Huang Lihui, Cai Zhenghua, Zhang Hua, Peng Shichun, Wu Dongsheng, Wang Lei, Fan Weiping, Yang Rulan, Huang Yan, Luo Xia, Tu Lin, En Hui, Qi Beier, Zhen Yong, Han Demin
Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Ministry of Education.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009 Aug;23(16):737-42.
To investigate the feasibility of universal newborn hearing screening in countryside in order to provide reliable evidence in launching this program all over the countryside of China.
Subjects were 12,638 infants who were born in 9 counties from Jan 2004 to Dec 2005. TEOAE was used for the fast hearing screening. Infants were screened on the 2-7 days after the birth. The re-screening was conducted in 4-6 weeks if failed in the initial screening, and follow-up were provided continually if they also failed in the re-screening.
Ten thousand eight hundred and forty-five of 12,638 (85.8%) were screened including 9,963 (91.9%) normal newborns and 882 (8.1%) newborns with high-risk. Seven thousand four hundred and fifty (68.7%) newborns passed the initial screening, and 3,395 (31.3%) people failed. One thousand seven hundred and ninety-three (14.2%) infants were refused to be screened. Only 2,536 (74.7%) were re-screened on time, and 859 (25.3%) did not receive re-screening. One hundred and twenty were failed in the re-screening or first screening, and 79 (65.8%) of them received diagnostic assessment. Among the infants received diagnostic assessment, 6 (7.6%) cases were found to have profound hearing loss in both ears, 9 (11.4%) cases were found to be severe hearing loss (7 in both ears and 2 in single ear), 11 (13.9%) cases were found to be moderate hearing loss (5 in both ear and 6 in single ear), 26 (32.9%) were found to have slight hearing loss (11 in both ear and 15 in single ears), and 27 (34.2%) were normal. Fifty-two infants were diagnosed as hearing loss with a prevalence of congenital hearing loss (in binaural and monaural) of 0.5% (52/10845) and a prevalence of bilateral hearing loss of 0.3% (29/10845). A prevalence of congenital hearing loss was 0.2% (22/9,963) in well infants and 3.4% (30/882) in high risk infants. Among the 13 cases of children with severe and profound hearing loss in both ears children, 8 (61.5%) cases were fitted with hearing aids and 1 (7.7%) case was implanted with cochlear implants.
It is necessary and feasible to conduct hearing screening program in the rural area. However, the suitable model to perform the program in the countryside needs to be set up as soon as possible in order to get more poor infants to participate into the hearing screening program for free and increase the screening rate.
探讨农村地区开展新生儿听力普遍筛查的可行性，为在全国农村推广该项目提供可靠依据。
选取2004年1月至2005年12月在9个县出生的12638名婴儿作为研究对象。采用瞬态诱发耳声发射（TEOAE）进行快速听力筛查。婴儿在出生后2至7天进行筛查。初筛未通过者在4至6周进行复筛，复筛仍未通过者继续进行随访。
12638名婴儿中，10845名（85.8%）接受了筛查，其中正常新生儿9963名（91.9%），高危新生儿882名（8.1%）。7450名（68.7%）新生儿初筛通过，3395名（31.3%）未通过。1793名（14.2%）婴儿拒绝筛查。仅2536名（74.7%）按时进行了复筛，859名（25.3%）未接受复筛。复筛或初筛未通过者120名，其中79名（65.8%）接受了诊断性评估。在接受诊断性评估的婴儿中，双耳极重度听力损失6例（7.6%），重度听力损失9例（11.4%）（双耳7例，单耳2例），中度听力损失11例（13.9%）（双耳5例，单耳6例），轻度听力损失26例（32.9%）（双耳11例，单耳15例），正常27例（34.2%）。52名婴儿被诊断为听力损失，先天性听力损失（双耳和单耳）患病率为0.5%（52/10845），双侧听力损失患病率为0.3%（29/10845）。正常婴儿先天性听力损失患病率为0.2%（22/9963），高危婴儿为3.4%（30/882）。在13例双耳重度和极重度听力损失儿童中，8例（61.5%）佩戴了助听器，1例（7.7%）植入了人工耳蜗。
在农村地区开展听力筛查项目是必要且可行的。然而，需要尽快建立适合农村地区的筛查模式，以使更多贫困婴儿免费参与听力筛查项目，提高筛查率。
