Hess M, Finckh-Krämer U, Bartsch M, Kewitz G, Versmold H, Gross M
Department of Audiology and Phoniatrics, Benjamin Franklin Medical Center, Freie Universität Berlin, Germany.
Int J Pediatr Otorhinolaryngol. 1998 Nov 15;46(1-2):81-9. doi: 10.1016/s0165-5876(98)00151-7.
This prospective study reports on the prevalence of hearing impairment in an at-risk neonatal intensive care unit (NICU) population.
From 1990 to 1997, 942 neonates were screened with transient evoked otoacoustic emissions (TEOAE) and brainstem evoked response audiometry (BERA).
835 Infants passed the primary screen for both ears, 57 for one ear, adding up to 94.7%. Seventeen infants (1.9%) were lost to follow-up. In thirteen infants (1.4%), bilateral hearing impairment above 30 dB was confirmed. While all children with hearing impairment belonged to the group of 820 children receiving aminoglycosides, only one presented no other risk factors. In 11 of the hearing impaired children other anamnestic factors, i.e. dysmorphism, prenatal rubella or cytomegaly, family history of hearing loss or severe peri- and postnatal complications seem to be more probable causes of the identified hearing loss.
From our data, aminoglycosides seem not to be an important risk factor for communication related hearing impairment, when serum levels are continuously monitored, as occurred in our cohort. After adjustment for other risk factors, birth weight between 1000 and 1500 g and a gestational age between 29 and 31 weeks were no predictive markers for hearing impairment. It might be speculated that the improved medical treatment in a Neonatal Intensive Care Unit (NICU) reduces the probability of hearing impairment for those two groups. Conductive hearing loss as a possible additional cause for hearing impairment was not studied in detail, but the high percentage of malformations detected (four out of 13 hearing impaired infants) demands further monitoring, close follow-up, counselling and adequate treatment.
本前瞻性研究报告了高危新生儿重症监护病房（NICU）人群中听力障碍的患病率。
1990年至1997年，对942名新生儿进行了瞬态诱发耳声发射（TEOAE）和脑干诱发反应测听（BERA）筛查。
835名婴儿双耳通过初筛，57名单耳通过，总计94.7%。17名婴儿（1.9%）失访。13名婴儿（1.4%）被确诊为双耳听力障碍，听力损失超过30分贝。虽然所有听力障碍儿童都属于接受氨基糖苷类药物治疗的820名儿童组，但只有一名儿童没有其他危险因素。在11名听力障碍儿童中，其他既往因素，即畸形、产前风疹或巨细胞病毒感染、听力损失家族史或严重的围产期和产后并发症似乎是已确定听力损失的更可能原因。
根据我们的数据，当像我们队列中那样持续监测血清水平时，氨基糖苷类药物似乎不是与交流相关的听力障碍的重要危险因素。在调整其他危险因素后，出生体重在1000至1500克之间以及胎龄在29至31周之间不是听力障碍的预测指标。可以推测，新生儿重症监护病房（NICU）中医疗水平的提高降低了这两组儿童听力障碍的可能性。作为听力障碍可能的额外原因的传导性听力损失未进行详细研究，但检测到的高畸形率（13名听力障碍婴儿中有4名）需要进一步监测、密切随访、咨询和适当治疗。
