1
|
Results of cochlear implant surgery in patients with auditory neuropathy. Int J Pediatr Otorhinolaryngol 2023; 165:111431. [PMID: 36628905 DOI: 10.1016/j.ijporl.2022.111431] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 12/13/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The primary aim of this study was to analyze the benefit of cochlear implants for patients with auditory neuropathy. The secondary aim was to identify risk factors for auditory neuropathy. MATERIALS AND METHODS Patients with cochlear implants (CIs) who were educated in hearing rehabilitation schools were included in the study. A total of 175 children were operated on for cochlear implantation between August 2019 and August 2021 in the department of otorhinolaryngology at different centers in Turkey, and while 16 (9.1%) of those patients had auditory neuropathy spectrum disorder (ANSD), 159 (90.9%) had sensorineural hearing loss (SNHL). Differences in auditory perception between the two groups were examined. Auditory perception tests were applied for these patients 6 months after CI surgery. The auditory perception performances of the patients were evaluated with the Evaluation of Auditory Responses to Speech (EARS) battery, including the Littlears, Lip, Bıs4, Bıs12, Cap, Sır, Mtp-3, Mtp-6, Mtp-12, Matrix A1, and Gasp tests. RESULTS All patients had profound bilateral SNHL. Four auditory perception tests (Littlears, Bıs-12, Sır, Matrix A1) showed similar results between patients with ANSD and SNHL, but seven auditory perception tests (Lıp, Bıs-4, Cap, Mtp-3, Mtp-6, Mtp-12, Gasp) showed significantly higher results among patients with SNHL. Hyperbilirubinemia, prematurity, consanguineous marriage, and family history of hearing loss were found to be common among patients with ANSD. CONCLUSIONS ANSD patients who do not benefit from hearing aids benefit from CI surgery.
Collapse
|
2
|
Savenko IV, Garbaruk ES, Boboshko MY. [Auditory neuropathy and prematurity: modern view of the issue (literature review)]. Vestn Otorinolaringol 2022; 87:63-71. [PMID: 35818948 DOI: 10.17116/otorino20228703163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a specific auditory disorder caused by dysfunction of periphery part of the auditory system, in which the function of the outer hair cells is preserved, but the afferent input at the cochlear level suffers due to the pathology of the inner hair cells, neurons of the spiral ganglion and/or the auditory nerve, as well as synaptic contact between them. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, the discrepancy between the hearing level and the electrophysiological data, poor speech perception which may not correlate with the hearing thresholds. ANSD is a multifactorial disease. One of the main risk factors is perinatal pathology and, in particular, prematurity. The possible factors associated with prematurity that provoke the onset of the disease, features of the pathogenesis, clinical and audiological peculiarities of ANSD in premature infants, contemporary approaches to the habilitation of such patients are discussed in the article. The necessity of an individual, patient-oriented approach to the treatment of premature infants with ANSD is substantiated; such an approach should be based both on the genesis of the disorder, taking into account possible points of lesion in the auditory system, and the developmental peculiarities of a premature baby considering the presence of concomitant diseases associated with prematurity. In the article attention is focused on the main directions of habilitation work with such children, including a multidisciplinary approach, regular careful monitoring of the auditory, speech and language skills, intensive psychological and speech therapist support, the choice of an adequate way of intervention and its improvement as necessary.
Collapse
Affiliation(s)
- I V Savenko
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
| | - E S Garbaruk
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
- St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - M Yu Boboshko
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
- Mechnikov North-West State Medical University, St. Petersburg, Russia
| |
Collapse
|
3
|
Kumm J. Newborn Eye Screening as an Application of AI. Ophthalmic Surg Lasers Imaging Retina 2021; 52:S17-S22. [PMID: 34908492 DOI: 10.3928/23258160-20211115-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Artificial intelligence (AI) applications are diverse and serve varied functions in clinical practice. The most successful products today are clinical decision tools used by physicians, but autonomous AI is gaining traction. Widespread use of AI is limited in part because of concerns about bias, fault-tolerance, and specificity. Adoption of AI often depends on removing cost and complexity in clinical workflow integration, providing clear incentives for use, and providing clear demonstration of clinical outcome. Existing wide-angle photographic screening could be integrated into the clinical workflow based on prior implementations for premature babies and linked with AI interpretation with existing technology. Incidence of retinal abnormality, clinical considerations, AI performance, grading variation for AI-augmented human grading, and cost and policy aspects play a significant role. Improved outcomes for newborns and a relatively high estimated incidence of abnormality have been named as benefits to counterweigh costs in the long term. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:S17-S22.].
