Unlu Ilhan, Guclu Ender, Yaman Huseyin
Duzce University Medical Faculty, Department of ENT, Duzce, Turkey.
Auris Nasus Larynx. 2015 Jun;42(3):199-202. doi: 10.1016/j.anl.2014.10.005. Epub 2014 Nov 5.
The aim of this study was to investigate the referral rate and when automatic Auditory Brainstem Response (aABR) should be used for newborn hearing screening.
The present study enrolled 2933 healthy full-term infants and 176 infants with perinatal risk factors. Hearing screening using Transient Evoked Otoacoustic Emissions (TEOAEs) was performed in newborns for the first time 5 days after birth except perinatal risk factors infants. The TEOAE was repeated to neonates failing to pass at the 15th day after birth. Neonates failing to pass the second TEOAE, repeated the test again at the 30th day after birth. Neonates failing to pass the third TEOAE were referred for the second stage screening using aABR. In addition, neonates with risk factors were tested with aABR directly.
In this research, 85 (2.9%) infants who could not pass the TEOAE and 176 infants exposed to perinatal risk factors, underwent the aABR test. In the aABR, 14 (7.9%) of 176 infants exposed to perinatal risk factors and 10 (11.7%) of 85 infants who could not pass the TEOAE failed to pass. As a result, hearing loss was detected in only 10 (0.34%) of 2933 healthy full-term infants.
TEOAE should be performed at least twice in healthy full-term infants before aABR, because aABR is to be performed by specially trained personnel and takes a long time. In view of these results, it is our opinion that infants without perinatal risk factors should undergo TEOAE screening test and infants who did not pass control screening tests and have perinatal risk factors should absolutely undergo aABR test. But it should be remembered that TEOAE can cause a problem to miss auditory neuropathy in infants without perinatal risk factors.
本研究旨在调查转诊率以及何时应使用自动听性脑干反应（aABR）进行新生儿听力筛查。
本研究纳入了2933名健康足月儿和176名有围产期危险因素的婴儿。除有围产期危险因素的婴儿外，出生后5天首次对新生儿进行瞬态诱发耳声发射（TEOAE）听力筛查。对出生后第15天未通过TEOAE的新生儿重复进行该检查。未通过第二次TEOAE的新生儿在出生后第30天再次进行检查。未通过第三次TEOAE的新生儿被转诊至第二阶段使用aABR进行筛查。此外，对有危险因素的新生儿直接进行aABR检查。
在本研究中，85名（2.9%）未通过TEOAE的婴儿和176名有围产期危险因素的婴儿接受了aABR检查。在aABR检查中，176名有围产期危险因素的婴儿中有14名（7.9%）未通过，85名未通过TEOAE的婴儿中有10名（11.7%）未通过。结果，在2933名健康足月儿中仅检测到10名（0.34%）听力损失。
在健康足月儿中，应在进行aABR之前至少进行两次TEOAE检查，因为aABR需要由经过专门培训的人员进行，且耗时较长。鉴于这些结果，我们认为无围产期危险因素的婴儿应接受TEOAE筛查，未通过对照筛查且有围产期危险因素的婴儿应绝对接受aABR检查。但应记住，TEOAE可能会导致漏诊无围产期危险因素婴儿的听觉神经病。
