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Bessen SY, Magro IL, Alvarez KM, Cowan DR, Peñalba D, Fellows A, Gonzalez-Quiroz M, Rieke C, Buckey JC, Niemczak C, Saunders JE. Test-Retest repeatability of automated threshold audiometry in Nicaraguan schoolchildren. Int J Audiol 2023; 62:209-216. [PMID: 35130458 DOI: 10.1080/14992027.2022.2032416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Automated threshold audiometry (ATA) could increase access to paediatric hearing assessment in low- and middle-income countries, but few studies have evaluated test-retest repeatability of ATA in children. This study aims to analyse test-retest repeatability of ATA and to identify factors that affect the reliability of this method. DESIGN ATA was performed twice in a cohort of Nicaraguan schoolchildren. During testing, the proportion of responses occurring in the absence of a stimulus was measured by calculating a stimulus response false positive rate (SRFP). Absolute test-retest repeatability was determined between the two trials, as well as the impact of age, gender, ambient noise, head circumference, and SRFP on these results. STUDY SAMPLE 807 children were randomly selected from 35 schools in northern Nicaragua. RESULTS Across all frequencies, the absolute value of the difference between measurements was 5.5 ± 7.8 dB. 89.6% of test-retest differences were within 10 dB. Intra-class correlation coefficients between the two measurements showed that lower SRFP was associated with improved repeatability. No effect of age, gender, or ambient noise was found. CONCLUSIONS ATA produced moderate test-retest repeatability in Nicaraguan schoolchildren. Participant testing behaviours, such as delayed or otherwise inappropriate response patterns, significantly impacts the repeatability of these measurements.
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Affiliation(s)
- Sarah Y Bessen
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Isabelle L Magro
- Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | | | - Devin R Cowan
- Dartmouth Geisel School of Medicine, Hanover, NH, USA
| | - Donoso Peñalba
- National Autonomous University of Nicaragua, León (UNAN-León), León, Nicaragua
| | | | - Marvin Gonzalez-Quiroz
- Research Center on Health, Work, and Environment at the National Autonomous University of Nicaragua, Leon (UNAN-Leon), Leon, Nicaragua.,Centre for Nephrology, University College London, London, UK
| | | | - Jay C Buckey
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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2
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Mackey AR, Bussé AML, Del Vecchio V, Mäki-Torkko E, Uhlén IM. Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening: a systematic review. BMC Pediatr 2022; 22:473. [PMID: 35932008 PMCID: PMC9354382 DOI: 10.1186/s12887-022-03218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic review identified studies evaluating the effect of protocol and programme factors on these two outcomes, including the screening method used and the infant group. Methods Five databases were searched (latest: April 2021). Included studies reported original data from newborn hearing screening and described the target outcomes against a protocol or programme level factor. Studies were excluded if results were only available for one risk condition, for each ear, or for < 100 infants, or if methodological bias was observed. Included studies were evaluated for quality across three domains: sample, screening and outcome, using modified criteria from the Ottawa-Newcastle and QUADAS-2 scales. Findings from the included studies were synthesised in tables, figures and text. Results Fifty-eight studies reported on referral rate, 8 on LTFU rate, and 35 on both. Only 15 studies defined LTFU. Substantial diversity in referral and LTFU rate was observed across studies. Twelve of fourteen studies that evaluated screening method showed lower referral rates with aABR compared to TEOAE for well babies (WB). Rescreening before hospital discharge and screening after 3 days of age reduced referral rates. Studies investigating LTFU reported lower rates for programmes that had audiologist involvement, did not require fees for step 2, were embedded in a larger regional or national programme, and scheduled follow-up in a location accessible to the families. In programmes with low overall LTFU, higher LTFU was observed for infants from the NICU compared to WB. Conclusion Although poor reporting and exclusion of non-English articles may limit the generalisability from this review, key influential factors for referral and LTFU rates were identified. Including aABR in WB screening can effectively reduce referral rates, but it is not the only solution. The reported referral and LTFU rates vary largely across studies, implying the contribution of several parameters identified in this review and the context in which the programme is performed. Extra attention should be paid to infants with higher risk for hearing impairment to ensure their return to follow-up. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03218-0.
