Weichbold Viktor, Nekahm-Heis Doris, Welzl-Müller Kunigunde
Klinische Abteilung für Hör-, Stimm- und Sprachstörungen, Medizinische Universität Innsbruck, Innsbruck, Osterreich.
Wien Klin Wochenschr. 2005 Sep;117(18):641-6. doi: 10.1007/s00508-005-0414-z.
Universal Neonatal Hearing Screening (UNHS) has been gradually implemented since the mid-nineties in Austrian maternity wards and neonatal intensive care units. This study evaluated the effect of UNHS on reducing age at identification as well as age of intervention for children with congenital and perinatal sensorineural hearing impairment.
This was a retrospective analysis of clinical data of 394 Austrian children diagnosed with an at least mild degree (> 20 dB hearing level) of permanent sensorineural hearing loss. Age at identification and age at intervention were compared between children who underwent UNHS ('with UNHS') and those who did not undergo UNHS ('without UNHS').
The median of age of identification was 37.6 months in children without UNHS, and 3.9 months in children with UNHS. By six months of age, 69% of hearing-impaired children who underwent UNHS, were identified but only 6% of those without UNHS. At one year, the corresponding percentages are 80% and 12%, respectively. In children without UNHS, the degree of hearing loss was the most predictive factor of age at identification (median of age at diagnosis for profound hearing loss: 15 months; severe: 26 months; moderate: 52 months; mild: 73 months). In children with UNHS, age of identification was unrelated to degree of hearing loss (medians between 3.7 and 4.4 months). In the majority of children intervention began within one month after diagnosis, regardless of whether or not the child was identified by UNHS.
UNHS greatly increases the proportion of children whose hearing impairment is diagnosed before six months of age. However, in some 20% of children, hearing impairment was diagnosed later than one year of age, despite having failed the screening. Additionally, data from this study suggest that about 15% of childhood hearing losses manifest themselves after the hearing screening period. Efforts are thus required for the early detection of these children as well.
自九十年代中期以来，奥地利的产科病房和新生儿重症监护病房已逐步实施新生儿听力普遍筛查（UNHS）。本研究评估了UNHS对降低先天性和围产期感音神经性听力障碍儿童的确诊年龄以及干预年龄的效果。
这是一项对394名被诊断患有至少轻度（听力水平>20 dB）永久性感音神经性听力损失的奥地利儿童的临床数据进行的回顾性分析。比较了接受UNHS的儿童（“接受UNHS”）和未接受UNHS的儿童（“未接受UNHS”）的确诊年龄和干预年龄。
未接受UNHS的儿童确诊年龄中位数为37.6个月，接受UNHS的儿童为3.9个月。到6个月大时，接受UNHS的听力受损儿童中有69%被确诊，但未接受UNHS的儿童中只有6%。到1岁时，相应的百分比分别为80%和12%。在未接受UNHS的儿童中，听力损失程度是确诊年龄的最主要预测因素（极重度听力损失的诊断年龄中位数：15个月；重度：26个月；中度：52个月；轻度：73个月）。在接受UNHS的儿童中，确诊年龄与听力损失程度无关（中位数在3.7至4.4个月之间）。大多数儿童在诊断后一个月内开始干预，无论该儿童是否通过UNHS确诊。
UNHS大大提高了在6个月龄前被诊断出听力障碍的儿童比例。然而，约20%的儿童尽管筛查未通过，但在1岁以后才被诊断出听力障碍。此外，本研究数据表明，约15%的儿童听力损失在听力筛查期之后才显现出来。因此，也需要努力尽早发现这些儿童。