Collapse
|
4
|
Alanazi AA. Referral and Lost to System Rates of Two Newborn Hearing Screening Programs in Saudi Arabia. Int J Neonatal Screen 2020; 6:50. [PMID: 33123632 PMCID: PMC7570083 DOI: 10.3390/ijns6030050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/19/2020] [Indexed: 11/17/2022] Open
Abstract
Congenital hearing loss has been commonly reported as a significant health problem. Lost to system (LTS) is a major challenge facing newborn hearing screening (NHS) programs. This retrospective cross-sectional descriptive study aimed to determine the referral and LTS rates after the two-stage NHS based on transient evoked otoacoustic emissions (TEOAEs) in two main hospitals in Riyadh, Saudi Arabia (SA). NHS was performed on newborns before hospital discharge. Newborns were only rescreened if NHS initially revealed a fail/refer outcome in one or both ears. Those who failed the first and second screenings or had risk factors were referred for auditory brainstem response (ABR) testing to confirm or exclude hearing loss. In total, 20,171 newborns (40,342 ears; 52% males; 48% females) were screened, of whom 19,498 (96.66%) passed the initial screening, while 673 (3.34%) failed. Of the 673 newborns, 235 (34.92%) were LTS, and 438 (65.08%) were rescreened, of whom 269 (61.42%) failed and were referred for a comprehensive audiological assessment to confirm the existence of hearing loss. The referral rate after the initial two-stage screening was equal to 1.33%. The lack of awareness of the importance of NHS among parents seems to be the major cause behind the LTS rate. The stakeholders have to work efficiently to reduce the LTS rate.
Collapse
Affiliation(s)
- Ahmad A Alanazi
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia; ; Tel.: +966-112499999 (ext. 95117)
| |
Collapse
|
5
|
Richard C, Neel ML, Jeanvoine A, Connell SM, Gehred A, Maitre NL. Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1618-1635. [PMID: 32407639 DOI: 10.1044/2020_jslhr-19-00322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.
Collapse
Affiliation(s)
- Céline Richard
- Center for Perinatal Research and Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
- Laboratory for Investigative Neurophysiology, Department of Radiology and Department of Clinical Neurosciences, University Hospital Center and University of Lausanne, Switzerland
| | - Mary Lauren Neel
- Center for Perinatal Research and Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Arnaud Jeanvoine
- Center for Perinatal Research and Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Sharon Mc Connell
- Center for Perinatal Research and Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
| | - Alison Gehred
- Medical Library Division, Nationwide Children's Hospital, Columbus, OH
| | - Nathalie L Maitre
- Center for Perinatal Research and Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|
6
|
Ngui LX, Tang IP, Prepageran N, Lai ZW. Comparison of distortion product otoacoustic emission (DPOAE) and automated auditory brainstem response (AABR) for neonatal hearing screening in a hospital with high delivery rate. Int J Pediatr Otorhinolaryngol 2019; 120:184-188. [PMID: 30844634 DOI: 10.1016/j.ijporl.2019.02.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 02/09/2019] [Accepted: 02/25/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Congenital hearing loss is one of the commonest congenital anomalies. Neonatal hearing screening aims to detect congenital hearing loss early and provide prompt intervention for better speech and language development. The two recommended methods for neonatal hearing screening are otoacoustic emission (OAE) and automated auditory brainstem response (AABR). OBJECTIVE To study the effectiveness of distortion product otoacoustic emission (DPOAE) and automated auditory brainstem response (AABR) as first screening tool among non-risk newborns in a hospital with high delivery rate. METHOD A total of 722 non-risk newborns (1444 ears) were screened with both DPOAE and AABR prior to discharge within one month. Babies who failed AABR were rescreened with AABR ± diagnostic auditory brainstem response tests within one month of age. RESULTS The pass rate for AABR (67.9%) was higher than DPOAE (50.1%). Both DPOAE and AABR pass rates improved significantly with increasing age (p-value<0.001). The highest pass rate for both DPOAE and AABR were between the age of 36-48 h, 73.1% and 84.2% respectively. The mean testing time for AABR (13.54 min ± 7.47) was significantly longer than DPOAE (3.52 min ± 1.87), with a p-value of <0.001. CONCLUSIONS OAE test is faster and easier than AABR, but with higher false positive rate. The most ideal hearing screening protocol should be tailored according to different centre.
