Universal neonatal audiological screening: experience of the University Hospital of Pisa
Tóm tắt
The early identification of pre-lingual deafness is necessary to minimize the consequences of hearing impairment on the future communication skills of a baby. According to the most recent international guidelines the deafness diagnosis must occur before the age of three months and the prosthetic-rehabilitative treatment with a traditional hearing aid should start within the first six months. When a Cochlear implant becomes necessary, the treatment should start between the age of 12 months and 18 months. The only way to diagnose the problem early is the implementation of universal neonatal audiological screening programs. Transient evoked otoacoustic emissions (TEOAE) is the most adequate test because it's accurate, economic and of simple execution. Automatic auditory brainstem response (AABR) is necessary to identify patients with auditory neuropathy but it is also important to reduce the number of false-positives.The 20-30% of infant hearing impairment is represented by progressive or late-onset hearing loss (HL) so it's also necessary to establish an audiological follow up program, especially in infants at risk. From November 2005 all neonates born in the University hospital of Pisa undergo newborn hearing screening. From 2008 the screening program follows the guidelines for the execution of the audiological screening in Tuscany which have been formulated by our group according to the 2007 JCIH Position Statement and adaptated to our regional reality by a multidisciplinary effort. From November 2005 to April 2009 8113 neonates born in the Neonatal Unit of Santa Chiara Hospital (Pisa) have undergone newborn hearing screening. 7621 neonates (93.9%) without risk factors executed only the TEOAE test. 492 (6.1%) neonates had audiological risk factors and thus underwent TEOAE and AABR. 84 patients (1,04%) failed both TEOAE and AABR tests. 78 of them underwent further investigations. 44 patients resulted falsepositives (the 0,54% of the screened newborns). 34 neonates (4,2 ‰) had a final diagnosis of hearing impairment. 8 patients (0.99 ‰) had unilateral hearing loss (HL). 26 patients (3,2 ‰) had bilateral hearing impairment. In our screening program the percentage of false-positives was quite low (0.54%) while the incidence of bilateral HL (3.2 ‰) is a little higher than that found in literature reports. In most of our patients premature birth or neonatal suffering represent the main cause of HL.
Tài liệu tham khảo
Joint Committee on Infant Hearing: Joint Statement on neonatal screening for hearing impairment. 1971, [http://www.jcih.org/posstatemts.htm]
Joint Committee on Infant Hearing: Screening for infant hearing. 1973, [http://www.jcih.org/posstatemts.htm]
Joint Committee on Infant Hearing: Position Statement 1982. [http://www.jcih.org/posstatemts.htm]
Joint Committee on Infant Hearing: 1990 Position Statement. [http://www.jcih.org/posstatemts.htm]
Joint Committee on Infant Hearing: 1994 Position Statement. [http://www.jcih.org/posstatemts.htm]
Joint Committee on Infant Hearing: Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. Pediatrics. 2000, 106 (4): 798-217. 10.1542/peds.106.4.798.
Joint Committee on Infant Hearing: Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. Pediatrics. 2007, 120 (4): 898-921. 10.1542/peds.2007-2333.
Berrettini S, Passetti S, Forli F: Audiological indications to the cochlear implant procedure in the child. Minerva Pediatr. 2007, 59: 458-60.
US Preventive Services Task Force: Universal Screening for Hearing Loss in Newborns: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2008, 122: 143-148.s. 10.1542/peds.2007-2210.
Moeller M: Early intervention and language development in children who are deaf and hard of hearing. Pediatrics. 2000, 106: e43-10.1542/peds.106.3.e43.
Quaranta A, Arslan E, Burdo S, Cuda D, Filipo R, Quaranta N: Documento del gruppo SIO impianti cocleari: linee guida per l'applicazione dell'impianto cocleare e la gestione del centro impianti cocleari. Argomenti di Acta Otorinolaryngologica Italica. 2009, 3: 1-5.
