Schade Götz
Univ. HNO-Klinik Bonn, Deutschland.
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2008;7:Doc05. Epub 2010 Oct 7.
The universal newborn hearing screening (UNHS) is currently spreading in Germany, as well, even though there can be no talk of a comprehensive establishment. The introduction of UNHS in several federal states such as Hamburg, Hessen, and Schleswig-Holstein can be ascribed to the personal commitment of individual pediatric audiologists. Apart from the procurement of the screening equipment and the training of the staff responsible for the examination of the newborns, the tracking, i.e. the follow-up on children with conspicuous test results, is of utmost importance. This involves significant administration effort and work and is subject to data protection laws that can differ substantially between the various federal states. Among audiologists, there is consensus that within the first three months of a child's life, a hearing loss must be diagnosed and that between the age of 3 and 6 months, the supply of a hearing aid must have been initiated. For this purpose, screening steps 1 (usually a TEOAE measurement) and 2 (AABR testing) need to be conducted in the maternity hospital. The follow-up of step 1 then comprises the repetition of the TEOAE- and AABR measurement for conspicuous children by a specialized physician. The follow-up of step 2 comprises the confirmatory diagnostics in a pediatric audiological center. This always implies BERA diagnostics during spontaneous sleep or under sedation. The subsequent early supply of a hearing aid should generally be conducted by a (pediatric) acoustician specialized on children.
新生儿听力普遍筛查(UNHS)目前在德国也在推广,尽管还谈不上全面实施。在汉堡、黑森州和石勒苏益格-荷尔斯泰因州等几个联邦州引入UNHS可归因于个别儿科听力学家的个人努力。除了采购筛查设备和培训负责新生儿检查的工作人员外,追踪,即对检查结果异常的儿童进行随访,至关重要。这涉及大量的行政工作,并且受不同联邦州差异很大的数据保护法的约束。听力学家们一致认为,必须在儿童出生后的头三个月内诊断出听力损失,并且在3至6个月大时必须开始提供助听器。为此,需要在妇产医院进行筛查步骤1(通常是TEOAE测量)和步骤2(AABR测试)。步骤1的随访包括由专科医生对检查结果异常的儿童重复进行TEOAE和AABR测量。步骤2的随访包括在儿科听力中心进行确诊诊断。这通常意味着在自然睡眠或镇静状态下进行脑干听觉诱发电位(BERA)诊断。随后的助听器早期供应一般应由专门从事儿童工作的(儿科)听力专家进行。