Eiserman William D, Hartel Diana M, Shisler Lenore, Buhrmann Jan, White Karl R, Foust Terry
Utah State University, United States.
Int J Pediatr Otorhinolaryngol. 2008 Apr;72(4):475-82. doi: 10.1016/j.ijporl.2007.12.006. Epub 2008 Feb 13.
Until recently, no objective tool has been available to help health and early childhood education providers screen young children for hearing loss. The aim of this study was to screen underserved children <or=3 years of age for hearing loss using otoacoustic emissions (OAE) technology and to systematically document multi-step screening and diagnostic outcomes.
A total of 4,519 children, <or=3 years of age in four states were screened by trained lay screeners using portable OAE equipment set to deliver stimuli and measurement levels sensitive to mild hearing loss as low as 25 decibels (dB) hearing level. The screening and follow-up protocol specified that children not passing the multi-step OAE screening be evaluated by local physicians and hearing specialists.
Of the 4,519 children screened as a part of the study, 257 (6%) ultimately required medical or audiological follow-up. One hundred and seven children were identified as having a hearing loss or disorder of the outer, middle or inner ear requiring treatment or monitoring. Of these 107 children, 5 had permanent bilateral and 2 had permanent unilateral hearing loss. The seven children with permanent hearing loss included four who had passed newborn screening, two who were not screened at birth and one who did not receive follow-up services after referring from newborn screening.
OAE screening, using a multi-step protocol, was found to be a feasible and accurate practice for identifying a wide range of hearing-health conditions warranting monitoring and treatment among children <or=3 years of age in early childhood care programs. Future studies are needed to: (1) further examine barriers to effective OAE screening in early childhood care settings and (2) explore the value of extending early childhood OAE hearing screening into health care clinics and settings where young children receive routine care.
直到最近，一直没有客观工具可用于帮助健康和幼儿教育服务提供者对幼儿进行听力损失筛查。本研究的目的是使用耳声发射（OAE）技术对3岁及以下服务不足的儿童进行听力损失筛查，并系统记录多步骤筛查和诊断结果。
四个州的4519名3岁及以下儿童由经过培训的非专业筛查人员使用便携式OAE设备进行筛查，该设备设置为能提供对低至25分贝（dB）听力水平的轻度听力损失敏感的刺激和测量水平。筛查和随访方案规定，未通过多步骤OAE筛查的儿童由当地医生和听力专家进行评估。
在作为研究一部分接受筛查的4519名儿童中，257名（6%）最终需要进行医学或听力学随访。107名儿童被确定患有听力损失或外耳、中耳或内耳疾病，需要治疗或监测。在这107名儿童中，5名患有永久性双侧听力损失，2名患有永久性单侧听力损失。这7名患有永久性听力损失的儿童中，4名通过了新生儿筛查，2名出生时未接受筛查，1名在新生儿筛查转诊后未接受随访服务。
使用多步骤方案的OAE筛查被发现是一种可行且准确的方法，可用于识别幼儿护理项目中3岁及以下儿童中需要监测和治疗的广泛听力健康状况。未来的研究需要：（1）进一步研究幼儿护理环境中有效OAE筛查的障碍；（2）探索将幼儿OAE听力筛查扩展到幼儿接受常规护理的医疗诊所和环境中的价值。
