Martínez-Cruz Carlos F, Poblano Adrián, García-Alonso Themann Patricia
Department of Pediatric Follow-up, National Institute of Perinatology, "Dr. Isidro Espinosa de los Reyes", Mexico City, Mexico.
Laboratory of Cognitive Neurophysiology, National Institute of Rehabilitation, Mexico City, Mexico.
Int J Pediatr Otorhinolaryngol. 2017 Oct;101:235-240. doi: 10.1016/j.ijporl.2017.08.022. Epub 2017 Aug 29.
Newborns from Neonatal intensive care units (NICU) are at high-risk for sensorineural hearing loss (SNHL) a follow-up is needed for early diagnosis and intervention. Our objective here was to describe the features and changes of SNHL at different periods during a follow-up of almost 20 years.
Risk factors for SNHL during development were analyzed. The audiological examination included: Brainstem auditory evoked potentials (BAEP), and Transient evoked otoacoustic emissions (TEOAE). At birth; tonal audiometry (between 125 and 8000 Hz), and tympanometry were performed at 5, 10, 15, and 20 years of age.
Sixty-five percent of cases presented bilateral absence of BAEP. At 5 years of age, the most frequent SNHL level was severe (42.5%), followed by moderate (22.5%), and profound level (20%), in all cases, the SNHL was symmetrical with a predominance of lesion for the high frequencies. Exchange transfusion was associated with a higher degree of SNHL (OR = 6.00, CI = 1.11-32.28, p < 0.02). In 55%, SNHL remained stable, but in 40% of the cases it was progressive. At the end of the study six cases with moderate loss progressed to the severe level and seven cases with severe level progressed to profound.
Forty percent of infants with SNHL discharged from NICU may present a progression in the hearing loss. Exchange transfusion was associated with a higher degree of SNHL. NICU graduates with SNHL merit a long-term audiological follow-up throughout their lifespan.
新生儿重症监护病房(NICU)的新生儿存在感音神经性听力损失(SNHL)的高风险,需要进行随访以实现早期诊断和干预。我们的目的是描述近20年随访期间不同阶段SNHL的特征和变化。
分析发育过程中SNHL的危险因素。听力检查包括:脑干听觉诱发电位(BAEP)和瞬态诱发耳声发射(TEOAE)。出生时;在5、10、15和20岁时进行纯音听力测试(125至8000赫兹之间)和鼓室图检查。
65%的病例表现为双侧BAEP缺失。在5岁时,最常见的SNHL程度为重度(42.5%),其次是中度(22.5%)和极重度(20%),在所有病例中,SNHL是对称的,高频病变占主导。换血与更高程度的SNHL相关(OR = 6.00,CI = 1.11 - 32.28,p < 0.02)。55%的SNHL保持稳定,但40%的病例呈进行性发展。在研究结束时,6例中度听力损失的病例进展为重度,7例重度听力损失的病例进展为极重度。
从NICU出院的SNHL婴儿中有40%可能出现听力损失进展。换血与更高程度的SNHL相关。患有SNHL的NICU毕业生在其一生中都需要进行长期的听力随访。