Collapse
Affiliation(s)
- Ling Xiu Ngui
- Department of ORL-HNS, University Malaya, Malaysia; Department of ORL-HNS, Sarawak General Hospital, Malaysia.
| | - Ing Ping Tang
- Department of ORL-HNS, Sarawak General Hospital, Malaysia; Department of ORL-HNS, University Malaysia Sarawak, Malaysia
| | | | - Zhun Wieng Lai
- Department of ORL-HNS, Sarawak General Hospital, Malaysia
| |
Collapse
|
7
|
Kanji A, Khoza-Shangase K, Moroe N. Newborn hearing screening protocols and their outcomes: A systematic review. Int J Pediatr Otorhinolaryngol 2018; 115:104-109. [PMID: 30368368 DOI: 10.1016/j.ijporl.2018.09.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To conduct a review of the most current research in objective measures used within newborn hearing screening protocols with the aim of exploring the actual protocols in terms of the types of measures used and their frequency of use within a protocol, as well as their outcomes in terms of sensitivity, specificity, false positives, and false negatives in different countries worldwide. METHODS A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Electronic databases such as PubMed, Google Scholar and Science Direct were used for the literature search. A total of 422 articles were identified, of which only 15 formed part of the current study. The 15 articles that met the study's criteria were reviewed. Pertinent data and findings from the review were tabulated and qualitatively analysed under the following headings: country; objective screening and/or diagnostic measures; details of screening protocol; results (including false positive and negative findings, sensitivity and/or specificity), conclusion and/or recommendations. These tabulated findings were then discussed with conclusions and recommendations offered. RESULTS Findings reported in this paper are based on a qualitative rather than a quantitative analysis of the reviewed data. Generally, findings in this review revealed firstly, that there is a lack of uniformity in protocols adopted within newborn hearing screening. Secondly, many of the screening protocols reviewed consist of two or more tiers or stages, with transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) being most commonly used. Thirdly, DPOAEs appear to be less commonly used when compared to TEOAEs. Lastly, a question around routine inclusion of AABR as part of the NHS protocol remains inconclusively answered. CONCLUSIONS There is sufficient evidence to suggest that the inclusion of AABR within a NHS programme is effective in achieving better hearing screening outcomes. The use of AABR in combination with OAEs within a test-battery approach or cross-check principle to screening is appropriate, but the inclusion of AABR to facilitate appropriate referral for diagnostic assessment needs to be systematically studied.
Collapse
|
8
|
Zeitlin W, Auerbach C, Mason SE, Spivak LG, Reiter B. Factors Related to Not Following Up with Recommended Testing in the Diagnosis of Newborn Hearing Loss. HEALTH & SOCIAL WORK 2017; 42:24-31. [PMID: 28395068 DOI: 10.1093/hsw/hlw061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 03/10/2016] [Indexed: 06/07/2023]
Abstract
Children's hearing is a public health concern, and universal newborn hearing screenings are the first step in detecting and treating congenital hearing loss. Despite the high rate of participation in such programs, loss to follow-up (LTF) with additional recommended diagnosis and treatment has been a persistent problem. The current research seeks to expand the knowledge base at the point of diagnosis, where there is a large drop-off in parents following through with recommended care. This research was organized around the following question: What biopsychosocial factors are associated with LTF between screenings and diagnostic evaluations? A prospective quantitative longitudinal study tracked 203 families whose newborns were referred for additional testing at discharge from the hospital after birth. Binary logistic regression was used to determine what constellation of factors best predicted LTF. Psychosocial factors related to being lost to follow-up at diagnosis included race and ethnicity and access to health care professionals, with African American babies being most at risk for LTF; however, the impact of race and ethnicity declined when parents believed they had more health care professionals with whom to consult.
