specificity and sensitivity of transient otoacoustic emission in neonatal hearing screening compared with diagnostic test of auditory brain stem response in Tehran hospitals

Since early detection [specially before 6 months of age] of deaf people leads to better hearing and speech outcome after treatment, several clinical trials have been performed in order to find a cost effective, short duration screening test for diagnosis of neonatal hearing impairment. The aim of this study was to assess the sensitivity and specificity of Transient Otoacustic Emission [TEOAE] test in newborns comparing with auditory brain stem response [ABR] in the age of 3 months and to analyze the association between risk factors and hearing loss in neonates. A cross-sectional study was conducted January 2008 - May 2009 in Tehran. 1000 newborns [526 boys and 474 girls] were assessed. First, all of neonates were evaluated by TEOAE 24h after birth. If responses of OAE were failing, they were retested 10 to 15 days after birth by TEOAE. Also, All Neonates were assessed by ABR in the age of 3 months. Descriptive Statistics was used to analyze data. Eighteen out of 1000 neonates failed double-checked TEOAE tests, of which 6 were confirmed by ABR test [12 false positive results]. Nine out of 1000 neonates had impaired ABR tests, from these patients, 6 had failed OAE as well, but 3 had normal OAE [3 false negative results]. From these 9 patients 2 had profound hearing loss and received cochlear implantation. We found that OAE has 66.7% sensitivity and 98.8% specificity in diagnosis of neonatal hearing impairment. Its positive and negative predictive value was 33.3% and 99.7% respectively. Also we did not find statistically significant relationship between hearing loss and risk factors. TEOAE as a simple, non-invasive, short duration and cost effective method, is a suitable test for neonatal hearing screening. Even though only two thirds of patients were detected by this method, 99.7% negative predictive value makes it a good screening test. We recommend OAE as a suitable primary neonatal hearing screening all over the country

repot of surgical complications in a series of 262 consecutive pediatric cochlear implantations in Iran

Cochlear implantations have become a routinely performed and successful surgical intervention in both adults and children. The current article reports the complications encountered in various age groups of consecutive children who underwent implantation in our center. We performed a prospective analysis of all profoundly deaf children who underwent cochlear implantation from March 2006 to July 2009 at Baqhiyatallah Cochlear Implantation Center. All patients were younger than 5 years old at the time of implantation. The minor complications occurred in 49 [18.7%] cases, The most common postoperative complications were temporary facial weakness detected in 15 cases [5.7%] all of which were reversible. Magnet wound was observed in 14 [5.3%] patients, keloid formation in 10 [3.8%], wound infection in 2 [0.8%], otitis media in 5 [2%], and electrode movement, meningitis, vertigo, Laryngospasm each in 1 [0.4%] case was detected among our patients. Cochlear implantation in children continues to be reliable and safe in experienced hands, with a low percentage of severe complications as long as the patient is monitored closely

Impact of implantation on anxiety and depression in mothers of children under cochlear implant

The aim of our study is to determine the impact of cochlear implantation on anxiety and depression in mothers of children with cochlear implant. In a Cohort design, 35 mothers of deaf children with cochlear implantion admitted to the clinic of Baqiyatallah hospital during January 2008 - January 2010 were selected through systematic sampling. Information of demography, depression and anxiety are obtained from the parents by checklist and beck questionnaires, respectively. Mean depression and anxiety scores in cochlear implant candidates were more than cochlear implant recipients. The difference was significant in depression and anxiety [P=0.001]. It seems that cochlear implant use leads to decrease of depression and anxiety but still high prevalence of these complications than the normal population