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新生儿听力筛查:早期耳部检查可提高通过率。

Newborn Hearing Screening: Early Ear Examination Improves the Pass Rate.

机构信息

Department of Otolaryngology Head and Neck Surgery, Assuta Ashdod Samson University Hospital, Ashdod, Israel; Ben Gurion University of the Negev, Faculty of Health Sciences, Beer Sheba, Israel.

Ben Gurion University of the Negev, Faculty of Health Sciences, Beer Sheba, Israel; Department of Neonatology, Assuta Ashdod Samson University Hospital, Ashdod, Israel.

出版信息

J Int Adv Otol. 2023 Oct;19(5):402-406. doi: 10.5152/iao.2023.22987.

Abstract

BACKGROUND

Temporary conductive hearing loss due to vernix accumulation in the external ear canal may lead to a false-positive result in newborn hearing screening tests. The aim of this study was to evaluate whether ear examination and intervention may reduce the false-positive rate prior to hospital discharge.

METHODS

A case series of 42 newborns who failed initial otoacoustic emissions screening were studied in our institution between May and December 2020.

RESULTS

During the study period, a total of 735 neonates (1470 ears) were screened by otoacoustic emissions in our hospital. Forty-two newborns who failed otoacoustic emissions were included in our study. They constituted 3.9% (n=58 ears) of the total number of ears screened. Forty-four ears (75.9%) passed and 14 ears (24.1%) failed otoacoustic emissions rescreening performed shortly following vernix cleaning. Twelve of the remaining 14 ears passed at 10-day rescreening. The remaining 2 ears presented true bilateral hearing loss. During the study period, the general false-positive rate decreased from 56/735 (7.61%) to 12/735(1.63%) (P < .00001).

CONCLUSION

Cleaning the vernix of infants who failed otoacoustic emissions prior to hospital discharge lowers the false-positive rate of universal neonatal hearing screening. We may assume that vernix cleaning will reduce significant healthcare workload, costs of unnecessary investigations, as well as parental anxiety.

摘要

背景

由于外耳道胎脂的堆积,可能导致新生儿听力筛查测试出现暂时的传导性听力损失,从而出现假阳性结果。本研究旨在评估在出院前进行耳部检查和干预是否可以降低假阳性率。

方法

本研究为我院 2020 年 5 月至 12 月期间进行的一项病例系列研究,共纳入 42 例初次通过耳声发射筛查的新生儿。

结果

在研究期间,我院共有 735 例新生儿(1470 耳)通过耳声发射进行筛查。42 例耳声发射筛查未通过的新生儿被纳入本研究。他们占筛查总耳数的 3.9%(n=58 耳)。初次行胎脂清理后,44 耳(75.9%)通过了耳声发射复测,14 耳(24.1%)复测仍未通过,其中 12 耳在 10 日复测时通过,其余 2 耳为双侧真实听力损失。研究期间,总体假阳性率从 56/735(7.61%)降至 12/735(1.63%)(P<0.00001)。

结论

在出院前为初次耳声发射筛查未通过的婴儿清理胎脂,可降低新生儿听力筛查的假阳性率。我们可以假设胎脂清理将减少大量的医疗保健工作量、不必要的检查费用以及父母的焦虑。

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