Collapse
Affiliation(s)
- Wendy Zeitlin
- Montclair State University, 1 Normal Avenue, Montclair, NJ, USA
| | - Charles Auerbach
- Wurzweiler School of Social Work, Yeshiva University, New York City, New York, USA
| | - Susan E Mason
- Wurzweiler School of Social Work, Yeshiva University, New York City, New York, USA
| | | | - Bena Reiter
- Montclair State University, 1 Normal Avenue, Montclair, NJ, USA
- NYU Langone Medical Center, New York City, New York, USA
| |
Collapse
|
9
|
Dimitriou A, Perisanidis C, Chalkiadakis V, Marangoudakis P, Tzagkaroulakis A, Nikolopoulos TP. The universal newborn hearing screening program in a public hospital: The importance of the day of examination. Int J Pediatr Otorhinolaryngol 2016; 91:90-93. [PMID: 27863649 DOI: 10.1016/j.ijporl.2016.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 10/08/2016] [Accepted: 10/12/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Newborn hearing screening programs are already implemented in many countries worldwide. Nonetheless there is still no consensus about the most proper post-birth day of examination. The purpose of this study was to assess the most appropriate day of universal hearing screening program in a public hospital. MATERIAL AND METHODS A prospective cohort study was conducted in "Attiko University National Health System Hospital" and included 2494 newborns. They were examined before discharge from the hospital, using transient evoked otoacoustic emissions (TEOAEs). RESULTS From 2494 neonates included in the study, 2129 (85.4%) bilaterally passed the screening examination, while 365 (14.6%) failed the test. Higher levels of "pass" result per day of life were presented the third (90%) and fourth (94%) day of life. These days the referral scores were lower, reaching 6% the 4th post-birth day. CONCLUSION All infants should be screened for their hearing in the first days of life as otoacoustic emissions can be recorded from the first 24 h of life. If the babies stay in the maternity unit for more that 1-2 days for any reason (protocol of the maternity unit, parents leave in remote areas, etc.) we recommend the 4th day of life as the most appropriate day of examination in order to minimize the false positive ("refer") results at the initial examination.
Collapse
Affiliation(s)
- Anastasia Dimitriou
- 1st University Department of Otorhinolaryngology, Hippokrateio Hospital, 114 Vasilissis Sofias str, 11527 Athens, Greece
| | - Christos Perisanidis
- Department of Maxillofacial and Oral Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | | | - Pavlos Marangoudakis
- 2nd University Department of Otorhinolaryngology, Attiko Hospital, 1 Rimini str, 12462 Athens, Greece
| | - Antonios Tzagkaroulakis
- 1st University Department of Otorhinolaryngology, Hippokrateio Hospital, 114 Vasilissis Sofias str, 11527 Athens, Greece
| | - Thomas P Nikolopoulos
- 2nd University Department of Otorhinolaryngology, Attiko Hospital, 1 Rimini str, 12462 Athens, Greece.
| |
Collapse
|
10
|
Kanji A, Khoza-Shangase K. Feasibility of newborn hearing screening in a public hospital setting in South Africa: A pilot study. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2016; 63:e1-e8. [PMID: 27443006 PMCID: PMC5843149 DOI: 10.4102/sajcd.v63i1.150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 06/13/2016] [Accepted: 05/08/2016] [Indexed: 12/20/2022] Open
Abstract
Objectives The current pilot study aimed to explore the feasibility of newborn hearing screening (NHS) in a hospital setting with clinical significance for the implementation of NHS. Context-specific objectives included determining the average time required to screen each neonate or infant; the most suitable time for initial hearing screening in the wards; as well as the ambient noise levels in the wards and at the neonatal follow-up clinic where screening would be conducted. Method A descriptive, longitudinal, repeated measures, within-subjects design was employed. The pilot study comprised 11 participants who underwent hearing screening. Data were analysed using descriptive statistics. Results The average time taken to conduct hearing screening using otoacoustic emissions and automated auditory brainstem response was 18.4 minutes, with transient evoked otoacoustic emissions taking the least time. Ambient noise levels differed between wards and clinics with the sound level readings ranging between 50 dBA and 70 dBA. The most suitable screening time was found to be the afternoons, after feeding times. Conclusion Findings highlight important considerations when embarking on larger scale NHS studies or when planning a hospital NHS programme. Current findings suggest that NHS can be efficiently and effectively conducted in public sector hospitals in South Africa, provided that test time is considered in addition to sensitivity and specificity when deciding on a screening protocol; bar recognised personnel challenges.
