Shukla Anirudh, Hosamani Pavan
Medical College Colony, NSCB Medical College Jabalpur, tilwara road, Jabalpur, Madhya Pradesh 482003 India.
SNMC Bagalkot APMC Yard Bagalkot, bagalkot, Karnataka 587103 India.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):593-599. doi: 10.1007/s12070-020-02356-0. Epub 2021 Feb 8.
Hearing is one of the very important five senses. The most important period for language and speech development is generally regarded as the first three years of life. For the past 20 years, electrophysiological methods are most commonly used which include otoacoustic emission (OAE) and auditory brain stem response (ABR). Regardless of the screening method chosen, hearing screening, though critical, is only the first stage of a comprehensive early intervention plan. Screening alone is useless unless appropriate diagnostic testing services and high quality amplification and rehabilitation services are in place and are implemented in a timely fashion. Early screening does not substitute for further periodic childhood hearing screening. To screen the newborns which are high risk or born to high risk mother using optoacoustic emission and auditory brain stem response (ABR). Also to co-relate hearing loss with various risk factors involved in pre-natal, natal and post-natal. Methods: we conducted a prospective study with 100 high risk newborns in a tertiary care centre. First, all babies were screened using transient evoked otoacoustic emission(TEOAE). Babies not responsive in this were screening again after 14 days using TEOAE. Babies who were reffered to during this screening with TEOAE were subjected to further screening with ABR to confirm the diagnosis. Out of 100 infants, 73% infants passed first screening by TEOAE whereas 27% failed. those 27 infants which failed were screened after 14 days, of them, 3 (11.1%) infants failed the second screening and were referred. Further screening with BERA was conducted for 3 children who failed the second screening by TEOAE. Of them 1 (33.3%) infant passed the BERA whereas 2 infants failed. Test of significance observed no statistically significant association of OAE with prenatal risk factors in present study (>0.05). whereas shows highly statistically significant association of OAE with natal (birth asphyxia, NICU admission and Apgar score at 5 minutes) and post natal (viral/bacterial infections) risk factors (<0.01). New born hearing screening is important in recognizing babies born with congenital hearing loss. The screening protocol using OAE can be used in a two staged screening. This study aimed to detect the congenital hearing loss as early as possible and its association with various risk factors in high risk newborns and role of OAE and ABR as a screening tool. Timely diagnosis and intervention for hearing loss are not the reality throughout India. The population and professionals involved in childcare should be made aware of the impact of hearing loss, this could result in better outcome of neonatal hearing screening programs.
听力是非常重要的五种感官之一。语言和言语发展的最重要时期通常被认为是生命的头三年。在过去20年中,最常用的是电生理方法,包括耳声发射(OAE)和听性脑干反应(ABR)。无论选择何种筛查方法,听力筛查虽然至关重要,但只是全面早期干预计划的第一阶段。除非有适当的诊断测试服务以及高质量的听力放大和康复服务并及时实施,仅靠筛查是没有用的。早期筛查不能替代儿童期进一步的定期听力筛查。使用耳声发射和听性脑干反应(ABR)对高危新生儿或高危母亲所生的新生儿进行筛查。同时将听力损失与产前、产时和产后涉及的各种风险因素相关联。方法:我们在一家三级护理中心对100名高危新生儿进行了一项前瞻性研究。首先,所有婴儿均使用瞬态诱发耳声发射(TEOAE)进行筛查。对此无反应的婴儿在14天后再次使用TEOAE进行筛查。在此TEOAE筛查过程中被转诊的婴儿接受ABR进一步筛查以确诊。在100名婴儿中,73%的婴儿通过了TEOAE首次筛查,而27%的婴儿未通过。那27名未通过的婴儿在14天后进行了筛查,其中3名(11.1%)婴儿第二次筛查未通过并被转诊。对3名TEOAE第二次筛查未通过的儿童进行了脑干电反应测听(BERA)进一步筛查。其中1名(33.3%)婴儿通过了BERA,而2名婴儿未通过。在本研究中,显著性检验未观察到OAE与产前风险因素之间有统计学显著关联(>0.05)。而显示OAE与产时(出生窒息、入住新生儿重症监护病房和5分钟阿氏评分)和产后(病毒/细菌感染)风险因素之间有高度统计学显著关联(<0.01)。新生儿听力筛查对于识别先天性听力损失的婴儿很重要。使用OAE的筛查方案可用于两阶段筛查。本研究旨在尽早检测高危新生儿中的先天性听力损失及其与各种风险因素的关联以及OAE和ABR作为筛查工具的作用。在印度全国范围内,听力损失的及时诊断和干预并非现实情况。参与儿童保育的人群和专业人员应了解听力损失的影响,这可能会使新生儿听力筛查项目取得更好的结果。