Padinharakandy Akshay, Ramaswamy Balakrishnan, K Devaraja, Edward Leslie, G Priya
Department of Otorhinolaryngology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India.
Department of Paediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):453-457. doi: 10.1007/s12070-023-04181-7. Epub 2023 Aug 29.
Elevated bilirubin levels in neonates are commonly seen both physiologically and in pathological conditions. There are few articles describing the effects of elevated bilirubin levels on the auditory system. The objectives of this paper was to study the prevalence of hearing impairment in neonates with hyperbilirubinemia and assess outcome/reversibility of hearing impairment in these neonates with follow-up hearing evaluation. This was a prospective single centre, case control study. Cases: neonates, total bilirubin levels >15 mg/dl. Controls: <15 mg/dl. Exclusion criteria included neonates with neonatal hypoxia, intrauterine infections, sepsis or meningitis, infants with a family history of hearing loss, low birth weight, ototoxic medications, external and middle ear pathology. Otoacoustic emission testing (OAE) was done at birth. Neonates who fail OAE were advised follow up with Brainstem Evoked Response Audiometry (BERA) after 2 months. Neonates having abnormal BERA waves were called for follow up at 6 months. Out of 57 cases, 3 had failed OAE and had normal BERA waves on follow up at 2 months. Out of 60 controls, 5 had failed OAE and follow up BERA for 3 patients were normal and 2 babies were lost to follow up. No statistical significance in hearing impairment in hyperbilirubinemia v/s normal babies was noted. Elevated bilirubin levels in the absence of any other risk factors may not show significant changes in the hearing screening. Some effect owing to the p value close to being significant in cases has been noted. The same may not contribute to permanent hearing impairment as first OAE changes may be transient and seem to revert with age.
The online version contains supplementary material available at 10.1007/s12070-023-04181-7.
新生儿胆红素水平升高在生理和病理情况下都很常见。很少有文章描述胆红素水平升高对听觉系统的影响。本文的目的是研究高胆红素血症新生儿听力障碍的患病率，并通过后续听力评估评估这些新生儿听力障碍的转归/可逆性。这是一项前瞻性单中心病例对照研究。病例：新生儿，总胆红素水平>15mg/dl。对照：<15mg/dl。排除标准包括患有新生儿缺氧、宫内感染、败血症或脑膜炎的新生儿、有听力损失家族史的婴儿、低出生体重、耳毒性药物、外耳和中耳病变。出生时进行耳声发射测试（OAE）。OAE测试未通过的新生儿在2个月后建议进行脑干听觉诱发电位（BERA）检查。BERA波异常的新生儿在6个月时进行随访。在57例病例中，3例OAE测试未通过，2个月随访时BERA波正常。在60例对照中，5例OAE测试未通过，3例随访BERA正常，2例失访。高胆红素血症患儿与正常婴儿在听力障碍方面未发现统计学差异。在没有任何其他危险因素的情况下，胆红素水平升高可能在听力筛查中未显示出显著变化。在病例中已注意到由于p值接近显著而产生的一些影响。这可能不会导致永久性听力障碍，因为最初的OAE变化可能是短暂的，并且似乎会随着年龄的增长而恢复。
在线版本包含可在10.1007/s12070-023-04181-7获取的补充材料。