Collapse
Affiliation(s)
- Amisha Kanji
- Department of Speech Pathology and Audiology, University of the Witwatersrand.
| | | |
Collapse
|
11
|
Alaee E, Sirati M, Taziki MH, Fouladinejad M. Risk Factors for Sensorineural Hearing Loss Among High-Risk Infants in Golestan Province, Iran in 2010 - 2011. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e20419. [PMID: 26759724 PMCID: PMC4707290 DOI: 10.5812/ircmj.20419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/02/2014] [Accepted: 12/03/2014] [Indexed: 11/28/2022]
Abstract
Background: Hearing impairment, as one of the most common birth defects, is a hidden disability with negative impacts on speech and cognitive development. Objectives: The aim of this study was to assess the prevalence of sensorineural hearing loss (SNHL) and determine the associated risk factors among infants admitted to neonatal intensive care units (NICUs) and neonatal wards of teaching hospitals, affiliated to Golestan University of Medical Sciences, Gorgan, Iran. Patients and Methods: In this cross-sectional study, 791 infants were recruited via non-random sampling. Demographic and clinical characteristics of the subjects were gathered, and the Automated Auditory Brainstem Response (AABR) test was performed upon admission. Afterwards, the subjects were followed-up and re-assessed, using the AABR test. For infants with abnormal AABR results, the Auditory Brainstem Response (ABR) test was performed on the day of discharge. Results: The mean age of the infants was 3.75 ± 4.86 days upon admission, and 56.4% of the subjects were female. The mean length of hospital stay was 9.63 ± 1.1 days; the subjects were hospitalized for 3.50 ± 10.21 days in the NICUs and 6.1 ± 5.27 days in the neonatal wards. In total, 3.4% of the infants presented with SNHL. No significant difference was found between SNHL and neonates’ age (P = 0.52), sex (P = 0.5), or sepsis (P = 0.94). However, SNHL was significantly associated with gestational age (P = 0.045), birth weight (P < 0.001), length of hospital stay (P < 0.001), pathological jaundice (P=0.033), antibiotic treatments (P = 0.007), and total serum bilirubin level (P = 0.01). Additionally, binary logistic regression analysis demonstrated the association between SNHL and these factors. Conclusions: In this study, the prevalence of SNHL among hospitalized neonates was similar to previous reports in Iran and other countries. Based on the findings, administration of ototoxic drugs during the neonatal period can lead to SNHL. Therefore, it seems essential to regularly screen newborns under treatment and limit the indiscriminate use of ototoxic drugs.
