Hearing Screening in Physiological and Risk Newborn Children by the OAE and AABR Methods – Evaluation of Results

Česká verzia

Authors: E. Havlíková ¹; R. Poláčková ²; T. Vítečková ²; Karol Zeleník ^1,3 ; Pavel Komínek ^1,3
Authors place of work: Otorinolaryngologická klinika, FN Ostrava ¹; Oddělení neonatologie, FN Ostrava ²; Lékařská fakulta, Katedra kraniofaciálních oborů, Ostravská univerzita ³
Published in the journal: Otorinolaryngol Foniatr, 64, 2015, No. 1, pp. 17-21.
Category: Original Article

Summary

Introduction:
Examination of otoacoustic emissions (OAE) and automated auditory brainstem response (AABR) are the most commonly screening methods used for detection of hearing problems in newborns. The methods can be used alone or in combination, each method has its advantages and disadvantages. The aim of the study was to determine the incidence of bilateral moderate and severe hearing loss in physiological newborns and risk infants and to determine the number of false-positive results for both screening methods for bilateral moderate to severe hearing loss.

Methods:
All physiological and risk newborns born at University Hospital Ostrava in the period from 10/2012 to 2/2014 were included in the study. In the group of physiological newborns (group I) OAE was performed. In case of absent OAE, AABR were examine. If AABR showed possible hearing defect, examination of brainstem evoked response audiometry (BERA) and/or SSEP (steady-state evoked potentials) was performed. Both, OAE and AABR, were examined in all risk neonates (group II). In the case of bilateral absent OAE and/or AABR examination BERA and/or SSEP was performed to establish the hearing threshold.

Results:
Of the 2460 physiological newborns (group I), 2457 were enrolled in the study. Bilateral absent OAE were detected in 40 (1.6%) neonates, one of them (0.04%) was diagnosed with severe sensorineuaral hearing loss, one (0.04%) with moderate sensorineuaral hearing loss and three (0.12%) with unilateral sensorineural hearing loss. The number of false positive tests in the group of bilateral absent OAE was 35/2457 (1.4%).

From 889 risk infants, 836 were enrolled in the study. Bilateral absent OAE were detected in 22/836 (2.6%) neonates and bilateral pathological AABR at 18/836 (2.2%) newborns. Subsequent BERA examination confirmed in 4/836 (0.47%) risk infants bilateral moderate to severe sensorineural hearing loss, all 4 patients had bilaterally absent both, OAE as well as AABR. The number of false positive OAE in the group of bilateral absent OAE was 18/836 (2.1%). The number of false positive AABR in the group of bilateral absent AABR was 14/836 (1.7%).

Conclusion:
Bilateral moderate to severe hearing loss requiring further rehabilitation with hearing aids or cochlear implant was detected more often in risk newborns. OAE and AABR have a low number of false positive results. Although the child with present OAE and absent AABR (typical for auditory neuropathy) was not present in our group, according to the results from largest abroad studies it is recommended in risk neonates perform both screening methods.

Keywords:
screening methods, otoacoustic emissions, hearing aid, cochlear implants

Zdroje

1. Bansal, S., Gupta, A., Nagarkar, A.: Transient evoked otoacoustic emissions in hearing screening programs: protocol for developing countries. Int. J. Pediatr. Otorhinolaryngol., 2008, 72, s. 1059-1063.

2. Benito-Orejas, J. I., Ramírez, B., Morais, D., Almaraz A., Fernandez-Calvo, J. L.: Comparison of two-step transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR) for universal newborn hearing screening programs. . J. Pediatr. Otorhinolaryngol., 2008, 72, s. 1193-1201.

3. Brienesse, P., Debyelaan, P.: Maturation of otoacustic emissions: longitudinal versus cross-sectional study. Int. J. Pediatr. Otorhinolaryngolog., 40, s. 73-74.

4. Cebulla, M., Shehata-Dieler, W.: ABR – based newborn hearing screening with MB 11 BERAphone using an optimized chirp for acoustical stimulation. Inter J. Pediatr. Otorhinolaryngol., 2012, 76, s. 536-543.

5. Clarke, P., Iqbal, M., Mitchell, S.: A comparison of transient evoked otoacoustic emissions and automated auditory brainstem responses for pre-discharge neonatal hearing screening, Int. J. Audiol., 2003, 42, s. 443-447.

