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Observational Study
. 2018 Jan:192:144-151.e1.
doi: 10.1016/j.jpeds.2017.09.049.

Hearing Loss after Cardiac Surgery in Infancy: An Unintended Consequence of Life-Saving Care

Madison A Grasty  1 , Richard F Ittenbach  2 , Carol Knightly  3 , Cynthia B Solot  3 , Marsha Gerdes  4 , Judy C Bernbaum  5 , Gil Wernovsky  6 , Thomas L Spray  1 , Susan C Nicolson  7 , Robert R Clancy  8 , Daniel J Licht  8 , Elaine Zackai  9 , J William Gaynor  1 , Nancy B Burnham  10
Affiliations
Observational Study

Hearing Loss after Cardiac Surgery in Infancy: An Unintended Consequence of Life-Saving Care

Madison A Grasty et al. J Pediatr. 2018 Jan.

Abstract

Objectives: To investigate the prevalence of hearing loss after cardiac surgery in infancy, patient and operative factors associated with hearing loss, and the relationship of hearing loss to neurodevelopmental outcomes.

Study design: Audiologic and neurodevelopmental evaluations were conducted on 348 children who underwent repair of congenital heart disease at the Children's Hospital of Philadelphia as part of a prospective study evaluating neurodevelopmental outcomes at 4 years of age. A prevalence estimate was calculated based on presence and type of hearing loss. Potential risk factors and the impact of hearing loss on neurodevelopmental outcomes were evaluated.

Results: The prevalence of hearing loss was 21.6% (95% CI, 17.2-25.9). The prevalence of conductive hearing loss, sensorineural hearing loss, and indeterminate hearing loss were 12.4% (95% CI, 8.8-16.0), 6.9% (95% CI, 4.1-9.7), and 2.3% (95% CI, 0.6-4.0), respectively. Only 18 of 348 subjects (5.2%) had screened positive for hearing loss before this study and 10 used a hearing aid. After adjusting for patient and operative covariates, younger gestational age, longer postoperative duration of stay, and a confirmed genetic anomaly were associated with hearing loss (all P < .01). The presence of hearing loss was associated with worse language, cognition and attention (P <.01).

Conclusions: These findings suggest that the prevalence of hearing loss in preschool children after heart surgery in infancy may be 20-fold higher than in the 1% prevalence seen in the general population. Younger gestational age, presence of a genetic anomaly, and longer postoperative duration of stay were associated with hearing loss. Hearing loss was associated with worse neurodevelopmental outcomes.

Keywords: attention; cognition; language; neurodevelopmental; prevalence; sensorineural.

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Conflict of interest statement

The other authors declare no conflicts of interest.

Figures

Figure
Figure
Distribution of hearing loss seen within our cohort. The first column depicts the total prevalence of hearing loss among our study population. The following columns illustrate the proportion of the three hearing loss diagnoses assigned in this group.
See this image and copyright information in PMC

References

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