The Validity Using Two-stage Automated Auditory Brainstem Response as a Universal Newborn Hearing Screening Protocol : Experiences in Asan Medical Center / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Universal newborn hearing screening is widely accepted due to socioeconomic harm of congenital hearing loss. The aim of this study was to assess whether two-stage automated auditory brainstem response (AABR) is acceptable method for newborn hearing screening and to check the presence of potential false negative cases by using another criterion considering sweep number. SUBJECTS AND METHOD: Among 3761 neonates who were born from March 2004 to December 2005, 3053 healthy neonates (81.18%) whose parents agreed to hearing screening protocol were screened with AABR. Failed neonates ('refer') at first stage test and neonates showing high sweep number (>4000) on repeated test were received second stage retest within 24 hours from the first test. Neonates whose retest AABR results were failed or high sweep number continuously were tested with conventional ABR as a confirmative study within 3 months. RESULTS: 94 neonates (3.08%) were failed and 180 neonates (5.89%) showed high sweep number on first stage AABR test. On second stage AABR test, neonates with 'final refer' result were 46 (1.51%) and neonates with 'final high sweep number' result were 44 (1.44%). Neonates with threshold of over 30 dB at ABR were 14 among final refer group and 5 among final high sweep number group. Three bilateral profound hearing loss cases were detected and proper management was done. Nine false negative cases were detected and of these, 3 neonates showed moderate hearing loss. There is no clear relationship between predicting false negative case and sweep number. CONCLUSION: Our current two stage AABR test is useful tool for newborn hearing screening with acceptable referral rate and positive predictive value. False negative cases detected through our protocol have no clear relationship with high sweep number.