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Affiliation(s)
- Allison R Mackey
- Karolinska Institutet, Department of Clinical Science Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden.
| | - Andrea M L Bussé
- Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Valeria Del Vecchio
- Department of Neuroscience, University of Padua, Bologna, Italy.,Unit of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elina Mäki-Torkko
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Inger M Uhlén
- Karolinska Institutet, Department of Clinical Science Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden
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Chandrasekar M, Selvarajan HG. Status of Newborn Hearing Screening Program in the State of Tamil Nadu, India. Indian J Otolaryngol Head Neck Surg 2022; 74:639-650. [PMID: 36032889 PMCID: PMC9411284 DOI: 10.1007/s12070-021-02444-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/02/2021] [Indexed: 10/22/2022] Open
Abstract
Newborn hearing screening in India is gaining momentum and more programs are getting established every year. We need to know their performance levels, strengths and weaknesses to provide suggestions for building effective future programs. The study aimed to report the status of Newborn Hearing Screening (NHS) program in the state of Tamil Nadu, India. A questionnaire on "Newborn Hearing Screening Survey" was developed and sent to 80 sites with NHS facility all over Tamil Nadu, India. The information collected was subjected to descriptive statistical analyses. On a 95% return rate, private sector contribution towards NHS program are the highest and most of the private hospitals have outsourced the NHS program. In most of the sites, audiologists are incharge of the NHS program and carried out the NHS testing. The majority of sites (67.1%) follow selective screening such as high risk factors, doctor's referral and admission at NICU. The preferred testing was TEOAE in the screening program. NHS protocol was found to be variable at each site and for each patient. The time between second screening and diagnostic testing went up to 3-6 months. However, there is a lack of organized system for documenting the program outcome. The result of this study calls the need for wider implementation of UNHS and to introduce a centralised state or local reporting system for documenting and tracking the infants with hearing impairment.
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Ototacoustic Emissions-Based Hearing Assessment of Neonates in Tertiary Care Hospital. Indian J Otolaryngol Head Neck Surg 2022; 74:612-618. [PMID: 36032868 PMCID: PMC9411344 DOI: 10.1007/s12070-021-02365-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022] Open
Abstract
Hearing is a special sense needed for appropriate mental, speech and language development and academic performance. Even among normal babies, 50% of cases of hearing loss are missed out if screening protocol is not followed. In this study, we assess the hearing of all neonates born and brought to the tertiary care hospital, and also find out how many well babies with hearing loss would have been missed if this screening had not been done. Hence, the study aims to estimate the prevalence of neonatal hearing loss and study the associated risk factors. Neonates (N = 1559) attended the outpatient department of paediatrics were included. A detailed history of the neonates with special emphasis on prenatal, natal, postnatal, family history, and maternal risk factors were elicited. Three-stage hearing testing protocol was followed with transient evoked otoacoustic emission testing, a gold standard test for stage 1 and 2 and brainstem evoked response audiometry for stage 3. Of 1559 neonates, 138 had hearing loss. History of drug intake, order of the child, place of delivery and maternal history were the significant factors associated with hearing loss in neonates. Bivariate analysis revealed order of child, maternal history, and history of drug taken were the significant factors affecting the hearing loss in the neonates (P < 0.001). The prevalence of hearing loss was 8.85%. Early detection of hearing loss is essential for timely intervention and development of optimal communication skills. Further studies are required to decide the essentiality of Universal New-born hearing screening.
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Magro I, Clavier O, Mojica K, Rieke C, Eisen E, Fried D, Stein-Meyers A, Fellows A, Buckey J, Saunders J. Reliability of Tablet-based Hearing Testing in Nicaraguan Schoolchildren: A Detailed Analysis. Otol Neurotol 2020; 41:299-307. [PMID: 31851067 DOI: 10.1097/mao.0000000000002534] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Determine whether an electronic tablet-based Wireless Automated Hearing-Test System can perform high-quality audiometry to assess schoolchildren for hearing loss in the field in Nicaragua. STUDY DESIGN Cross-sectional. SETTING A school and hospital-based audiology clinic in Jinotega, Nicaragua. SUBJECTS AND METHODS Second and third graders (n = 120) were randomly selected for hearing testing in a school. Air conduction hearing thresholds were obtained bilaterally using a Wireless Automated Hearing-Test System at 1000, 2000, and 4000 Hz. Referral criteria were set at more than 25 dBHL at one or more frequencies. A cohort of children was retested with conventional audiometry in a hospital-based sound booth. Factors influencing false-positive examinations, including ambient noise and behavior, were examined. RESULTS All children with hearing loss were detected using an automated, manual, or two-step (those referred from automated testing were tested manually) protocol in the school (sensitivity = 100%). Specificity was 76% for automated testing, 97% for manual testing, and 99% for the two-step protocol. The variability between thresholds obtained with automated testing was greater than manual testing when compared with conventional audiometry. The percentage of participant responses when no stimulus tone was presented during automated testing was higher in children with false-positive examinations. CONCLUSION A Wireless Automated Hearing-Test System identified all children with hearing loss in a challenging field setting. A two-step protocol (those referred from automated testing are tested manually) reduced false-positive examinations and unnecessary referrals. Children who respond frequently when no tone is presented are more likely to have false-positive automated examinations and should be tested manually.
