Role of Hearing Screening in High-Risk Newborns

Abstract

Hearing is one of the very important five senses. The most important period for language and speech development is generally regarded as the first three years of life. For the past 20 years, electrophysiological methods are most commonly used which include otoacoustic emission (OAE) and auditory brain stem response (ABR). Regardless of the screening method chosen, hearing screening, though critical, is only the first stage of a comprehensive early intervention plan. Screening alone is useless unless appropriate diagnostic testing services and high quality amplification and rehabilitation services are in place and are implemented in a timely fashion. Early screening does not substitute for further periodic childhood hearing screening. To screen the newborns which are high risk or born to high risk mother using optoacoustic emission and auditory brain stem response (ABR). Also to co-relate hearing loss with various risk factors involved in pre-natal, natal and post-natal. Methods: we conducted a prospective study with 100 high risk newborns in a tertiary care centre. First, all babies were screened using transient evoked otoacoustic emission(TEOAE). Babies not responsive in this were screening again after 14 days using TEOAE. Babies who were reffered to during this screening with TEOAE were subjected to further screening with ABR to confirm the diagnosis. Out of 100 infants, 73% infants passed first screening by TEOAE whereas 27% failed. those 27 infants which failed were screened after 14 days, of them, 3 (11.1%) infants failed the second screening and were referred. Further screening with BERA was conducted for 3 children who failed the second screening by TEOAE. Of them 1 (33.3%) infant passed the BERA whereas 2 infants failed. Test of significance observed no statistically significant association of OAE with prenatal risk factors in present study (p>0.05). whereas shows highly statistically significant association of OAE with natal (birth asphyxia, NICU admission and Apgar score at 5 minutes) and post natal (viral/bacterial infections) risk factors (p<0.01). New born hearing screening is important in recognizing babies born with congenital hearing loss. The screening protocol using OAE can be used in a two staged screening. This study aimed to detect the congenital hearing loss as early as possible and its association with various risk factors in high risk newborns and role of OAE and ABR as a screening tool. Timely diagnosis and intervention for hearing loss are not the reality throughout India. The population and professionals involved in childcare should be made aware of the impact of hearing loss, this could result in better outcome of neonatal hearing screening programs.

Keywords: High risk newborns; Auditory brain stem response; Otoacoustic emission.