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新生儿听力筛查:我们已取得的成果及有待改进之处。

Neonatal hearing screening: what we have achieved and what needs to be improved.

作者信息

Nikolopoulos Thomas P

机构信息

Department of Otorhinolaryngology, 125 Anakous Street, 14342 Athens, Greece.

出版信息

Int J Pediatr Otorhinolaryngol. 2015 May;79(5):635-7. doi: 10.1016/j.ijporl.2015.02.010. Epub 2015 Feb 16.

DOI:10.1016/j.ijporl.2015.02.010
PMID:25758196
Abstract

OBJECTIVE

To review the literature on neonatal hearing screening and its weaknesses with regard to missed follow-ups and delayed diagnosis and management.

RESULTS

The implementation of newborn hearing screening programs has indeed lowered the mean age of hearing loss identification and many deaf children are now diagnosed at an early age of some months. However, the present collection of 32 studies published in the International Journal of Pediatric Otorhinolaryngology revealed that late-onset deafness, auditory neuropathy, and the alarming percentage of newborns who fail the initial testing and then are lost to follow-up are major weaknesses of neonatal hearing screening programs. It seems that parents may be satisfied of hearing screening but in a significant percentage of them do not bring their children for follow-up or further testing due to phycho-social or other reasons. In addition, the same collection revealed that socioeconomic factors may have a significant influence on the effectiveness of hearing screening programs in the developed and developing countries, where improvements in health care politics, tracking system and public awareness is crucial for successful program implementation.

CONCLUSIONS

Neonatal hearing screening programs have changed the whole picture of congenital deafness as age identification has significantly fallen with a very positive effect on timely management. However, the selected and proposed 32 related articles published in the International Journal of Pediatric Otorhinolaryngology show that there are still serious weakness in the neonatal hearing screening that need improvements in order to achieve an efficient and cost-effective system of deafness identification.

摘要

目的

回顾关于新生儿听力筛查及其在漏诊随访、延迟诊断和管理方面的不足的文献。

结果

新生儿听力筛查项目的实施确实降低了听力损失确诊的平均年龄,现在许多失聪儿童在几个月大时就能被早期诊断。然而,发表在《国际小儿耳鼻咽喉科杂志》上的32项研究表明,迟发性耳聋、听神经病,以及初次检测未通过随后失访的新生儿比例惊人,这些都是新生儿听力筛查项目的主要不足。似乎家长可能对听力筛查感到满意,但由于心理社会或其他原因,很大一部分家长不会带孩子进行随访或进一步检测。此外,这些研究还表明,社会经济因素可能对发达国家和发展中国家听力筛查项目的有效性产生重大影响,改善医疗保健政策、追踪系统和公众意识对于项目的成功实施至关重要。

结论

新生儿听力筛查项目改变了先天性耳聋的整体状况,因为确诊年龄显著降低,对及时管理产生了非常积极的影响。然而,发表在《国际小儿耳鼻咽喉科杂志》上的32篇相关文章表明,新生儿听力筛查仍存在严重不足,需要改进以建立一个高效且具有成本效益的耳聋诊断系统。

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