[Universal newborn hearing screening in Cantabria (Spain): results of the first two years]. / Cribado universal de la hipoacusia congénita en Cantabria: resultados de los dos primeros años.

AIMS: We present the results of the first 2 years of universal newborn hearing screening in Cantabria. MATERIAL AND METHODS: We performed a descriptive study of screening with two levels of transient evoked otoacoustic emissions in 8,836 newborns, diagnostic confirmation with auditory brainstem response, and treatment. RESULTS: The coverage of the first two levels of otoacoustic emissions was 98.4 % and 99.5 %. The incidence of risk factors was 3.08 %. A total of 6.7 % of those studied in the first stage were referred to the second, and 0.7 % of those studied in the second stage were referred to testing of auditory brainstem responses. Of the patents referred to the second stage, 97.6 % attended, and of those referred to the third stage 87.1 % attended. The positive predictive value after the second session of otoemissions was 7.9 %, and the false positive rate was 3.3 %. Sensorineural and bilateral hearing loss was diagnosed in 11 children, and permanent unilateral hypoacousia was diagnosed in one child, representing an incidence of 1.38/1,000 newborns. Sixty percent were diagnosed before the age of 3 months and 100 % before the age of 7 months. Fifty percent began treatment before the age of 6 months and 90 % before the age of 1 year. Of three cochlear implants indicated, two were implanted at 11 and 13 months. The cost was 1.3 3 per child screened and 867 3 for each case diagnosed. CONCLUSIONS: All the objectives of the first and second stages of screening were achieved. The continuity index anticipated for the third stage (87.1 vs 95 %) and access to treatment at 6 months (50 % vs 100 %) were less satisfactory, although these results compare favorably with those of previously published studies.

Cribado universal de la hipoacusia congénita en Cantabria: resultados de los dos primeros años / Universal newborn hearing screening in Cantabria (Spain): results of the first two years

Objetivo: Exponer los resultados de los primeros 2 años del cribado universal de la hipoacusia en Cantabria. Material y métodos: Estudio descriptivo del cribado con dos pases de otoemisiones de 8.836 neonatos, de la confirmación diagnóstica con potenciales evocados, y su tratamiento. Resultados: La cobertura de los dos primeros pases de otoemisiones fue del 98,4 y 99,5 %. La incidencia de factores de riesgo fue del 3,08 %. El 6,7 % de los estudiados en el primer nivel se remitieron al segundo, y el 0,7 % de los estudiados en el segundo se remitieron a potenciales. De los remitidos al segundo nivel acudieron el 97,6 %, y de los remitidos al tercer nivel el 87,1 %. El valor predictivo positivo tras el segundo pase de otoemisiones fue del 7,9 %, y los falsos positivos el 3,3 %. Se diagnosticaron 11 hipoacusias neurosensoriales bilaterales y una unilateral de transmisión permanente, lo que da una incidencia de 1,38 por 1.000 recién nacidos. El 60% fueron diagnosticados antes de los 3 meses y el 100% antes de los siete. Respecto al tratamiento, el 50 % lo iniciaron antes de los 6 meses y el 90 % antes del año. De los tres implantes cocleares indicados, dos se realizaron a los 11 y 13 meses. El coste ha sido de 1,3 3 por niño cribado y de 867 3 por caso detectado. Conclusiones: Se han cumplido los objetivos del primer y segundo niveles. No se ha alcanzado el índice de continuidad previsto para el tercer nivel (87,1% frente a 95 %) ni el acceso al tratamiento a los 6meses (50 % frente a 100 %), aunque estos resultados se comparan de forma favorable con otros publicados previamente

Aims: We present the results of the first 2 years of universal newborn hearing screening in Cantabria. Material and methods: We performed a descriptive study of screening with two levels of transient evoked otoacoustic emissions in 8,836 newborns, diagnostic confirmation with auditory brainstem response, and treatment. Results: The coverage of the first two levels of otoacoustic emissions was 98.4 % and 99.5 %. The incidence of risk factors was 3.08 %. A total of 6.7 % of those studied in the first stage were referred to the second, and 0.7% of those studied in the second stage were referred to testing of auditory brainstem responses. Of the patents referred to the second stage, 97.6 % attended, and of those referred to the third stage 87.1 % attended. The positive predictive value after the second session of otoemissions was 7.9 %, and the false positive rate was 3.3 %. Sensorineural and bilateral hearing loss was diagnosed in 11 children, and permanent unilateral hypoacousia was diagnosed in one child, representing an incidence of 1.38/1,000 newborns. Sixty percent were diagnosed before the age of 3 months and 100 % before the age of 7 months. Fifty percent began treatment before the age of 6 months and 90 % before the age of 1 year. Of three cochlear implants indicated, two were implanted at 11 and 13 months. The cost was 1.3 3 per child screened and 867 3 for each case diagnosed. Conclusions: All the objectives of the first and second stages of screening were achieved. The continuity index anticipated for the third stage (87.1 vs 95 %) and access to treatment at 6 months (50 % vs 100 %) were less satisfactory, although these results compare favorably with those of previously published studies

[Program of hearing loss early detection in newborn infants in Cantabria. Results of the first year of activities]. / Programa de detección precoz de la hipoacusia en neonatos en Cantabria. Resultados del primer año de funcionamiento.