Yoshinaga-Itano C, Coulter D, Thomson V: Developmental outcomes of children with hearing loss born in Colorado hospitals with and without universal newborn hearing screening programs. Semin Neonatol. 2001, 6: 521-9. 10.1053/siny.2001.0075.
Yoshinaga-Itano C, Sedey AL, Coulter DK, Mehl AL: Language of early- and later identified children with hearing loss. Pediatrics. 1998, 102: 1161-71. 10.1542/peds.102.5.1161.
Yoshinaga-Itano C: Universal newborn hearing screening programs and developmental outcomes. Audiological Medicine. 2003, 1: 199-206. 10.1080/16513860310002031.
Bubbico L, Tognola G, Greco A, Grandori F: Universal newborn hearing screening programs in Italy: survey of year 2006. Acta Otolaryngol. 2008, 128: 1329-36. 10.1080/00016480802008165.
Davis A, Hind S: The newborn hearing screening programme in England. Int J Pediatr Otorhinolaryngol. 2003, 67 (Suppl 1:): S193-S196. 10.1016/j.ijporl.2003.08.024.
Davis A, Wood S: The epidemiology of childhod hearing impairment: factors relevant to planning of services. Br J Audiol. 1992, 26: 77-90. 10.3109/03005369209077875.
Davis A, Bamford J, Wilson I, Ramkalawan T, Forshaw M, Wright S: A critical review of the role of neonatal hearing screening in the detection of congenital hearing impairment. Health Technol Assess. 1997, 1: 1-177.
Finitzo T, Albright K, O'Neal J: The newborn with hearing loss: detection in the nursery. Pediatrics. 1998, 102: 1452-60. 10.1542/peds.102.6.1452.
Fortnum HM: Epidemiology of permanent childhood hearing impairment: implications for neonatal hearing screening. Audiological Medicine. 2003, 1: 155-64. 10.1080/16513860310001997.
Govaerts PJ, Yperman M, De Ceulaer G, Daemers K, Van Driessche K, Somers T, Offeciers FE: A two-stage bipodal screening model for universal neonatal hearing screening. Otol Neurotol. 2001, 22: 850-4. 10.1097/00129492-200111000-00023.
Jakubíková J, Kabátová Z, Pavlovcinová G, Profant M: Newborn hearing screening and strategy for early detection of hearing loss in infants. Int J Pediatr Otorhinolaryngol. 2009, 73: 607-12.
Arslan E, Guarnaccia MC: Prevalenza e fattori di rischio. Eziologia, diagnosi, prevenzione e terapia della sordità infantile preverbale. Quaderni monografici di aggiornamento AOOI. Ed Torgraf, Galatina (LE). 45-60.
Van Naarden Kim, Decouflè Pierre: Relative and attributable risks for moderate to profound bilateral sensorineural hearing impairment associated with lower birth weight in children 3 to 10 years old. Pediatrics. 1999, 104: 905-910. 10.1542/peds.104.4.905.
Martini A, Trevisi P: Eziologia delle ipoacusie preverbali. Eziologia, diagnosi, prevenzione e terapia della sordità infantile preverbale. A cura di R. Luppari Quaderni monografici di aggiornamento AOOI. Ed Torgraf, Galatina (LE). Pagg. 15-43.
Robertson CM, Howarth TM, Bork DL, Dinu IA: Permanent bilateral sensory and neural hearing loss of children after neonatal intensive care because of extreme prematurity: a thirty-year study. Pediatrics. 2009, 123: e797-807. 10.1542/peds.2008-2531.
Satoko Y, Katsuhisa I, Takayuki K, Toshimitsu K: The effects of hypoxia, premature birth, infection, ototoxic drugs, circulatory system and congenital disease on neonatal hearing loss. Auris Nasus Larynx. 2004, 31: 361-368.
Xoinis K, Weirather Y, Mavoori H, Shaha SH, Iwamoto LM: Extremely low birth weight infants are at high risk for auditory neuropathy. J Perinatol. 2007, 27: 718-23. 10.1038/sj.jp.7211803.
