Distortion Product and Spontaneous Otoacoustic Emissions in Normal Neonates / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Distortion product otoacoustic emission (DPOAE) offers an alternative to transiently evoked OAE as a neonatal hearing screening, and may provide frequency specific information of the cochlea. The purpose of this study is to establish the relevant characteristics of spontaneous OAE (SOAE) and DPOAE of neonates and their efficacy as a neonatal screening method for hearing loss. MATERIALS AND METHODS: From July to September 1999, 72 healthy newborns (144 ear) were included in this study and test was performed within 3 days after birth at nursery. DP audiogram, input/output (I/O) curve at 3 kHz, and SOAE were recorded. RESULTS: The DP audiogram had characteristics with two broad peaks of amplitude at Fe (geometric mean of two primaries) frequencies of 3 kHz and 6 kHz. From the Fe near 3 and 6 kHz, DPOAE was found over 95% of 144 ears. Median threshold of 3 kHz I/O curve was 40 dB. The threshold in 3 kHz could be obtained even in 7 ears that had failed to pass DP audiogram. The thresholds of the ears that failed in DP audiogram were not statistically different from those that passed the test, The amplitude in DP audiogram was not correlated with the threshold in 3 kHz I/O curve. The positive rate for SOAE was 45% (39% in male, 53% in female, 51% in right ear, 38% in left ear, respectively), All the SOAE positive cases passed DP audiogram test. CONCLUSIONS: DPOAE has a potential for neonatal screening test for hearing loss. Near 3 kHz and 6 kHz, DPOAE were highly positive, and these frequencies can be used in screening test. The duration of a diagnostic test would be shorter by excluding certain frequencies. Using the 3 kHz I/O curve in addition to DP audiogram may increase the validity and the e6cacy of the test. SOAF has limitations as a single modality of neonatal screening test for hearing loss.

Congenital Heart Disease and Associated Extracardiac Anomalies in Autopsies

PURPOSE: In order to find out how frequently and what kind of extra-cardiac anomalies (CAs) is associated with congenital heart disease (CHD) in general and in each CAs, autopsies with congenital cardiovascular malformations were studied. METHODS: Autopsy files of Seoul National University Children's Hospital from 1991 to 1995 were reviewed to find cases of CHDs. Other extra-CAs were tabulated from the records of autopsy files. The study population was comprised of 156 cases (86 still birth or product of terminated pregnancy; 66 livebirth; 4 unknowns-whether still birth or livebirth). RESULTS: The sex ratio was 1.14:1 males to females. In still birth cases, gestational age ranged from 16 to 42 weeeks and in live birth cases, age ranged from 1 day to 1 year 7 months (mostly neonates). The ventricular septal defect (VSD) was the most common CA, followed by coarctation of aorta, tetralogy of Follot in this order of frequency. No extra-CA was found in 55 cases, 1 extra-CA in 54 cases, 2 extra-CAs in 35 cases, 3 or more extra-CAs in 12 cases. VSD was commonly associated with Edward syndrome and holoprosencephaly, tetralogy of Fallot with holoprosencephaly, and coarctation with cystic hygroma. The most commonly involved organ system was the central nervous system followed by the digestive system, facial anomaly, and so on. Chromosomal anomaly associated with CHDs was 24 cases. Common individual anomalies were cystic hygroma, Edward syndrome, holoprosencephaly, and so on. CONCLUSION: As the fetus and infants with CHD have high incidence of associated extra-CAs, collaborative works involving dysmorphologist, geneticist, pathologist, surgeons, and pediatric cardiologist are needed. For further studies of CA and extra-CAs, a systematic database andprecise medical records and interdepartmental collaboration are necessary.

Congenital Anomaly in Babies Born by In Vitro Fertilization and Embryo Transfer

PURPOSE: In infertility clinics, ectosomatic fertilization technique is becoming very popular but there has not been clear documentation of the incidence of congenital anomalies in babies born by this method. The aim of this study were to investigate the incidenceof congenital anomalies in babies born by in vitro fertilization (IVF) and to find out risk factors for congenital anomaly. METHODS: The study population was comprised of 275 liveborn babies by IVF with a gestation period of more than 20 weeks. Medical records of these babies and obstetric records of the mothers reviewed. All the congenital anomalies were searched out and many infantile and maternal factors were tabulated. Statistical analysis was performed to determine the risk factors of congenital anomalies in babies born by IVF. Also fetal echocardiographic records were reviewed to find out fetuses born by IVF and their outcome was reviewed. RESULTS: The incidence of congenital anomalies was 47/275 (17/1%) in babies born in our hospital. Of fetal echocardiographic group, 2/6 had congenital anomalies. Although premature babies were prone to have severe congenital anomalies, there are no statistical correlations between congenital anomalies and hospital in which IVF performed, method of IVF, sex and multiple gestation. CONCLUSION: Although the incidence of congenital anomalies seemed to be high in our population, our patient population is probably biased to a higher risk population. There are no statistical risk factors observed except gestational age, but further studies will be necessary.

Congenital Anomaly in Babies Born by In Vitro Fertilization and Embryo Transfer

PURPOSE: In infertility clinics, ectosomatic fertilization technique is becoming very popular but there has not been clear documentation of the incidence of congenital anomalies in babies born by this method. The aim of this study were to investigate the incidenceof congenital anomalies in babies born by in vitro fertilization (IVF) and to find out risk factors for congenital anomaly. METHODS: The study population was comprised of 275 liveborn babies by IVF with a gestation period of more than 20 weeks. Medical records of these babies and obstetric records of the mothers reviewed. All the congenital anomalies were searched out and many infantile and maternal factors were tabulated. Statistical analysis was performed to determine the risk factors of congenital anomalies in babies born by IVF. Also fetal echocardiographic records were reviewed to find out fetuses born by IVF and their outcome was reviewed. RESULTS: The incidence of congenital anomalies was 47/275 (17/1%) in babies born in our hospital. Of fetal echocardiographic group, 2/6 had congenital anomalies. Although premature babies were prone to have severe congenital anomalies, there are no statistical correlations between congenital anomalies and hospital in which IVF performed, method of IVF, sex and multiple gestation. CONCLUSION: Although the incidence of congenital anomalies seemed to be high in our population, our patient population is probably biased to a higher risk population. There are no statistical risk factors observed except gestational age, but further studies will be necessary.

Click evoked otoacoustic emissions in healthy newborns / 대한이비인후과학회지

No abstract available.