Aim. To compare targeted neonatal hearing screening (TNHS) and universal neonatal hearing screening (UNHS) since many developing countries, including Egypt, implement selective screening for high-risk neonates. Methods. 150 neonates were assessed; 50 full terms consecutively admitted to the well-baby nursery and 100 neonates consecutively admitted to neonatal intensive care unit (NICU), Ain Shams University. Patients were further subdivided into high-risk group which included 50 neonates with multiple risk factors for hearing loss and low risk group which included 50 neonates with only one risk factor. Transient evoked otoacoustic emissions (TEOAEs) were used for hearing screening. Auditory brain response (ABR) was performed 3 months later for failed TEOAEs. Results. The most frequent risk factor was consanguinity (46%). In the well-baby population, 16% failed TEOAEs. In the NICU, 30% of the low risk and 38% of the high risk groups failed TEOAEs. Regarding ABR, failed results were 12%, 10%, and 8% in the high-risk, low-risk, and healthy groups, respectively. Conclusion. The use of TNHS would have missed 8% of neonates from the well-baby group who actually had PCHL (permanent congenital hearing loss). The use of UNHS would identify all cases with PCHL, allowing for early intervention and follow-up. 1. Introduction Significant hearing loss is one of the most frequent congenital diseases present at birth occurring in about 1 to 3 of every 1,000 healthy neonates and 2 to 4 of every 100 neonates in the neonatal intensive care unit (NICU) population [1, 2], although the prevalence of hearing loss varies because of differences in criteria for defining hearing impairment, the age group surveyed, and the testing methods used. Many etiological factors may result in severe hearing loss in neonates. Genetic causes account for at least 50 to 60 percent of childhood hearing loss. Environmental causes of hearing loss includes, for example, rubella embryopathy, prematurity, bacterial meningitis, and head trauma [3]. The initial signs of hearing loss are very subtle, and systematic neonatal hearing screening is the most effective means of early detection. The early identification of congenital hearing loss is necessary to minimize the consequences of hearing impairment on the future communication skills of a baby [4, 5]. The Joint Committee on Infant Hearing (JCIH) has set 3 goals: screening should be completed by 1 month of age, diagnosis should be made by 3 months, and intervention and treatment should commence by 6 months [5]. This was achieved by technologic
References
[1]
A. Erenberg, J. Lemons, C. Sia, D. Tunkel, and P. Ziring, “Newborn and infant hearing loss: detection and intervention,” Pediatrics, vol. 103, no. 2, pp. 527–530, 1999.
[2]
H. D. Nelson, C. Bougatsos, and P. Nygren, “Universal newborn hearing screening: systematic review to update the 2001 US preventive services task force recommendation,” Pediatrics, vol. 122, no. 1, pp. e266–e276, 2008.
[3]
C. C. Morton and W. E. Nance, “Newborn hearing screening—a silent revolution,” The New England Journal of Medicine, vol. 354, no. 20, pp. 2151–2164, 2006.
[4]
M. P. Moeller, J. B. Tomblin, C. Yoshinaga-Itano, C. M. Connor, and S. Jerger, “Current state of knowledge: language and literacy of children with hearing impairment,” Ear and Hearing, vol. 28, no. 6, pp. 740–753, 2007.
[5]
American Academy of Pediatrics, Joint Committee on Infant Hearing, “Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs,” Pediatrics, vol. 120, no. 4, pp. 898–921, 2007.
[6]
S. Korres, T. P. Nikolopoulos, V. Komkotou et al., “Newborn hearing screening: effectiveness, importance of high-risk factors, and characteristics of infants in the neonatal intensive care unit and well-baby nursery,” Otology and Neurotology, vol. 26, no. 6, pp. 1186–1190, 2005.
[7]
V. K. Bhutani, L. Johnson, and E. M. Sivieri, “Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns,” Pediatrics, vol. 103, no. 1, pp. 6–14, 1999.
