Núñez-Batalla Faustino, Carro-Fernández Pilar, Antuña-León María Eva, González-Trelles Teresa
Unidad de Hipoacusia Infantil, Hospital Universitario Central de Asturias, PADAI de la Consejería de Salud y Servicios Sanitarios del Gobierno del Principado de Asturias, Oviedo, Asturias, Spain.
Acta Otorrinolaringol Esp. 2008 Mar;59(3):108-13.
Hyperbilirubinaemia is a neonatal risk factor that has been proved to be associated with sensorineural hearing loss. A high concentration of unconjugated bilirubin place newborn children at risk of suffering toxic effects, including hypoacusia.
Review of the newborn screening results with a diagnosis of pathological hyperbilirubinaemia as part of a hearing-loss early detection protocol in the general population based on otoemissions and evoked potentials.
Retrospective study of 21 590 newborn children screened between 2002 and 2006. The selection criteria for defining pathological hyperbilirubinaemia were bilirubin concentrations in excess of 14 mg/dL in pre-term infants and 20 mg/dL in full-term babies. The Universal Neonatal Hearing Screening Programme is a two-phase protocol in which all children are initially subjected to a transient otoacoustic emissions test (TOAE). Children presenting risk factors associated with auditory neuropathy were always given brainstem auditory evoked potentials (BAEP).
The patients identified as having severe hyperbilirubinaemia in the neonatal period numbered 109 (0.5 %) and 96 of these (88.07 %) passed the otoacoustic emissions test at the first attempt and 13 (11.93 %) did not; 11 of the 13 children in whom the otoacoustic emissions test was repeated passed it successfully. The 2 children who failed to pass the otoacoustic emissions test has normal BAEP results; 3 (2.75 %) of the newborn infants who passed the TOAE test did not pass the BAEP.
Hyperbilirubinaemia values previously considered safe may harm the hearing system and give rise to isolated problems in auditory processing without being associated with other signs of classical kernicterus. Our results show that hyperbilirubinaemia-related auditory neuropathy reveals changes over time in the audiometric outcomes.
高胆红素血症是一种已被证实与感音神经性听力损失相关的新生儿危险因素。高浓度的未结合胆红素使新生儿面临遭受毒性作用的风险，包括听力减退。
回顾新生儿筛查结果，这些结果将病理性高胆红素血症诊断作为基于耳声发射和诱发电位的普通人群听力损失早期检测方案的一部分。
对2002年至2006年间筛查的21590名新生儿进行回顾性研究。定义病理性高胆红素血症的选择标准为早产儿胆红素浓度超过14mg/dL，足月儿超过20mg/dL。通用新生儿听力筛查计划是一个两阶段方案，所有儿童最初都要接受瞬态耳声发射测试（TOAE）。存在与听神经病相关危险因素的儿童总是要接受脑干听觉诱发电位（BAEP）检查。
新生儿期被确定为患有严重高胆红素血症的患者有109名（0.5%），其中96名（88.07%）首次通过耳声发射测试，13名（11.93%）未通过；在重复进行耳声发射测试的13名儿童中，11名成功通过。未通过耳声发射测试的2名儿童BAEP结果正常；通过TOAE测试的新生儿中有3名（2.75%）未通过BAEP。
以前认为安全的高胆红素血症值可能会损害听力系统，并在听觉处理方面引发孤立问题，而不伴有其他典型核黄疸体征。我们的结果表明，与高胆红素血症相关的听神经病在听力测量结果中随时间会出现变化。