Collapse
Affiliation(s)
- Ehsan Alaee
- Neonatal and Children’s Health Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Mohsen Sirati
- School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Mohammad Hossein Taziki
- Department of Ear, Nose and Throat, Golestan University of Medical Sciences, Gorgan, IR Iran
| | - Mahnaz Fouladinejad
- Neonatal and Children’s Health Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran
- Corresponding Author: Mahnaz Fouladinejad, Neonatal and Children’s Health Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran. Tel: +98-1732547680, E-mail:
| |
Collapse
|
12
|
Cross CP, Liao S, Urdang ZD, Srikanth P, Garinis AC, Steyger PS. Effect of sepsis and systemic inflammatory response syndrome on neonatal hearing screening outcomes following gentamicin exposure. Int J Pediatr Otorhinolaryngol 2015; 79:1915-9. [PMID: 26384832 PMCID: PMC4593761 DOI: 10.1016/j.ijporl.2015.09.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Hearing loss in neonatal intensive care unit (NICU) graduates range from 2% to 15% compared to 0.3% in full-term births, and the etiology of this discrepancy remains unknown. The majority of NICU admissions receive potentially ototoxic aminoglycoside therapy, such as gentamicin, for presumed sepsis. Endotoxemia and inflammation are associated with increased cochlear uptake of aminoglycosides and potentiated ototoxicity in mice. We tested the hypothesis that sepsis or systemic inflammatory response syndrome (SIRS) and intravenous gentamicin exposure increases the risk of hearing loss in NICU admissions. METHODS The Institutional Review Board at Oregon Health & Science University (OHSU) approved this study design. Two hundred and eight infants met initial criteria, and written, informed consent were obtained from parents or guardians of 103 subjects ultimately enrolled in this study. Prospective data from 91 of the enrolled subjects at OHSU Doernbecher Children's Hospital Neonatal Care Center were processed. Distortion product otoacoustic emissions (DPOAEs; f2 frequency range: 2063-10,031 Hz) were obtained prior to discharge to assess auditory performance. To pass the DPOAE screen, normal responses in >6 of 10 frequencies in both ears were required; otherwise the subject was considered a "referral" for a diagnostic hearing evaluation after discharge. Cumulative dosing data and diagnosis of neonatal sepsis or SIRS were obtained from OHSU's electronic health record system, and the data processed to obtain risk ratios. RESULTS Using these DPOAE screening criteria, 36 (39.5%) subjects would be referred. Seventy-four (81%) subjects had intravenous gentamicin exposure. Twenty (22%) had ≥4 days of gentamicin, and 71 (78%) had <4 days. The risk ratio (RR) of referral with ≥4 days of gentamicin was 1.92 (p=0.01). Eighteen subjects had sepsis or met neonatal SIRS criteria, 9 of whom had ≥5 days of gentamicin and a DPOAE referral risk ratio of 2.12 (p=0.02) compared to all other subjects. Combining subjects with either vancomycin or furosemide overlap with gentamicin treatment yielded an almost significant risk ratio (RR=1.77, p=0.05) compared to the rest of the cohort. CONCLUSIONS We report an increased risk of referral with DPOAE screening for those receiving ≥4 days of intravenous gentamicin administration that may contribute to the greater prevalence of hearing loss in NICU graduates. We propose an expanded prospective study to gather a larger cohort of subjects, identifying those with sepsis or neonatal SIRS, to increase the statistical power of this study design. Subsequent studies also need to obtain follow-up diagnostic audiological data to verify whether the outcomes of DPOAE screening, in addition to the standard AABR screen, is a reliable predictor of permanent hearing loss following gentamicin exposure in the NICU.
Collapse
Affiliation(s)
- Campbell P Cross
- Oregon Hearing Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
| | - Selena Liao
- Otolaryngology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Zachary D Urdang
- Oregon Hearing Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Oregon Health & Science University, MD/PhD Program, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Priya Srikanth
- Department of Public Health & Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code CB 669, Portland, OR 97239, USA
| | - Angela C Garinis
- Oregon Hearing Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Portland Veterans Administration, National Center for Rehabilitative Auditory Research (NCRAR), 3710 SW US Veterans Hospital Road, Portland, OR 97239, USA
| | - Peter S Steyger
- Oregon Hearing Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Otolaryngology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Portland Veterans Administration, National Center for Rehabilitative Auditory Research (NCRAR), 3710 SW US Veterans Hospital Road, Portland, OR 97239, USA.
| |
Collapse
|
13
|
Soh LJM, Chan YM. Revisiting Oto-Acoustic Emissions. PROCEEDINGS OF SINGAPORE HEALTHCARE 2015. [DOI: 10.1177/201010581502400204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Oto-acoustic emissions (OAEs) are an audiometric diagnostic test that allows quick objective measure of hair cell function in the inner ear. It is a reflection of hearing function at the interface of conductive and sensorineural components in the human ear. Unfortunately, it is not commonly used due to the unique expertise and niche equipment required to successfully carry it out. This article is to further shed light about the use of such tests to junior doctors so that such resources can be better utilised. It also reviews the current and possible future applications of OAEs at the frontiers in otology today.
