Mother and Child Department, Neonatology Unit and Section of Neonatal Endocrinology and Dysmorphology, University Hospital of Pisa, Pisa, Italy.
Ital J Pediatr. 2011 Apr 11;37:16. doi: 10.1186/1824-7288-37-16.
The early identification of pre-lingual deafness is necessary to minimize the consequences of hearing impairment on the future communication skills of a baby. According to the most recent international guidelines the deafness diagnosis must occur before the age of three months and the prosthetic-rehabilitative treatment with a traditional hearing aid should start within the first six months. When a Cochlear implant becomes necessary, the treatment should start between the age of 12 months and 18 months. The only way to diagnose the problem early is the implementation of universal neonatal audiological screening programs. Transient evoked otoacoustic emissions (TEOAE) is the most adequate test because it's accurate, economic and of simple execution. Automatic auditory brainstem response (AABR) is necessary to identify patients with auditory neuropathy but it is also important to reduce the number of false-positives.The 20-30% of infant hearing impairment is represented by progressive or late-onset hearing loss (HL) so it's also necessary to establish an audiological follow up program, especially in infants at risk.From November 2005 all neonates born in the University hospital of Pisa undergo newborn hearing screening. From 2008 the screening program follows the guidelines for the execution of the audiological screening in Tuscany which have been formulated by our group according to the 2007 JCIH Position Statement and adaptated to our regional reality by a multidisciplinary effort. From November 2005 to April 2009 8113 neonates born in the Neonatal Unit of Santa Chiara Hospital (Pisa) have undergone newborn hearing screening. 7621 neonates (93.9%) without risk factors executed only the TEOAE test. 492 (6.1%) neonates had audiological risk factors and thus underwent TEOAE and AABR. 84 patients (1,04%) failed both TEOAE and AABR tests. 78 of them underwent further investigations. 44 patients resulted false positives (the 0,54% of the screened newborns). 34 neonates (4,2 ‰) had a final diagnosis of hearing impairment. 8 patients (0.99 ‰) had unilateral hearing loss (HL). 26 patients (3,2 ‰) had bilateral hearing impairment.In our screening program the percentage of false-positives was quite low (0.54%) while the incidence of bilateral HL (3.2 ‰) is a little higher than that found in literature reports. In most of our patients premature birth or neonatal suffering represent the main cause of HL.
早期识别语前聋对于将听力损伤对婴儿未来语言交流能力的影响降到最低至关重要。根据最新的国际指南，聋病诊断必须在 3 个月内完成，而传统助听器的修复治疗应在 6 个月内开始。当需要进行人工耳蜗植入时，治疗应在 12 个月至 18 个月之间开始。早期诊断的唯一方法是实施普遍的新生儿听力筛查计划。瞬态诱发耳声发射（TEOAE）是最准确、经济且易于实施的检测方法。自动听性脑干反应（AABR）对于识别听神经病患者很重要，但减少假阳性也很重要。20%至 30%的婴儿听力损失是渐进性或迟发性听力损失（HL），因此还需要建立听力随访计划，尤其是在有听力损失风险的婴儿中。自 2005 年 11 月起，比萨大学医院的所有新生儿都接受新生儿听力筛查。自 2008 年以来，该筛查计划遵循了我们小组根据 2007 年 JCIH 立场声明制定的托斯卡纳执行听力筛查指南，并通过多学科努力适应了我们地区的实际情况。自 2005 年 11 月至 2009 年 4 月，圣克拉拉医院新生儿科的 8113 名新生儿接受了新生儿听力筛查。7621 名（93.9%）无风险因素的新生儿仅接受了 TEOAE 测试。492 名（6.1%）有听力风险因素的新生儿接受了 TEOAE 和 AABR 测试。84 名患者（1.04%）两项测试均未通过。其中 78 名接受了进一步检查。44 名患者结果为假阳性（筛查新生儿的 0.54%）。34 名新生儿（4.2‰）最终诊断为听力障碍。8 名患者（0.99‰）单侧听力损失（HL）。26 名患者（3.2‰）双侧听力受损。在我们的筛查计划中，假阳性率相当低（0.54%），而双侧 HL 的发病率（3.2‰）略高于文献报道。在我们的大多数患者中，早产或新生儿疾病是 HL 的主要原因。
