Children With Sensorineural Hearing Loss After Passing the Newborn Hearing Screen
Children With Sensorineural Hearing Loss After Passing the Newborn Hearing Screen
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DOI：
10.1001/jamaoto.2013.1229
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发表时间：
2013-02-01
影响因子：
7.8
通讯作者：
Chi, David H.
中科院分区：
文献类型：
--
作者：
Dedhia, Kavita;Kitsko, Dennis;Chi, David H.
目标：识别和描述通过新生儿听力筛查 (NHS) 并随后被发现患有儿童听力损失的儿童的结果。地点：学术三级护理中心。设计：回顾性医疗图表审查。方法：经机构审查委员会批准，对诊断为听力损失的儿童的医院记录进行审查。我们从 2001 年到 2011 年确定了 923 名患有听力损失的儿童。通过 NHS 后出现听力损失的患者也被纳入其中。结果：我们的研究中包括了 78 名患者。通过 NHS 的患者怀疑听力损失最常见的原因是父母的担忧 (n=28 [36%]) 和未通过学校听力筛查 (n=25 [32%])。言语和语言发育迟缓以及初级保健医生筛查失败分别占 17% 和 12%。听力图的配置为双侧对称（n=42 [54%]）、双侧不对称（n=16 [21%]）和单侧（n=20 [26%]）损失。 37 名患者 (47%) 患有严重或极重度听力损失。 42 名患者（54%）病因不明；其余的归因于遗传 (n=13 [17%])、解剖异常 (n=11 [14%])、获得性围产期 (n=9 [12%]) 和听神经病变 (n=3 [4%])。 结论：这是对通过 NHS 的听力损失儿童进行表征的最大规模的研究。在我们的审查中，家长的关注和学校听力筛查是通过 NHS 后诊断听力损失的最常见方法。当患者通过 NHS 并忽视听力损失症状时，家人和初级保健医生可能会有一种错误的安全感。这项研究提出了一个问题：通过 NHS 后，进一步的筛查是否可以识别儿童的听力损失。 JAMA 耳鼻喉头颈外科。 2013年； 139（2）：119-123。在线发布，2013 年 1 月 17 日。doi：10.1001/jamaoto.2013.1229
Objectives: To identify and describe the findings of children who passed their newborn hearing screen (NHS) and were subsequently found to have childhood hearing loss.Setting: Academic tertiary care center.Design: Retrospective medical chart review.Methods: With approval of the institutional review board, hospital records were reviewed for children diagnosed as having hearing loss. We identified 923 children with hearing loss from 2001 to 2011. Patients who passed the NHS with subsequent hearing loss were included.Results: Seventy-eight patients were included in our study. The suspicion of hearing loss in patients who passed the NHS was most often from parental concerns (n=28 [36%]) and failed school hearing screens (n=25 [32%]). Speech and language delay and failed primary care physician screens accounted for 17% and 12%, respectively. Configuration of the audiogram was bilateral symmetric (n=42 [54%]), bilateral asymmetric (n=16 [21%]), and unilateral (n=20 [26%]) loss. Thirty-seven patients (47%) had severe or profound hearing loss. The etiology was unknown in 42 patients (54%); the remaining was attributed to genetics (n=13 [17%]), anatomic abnormality (n=11 [14%]), acquired perinatal (n=9 [12%]), and auditory neuropathy (n=3 [4%]).Conclusions: This is the largest study to characterize children with hearing loss who passed the NHS. In our review, parental concerns and school hearing screens were the most common method to diagnose hearing loss after passing the NHS. Families and primary care physicians may have a false sense of security when patients pass the NHS and overlook symptoms of hearing loss. This study raises the question whether further screens would identify hearing loss in children after passing the NHS. JAMA Otolaryngol Head Neck Surg. 2013; 139(2): 119-123. Published online January 17, 2013. doi: 10.1001/jamaoto.2013.1229