Collapse
Affiliation(s)
| | - Yew Meng Chan
- Department of Otorhinolaryngology, Singapore General Hospital, Singapore
| |
Collapse
|
14
|
Nash R, Veness J, Wyatt M, Raglan E, Rajput K. Vestibular function in children with auditory neuropathy spectrum disorder. Int J Pediatr Otorhinolaryngol 2014; 78:1269-73. [PMID: 24880924 DOI: 10.1016/j.ijporl.2014.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/04/2014] [Accepted: 05/06/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Children with auditory neuropathy spectrum disorder (ANSD) account for about 10% of paediatric patients referred for cochlear implantation. Vestibulopathy may be associated with ANSD, and may have implications when formulating management plans in this patient group. We wanted to determine the incidence and predictive factors for vestibulopathy in this patient group to guide vestibular testing in this patient population, and give insight to the aetiology of ANSD. METHODS We reviewed the outcomes of vestibular function testing in a cohort of paediatric patients with ANSD. RESULTS Probable or definite vestibulopathy was seen in 42% of patients who were tested. Vestibulopathy was associated with medical co-morbidities, but was not associated with imaging findings. CONCLUSIONS Vestibulopathy is relatively prevalent in this patient group, and should be considered when planning the investigation and management of children with ANSD.
Collapse
Affiliation(s)
- Robert Nash
- Department of ENT, Great Ormond Street Hospital, WC1N 3JH London, UK.
| | - John Veness
- Department of Audiology, Great Ormond Street Hospital, WC1N 3JH London, UK
| | - Michelle Wyatt
- Department of ENT, Great Ormond Street Hospital, WC1N 3JH London, UK
| | - Ewa Raglan
- Department of Audiology, Great Ormond Street Hospital, WC1N 3JH London, UK
| | - Kaukab Rajput
- Cochlear Implant Department, Great Ormond Street Hospital, WC1N 3JH London, UK
| |
Collapse
|
15
|
Does congenital cytomegalovirus infection lead to hearing loss by inducing mutation of the GJB2 gene? Pediatr Res 2013; 74:121-6. [PMID: 23665763 DOI: 10.1038/pr.2013.77] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 02/11/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection and mutation of the gap junction β-2 (GJB2) gene are important causes of sensorineural hearing loss (SNHL). This study aims to determine if congenital CMV infection leads to deafness by inducing GJB2 mutation. METHODS GJB2 gene sequencing and auditory brainstem response testing were performed in 159 neonates (63 with and 96 without CMV infection) from August 2008 to August 2011. For neonates with GJB2 mutation, their parents were further screened for GJB2 sequence. RESULTS The incidence of SNHL was 12.7% in CMV-infected but 0% in uninfected children aged 1-1.5 y (P = 0.000). Similar mutation rates of the GJB2 gene were observed in neonates with or without CMV infection (34.9 vs. 32.3%, respectively, P = 0.734). No significant difference in the mutation rate of GJB2 was found among neonates with CMV infection and SNHL, those with CMV infection and normal hearing, and uninfected newborns with normal hearing (P = 0.438). Mutations 79G>A, 109G>A, 341A>G, and 608T>C were found in neonates with and without CMV infection. All of the above mutations were also found in both or one of the corresponding parents. CONCLUSION Congenital CMV infections may cause deafness in neonates, but this might be independent of GJB2 gene mutation.
Collapse
|
16
|
Liang C, Hong Q, Jiang TT, Gao Y, Yao XF, Luo XX, Zhuo XH, Shinn JB, Jones RO, Zhao HB, Lu GJ. The effects and outcomes of electrolyte disturbances and asphyxia on newborns hearing. Int J Pediatr Otorhinolaryngol 2013; 77:1072-6. [PMID: 23648318 PMCID: PMC3738180 DOI: 10.1016/j.ijporl.2013.03.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 03/25/2013] [Accepted: 03/28/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine the effect of electrolyte disturbances (ED) and asphyxia on infant hearing and hearing outcomes. STUDY DESIGN We conducted newborn hearing screening with transient evoked otoacoustic emission (TEOAE) test on a large scale (>5000 infants). The effects of ED and asphyxia on infant hearing and hearing outcomes were evaluated. RESULT The pass rate of TEOAE test was significantly reduced in preterm infants with ED (83.1%, multiple logistic regression analysis: P<0.01) but not in full-term infants with ED (93.6%, P=0.41). However, there was no significant reduction in the pass rate in infants with asphyxia (P=0.85). We further found that hypocalcaemia significantly reduced the pass rate of TEOAE test (86.8%, P<0.01). In the follow-up recheck at 3 months of age, the pass rate remained low (44.4%, P<0.01). CONCLUSION ED is a high-risk factor for preterm infant hearing. Hypocalcaemia can produce more significant impairment with a low recovery rate.
