Stewart D L, Pearlman A
Department of Pediatrics, University of Louisville School of Medicine, KY 40292.
J Ky Med Assoc. 1994 Nov;92(11):444-9.
Congenital deafness is a relatively common problem with an incidence of 1/300 to 1/1000. Most states have no mass screening program for hearing loss, but the state of Kentucky compiles a High Risk Registry which is a historical survey of parents relating to risk factors for hearing loss. Unfortunately this survey can miss 50% of those who have a hearing deficit. If not detected prior to discharge, there is often a delay in diagnosis of deafness which prevents early intervention. We report 2 years' experience at Kosair Children's Hospital where 1,987 infants admitted to well baby, intermediate, or intensive care nurseries were screened using the ALGO-1 screener (Natus Medical Inc, Foster City, CA) which is a modified auditory brain stem evoked response (ABR). Our screening of this population led to an 11% incidence of referral for complete audiological evaluation. There were no significant complications. Forty-eight infants were found to have nonspecified, sensorineural, or conductive hearing loss. The positive predictive value of the test was 96%. Therefore, we feel that the use of the modified ABR in the newborn is a timely, cost efficient method of screening for hearing loss and should be used for mass screening of all newborns.
先天性耳聋是一个相对常见的问题，发病率为1/300至1/1000。大多数州没有针对听力损失的大规模筛查项目，但肯塔基州编制了一个高危登记册，这是一项针对与听力损失风险因素相关的父母的历史调查。不幸的是，这项调查可能会遗漏50%有听力缺陷的人。如果在出院前未被发现，耳聋的诊断往往会延迟，从而妨碍早期干预。我们报告了在科赛尔儿童医院两年的经验，在那里，对1987名入住健康婴儿、中级或重症监护病房的婴儿使用ALGO-1筛查仪（美国加州福斯特城的纳图斯医疗公司）进行了筛查，这是一种改良的听觉脑干诱发电位（ABR）。我们对这一人群的筛查导致转诊进行全面听力评估的发生率为11%。没有明显的并发症。发现48名婴儿患有未明确的、感音神经性或传导性听力损失。该测试的阳性预测值为96%。因此，我们认为在新生儿中使用改良的ABR是一种及时、经济有效的听力损失筛查方法，应用于所有新生儿的大规模筛查。
