Cianfrone F, Mammarella F, Ralli M, Evetovic V, Pianura C M, Bellocchi G
Department of Otolaryngology, San Camillo Forlanini Hospital, Rome, Italy.
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy.
J Neonatal Perinatal Med. 2018;11(1):87-92. doi: 10.3233/NPM-181744.
Universal newborn hearing screening (UNHS) aims to identify hearing loss in the early postnatal period; prompt detection of bilateral or unilateral hearing loss is mandatory for timely intervention.
This retrospective study reports the results of the first two years of a UNHS program on 4,719 newborns in a large public Italian hospital. Screening was divided into two levels: automated transient otoacoustic emissions were used for first level; automated auditory brainstem response for second level. Second level included children with a "refer" response at first level and babies with a family history for hearing loss or other risk factors. Hearing loss diagnosis was made using clinical auditory brainstem response.
During first level, 254 (5.4% ) newborns were "refer". At retest, 130 (51.1% ) babies were PASS and 48 (18.8% ) were "refer". 76 babies dropped out (29.9% ). 146 babies (3.1% ) were referred to the second level: 48 for a "refer" response at first level and 98 for a PASS response but potential hearing loss due to risk factors. 24 babies dropped out (16.4% ). Out of 122 newborns tested in the second level, 105 (86.1% ) had a PASS response and 17 (13.9% ) were "refer". Our screening protocol identified 7 (0.14% ) babies with profound hearing loss; 5 had unilateral and 2 had bilateral hearing loss. 2 babies dropped out at diagnostic level (11.8% ).
A correct and early diagnosis of hearing loss is mandatory to prevent permanent consequences; the spread of hearing screening programs is the optimal solution to reach this goal.
新生儿听力普遍筛查（UNHS）旨在在出生后早期识别听力损失；及时发现双侧或单侧听力损失对于及时干预至关重要。
这项回顾性研究报告了意大利一家大型公立医院针对4719名新生儿开展的UNHS项目头两年的结果。筛查分为两个阶段：第一阶段使用自动瞬态耳声发射；第二阶段使用自动听性脑干反应。第二阶段包括在第一阶段有“转诊”反应的儿童以及有听力损失家族史或其他风险因素的婴儿。使用临床听性脑干反应进行听力损失诊断。
在第一阶段，254名（5.4%）新生儿被“转诊”。在复测时，130名（51.1%）婴儿通过，48名（18.8%）被“转诊”。76名婴儿退出（29.9%）。146名婴儿（3.1%）被转诊至第二阶段：48名因第一阶段“转诊”反应，98名因通过反应但存在风险因素导致潜在听力损失。24名婴儿退出（16.4%）。在第二阶段接受测试的122名新生儿中，105名（86.1%）通过反应，17名（13.9%）被“转诊”。我们的筛查方案识别出7名（0.14%）患有重度听力损失的婴儿；5名单侧听力损失，2名双侧听力损失。2名婴儿在诊断阶段退出（11.8%）。
对听力损失进行正确和早期诊断对于预防永久性后果至关重要；听力筛查项目的推广是实现这一目标的最佳解决方案。
