Kumar Sanjay, Natraj Rashmi, Dutta Angshuman
Department of Ear, Throat - Head and Neck Surgery, ENT-HNS), Command Hospital Airforce, Bangalore, Karnataka 560007 India.
Department of ENT-HNS, Command Hospital Airforce, Bangalore, Karnataka 560007 India.
Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3396-3404. doi: 10.1007/s12070-024-04700-0. Epub 2024 Apr 17.
Identifying auditory impairments early in newborns is essential to prevent developmental delays. Otoacoustic Emissions (OAE) screenings play a critical role in newborn hearing assessments. However, the ideal timing post-birth for these tests remains unclear. This study evaluates the efficacy of OAE screenings within the first five days after birth to determine the most effective timing. An observational study involved 1,013 full-term neonates at a tertiary care centre. These neonates underwent Transient Evoked Otoacoustic Emissions (TEOAE) screenings daily from Day 1 to Day 5, following WHO and JCIH guidelines. The study assessed pass rates, false positives, and false negatives, with follow-up screenings at one and three months for neonates with initial ambiguous results. The study found that screening efficiency significantly increased, with Day 1 pass rates at 8% (81 neonates) and 98% (992 neonates) by Day 5, marking a significant improvement in diagnostic accuracy ( < 0.001). False positive rates dropped from 92% on Day 1 to 2% by Day 5, and false negatives decreased to below 1%. Sensitivity and specificity reached their peak at 98% and 99.5%, respectively, on Day 5. Our study findings advocate for adjusting neonatal hearing screening protocols to include OAE tests on the fifth day post-birth, optimizing clinical efficacy through enhanced diagnostic accuracy and reducing the logistical and emotional burdens on families and healthcare providers.
The online version contains supplementary material available at 10.1007/s12070-024-04700-0.
尽早发现新生儿的听力障碍对于预防发育迟缓至关重要。耳声发射（OAE）筛查在新生儿听力评估中起着关键作用。然而，这些测试在出生后的理想时间仍不明确。本研究评估出生后前五天内进行OAE筛查的效果，以确定最有效的时间。一项观察性研究纳入了一家三级护理中心的1013名足月儿。这些新生儿按照世界卫生组织（WHO）和美国儿科学会听力联合委员会（JCIH）的指南，从第1天到第5天每天进行瞬态诱发耳声发射（TEOAE）筛查。该研究评估了通过率、假阳性和假阴性，并对初始结果不明确的新生儿在1个月和3个月时进行了后续筛查。研究发现筛查效率显著提高，第1天的通过率为8%（81名新生儿），到第5天升至98%（992名新生儿），诊断准确性有显著提高（<0.001）。假阳性率从第1天的92%降至第5天的2%，假阴性率降至1%以下。第5天的敏感性和特异性分别达到峰值98%和99.5%。我们的研究结果主张调整新生儿听力筛查方案，将出生后第五天的OAE测试纳入其中，通过提高诊断准确性优化临床疗效，并减轻家庭和医疗服务提供者的后勤和情感负担。
在线版本包含可在10.1007/s12070-024-04700-0获取的补充材料。