[8]
A. B. Maxon, K. R. White, B. R. Vohr, and T. R. Behrens, “Using transient evoked otoacoustic emissions for neonatal hearing screening,” The British Journal of Audiology, vol. 27, no. 2, pp. 149–153, 1993.
[9]
Y. El-Gamal, N. Hazaa, and K. Awwad, “Otoacustic emission in high risk neonates,” Egyptian Journal of Otolaryngology, vol. 185, no. 1, supplement, pp. 145–155, 2001.
[10]
A. Abdullah, M. Y. S. Hazim, A. Almyzan et al., “Newborn hearing screening: experience in a Malaysian hospital,” Singapore Medical Journal, vol. 47, no. 1, pp. 60–64, 2006.
[11]
S. J. Norton, M. P. Gorga, J. E. Widen et al., “Identification of neonatal hearing impairment: transient evoked otoacoustic emissions during the perinatal period,” Ear and Hearing, vol. 21, no. 5, pp. 425–442, 2000.
[12]
P. Clarke, M. Iqbal, and S. Mitchell, “A comparison of transient-evoked otoacoustic emissions and automated auditory brainstem responses for pre-discharge neonatal hearing screening,” International Journal of Audiology, vol. 42, no. 8, pp. 443–447, 2003.
[13]
G. Yamamah, A. Mabrouk, E. Ghorab, M. Ahmady, and H. Abdulsalam, “Middle ear and hearing disorders of schoolchildren aged 7–10 years in South Sinai, Egypt,” Eastern Mediterranean Health Journal, vol. 18, no. 3, pp. 255–260, 2012.
[14]
A. A. Taha, S. R. Pratt, T. M. Farahat et al., “Prevalence and risk factors of hearing impairment among primary-school children in Shebin El-Kom District, Egypt,” The American Journal of Audiology, vol. 19, no. 1, pp. 46–60, 2010.
[15]
M. M. Elahi, F. Elahi, A. Elahi, and S. B. Elahi, “Paediatric hearing loss in rural Pakistan,” Journal of Otolaryngology, vol. 27, no. 6, pp. 348–353, 1998.
[16]
H. S. Talaat, A. H. Kabel, H. Samy, and M. Elbadry, “Prevalence of auditory neuropathy (AN) among infants and young children with severe to profound hearing loss,” International Journal of Pediatric Otorhinolaryngology, vol. 73, no. 7, pp. 937–939, 2009.
[17]
M. R. Mohamed, I. Alesutan, M. F？ller et al., “Functional analysis of a novel I71N mutation in the GJB2 gene among Southern Egyptians causing autosomal recessive hearing loss,” Cellular Physiology and Biochemistry, vol. 26, no. 6, pp. 959–966, 2010.
[18]
J. Davidson, M. L. Hyde, and P. W. Alberti, “Epidemiologic patterns in childhood hearing loss: a review,” International Journal of Pediatric Otorhinolaryngology, vol. 17, no. 3, pp. 239–266, 1989.
[19]
“WHO global report. Preventing chronic disease: a vital investment,” World Health Organization, 2005, http://www.who.int/chp/chronic_disease_report/contents/en/index.html.
[20]
D. W. Swanepoel, R. Hugo, and B. Louw, “Infant hearing screening at immunization clinics in South Africa,” International Journal of Pediatric Otorhinolaryngology, vol. 70, no. 7, pp. 1241–1249, 2006.
[21]
K. Wroblewska-Seniuk, K. Chojnacka, B. Pucher, J. Szczapa, J. Gadzinowski, and M. Grzegorowski, “The results of newborn hearing screening by means of transient evoked otoacoustic emissions,” International Journal of Pediatric Otorhinolaryngology, vol. 69, no. 10, pp. 1351–1357, 2005.
[22]
B. de Capua, C. de Felice, D. Costantini, F. Bagnoli, and D. Passali, “Newborn hearing screening by transient evoked otoacoustic emissions: analysis of response as a function of risk factors,” Acta Otorhinolaryngologica Italica, vol. 23, no. 1, pp. 16–20, 2003.