Hall D, Davis A: Commentary on neonatal screening for hearing impairment. Arch Dis Child. 2000, 83: 382-3.
Harrison M, Roush J, Wallace J: Trends in age of identification and intervention in infants with hearing loss. Ear Hear. 2003, 24: 89-95. 10.1097/01.AUD.0000051749.40991.1F.
Thompson DC, McPhillips H, Davis RL, Lieu TL, Homer CJ, Helfand M: Universal newborn hearing screening, summary of evidence. JAMA. 2001, 286: 2000-10. 10.1001/jama.286.16.2000.
Starr A, Picton TW, Sininger Y, Hood LJ, Berlin CI: Auditory neuropathy. Brain. 1996, 119: 741-53. 10.1093/brain/119.3.741.
Kennedy CR, Kimm L, Thornton R, Davis A: False positives in universal neonatal screening for permanent childhood hearing impairment. Lancet. 2000, 356 (9245): 1903-4. 10.1016/S0140-6736(00)03267-0.
Kennedy CR: Controlled trial of universal neonatal screening for early identifìcation of permanent childhood hearing impairment: coverage, positive predictive value, effect on mothers and incremental yield. Acta Paediatr Suppl. 1999, 432: 73-5. 10.1111/j.1651-2227.1999.tb01164.x.
Kennedy CR: Neonatal screening for hearing impairment. Arch Dis Child. 2000, 83: 377-82. 10.1136/adc.83.5.377.
Dowley AC, Whitehouse WP, Mason SM, Cope Y, Grant J, Gibbin KP: Auditory neuropathy: unexpectedly common in a screened newborn population. Dev Med Child Neurol. 2009, 51: 642-6. 10.1111/j.1469-8749.2009.03298.x.
Santarelli R, Arslan E: Electrocochleography in auditory neuropathy. Hear Res. 2002, 170: 32-47. 10.1016/S0378-5955(02)00450-1.
Santarelli R, Starr A, Michalewski HJ, Arslan E: Neural and receptor cochlear potentials obtained by transtympanic electrocochleography in auditory neuropathy. Clin Neurophysiol. 2008, 119: 1028-41. 10.1016/j.clinph.2008.01.018.
Berrettini S, Ravecca F, Sellari Franceschini S, Matteucci F, Siciliano G, Ursino F: Progressive sensorineural hearing loss in childhood. Pediatric Neurology. 1999, 20: 130-136. 10.1016/S0887-8994(98)00123-4.
Martini A, Shindler O: La sordità prelinguale. Omega Edizioni. 2004
Norton SJ, Gorga MP, Widen JE: Identification of neonatal hearing ímpairment: evaluation of transient evoked otocacoustic emission, distortion product otoacoustic emission and auditory brain stem response test performance. Ear Hear. 2000, 21: 508-28. 10.1097/00003446-200010000-00013.
Watkin PM, Baldwin M: Confirmation of deafness in infancy. Arch Dis Child. 1999, 81: 380-9. 10.1136/adc.81.5.380.
Watkin PM: Neonatal hearing screening: methods and outcome. Audiological Medicine. 2003, 1: 165-74. 10.1080/16513860310002022.
Watkin PM: Neonatal screening for hearing impairment. Semin Neonatol. 2001, 6: 501-9. 10.1053/siny.2001.0081.
Nelson Heidi, Bougatsos Christina, Nygren Peggy: Universal Newborn Hearing Screening: Systematic Review to Update the 2001 US Preventive Services Task Force Recommendation. Pediatrics. 2008, 122: e266-e276. 10.1542/peds.2007-1422.
Wessex Universal Hearing Screening Trial Group: Controlled trial of universal neonatal screening for early identifìcation of permanent childhood hearing impairment. Lancet. 1998, 352: 1957-64. 10.1016/S0140-6736(98)06359-4.