Tasci Y, Muderris I I, Erkaya S, Altinbas S, Yucel H, Haberal A
Ankara Etlik Zubeyde Hanim Maternity and Women's Health Research Hospital, Department of Obstetrics and Gynecology, Etlik, Ankara, Turkey.
Child Care Health Dev. 2010 May;36(3):317-22. doi: 10.1111/j.1365-2214.2009.01029.x. Epub 2009 Dec 10.
Universal neonatal hearing screening programmes are encouraged to define and manage hearing loss in early ages of life. The aim of this study is to introduce our 14-month three-step hearing screening programme results with 16 975 births in Turkey.
In healthy neonates, Transient Evoked Otoacoustic Emission (TEOAE) is served as the initial screening in the first day of life. In newborns that did not meet pass criteria TEOAE was repeated in 10-day period. If the second test was 'refer' again, the screening was completed with auditory brainstem response (ABR). Additionally, ABR was performed for the neonates with neonatal intensive care unit (NICU) requirement and at high audiologic risk. Neonates who failed the screening test with ABR were referred for further evaluation.
A total of 15 323 newborns and 1652 NICU infants were tested. The screening coverage was 94.4%; 14 521 neonates (94.7%) passed the first screening step (TEOAE), while 802 (5.2%) neonate failed. In total, 322 (40.1%) of the neonates out of 802 was subjected to the second TEOAE after 10 days have failed and ABR was applied. From the neonates participated the third step (ABR) totalling 1974, 43 (2.17%) of neonates obtained a 'refer' response. Out of these 43 neonates, 17 neonates were (39.5%) NICU infants. From the 43 neonates, 38 cases (88.4%) were found to have hearing impairment. The false-positive rate for first step screening with TEOAE was 4.9%; second step with TEOAE was 1.85% and for ABR was 0.25%.
It is apparent that three step national hearing screening programme which has been applied for the latest years in Turkey is an accurate and non-invasive method to determine the congenital hearing loss. In the future, screening programmes could be rearranged with two steps as initial with TEOAE and retest with ABR and the coverage of the screening programme can be extended.
鼓励实施新生儿听力普遍筛查项目，以便在生命早期对听力损失进行界定和管理。本研究旨在介绍我们在土耳其针对16975例出生婴儿开展的为期14个月的三步听力筛查项目结果。
对于健康新生儿，瞬态诱发耳声发射（TEOAE）作为出生第一天的初次筛查。未通过TEOAE筛查标准的新生儿在10天内重复进行该检查。如果第二次检查结果仍为“转诊”，则通过听性脑干反应（ABR）完成筛查。此外，对有新生儿重症监护病房（NICU）需求和高听力风险的新生儿进行ABR检查。ABR筛查未通过的新生儿被转诊进行进一步评估。
共对15323例新生儿和1652例NICU婴儿进行了检测。筛查覆盖率为94.4%；14521例新生儿（94.7%）通过了第一步筛查（TEOAE），而802例（5.2%）新生儿未通过。在802例未通过的新生儿中，共有322例（40.1%）在10天后进行了第二次TEOAE检查，随后接受了ABR检查。在参与第三步（ABR）检查的1974例新生儿中，43例（2.17%）新生儿的检查结果为“转诊”。在这43例新生儿中，17例（39.5%）为NICU婴儿。在这43例新生儿中，38例（88.4%）被发现有听力障碍。TEOAE第一步筛查的假阳性率为4.9%；TEOAE第二步筛查的假阳性率为1.85%，ABR筛查的假阳性率为0.25%。
显然，土耳其近年来实施的三步国家听力筛查项目是一种准确且无创的先天性听力损失检测方法。未来，筛查项目可重新安排为两步，第一步采用TEOAE，第二步采用ABR进行复测，同时扩大筛查项目的覆盖范围。
