Lin Cheng-Yu, Huang Chii-Yuan, Lin Chun-Yu, Lin Yi-Hui, Wu Jiunn-Liang
Department of Otolaryngology, National Cheng Kung University Hospital, No. 138, Sheng-Li Rd., 704, Tainan, Taiwan
Int J Pediatr Otorhinolaryngol. 2004 Feb;68(2):185-9. doi: 10.1016/j.ijporl.2003.10.007.
Congenital bilateral hearing impairment occurs in approximately 1 in every 1000 live births. Universal newborn hearing screening (UNHS) programs are the most effective method for early diagnosis. Previously, newborn hearing screenings in Taiwan were often hospital-based. Our study is a community-based program designed to test the feasibility of performing neonatal hearing screening with a pay-for-test model, and to evaluate its acceptability to parents.
From March 2000 to December 2002, two hospitals and four obstetric clinics in Tainan city participated in this study. The subjects were healthy newborns whose parents agreed to pay for otoacoustic emissions (OAE) hearing screening. They were tested in the newborn nursery before discharge. The protocol used an initial transient evoked otoacoustic emissions screening followed by a diagnostic auditory brainstem response (ABR) test.
A total of 10,008 healthy neonates were recruited, and 5938 newborns (59.3%) were tested. Prior to hospital discharge, 5403 of the newborns (91.0%) had passed the transient evoked otoacoustic emissions test. Referral for further testing was made in 9.0% of cases (535/5938). There were 140 babies lost to 1-month follow up. Only 395 infants (73.8%) of the infants that failed their first otoacoustic emissions tests underwent a second session at the outpatient clinic, and 91 babies failed. They were referred for further auditory brainstem response testing. Ultimately, nine babies were diagnosed with sensorineural hearing loss (SNHL).
There are difficulties in performing universal newborn hearing screening within Taiwan's health insurance system. This study was performed with the cooperation of hospitals and obstetric clinics, and was undertaken with a pay-for-screening model. Our program, with a pay-for-test model, of newborn hearing screening is feasible and was well regarded by parents in Tainan city. It could be run without the government's financial support.
先天性双侧听力障碍在每1000例活产中约有1例发生。新生儿听力普遍筛查（UNHS）项目是早期诊断的最有效方法。此前，台湾的新生儿听力筛查通常以医院为基础。我们的研究是一个基于社区的项目，旨在测试采用付费检测模式进行新生儿听力筛查的可行性，并评估其对家长的可接受性。
2000年3月至2002年12月，台南市的两家医院和四家妇产科诊所参与了本研究。研究对象为其父母同意支付耳声发射（OAE）听力筛查费用的健康新生儿。他们在新生儿病房出院前接受检测。该方案采用初始瞬态诱发耳声发射筛查，随后进行诊断性听性脑干反应（ABR）测试。
共招募了10008名健康新生儿，其中5938名新生儿（59.3%）接受了检测。在出院前，5403名新生儿（91.0%）通过了瞬态诱发耳声发射测试。9.0%的病例（535/5938）被转诊进行进一步检测。有140名婴儿失访至1个月。首次耳声发射测试未通过的婴儿中，只有395名婴儿（73.8%）在门诊接受了第二次检测，91名婴儿未通过。他们被转诊进行进一步的听性脑干反应测试。最终，9名婴儿被诊断为感音神经性听力损失（SNHL）。
在台湾的医疗保险系统内进行新生儿听力普遍筛查存在困难。本研究是在医院和妇产科诊所的合作下进行的，采用了付费筛查模式。我们采用付费检测模式的新生儿听力筛查项目是可行的，并且在台南市受到了家长的好评。该项目可以在没有政府财政支持的情况下开展。
