Weichbold Viktor, Nekahm-Heis Doris, Welzl-Mueller Kunigunde
Clinical Department of Hearing, Voice and Speech Disorders, Innsbruck Medical University, Austria.
Int J Pediatr Otorhinolaryngol. 2006 Feb;70(2):235-40. doi: 10.1016/j.ijporl.2005.06.006. Epub 2005 Aug 8.
Current health care standards recommend that congenital hearing loss be confirmed before age three months and intervened for before age six months. This study evaluated to what extent the Austrian universal neonatal hearing screening (UNHS) program achieves this goal. The Austrian UNHS program is a hospital-based, two-stage screen based on transient oto-acoustic emissions, as promoted in 1995 in a position paper of the Austrian ENT Society.
Retrospective chart review and data analysis. All Austrian institutions engaged in the diagnosis and treatment of childhood hearing loss were requested to provide their data on children with permanent congenital sensorineural hearing impairment registered since 1990. Children who had undergone hearing screening, were compared to those who had not. Main outcome measures were age at confirmation of and age at intervention for the hearing loss. In each group, the percentage of children, whose hearing loss was confirmed by age three months, and intervened for by age six months, was determined.
Data from 321 hearing-impaired children were useable. Of these children, 167 were screened and 154 were not. At age three months, a hearing loss was diagnosed in 35% of screened children, but in only 2% of unscreened. These percentages rose to 69% and 6%, respectively, at age six months and to 81% and 12%, respectively, at age one year. Intervention mostly started within less than one month after diagnosis. At age six months, 61% of screened children, but only 4% of unscreened children, had undergone intervention.
Hearing screening enormously increases the number of early-detected children. However, in quite a few screened children hearing loss is neither confirmed within three months after birth, nor intervened for within six months after birth. Reasons for the delay must be paid attention in order to warrant that UNHS can be as effective as possible.
当前的医疗保健标准建议在三个月龄前确诊先天性听力损失，并在六个月龄前进行干预。本研究评估了奥地利新生儿听力普遍筛查（UNHS）计划在多大程度上实现了这一目标。奥地利的UNHS计划是一项基于医院的两阶段筛查，基于瞬态耳声发射，这是1995年奥地利耳鼻喉科学会的一篇立场文件中所倡导的。
回顾性病历审查和数据分析。要求所有参与儿童听力损失诊断和治疗的奥地利机构提供自1990年以来登记的永久性先天性感音神经性听力障碍儿童的数据。将接受听力筛查的儿童与未接受筛查的儿童进行比较。主要结局指标为听力损失确诊年龄和干预年龄。在每组中，确定听力损失在三个月龄前确诊且在六个月龄前进行干预的儿童百分比。
321名听力受损儿童的数据可用。其中，167名儿童接受了筛查，154名未接受筛查。在三个月龄时，35%的筛查儿童被诊断出听力损失，但未筛查儿童中只有2%被诊断出。在六个月龄时，这些百分比分别升至69%和6%，在一岁时分别升至81%和12%。干预大多在诊断后不到一个月内开始。在六个月龄时，61%的筛查儿童接受了干预，但未筛查儿童中只有4%接受了干预。
听力筛查极大地增加了早期发现儿童的数量。然而，相当一部分接受筛查的儿童在出生后三个月内未确诊听力损失，也未在出生后六个月内进行干预。必须关注延迟的原因，以确保UNHS尽可能有效。