6. Erenberg, A., Lemons, J., Sia, C., Trunkel, D., Ziring P.: Newborn and infant hearing loss: detection and intervention. American Academy of Pediatrics, Task Force on Newborn an Infant Hearing. Pediatrics, 1999, 103, s. 527-530.

7. Guastini, L., Mora, R., Dellepiane, M., Santomauro, V., Mo-ra, M., Rocca, A., Salami, A.: Evaluation of an automated auditory brainstem response in a multi-stage infant hearing screening, Eur. Arch. Otorhinolaryngol., 2010, 267, s. 1199-1205.

8. Hatzopoulos, S., Petruccelli, J., Ciorba, A., Martini, A.: Optimizing otoacoustic emission protocols for a UNHS program. Audio. Neurootol., 2009, 14, s. 7-16.

9. Illing, R. B.: Maturation and plasticity of the central auditory systém. Acta Otolaryngol., 2004, 552, s. 6-10.

10. Jakubíková, J. a kol: Detská audiológia. Bratislava, Slovak Academic Press, s.r.o., 2006, s. 129-134.

11. Joint Committee on Infant Hearing. Year 2000 Position Statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 2000, 106, s. 798-817.

12. Kennedy, C. R., Kimm, L., Cafarelli, D., Evans, P. I. P., Hunter, M., Lenton, S., Thornton, R. D.: Otoacoustic emissions and auditory brainstem responses in the newborn, Arch. Dis. Child., 66, 1991, s. 124-1129

13. Korres, S. G., Balatsouras, D. G., Lyra, C., Kandiloros, D., Ferekidis, E.: A comparison of automated auditory brainstem responses and transiently evoked otoacoustic emissions for universal newborn hearing screening, Med. Sci. Monit., 12, 2006, s. 260-263.

14. Mason, J. A., Herrmann, K. R.: Universal infant hearing screening by automated auditory brainstem response measurement. Paediatrics, 101, 1998, s. 211-228.

15. Meier, S., Narabayashi, O., Probst, R., Schmuziger, N.: Comparison of currently available devices designed for newborn hearing screening using automated auditory brainstem and/or otoacoustic emission measurements. Int. J. Pediatr. Otorhinolaryngol., 68, 2004, s. 927-934.

16. Neumann, K., Indermark, A.: Validation of a new TEOAE-AABR device for newborn hearing screening. International Journal of Audiology, 51, 2012, s. 570-575.

17. Norton, S. J., Gorga, M. P., Widen, J. E., Folsom R. C., Sininger Y., Cone - Wesson B. et al.: Identification of neonatal hearing impairtment: summary and recommendations. Ear Hear, 21, 2000, s. 529-535.

18. Ohl, C., Dornier, L., Czajka, Chobaut, J. C, Tavernier, L.: Newborn hearing screening on infants at risk. Int. J. Pediatr. Otorhinolaryngol., 73, 2009, s. 1691-1695.

19. Onoda, R. M., Azevedo, M. F., Santos, A. M.: Neonatal hearing screening: failures, hearing loss and risk indicators. Braz. J. Otorhinolaryngol., 77, 2011, s. 775-783.

20. Operating Instuctions MB 11.

21. Shahnaz, N.: Wideband reflectance in neonatal intensive care units. J. Am. Acad. Audio., 19, 2008, s. 419-429.

22. Turchetta, R., Orlando, M. P., Cammeresi, M. G., Altissi-mi, G., Celani, T., Mazzei F. et al: Modifications of auditory brainstem responses (ABR): observations in full-term and pre-term newborns. J. Matern. Fetal. Neonatal. Med., 24, 2011, s. 1-6.

23. Vohr, B. R., Oh, W., Stewart, E. J., Bentkover, J. D., Gab-bard, S., Lemons J. et al.: Comparison of costs and referral rates of universal newborn hearing screening protocols, J. Pediatr., 139, 2001, s. 238-244.

24. Zeleník, K., Havlíková, E., Poláčková, R., Komínek, P.:Otázky související se zaváděním plošného screeningu v Moravskoslezském kraji. Otorinolaryng. a Foniat. /Prague/, 61, 2012, s. 112-118.