ABSTRACT
Objetivo: Descrever os resultados de um programa de monitoramento audiológico em lactentes com indicadores de risco para deficiência auditiva e identificar o perfil das mães dos bebês que participaram do programa. Método: Estudo descritivo e transversal. Foram coletados 56 prontuários de lactentes entre 6 e 18 meses, resultado "passa" na Triagem Auditiva Neonatal e presença de indicadores de risco. Os pais/responsáveis responderam dois questionários sobre o perfil sociodemográfico materno e o desenvolvimento motor, auditivo e da linguagem do lactente, e foram realizados os procedimentos: Audiometria de Observação Comportamental, Audiometria com Reforço Visual e pesquisa do Reflexo Cócleo-palpebral. Resultados: Dos 56 lactentes selecionados, 22 (39,28%) compareceram ao monitoramento, com média de 11,6 meses, predominância do sexo masculino e etnia parda. Indicadores de risco mais frequentes: medicamento ototóxico, permanência em unidade de terapia intensiva maior que cinco dias, hiperbilirrubinemia e anóxia perinatal grave. Todos os bebês avaliados apresentaram respostas adequadas na Audiometria de Observação Comportamental e presença do Reflexo Cócleo-palpebral, e 19 (86,36%) resultados adequados na Audiometria com Reforço Visual. Das 22 mães, todas tiveram filhos em maternidade pública e 18 (81,8%) não foram orientadas sobre o monitoramento audiológico antes da participação neste estudo. Conclusão: Predomínio de normalidade no desenvolvimento auditivo dos lactentes avaliados, perfil de mães predominantemente jovens e donas do lar, e alta taxa de evasão, indicando a necessidade de ações que promovam informações sobre a importância do acompanhamento do desenvolvimento auditivo e estratégias que facilitem o acesso e a adesão ao monitoramento audiológico.
Objective: To describe the results of an audiological monitoring program for infants with risk indicators for hearing loss and identify the profile of mothers of infants who participated in the program. Methods: Descriptive and cross-sectional study. Fifty-six records were collected of infants between 6 and 18 months with "pass" result in Newborn Hearing Screening and presence of risk factors for hearing loss. Parents/guardians answered two questionnaires: concerning the sociodemographic profile of mother; and infant's motor, hearing and language development; and the following audiological monitoring procedures were performed: Behavioral Observation Audiometry, Visual Reinforcement Audiometry and Cochlear-eyelid Reflex research. Results: Of the 56 selected infants, only 22 (39.28%) participated in the audiological monitoring; with a mean age of 11.6 months, predominantly male, mixed ethnicity and more frequent risk indicators: ototoxic medication, permanence in intensive care unit for more than five days, hyperbilirubinemia and severe perinatal anoxia. All of the infants evaluated had adequate responses in the Behavioral Observation Audiometry and Cochlear-eyelid Reflex research; 19 (86.36%) infants had adequate results in the Visual Reinforcement Audiometry. Of the 22 mothers, all had their children in public hospital and 18 (81.8%) received no guidance on audiological monitoring before participating in this study. Conclusion: There was normal predominance in the auditory development of the infants assessed, predominance of young and housewife mothers, and high dropout rate, indicating a need for actions to promote information about the importance of monitoring the auditory development and strategies that facilitate access and adhesion to audiological monitoring. Keywords: Hearing; Hearing Tests; Risk Index; Infant; Hearing Loss.
Objetivo: Describir los resultados de un programa de monitoreo de la audición para niños con índice de riesgo para la pérdida auditiva e identificar el perfil de las madres de los bebes que participaron en el programa. Métodos: Estudio descriptivo y transversal. Recogieron 56 registros de niños entre 6 y 18 meses, resultado "pasa" en el Triage Auditivo del Recién Nacido e índice de riesgo. Los padres/ tutores respondieron cuestionarios sobre el perfil sociodemográfico de la madre y el desarrollo motor, de la audición y del lenguaje infantil. Realizados los procedimientos: Audiometría de la Observación Conductual, Audiometría de Refuerzo Visual e investigación de Reflexión Chocleo-párpado. Resultados: Solo 22 (39,28%) niños participaron del monitoreo, con media de 11,6 meses, hubo predominio masculino y origen étnico mixto. Índices de riesgo más frecuentes: medicamentos ototóxicos, permanencia en la unidad de cuidados intensivos, hiperbilirrubinemia y anoxia perinatal severa. Todos los niños lograron respuestas adecuadas en la Audiometría de la Observación Conductual y en el Reflexión Chocleopárpado, y 19 (86,36%) resultados adecuados en el Audiometría de Refuerzo Visual. Todas las madres tenían a sus hijos en el hospital público y 18 (81,8%) no fueron orientadas acerca del monitoreo antes de la participación en este estudio. Conclusión: Predominio normal en el desarrollo auditivo de los niños, predominio de las madres jóvenes y amas de casa y alta tasa de deserción, lo que indica la necesidad de acciones para promocionar informaciones sobre la importancia y estrategias que faciliten el acceso y la adhesión a el monitoreo.
