Unit:
Τομέας ΧειρουργικήςLibrary of the School of Health Sciences
Author:
Nisotakis Emmanouil
Dissertation committee:
Ελευθέριος Φερεκύδης, Καθηγητής, Ιατρική, ΕΚΠΑ
Δημήτριος Κανδηλώρος, Καθηγητής, Ιατρική, ΕΚΠΑ
Αντώνιος Τζαγκαρουλάκης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Ιωάννης Γιωτάκης, Καθηγητής, Ιατρική, ΕΚΠΑ
Θωμάς Νικολόπουλος, Καθηγητής, Ιατρική, ΕΚΠΑ
Παύλος Μαραγκουδάκης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Αλέξανδρος Δελίδης, Λέκτορας, Ιατρική, ΕΚΠΑ
Original Title:
Μελέτη των παραγόντων υψηλού κινδύνου για εμφάνιση βαρηκοΐας σε νεογνά της μονάδας εντατικής νοσηλείας
Summary:
Background
Congenital hearing impairment is proved to be one of the most frequently occurring sensory birth defects. NICU graduates are considered to be of higher risk for hearing impairment, either auditory neuropathy or hearing loss. The severity of hearing impairment during the early life critical periods of speech development determines the acquisition of fluent lingual ability thus it is crucial that any underlying hearing disorder is diagnosed and treated as early as possible.
In this study, we focus on the presence of audiological risk factors and try to clarify their correlation to the development of congenital hearing loss, including ANSD, in the population of newborns hospitalized in the NICU of our tertiary hospital.
Materials and Methods
In the present prospective cohort study, 453 neonates admitted to the NICU, between 2012 and 2016, for more than 24 hours with one or multiple risk factors were analyzed. All newborns were subjected to hearing screening test at least 48 hours after birth, by the use of automated ABRs (a-ABRs) in combination with Transiently Evoked Otoacoustic Emissions (TEOAEs). Newborns who failed the initial test were re-examined before their first month of age and if they still did not manage to pass the screening, they were referred to the audiology department for full hearing evaluation.
Results
Out of 453 neonates, 71 failed the initial hearing evaluation. Only 49 of them presented in the re-examination, resulting eventually in 8 neonates (1.8%) failing both a-ABRs and TEOAEs and being diagnosed with possible sensorineural hearing loss (HL), while 8 neonates (1.8%) passed TEOAEs but failed a-ABRs and were diagnosed with possible auditory neuropathy spectrum disease (ANSD). Ototoxic medication, prematurity, assisted ventilation, low birth weight and hyperbilirubinemia were the most frequently appeared of the 13 individual risk factors investigated. The majority of newborns (48%) presented with two risk factors. Low birth weight was proved to be of statistical significance regarding possible HL (p=0.002) while craniofacial deformities and TORCH infections depicted statistically significant attribution (p=0.03 και p=0.05 respectively) to the occurrence of possible hearing impairment, either HL or ANSD.
Conclusions
ABRs and OAEs remain the cornerstones of any universal hearing screening program in neonatal intensive care units as a significant number of children may have auditory neuropathy. Constant re-evaluation of risk factors and their relation to the development of hearing impairment is needed as they change through time. An efficient secretariat system is needed to reduce the number of lost to follow-up neonates.
Main subject category:
Health Sciences
Keywords:
Otoacoustic emissions, Auditory brainstem responses, Neonatal hearing screening, NICU
Number of references:
214