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Affiliation(s)
| | | | | | | | - Eric Eisen
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | | | | | | | - James Saunders
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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Sininger YS, Condon CG, Hoffman HJ, Elliott AJ, Odendaal HJ, Burd LL, Myers MM, Fifer WP. Transient Otoacoustic Emissions and Auditory Brainstem Responses in Low-Risk Cohort of Newborn and One-Month-Old Infants: Assessment of Infant Auditory System Physiology in the Prenatal Alcohol in SIDS and Stillbirth Network Safe Passage Study. J Am Acad Audiol 2019; 29:748-763. [PMID: 30222544 DOI: 10.3766/jaaa.17043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Prenatal Alcohol and Sudden Infant Death Syndrome and Stillbirth Network, known as the "Safe Passage Study," enrolled approximately 12,000 pregnant women from the United States and South Africa and followed the development of their babies through pregnancy and the infant's first year of life to investigate the role of prenatal alcohol exposure in the risk for sudden infant death syndrome (SIDS) and adverse pregnancy outcomes, such as stillbirth and fetal alcohol spectrum disorders. PURPOSE Auditory system tests were included in the physiologic test battery used to study the effects of prenatal alcohol exposure on neurophysiology and neurodevelopment, as well as potential causal relationships between neurodevelopmental disorders and SIDS and/or stillbirth. The purpose of this manuscript is to describe normative results when using the auditory test battery applied. RESEARCH DESIGN The test battery included the auditory brainstem response (ABR) and transient-evoked otoacoustic emissions (TEOAEs). Data were collected on individual ears of newborns and 1-month-old infants. STUDY SAMPLE From a cohort of 6,070 with auditory system exams, a normative subsample of 325 infants were selected who were not exposed prenatally to alcohol, cigarette smoke, or drugs nor were they preterm or low birthweight. The subsample is small relative to the overall study because of strict criteria for no exposure to substances known to be associated with SIDS or stillbirth and the exclusion of preterm and low birthweight infants. Expectant mothers were recruited from general maternity at two comprehensive clinical sites, in the northern plains in the United States and in Cape Town, South Africa. These populations were selected for study because both were known to be at high-risk for SIDS and stillbirth. DATA COLLECTION AND ANALYSIS ABR and TEOAE recordings were stored electronically. Peak latency and amplitude analysis of ABRs were determined by study personnel, and results were evaluated for differences by age, sex, test site, race, and ear (left versus right). RESULTS TEOAE findings were consistent with existing literature including the increase in signal-to-noise (SNR) over the first month of life. The SNR increase is due to an increase in amplitude of the emission. TEOAE amplitude asymmetry favoring the right ear was found, whereas SNR asymmetry was not, perhaps because of the small sample size. A nonsignificant trend toward larger responses in female babies was found; a result that is generally statistically significant in studies with larger samples. Latencies were found to be shorter in ABRs elicited in the right ear with amplitudes that were slightly bigger on average. An expected decrease in wave V latency was observed from birth to 1-month of age, but the finding was of borderline significance (p = 0.058). CONCLUSIONS One month is a short time to judge development of the auditory system; however, the ABR and TEOAE findings were consistent with current literature. We conclude that the auditory system data acquired for the Safe Passage Study, as reflected in the data obtained from this cohort of "unexposed" infants, is consistent with published reports of these auditory system measures in the general population.