Subject(s)
Humans , Infant , Hearing Loss , Hearing Tests , Infant , Risk IndexABSTRACT
BACKGROUND AND OBJECTIVES: This paper aimed at evaluating the characteristics of high-frequency (1,000 Hz) acoustic admittance (ya) for the neonates with transient evoked otoacoustic emissions (TEOAE) as either pass or refer group. SUBJECTS AND METHODS: Using a 1,000 Hz probe tone, 297neonates (152 male, 145 female aged 0–104 days old) were evaluated. Tympanometric parameters admittance value at +200 dapa, middle ear admittance, and tympanometric peak pressure were calculated for each tympanogram. RESULTS: The mean of ya was 0.9678 mmho in the TEOAE for the pass group and 0.7229 mmho in the refer group. The mean of acoustic admittance at +200 (y200) was 2.0657 in the TEOAE for the pass group and 1.7191 for the refer group. The mean of Tpp was 23/8591 in the TEOAE for the pass group and 59/7619 for the refer group. CONCLUSIONS: There were significant differences in the distribution of different types of tympanograms, the mean of ya, tympanic peak pressure, and y200 between the TEOAEs for the pass and the refer groups.
Subject(s)
Female , Humans , Infant, Newborn , Male , Acoustic Impedance Tests , Acoustics , Ear, MiddleABSTRACT
Background: Hearing impairment in neonates is a hidden disability, which is usually detected around 2 years of age. Crucial speech and language development begins during first six months of life. Undetected hearing loss present from an early age can impede acquisition of speech language, communication, cognitive and social-emotional development of a child. Across the globe, there is an evolving consensus that all infants should be screened for hearing impairment and appropriate interventions should be instituted in those found to have the problem by six months of age. Most developed countries have introduced mandatory screening and interventional programme with strategies appropriate for their public health concerns. Unfortunately, in developing countries, due to the paucity of resources, infant hearing screening programme has not been introduced as national programme. There have been very few large scale hearing screening studies done in India, to know the feasibility of universal hearing screening or high risk neonate hearing screening. The present study is taken to fill in the lacune in this aspect. Aims & Objective: To study the feasibility of using two staged Transient Evoked Otoacoustic Emissions (TEOAE) followed by confirmation with Auditory Brainstem Response (ABR) in hearing screening of newborns along with an attempt to identify additional risk factors, other than those included in “High Risk Registry (HRR)” given by Joint Committee on Infant Hearing (JCIH) in 2007. Material and Methods: A prospective observational study of hearing impairment screening was conducted on 800 newborns, who were screened with two staged Transient Evoked Otoacoustic Emissions TEOAE, using handheld TEOAE device, followed by confirmation with Auditory Brainstem Response (ABR). The study was done in Command Hospital Air Force, Bangalore, during Jan 2010 to May 2011, where in all new born, born during the study period were screened, which included 757 healthy neonates and remaining 43 high risk neonates as per HRR of JCIH 2007. Additional risk factors that could affect the hearing in the normal neonates was also studied. Results: At the end of the two TEOAE tests, 15 (1.8%) neonates of the 800 cohort screened were suspected of hearing impairment and referred for ABR test. Sensorineural hearing loss was confirmed by ABR in 5 (0.6%) of those 15 referred, with a 1.2% false positive rate at the end of 2nd TEOAE. 2 of the hearing impaired infants belonged to “at risk group” neonates with remaining 3 not having any risk factor as per “High Risk Registry (HRR)” of Joint Committee on Infant Hearing (JCIH). This study showed the presence of medical conditions like maternal Urinary Tract Infection (UTI), Gestational Diabetes Mellitus (GDM) or maternal Diabetes Mellitus (DM) and Pregnancy Induced Hypertension (PIH) along with the well-known risk factors of HRR in the infants with hearing loss. But a strong association between these maternal conditions and hearing impairment could not be established due to small sample size, warranting a detailed study of these other possible risk factor. Conclusion: This study has shown that two–stage hearing screening with TEOAE & ABR is a feasible method that can be successfully implemented for newborn hearing screening, for early detection of hearing impaired, on a large scale, in hospital, to achieve the high quality standard of screening programs. 3 of the 5 hearing impaired detected in the study had no known risk factor for hearing loss, advocating universal hearing screening and an extensive efforts are required to find additional risk factors that can be included in the HRR of JCIH so as to make high risk screening more effective.