B Meghana Mohan, Jain Chandni
All India Institute of Speech and Hearing, Naimisham campus, Manasagangothri, Mysore, 570006 India.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5188-5194. doi: 10.1007/s12070-024-04937-9. Epub 2024 Aug 7.
The study aimed to assess the risk of hearing loss in full-term neonates with hyperbilirubinemia, examining the relationship between bilirubin levels, onset age of hyperbilirubinemia, and hearing impairment. Additionally, it investigated whether hearing loss was transient or late-onset, using a cost-effective double-screening method. The study included 160 full-term neonates aged 0-1 month. Following completion of phototherapy for hyperbilirubinemia, all infants underwent initial screening with otoacoustic emissions (OAEs) and automated auditory brainstem responses (AABR). A second screening was administered to all infants within one month. Infants referred during the second screening, regardless of their first screening results, underwent diagnostic evaluation. For analysis, the infants were categorised into 4 groups, based on their bilirubin levels and onset of jaundice. After the initial screening, 37% of infants were referred, which decreased to 9% after subsequent screening, suggesting transient hearing loss in 76% of initially referred infants. Permanent hearing impairment was confirmed in 2.5% of infants following diagnostic evaluation, with 3 infants diagnosed with ANSD and 1 infant with sensorineural hearing loss, all from categories characterized by elevated bilirubin levels. The findings indicated that even bilirubin levels as low as 12 to 15 mg/dl could lead to hearing loss, particularly when jaundice onset occurred early. This study highlights the effectiveness of double-screening for identifying transient hearing losses in infants with hyperbilirubinemia, minimizing the need for diagnostic referrals. It underscores the importance of considering both bilirubin levels and onset timing to assess auditory risk fully.
该研究旨在评估足月新生儿高胆红素血症的听力损失风险，研究胆红素水平、高胆红素血症发病年龄与听力障碍之间的关系。此外，该研究采用一种经济高效的双重筛查方法，调查听力损失是暂时性的还是迟发性的。该研究纳入了160名年龄在0至1个月的足月新生儿。在完成高胆红素血症的光疗后，所有婴儿均接受了耳声发射（OAE）和自动听性脑干反应（AABR）的初步筛查。在一个月内对所有婴儿进行了第二次筛查。在第二次筛查中被转诊的婴儿，无论其第一次筛查结果如何，均接受诊断评估。为了进行分析，根据婴儿的胆红素水平和黄疸发作情况将其分为4组。初步筛查后，37%的婴儿被转诊，后续筛查后这一比例降至9%，这表明76%的最初转诊婴儿存在暂时性听力损失。诊断评估后，2.5%的婴儿被确诊为永久性听力障碍，其中3名婴儿被诊断为听神经病谱障碍（ANSD），1名婴儿为感音神经性听力损失，所有这些婴儿均来自胆红素水平升高的类别。研究结果表明，即使胆红素水平低至12至15mg/dl也可能导致听力损失，尤其是黄疸发作较早时。这项研究强调了双重筛查在识别高胆红素血症婴儿暂时性听力损失方面的有效性，最大限度地减少了诊断转诊的必要性。它强调了在全面评估听觉风险时考虑胆红素水平和发病时间的重要性。
