Clin Exp Otorhinolaryngol.  2012 Apr;5(Suppl 1):S32-S36.

Changes in the Hearing Thresholds of Infants Who Failed the Newborn Hearing Screening Test and in Infants Treated in the Neonatal Intensive Care Unit

• Kang MY
• Jeong SW
• Kim LS

Abstract

OBJECTIVES
The aim of this study was to investigate changes in the hearing thresholds during the first year of life in infants who failed the newborn hearing screening (NHS) test and of infants treated in the neonatal intensive care unit (NICU).
METHODS
From March 2007 to November 2010, 193 healthy infants who failed the NHS test and 51 infants who were treated in the NICU were referred for evaluation of hearing acuity. Their hearing was evaluated using impedance audiometry, auditory brainstem response (ABR), and otoacoustic emission before 6 months of age, and follow-up hearing tests were administered before 12 months of age. Changes in their hearing thresholds were then analyzed.
RESULTS
Of the 193 healthy infants who failed the NHS test, 60 infants (31%) had normal hearing acuity, 126 infants (65%) had sensorineural hearing loss (SNHL, ABR threshold > or =40 dB) and 7 infants (4%) had auditory neuropathy (AN). On the follow-up hearing tests, which were conducted in 65 infants, 6 infants showed a hearing threshold deterioration of more than 20 dB, and 19 infants showed a hearing threshold improvement of more than 20 dB. Of the 51 infants who were treated in the NICU, 38 infants (75%) had normal hearing acuity, 12 infants (24%) had SNHL, and one infant (2%) had AN. In the follow-up hearing tests, which were performed in 13 infants, one infant with normal hearing progressed to severe hearing loss. Five infants who had SNHL showed a hearing threshold improvement of more than 20 dB, and 4 infants recovered to normal hearing.
CONCLUSION
The hearing thresholds of infants with congenital SNHL can change during the first year of life; therefore, the importance of administration of follow-up hearing tests is emphasized. Irreversible intervention such as cochlear implantation should be considered with great caution within the first year after birth.

Keyword

Infant; Hearing loss; Newborn hearing screening

MeSH Terms

Acoustic Impedance Tests
Cochlear Implantation
Cochlear Implants
Evoked Potentials, Auditory, Brain Stem
Follow-Up Studies
Hearing
Hearing Loss
Hearing Loss, Central
Hearing Loss, Sensorineural
Hearing Tests
Humans
Infant
Infant, Newborn
Intensive Care, Neonatal
Mass Screening
Parturition
Hearing Loss, Central

Figure

• 

  Fig. 1 Results of the initial diagnostic hearing test and follow-up hearing tests conducted in infants who could not pass newborn hearing screening (NHS). SNHL, sensorineural hearing loss; ABR, auditory brainstem response; AN, auditory neuropathy; diff, difference. *Values in parentheses indicate the mean age at the time of hearing test.

• 

  Fig. 2 Incidence of hearing loss according to the presence of risk factors for hearing loss. The presence of risk factors did not increase the incidence of hearing loss. NHS, newborn hearing screening; SNHL, sensorineural hearing loss; AN, auditory neuropathy.

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  Fig. 3 Results of initial diagnostic hearing test and follow-up hearing test performed in infants who were treated in the neonatal intensive care unit (NICU). SNHL, sensorineural hearing loss; ABR, auditory brainstem response; AN, auditory neuropathy; diff, difference. *Values in parentheses indicate the mean age at the time of hearing test.

• 

  Fig. 4 Change in hearing thresholds of an infant with congenital cytomegalovirus infection. Initial auditory brainstem response (ABR) revealed normal hearing thresholds of 20 dBnHL for both ears. Follow-up ABR showed elevation of hearing thresholds to 70 and 80 dBnHL for both ears, respectively.

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  Fig. 5 Change in hearing thresholds of a healthy newborn. Initial auditory brainstem response (ABR) revealed that he had profound sensorineural hearing loss. His hearing improved to 70 dBnHL and then 50 dBnHL in follow-up hearing tests.

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