Department of ENT-HNS, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Kathmandu Univ Med J (KUMJ). 2020 Apr-Jun;18(70):160-164.
Background Hearing loss among neonates is one of the important health issue in pediatric population which may remain unnoticed until the child reaches a certain age. The importance of universal early screening, diagnosis and intervention in reducing the negative impact of congenital hearing loss has been described all over the world. Objective To observe the outcome of hearing screening by Automated Auditory Brainstem Response (AABR) in newborns delivered in Dhulikhel Hospital and neonates admitted in an intensive care unit (NICU) of Dhulikhel Hospital. Method A prospective study was done in neonates who were born at Dhulikhel Hospital, Kathmandu University Hospital from February 15th, 2017 to October 30th, 2019. AABR was used for their hearing assessment within 24 hours of birth and again at about 6 weeks of age in those neonates who failed the initial test. All the neonates admitted in NICU were studied regarding the risk factors based on Joint committee on Infant Hearing. Those who failed the test for the second time were referred for detailed audiological diagnostic work up. Result The screening rate was 92.6% of the total deliveries. A total of 5517 neonates comprising of 2800 males and 2717 females were screened from total deliveries of 5956 neonates in the study period. Among them, NICU (sick) babies were 422 (7.7%) and well babies were 5095 (92.3%). Out of them, 1675 failed the test in the first screening and 374 failed in the second screening. So, the total number of referred babies in second screening was 6.7% (374) out of 5517 screened. Amongst them, well babies were 6.59% (336), out of 5095 screened and sick babies were 9% (38) out of 422 screened. Low birth weight and prematurity were found to be the commonest risk factor present among them, followed by the use of ototoxic medications, hyperbilirubinemia and prolonged use of mechanical ventilation. Conclusion Automated Auditory Brainstem Response (AABR) is a very useful tool for hearing screening which should preferably be done in all the neonates where possible. It should be done within one month of life and those with confirmed hearing loss should receive early appropriate intervention for better hearing in future.
新生儿听力损失是儿科人群中的一个重要健康问题，如果不及时发现，可能会持续到孩子一定年龄。全世界都已经描述了普遍进行早期筛查、诊断和干预的重要性，以降低先天性听力损失的负面影响。目的：观察在 Dhulikhel 医院分娩的新生儿和 Dhulikhel 医院新生儿重症监护病房（NICU）中新生儿通过自动听性脑干反应（AABR）进行听力筛查的结果。方法：对 2017 年 2 月 15 日至 2019 年 10 月 30 日在加德满都大学医院 Dhulikhel 医院出生的新生儿进行前瞻性研究。在出生后 24 小时内使用 AABR 对其进行听力评估，如果初次测试失败，在大约 6 周龄时再次进行测试。根据联合婴儿听力委员会，对所有入住 NICU 的新生儿进行基于风险因素的研究。如果第二次测试失败，将被转介进行详细的听力诊断检查。结果：总分娩人数的筛查率为 92.6%。在研究期间，共有 5956 名新生儿中，有 5517 名新生儿进行了筛查，其中包括 2800 名男性和 2717 名女性。其中，NICU（患病）婴儿 422 名（7.7%），健康婴儿 5095 名（92.3%）。在第一次筛查中，有 1675 名婴儿测试失败，第二次筛查中有 374 名婴儿测试失败。因此，第二次筛查中转诊的婴儿总数为 6.7%（374 名），占筛查人数的 5517 名。其中，健康婴儿占 6.59%（336 名），占筛查人数的 5095 名，患病婴儿占 9%（38 名），占筛查人数的 422 名。体重低和早产是最常见的危险因素，其次是使用耳毒性药物、高胆红素血症和长时间使用机械通气。结论：自动听性脑干反应（AABR）是一种非常有用的听力筛查工具，最好在所有可能的新生儿中进行。它应该在出生后一个月内进行，对确诊有听力损失的婴儿应尽早进行适当的干预，以获得更好的未来听力。
