.02%) had a low birth weight and 1 newborn (0.006%) had a history of fever. CONCLUSION: Screening tests should be performed in all newborns for early detection of hearing loss. Even though frequency of hearing loss is higher in newborns with risk factors, the treatment should be started within 6 months, the latest, and newborns should be referred for rehabilitation and training.
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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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Fang BX, Cen JT, Yuan T, Yin GD, Gu J, Zhang SQ, Li ZC, Liang YF, Zeng XL. Etiology of newborn hearing impairment in Guangdong province: 10-year experience with screening, diagnosis, and follow-up. World J Pediatr 2020; 16:305-313. [PMID: 31912317 DOI: 10.1007/s12519-019-00325-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/06/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Hearing impairment is one of the most common birth defects in children. Universal newborn hearing screenings have been performed for 19 years in Guangdong province, China. A screening/diagnosis/intervention system has gradually been put in place. Over the past 10 years, a relatively complete data management system had been established. In the present study, an etiological analysis of newborn cases that failed the initial and follow-up screenings was performed. METHODS The nature and degree of hearing impairment in newborns were confirmed by a set of procedures performed at the time of initial hearing screening, rescreening and final hearing diagnosis. Then, multiple examinations were performed to explore the associated etiology. RESULTS Over a period of 10 years, 720 children were diagnosed with newborn hearing loss. Among these children, 445 (61.81%) children had a clearly identified cause, which included genetic factor(s) (30.56%), secretory otitis media (13.30%), maternal rubella virus infection during pregnancy (5.83%), inner ear malformations (4.86%), maternal human cytomegalovirus infection during pregnancy (2.92%), malformation of the middle ear ossicular chain (2.50%) and auditory neuropathy (1.81%). In addition, 275 cases of sensorineural hearing loss of unknown etiology accounted for 38.19% of the children surveyed. CONCLUSIONS Long-term follow-up is needed to detect delayed hearing impairment and auditory development in children. The need for long-term follow-up should be taken into account when designing an intervention strategy. Furthermore, the use of the deafness gene chip should further elucidate the etiology of neonatal hearing impairment.
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Affiliation(s)
- Bi-Xing Fang
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jin-Tian Cen
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Tao Yuan
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Gen-Di Yin
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jing Gu
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Shu-Qi Zhang
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Cheng Li
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yin-Fei Liang
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xiang-Li Zeng
- Division of Otology, Department of Otorhinolaryngology, Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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