The impact of two-stage newborn hearing screening protocol for early diagnosis of hearing loss | ACTA Otorhinolaryngologica Italica

Abstract

Objective: Early detection and prompt intervention of Permanent Hearing Impairment (PHI) can only be achieved through Universal Newborn Hearing Screening (UNHS) in the first month of life. The most common screening worldwide protocols involve the combined approach with transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR). Our study aims to evaluate the rate of infants with PHI in a population with discordant outcome TEOAEs/AABR through an audiological follow up. Methods:  The present study enrolled 637 well babies who failed TEOAEs at birth and were referred for a secondary level audiological evaluation with TEOAEs and AABR. Ninety babies with discordant outcome (TEOAEs refer/AABR pass) underwent to audiological retest adding tympanometry and clinical click-evoked auditory brainstem response. Results: The PHI was confirmed in 12 babies (7 bilaterally and 5 unilaterally) and the degree was by mild to moderate in 8 and in 4 babies, respectively. There was not risk factors for delayed onset of hearing loss in half of PHI. Conclusion: The discordance TEOAEs refer/AABR pass suggests that a follow-up should be recommended independently of the risk factors for PHI to avoid misleading diagnosis of mild or late-onset hearing loss.