Collapse
Affiliation(s)
- Chun Liang
- Maternal and Child Health Care Hospital of Baoan, Shenzhen, P.R. of China, 518133,Dept. of Otolaryngology, University of Kentucky Medical Center, Lexington, KY, USA 40536
| | - Qi Hong
- Maternal and Child Health Care Hospital of Baoan, Shenzhen, P.R. of China, 518133
| | - Tao-Tao Jiang
- Maternal and Child Health Care Hospital of Baoan, Shenzhen, P.R. of China, 518133
| | - Yan Gao
- Maternal and Child Health Care Hospital of Baoan, Shenzhen, P.R. of China, 518133
| | - Xiao-Fang Yao
- Maternal and Child Health Care Hospital of Baoan, Shenzhen, P.R. of China, 518133
| | - Xiao-Xing Luo
- Maternal and Child Health Care Hospital of Baoan, Shenzhen, P.R. of China, 518133
| | - Xiu-Hui Zhuo
- Maternal and Child Health Care Hospital of Baoan, Shenzhen, P.R. of China, 518133
| | - Jennifer B. Shinn
- Dept. of Otolaryngology, University of Kentucky Medical Center, Lexington, KY, USA 40536
| | - Raleigh O. Jones
- Dept. of Otolaryngology, University of Kentucky Medical Center, Lexington, KY, USA 40536
| | - Hong-Bo Zhao
- Dept. of Otolaryngology, University of Kentucky Medical Center, Lexington, KY, USA 40536
| | - Guang-Jin Lu
- Maternal and Child Health Care Hospital of Baoan, Shenzhen, P.R. of China, 518133
| |
Collapse
|
17
|
Martines F, Bentivegna D, Ciprì S, Costantino C, Marchese D, Martines E. On the threshold of effective well infant nursery hearing screening in Western Sicily. Int J Pediatr Otorhinolaryngol 2012; 76:423-7. [PMID: 22277265 DOI: 10.1016/j.ijporl.2011.12.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Revised: 12/22/2011] [Accepted: 12/26/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high "screen sensitivity" reducing the number of more expensive secondary level exams. METHODS The newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 - PASS without risk factor, free to go home; G2 - PASS with risk factor, retest at the age of 7 months; G3 - FAIL without risk factor, re-screening after 2 weeks for a maximum of four times before audiology assessment; G4 - FAIL with risk factor, retest after 2 weeks. RESULTS The coverage rate increased progressively from 89.8% to 92%. The referral rate was 1.51% after second stage with a specificity value of 98.78%. The four-stage screening performed for G3 reduced the numbers of global audiology assessment to 0.91% with a final global specificity of 99.4 ± 0.4%. CONCLUSION Less than 1% of infants underwent audiological assessment; the false positives resulted 0.62% with hearing loss global incidence of 2.95/1000 and a mean age of confirmation of 3.5 months of age. It is reasonable to think that this screening programme could be implement to overall 42 Western Sicily birth centres within few years.
Collapse
Affiliation(s)
- Francesco Martines
- Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Sezione di Otorinolaringoiatria, Via del Vespro, 129 - 90127 Palermo, Italy.
| | | | | | | | | | | |
Collapse
|
18
|
Uus K, Young A, Day M. Auditory neuropathy spectrum disorder in the wider health context: Experiences of parents whose infants have been identified through newborn hearing screening programme. Int J Audiol 2011; 51:186-93. [DOI: 10.3109/14992027.2011.625986] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
19
|
Henson RJ, McHughes K. Infant with failed hearing screening: considerations for the PNP in primary care. J Pediatr Health Care 2011; 25:399-404. [PMID: 22018431 DOI: 10.1016/j.pedhc.2011.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Revised: 06/05/2011] [Accepted: 06/09/2011] [Indexed: 11/25/2022]
|