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Affiliation(s)
- Yvonne S Sininger
- Department of Head & Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA.,C&Y Consultants, LLC, Santa Fe, NM
| | - Carmen G Condon
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY
| | - Howard J Hoffman
- Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD
| | - Amy J Elliott
- Center for Health Outcomes and Population Research, Sanford Research, Sioux Falls, SD.,Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD
| | - Hein J Odendaal
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Larry L Burd
- Department of Pediatrics, University of North Dakota Fetal Alcohol Syndrome Center, Grand Forks, ND.,University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND.,University of North Dakota School of Medicine, Grand Forks, ND
| | - Michael M Myers
- C&Y Consultants, LLC, Santa Fe, NM.,Department of Psychiatry, Columbia University Medical Center, New York, NY.,Department of Pediatrics, Columbia University Medical Center, New York, NY
| | - William P Fifer
- C&Y Consultants, LLC, Santa Fe, NM.,Department of Psychiatry, Columbia University Medical Center, New York, NY.,Department of Pediatrics, Columbia University Medical Center, New York, NY
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Ramkumar V, Vanaja CS, Hall JW, Selvakumar K, Nagarajan R. Validation of DPOAE screening conducted by village health workers in a rural community with real-time click evoked tele-auditory brainstem response. Int J Audiol 2018; 57:370-375. [DOI: 10.1080/14992027.2018.1425001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Vidya Ramkumar
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra University, Chennai, India,
| | - C. S. Vanaja
- Department of Audiology & Speech Language Pathology, Bharati Vidyapeeth Deemed University, Pune, India,
| | - James W. Hall
- Department of Audiology, Nova Southeastern University, St. Augustine, FL, USA,
- Department of Communication Pathology, University of Pretoria, Pretoria, South Africa,
| | - K. Selvakumar
- Department of Neurosurgery, Sri Ramachandra University, Chennai, India, and
| | - Roopa Nagarajan
- Department of Speech, Language and Hearing Sciences, Faculty of Allied Health Sciences, Sri Ramachandra University, Chennai, India
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Dzulkarnain AAA, Noor Ibrahim SHM, Anuar NFA, Abdullah SA, Tengku Zam Zam TZH, Rahmat S, Mohd Ruzai MA. Influence of two-electrode montages on the level-specific (LS) CE-Chirp auditory brainstem response (ABR) at multiple intensity levels. Int J Audiol 2017; 56:723-732. [DOI: 10.1080/14992027.2017.1313462] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ahmad Aidil Arafat Dzulkarnain
- Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Siti Hajra Mu’minah Noor Ibrahim
- Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Nur Farah Aida Anuar
- Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Siti Aisyah Abdullah
- Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Tengku Zulaila Hasma Tengku Zam Zam
- Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Sarah Rahmat
- Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
| | - Muhammad Amar Mohd Ruzai
- Department of Audiology and Speech-Language Pathology, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Pahang, Malaysia
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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.
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Affiliation(s)
- Amisha Kanji
- Department of Speech Pathology and Audiology, University of the Witwatersrand.
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10
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Vignesh SS, Jaya V, Sasireka BI, Sarathy K, Vanthana M. Prevalence and referral rates in neonatal hearing screening program using two step hearing screening protocol in Chennai - A prospective study. Int J Pediatr Otorhinolaryngol 2015; 79:1745-7. [PMID: 26296879 DOI: 10.1016/j.ijporl.2015.07.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 07/30/2015] [Accepted: 07/31/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To estimate the prevalence and referral rates in well born and high risk babies using two step hearing screening protocol with Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR). METHOD A prospective study was carried out on 1405 neonates (983 well born babies and 422 high risk babies) who were screened during May 2013 to January 2015 at Institute of Obstetrics and Gynecology, Madras Medical College, Chennai. All neonates were screened using two step screening protocol. They were initially tested with DPOAE. Referred babies in DPOAE were screened with AABR subsequently. RESULTS Among 1405 (100%) neonates 983 (69.96%) were well born babies and 422 (30.03%) were high risk babies. Total referral rate in DPOAE was found to be 311 (22.13%) among which 195 (13.87%) were well born babies and 116 (8.25%) were high risk babies. Out of 311 babies 31 (2.20%) babies were referred in AABR screening. In 31 babies referred in AABR 11(0.78%) were from well born group and 20 (1.42%) were from the high risk group. Further diagnostic evaluation of these babies, 2 (0.14%) were confirmed to have hearing loss. This study reveals, the prevalence of congenital hearing loss in our population is 1.42 per 1000 babies. CONCLUSION Using two step protocol especially AABR along with DPOAE at the initial level of testing significantly reduces referral rates in new born screening programs. Also AABR decreases the false positive responses hence increasing the efficiency of screening program.
