Gopineti Lalitha, Paulpillai Mane, Rosenquist Andrea, Van Bergen Andrew H
Pediatric Cardiology, Children's Mercy Hospitals and Clincs, Wichita, USA.
Pediatric Cardiology, Advocate Christ Medical Center, Oak Lawn, USA.
Cureus. 2020 Jan 4;12(1):e6566. doi: 10.7759/cureus.6566.
Background Children with congenital heart disease (CHD) are at increased risk of neurodevelopmental deficits, and the presence of sensorineural hearing loss (SNHL) may further lead to poor language skills acquisition and speech delays. Prevalence of SNHL in the general pediatric population is estimated to be 0.2% at birth to 0.35% during adolescence. Very few studies have attempted to estimate SNHL prevalence in children who have undergone congenital heart surgery. Methods This retrospective study aimed to estimate SNHL prevalence in children who underwent congenital heart surgery in our institution and were followed up in our high-risk pediatric cardiology clinics for four years from 2009 to 2013. Data were collected on demographics, preoperative variables, surgical variables, and post-operative variables. Results SNHL prevalence in asymptomatic, palliated/repaired CHD patients followed in our high-risk clinics and undergoing routine surveillance was 11.6% (20 of 172 patients with hearing impairment). SNHL prevalence was not statistically higher in single-ventricle patients (17.2%) compared to biventricular patients (14.7%). Inotropic score in the first 24 hours of postoperative period (p=0.05), lowest arterial PaO2 (p=0.003), duration of Lasix drip (p=0), and bolus dose in days (p=0.03) were all found to be statistically significant in the hearing-impaired group. However, using logistic regression, we identified no statistically significant predictors for hearing loss. Conclusion The results suggest the need for routine audiology screening of all patients with complex CHD, especially those who have undergone neonatal cardiac repair/palliation at less than one year of age, irrespective of risk factors.
先天性心脏病(CHD)患儿发生神经发育缺陷的风险增加,而感音神经性听力损失(SNHL)的存在可能进一步导致语言技能习得不良和言语发育迟缓。据估计,普通儿科人群中SNHL的患病率在出生时为0.2%,在青春期为0.35%。很少有研究试图估计接受先天性心脏手术的儿童中SNHL的患病率。方法:这项回顾性研究旨在估计2009年至2013年在我院接受先天性心脏手术并在我院高危儿科心脏病诊所随访四年的儿童中SNHL的患病率。收集了人口统计学、术前变量、手术变量和术后变量的数据。结果:在我们的高危诊所随访并接受常规监测的无症状、姑息性/修复性CHD患者中,SNHL患病率为11.6%(172例听力障碍患者中有20例)。单心室患者(17.2%)的SNHL患病率与双心室患者(14.7%)相比,在统计学上没有更高。术后第1个24小时的血管活性药物评分(p = 0.05)、最低动脉血氧分压(p = 0.003)、速尿滴注持续时间(p = 0)和每日推注剂量(p = 0.03)在听力受损组中均具有统计学意义。然而,使用逻辑回归分析,我们未发现听力损失的统计学显著预测因素。结论:结果表明,需要对所有复杂CHD患者进行常规听力筛查,尤其是那些在1岁前接受新生儿心脏修复/姑息治疗的患者,无论其风险因素如何。