Poonual Watcharapol, Navacharoen Niramon, Kangsanarak Jaran, Namwongprom Sirianong
J Med Assoc Thai. 2017 Feb;100(2):197-206.
To determine the outcome of early identification and intervention of hearing loss children.
An analytic prospective study. All neonates were screened with TEOAE/ABR. All infants were diagnosed and started early intervention at sixth month and followed for hearing and developmental evaluation until eighteen months of age.
Three thousand one hundred twenty neonates underwent hearing screening tests. One hundred and three infants had abnormal of 6 months of age and were diagnosed with congenital hearing loss (89 mild hearing loss, 12 moderate hearing loss, 1 moderate-severe hearing loss and 1 profound hearing loss). They received early intervention (8 hearing aid fitting (0.3%), 103 auditory training (3.3%), 103 counseling (3.3%) and 103 combine (3.3%) at 6 months of age). During follow up, eighty nine infants who had abnormal initial hearing tests were found to have normal hearing at eighteen months of age, Only Fourteen infants (0.4%) had permanent hearing loss. There were 7, 5, 1 and 1 infants in the mild, moderate, moderate-severe and profound hearing loss groups. The interventions offered to infants with different levels of hearing impairment were 5 hearing aid fittings (35.7%), 14 auditory training (100%), 14 counseling (100%) and 14 combination of three methods (100%). The development after 12 months follow up in infants with different levels of hearing impairment were 14 auditory improvement (100%), 14 speech improvement (100%) and 5 language improvement (35.7%). The common risk factors ranked in order of frequency are craniofacial anomalies( RR 2.57, 95%CI 1.49-4.43), ototoxic exposure(RR 4.71, 95%CI 1.94-11.46), severe hyperbilirubinemia (RR 2.10, 95%CI 1.08-4.06 ), low APGAR score at 5 minutes (RR 2.42, 95%CI 1.03-5.68) and sepsis (RR 2.02, 95%CI 1.01-4.03).
Continuing evaluation of hearing and development during follow-up is important in children with abnormal hearing tests. Early intervention can prevent acoustic deprivation and improve language development.
确定听力损失儿童早期识别与干预的效果。
一项前瞻性分析研究。所有新生儿均采用瞬态诱发耳声发射（TEOAE）/听性脑干反应（ABR）进行筛查。所有婴儿在6个月时进行诊断并开始早期干预，随后进行听力和发育评估，直至18个月龄。
3120例新生儿接受了听力筛查测试。103例6个月龄婴儿听力异常，被诊断为先天性听力损失（89例轻度听力损失、12例中度听力损失、1例中重度听力损失和1例极重度听力损失）。他们在6个月时接受了早期干预（8例佩戴助听器（0.3%）、103例听觉训练（3.3%）、103例咨询指导（3.3%）和103例综合干预（3.3%））。在随访期间，89例初始听力测试异常的婴儿在18个月龄时听力恢复正常，只有14例婴儿（0.4%）存在永久性听力损失。轻度、中度、中重度和极重度听力损失组分别有7例、5例、1例和1例婴儿。针对不同听力损伤程度婴儿的干预措施包括5例佩戴助听器（35.7%）、14例听觉训练（100%）、14例咨询指导（100%）和14例三种方法综合干预（100%）。随访12个月后，不同听力损伤程度婴儿的改善情况为：14例听觉改善（100%）、14例言语改善（100%）和5例语言改善（35.7%）。常见危险因素按发生频率排序依次为颅面畸形（相对危险度RR 2.57，95%置信区间CI 1.49 - 4.43）、耳毒性物质暴露（RR 4.71，95%CI 1.94 - 11.46）、重度高胆红素血症（RR 2.10，95%CI 1.08 - 4.06）、5分钟时阿氏评分低（RR 2.42，95%CI 1.03 - 5.68）和败血症（RR 2.02，95%CI 1.01 - 4.03）。
对于听力测试异常的儿童，随访期间持续进行听力和发育评估很重要。早期干预可预防听觉剥夺并改善语言发育。