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Affiliation(s)
- S S Vignesh
- Institute of Speech and Hearing - Upgraded Institute of Otorhinolaryngology, Madras Medical College and Rajiv Gandhi Government General Hospital, EVR Periyar Salai, Chennai 3, India.
| | - V Jaya
- Institute of Speech and Hearing - Upgraded Institute of Otorhinolaryngology, Madras Medical College and Rajiv Gandhi Government General Hospital, EVR Periyar Salai, Chennai 3, India.
| | - B I Sasireka
- Institute of Obstetrics and Gynecology, Government Hospital for Women and Children, Madras Medical College, Panpheon Road, Chennai 8, India.
| | - Kamala Sarathy
- Institute of Speech and Hearing - Upgraded Institute of Otorhinolaryngology, Madras Medical College and Rajiv Gandhi Government General Hospital, EVR Periyar Salai, Chennai 3, India.
| | - M Vanthana
- Institute of Speech and Hearing - Upgraded Institute of Otorhinolaryngology, Madras Medical College and Rajiv Gandhi Government General Hospital, EVR Periyar Salai, Chennai 3, India.
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11
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Contralateral ear occlusion for improving the reliability of otoacoustic emission screening tests. Int J Otolaryngol 2014; 2014:248187. [PMID: 24672553 PMCID: PMC3941788 DOI: 10.1155/2014/248187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 11/28/2013] [Indexed: 11/20/2022] Open
Abstract
Newborn hearing screening is an established healthcare standard in many countries and testing is feasible using otoacoustic emission (OAE) recording. It is well documented that OAEs can be suppressed by acoustic stimulation of the ear contralateral to the test ear. In clinical otoacoustic emission testing carried out in a sound attenuating booth, ambient noise levels are low such that the efferent system is not activated. However in newborn hearing screening, OAEs are often recorded in hospital or clinic environments, where ambient noise levels can be 60–70 dB SPL. Thus, results in the test ear can be influenced by ambient noise stimulating the opposite ear. Surprisingly, in hearing screening protocols there are no recommendations for avoiding contralateral suppression, that is, protecting the opposite ear from noise by blocking the ear canal. In the present study we have compared transient evoked and distortion product OAEs measured with and without contralateral ear plugging, in environmental settings with ambient noise levels <25 dB SPL, 45 dB SPL, and 55 dB SPL. We found out that without contralateral ear occlusion, ambient noise levels above 55 dB SPL can significantly attenuate OAE signals. We strongly suggest contralateral ear occlusion in OAE based hearing screening in noisy environments.
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12
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Dzulkarnain AAA, Buyong AS, Sulaiman NH. Intra-subject variability in the auditory brainstem response using a vertical montage recording. SPEECH LANGUAGE AND HEARING 2014. [DOI: 10.1179/2050572814y.0000000035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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Olusanya BO, Bamigboye BA. Is discordance in TEOAE and AABR outcomes predictable in newborns? Int J Pediatr Otorhinolaryngol 2010; 74:1303-9. [PMID: 20828836 DOI: 10.1016/j.ijporl.2010.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2010] [Accepted: 08/12/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the perinatal predictors of discordant screening outcomes based on a two-stage screening protocol with transient-evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR). METHODS A cross-sectional study of infants tested with TEOAE and AABR under a hospital-based universal newborn hearing screening program in Lagos, Nigeria. Maternal and infant factors associated with discordant TEOAE and AABR outcomes were determined with multivariable logistic regression analyses adjusting for potential confounding factors. RESULTS Of the 4718 infants enrolled under the program 1745 (36.9%) completed both TEOAE and AABR. Of this group, 1060 (60.7%) passed both TEOAE and AABR ("true-negatives"); 92 (5.3%) failed both TEOAE and AABR ("true-positive"); 571 (32.7%) failed TEOAE but passed AABR ("false-positives") while 22 (1.3%) passed TEOAE but failed AABR ("false-negatives"). Infants with false-positives were likely to be admitted into well-baby nursery (p=0.001), belong to mothers who attended antenatal care (p=0.010) or who delivered vaginally (p<0.001) compared to infants with true-negatives while infants with true-positives were also more likely to be delivered vaginally (p=0.002) or admitted into well-baby nursery (p=0.035) compared to infants with false-negatives. Infants with true-positives were significantly more likely to be delivered vaginally (p<0.001) and have severe hyperbilirubinemia (p=0.045) compared with infants with true-negatives. No association was observed between false-negatives and true-negatives. Antenatal care status, mode of delivery and nursery type were useful predictors of discordant outcomes among all infants undergoing screening (c-statistic=0.73). CONCLUSIONS Given the available screening technologies, discordant TEOAE and AABR may be inevitable for some categories of hearing loss among apparently healthy newborns whose mothers received prenatal care. The potential limitations of perinatal morbidities as basis of targeted screening for such cases therefore merit further consideration.
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Affiliation(s)
- Bolajoko O Olusanya
- Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
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