Standaert Nina, Loos Elke, Verhaert Nicolas, Royackers Liesbeth, Denys Sam, Desloovere Christian
University Hospitals of Leuven, Department of Otorhinolaryngology, Head and Neck Surgery, Belgium.
University Hospitals of Leuven, Department of Otorhinolaryngology, Head and Neck Surgery, Belgium; University of Leuven, Department of Neurosciences, Research Group Experimental Otorhinolaryngology (ExpORL) , Belgium; University Hospitals of Leuven, Department of Otorhinolaryngology, Head and Neck Surgery, Multidisciplinary University Centre for Speech and Language Therapy, and Audiology, Belgium.
Int J Pediatr Otorhinolaryngol. 2024 Jul;182:112017. doi: 10.1016/j.ijporl.2024.112017. Epub 2024 Jun 19.
Increased neonatal referral rate of conductive hearing loss (CHL) related to otitis media with effusion (OME) following universal neonatal hearing screening (UNHS) may cause an unnecessary clinical, emotional, and financial burden. This study analyzes the long-term, audiological, and medical characteristics of CHL associated with OME in neonates in order to establish a standardized protocol following technology-driven improvements in detection and referral rates in UNHS.
A retrospective study of all neonates with OME-related CHL referred to the University Hospital of Leuven (Belgium) after failing UNHS with the MAICO devices between January 1, 2013 and December 31, 2021 was performed. Follow-up consultations, auditory tests, referral side, birth month, hearing loss degree, underlying pathologies and risk factors, time to normalization, and need for ventilation tubes were assessed.
The incidence of CHL related to OME was stable between 2013 and 2021. Of all referred infants with OME, 52.3 % demonstrated spontaneous recovery. The average time to hearing normalization was significantly longer in children with underlying congenital pathologies compared to those without. Moreover, 74.4 % of these children received ventilation tubes compared to 32.0 % of children without underlying pathologies. No correlation was found between the incidence of OME-related CHL with either a hearing loss degree, admission to neonatal intensive care, or history of a nasogastric feeding tube.
In children who failed UNHS due to OME, hearing recovers spontaneously without surgical intervention in 2/3 of the infants without underlying conditions within one year. In children with underlying congenital disorders, the time to hearing recovery is longer and the risk for surgical intervention is higher, underlining the need for implementing a UNHS standardized protocol.
在普遍新生儿听力筛查（UNHS）之后，与中耳积液（OME）相关的传导性听力损失（CHL）的新生儿转诊率增加可能会造成不必要的临床、情感和经济负担。本研究分析新生儿中与OME相关的CHL的长期、听力学和医学特征，以便在UNHS检测和转诊率的技术驱动改进之后建立标准化方案。
对2013年1月1日至2021年12月31日期间使用MAICO设备UNHS未通过后转诊至鲁汶大学医院（比利时）的所有与OME相关的CHL新生儿进行回顾性研究。评估随访咨询、听力测试、转诊侧、出生月份、听力损失程度、潜在病理和危险因素、恢复正常的时间以及是否需要通气管。
2013年至2021年期间，与OME相关的CHL发病率稳定。在所有转诊的OME婴儿中，52.3%表现出自发性恢复。与无潜在先天性病理的儿童相比，有潜在先天性病理的儿童听力恢复正常的平均时间明显更长。此外，这些儿童中有74.4%接受了通气管，而无潜在病理的儿童中这一比例为32.0%。未发现与OME相关的CHL发病率与听力损失程度、入住新生儿重症监护病房或鼻胃管使用史之间存在相关性。
在因OME导致UNHS未通过的儿童中，三分之二无潜在疾病的婴儿在一年内听力可自发恢复，无需手术干预。对于有潜在先天性疾病的儿童，听力恢复时间更长，手术干预风险更高，这突出了实施UNHS标准化方案的必要性。
