Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Cleft Palate Craniofac J. 2024 Oct;61(10):1657-1662. doi: 10.1177/10556656231178437. Epub 2023 May 24.
To characterize the onset and prevalence of conductive hearing loss (CHL) in pediatric patients with cleft palate (CP) prior to palatoplasty with an enhanced audiologic protocol.
Retrospective cohort study.
Multidisciplinary cleft and craniofacial clinic at a tertiary care center.
Patients with CP who received audiologic workup pre-operatively. Patients with bilateral permanent hearing loss, expiration prior to palatoplasty, or no pre-operative data were excluded.
Patients with CP born February 2019 to November 2019 who passed newborn hearing screening (NBHS) received audiologic testing at 9 months of age (standard protocol). Patients born December 2019 to September 2020 underwent testing prior to 9 months of age (enhanced protocol).
Age of identification of CHL in patients after implementation of the enhanced audiologic protocol.
The number of patients who passed their NBHS in the standard protocol (n = 14, 54%) and the enhanced protocol (n = 25, 66%) did not differ. Infants who passed their NBHS, but demonstrated hearing loss on subsequent audiologic testing did not differ between enhanced (n = 25, 66%) and standard cohort (n = 14, 54%). Of patients who passed NBHS in the enhanced protocol, 48% (n = 12) had CHL identified by 3 months, and 20% (n = 5) by 6 months of age. With the enhanced protocol, patients who did not undergo additional testing post NBHS significantly dropped from 44.9% (n = 22) to 4.2% (n = 2) ( < .0001).
Even with passed NBHS, CHL is still present for infants with CP pre-operatively. Earlier and more frequent testing for this population is recommended.
通过强化听力学方案,描述腭裂(CP)患儿行腭裂修补术前传导性听力损失(CHL)的发病和流行情况。
回顾性队列研究。
三级医疗中心多学科腭裂和颅面诊所。
接受术前听力学检查的 CP 患者。排除双侧永久性听力损失、腭裂修补术前呼气或无术前数据的患者。
2019 年 2 月至 2019 年 11 月出生且通过新生儿听力筛查(NBHS)的 CP 患儿于 9 月龄时(标准方案)接受听力学检查。2019 年 12 月至 2020 年 9 月出生的患儿在 9 月龄前进行检查(强化方案)。
强化听力学方案实施后 CHL 患儿的识别年龄。
在标准方案(n=14,54%)和强化方案(n=25,66%)中通过 NBHS 的患儿数量无差异。通过 NBHS,但随后的听力学检查显示听力损失的婴儿在强化组(n=25,66%)和标准组(n=14,54%)之间无差异。在通过强化方案 NBHS 的患儿中,48%(n=12)在 3 月龄时发现 CHL,20%(n=5)在 6 月龄时发现 CHL。通过强化方案,未在 NBHS 后进行进一步检查的患儿比例从 44.9%(n=22)显著下降至 4.2%(n=2)( < .0001)。
即使通过了 NBHS,CP 患儿术前仍存在 CHL。建议对这一人群进行更早和更频繁的检查。