AIMS: To report the findings in the first year of follow-up of the Cantabrian Program to screen newborn babies for congenital permanent hearing loss. METHODS: The study population consisted of infants born during a year period in Cantabria (Spain). Universal hearing screening by transient evoked otoacoustic emissions (TEOAE) in 2 stage protocol was performed. Infants with failure scores in these 2 stages and those with risk factors for hearing loss were referred for diagnostic evaluation with auditory brainstem response. Hearing aids were recommended for those infants who had bilateral hearing loss and referrals to infant speech and language rehabilitation. RESULTS: Out of the 4117 eligible babies, 3987 were studied. One hundred and ten (2.6) had risk factors for hearing loss, 3.5% were referred for audiological assessment and 1.2/1000 were diagnosed as having a permanent hearing loss. The false-positive rate was 0.72% after the two-stage screening procedure was performed. Positive predictive value for permanent hearing loss was 10%. CONCLUSIONS: During the first year working with the Cantabrian Screening Program for congenital permanent hearing loss in newborn babies, the most part of the proposed aims have been achieved.

Programa de detección precoz de la hipoacusia en neonatos en Cantabria. Resultados del primer año de funcionamiento / Early hearing loss detection program for newborn babies in Cantabria. First year results

Objetivos: Evaluar los hallazgos obtenidos en el primer año de funcionamiento del Programa Cántabro para la Detección Precoz de la Hipoacusia Neonatal. Métodos: El ámbito de estudio incluyó a todos los recién nacidos en la Comunidad Autónoma de Cantabria (España) entre el 1 de abril de 2001 y 31 de marzo de 2002. El programa se dividió en 4 fases; las 3 primeras son las que se incluyen en este estudio: fase de screening con otoemisiones acústicas automatizadas (OAE), fase de diagnóstico con potenciales evocados auditivos (neonatos con OAE negativas y/o factores de riesgo de hipoacusia) y fase de tratamiento (adaptación de prótesis auditivas y rehabilitación logopédica). Resultados: Durante el periodo de estudio nacieron 4.117 niños, de los que 110 (2,6%) tenían factores de riesgo. Un 0,8 por ciento de los neonatos sin factores de riesgo y un 3,5 por ciento del total de los incluidos en el programa fueron remitidos a la fase de diagnóstico. 3.987 niños (96,8%) completaron el estudio. La incidencia de hipoacusia permanente fue de 1.2/1000. El valor predictivo positivo en los neonatos sin factores de riesgo fue del 10% y el porcentaje de falsos positivos respecto a la población sometida a screening del 0,72%. Conclusiones: En el primer año de funcionamiento del Programa Cántabro de Detección Precoz de la Hipoacusia Infantil se han cumplido la mayor parte de los objetivos de calidad propuestos (AU)

AIMS: To report the findings in the first year of follow-up of the Cantabrian Program to screen newborn babies for congenital permanent hearing loss. METHODS: The study population consisted of infants born during a year period in Cantabria (Spain). Universal hearing screening by transient evoked otoacoustic emissions (TEOAE) in 2 stage protocol was performed. Infants with failure scores in these 2 stages and those with risk factors for hearing loss were referred for diagnostic evaluation with auditory brainstem response. Hearing aids were recommended for those infants who had bilateral hearing loss and referrals to infant speech and language rehabilitation. RESULTS: Out of the 4117 eligible babies, 3987 were studied. One hundred and ten (2.6) had risk factors for hearing loss, 3.5% were referred for audiological assessment and 1.2/1000 were diagnosed as having a permanent hearing loss. The false-positive rate was 0.72% after the two-stage screening procedure was performed. Positive predictive value for permanent hearing loss was 10%. CONCLUSIONS: During the first year working with the Cantabrian Screening Program for congenital permanent hearing loss in newborn babies, the most part of the proposed aims have been achieved (AU)

Programa de detección precoz de la hipoacusia infantil en Cantabria / Early detection program of infant hipoacusia in Cantabria (Spain)

Se presenta el Programa de Detección Precoz de la Hipoacusia Infantil que va a implantarse en Cantabria a partir del presente año 2001. Se trata de un programa universal (no dirigido a grupos de riesgo sino a la totalidad de los recién nacidos) y gratuito (tanto para niños que nazcan en hospitales públicos como en privados de nuestra Comunidad). Se estructura en 5 niveles, de los cuales los tres primeros son los del screening propiamente dicho. En la población sin factores de riesgo se establecen dos niveles iniciales basados en otoemisiones acústicas evocadas, siendo remitidos los niños que no superen el 2º nivel a una unidad específica (Unidad de Diagnóstico Precoz de la Hipoacusia Infantil) donde se aplicarán potenciales evocados y/o otras técnicas diagnósticas hasta llegar al diagnóstico de confirmación y etiológico. Los niños con factores de riesgo serán remitidos directamente a la Unidad de Diagnóstico Precoz de la Hipoacusia Infantil para ser sometidos a potenciales evocados y/o otoemisiones acústicas evocadas. Se especifican los índices que se utilizarán para evaluar el programa y los objetivos del mismo (AU)