Neonatal hearing screening in remote areas of China: a comparison between rural and urban populations.

Objectives Universal neonatal hearing screening (UNHS) started late in some underdeveloped areas in China, with relatively scarce screening resources and a wide regional distribution. This study aimed to compare the screening performance between rural and urban populations, and to examine the characteristics and problems of UNHS in underdeveloped regions in China. Methods A two-step hearing screening program was used in neonates born in Liuzhou Maternal and Child Health Hospital and in patients who were born in other hospitals, but admitted to the neonatal intensive care unit. This program involved distortion product otoacoustic emission and automated auditory brainstem response. Characteristics of each newborn, as well as the screening outcomes and performance were compared between rural and urban populations. Results A total of 19,098 newborns were screened with a referral rate of 17.9% at the first step. Sixty-three (0.33%) newborns had hearing loss. The prevalence of permanent hearing loss was 2.25‰. The average screening age was significantly older in the rural population than in the urban population in the first ( P < 0.01) and second steps of screening ( P < 0.05). The rural population had a higher referral rate in both steps than the urban population ( P < 0.01). The follow-up rate was much lower in the rural population than in the urban population ( P < 0.05), but dramatically increased in 2014 compared with the previous 2 years. Conclusions A low follow-up rate is a critical issue when carrying out UNHS in developing countries, such as China, especially for rural populations. The government should establish more hearing referral centres to increase service coverage and supply financial assistance for low-income populations.

The Audiological Characteristics of Neonate with Severe Hyperbilirubinemia Need to be Exchanged Transfusion / 听力学及言语疾病杂志

Objective To study the change of audiological characteristics of neonate with severe hyperbilirubi‐nemia need to be exchanged transfusion ,and to explore the correlation between the peak concentrations of serum to‐tal bilirubin and hearing loss .Methods A total of 130 cases of neonate diagnosed with severe hyperbilirubinemia need to be exchanged transfusion were included in this study .Hearing tests of auditory brainstem response (ABR) , distortion product otoacoustic emission (DPOAE) and acoustic immittance were administered to these neonates and they were followed up three months old .They were divided into the normal group ,the mild - moderate group and the severe - extreme group according to the hearing tests results of three months .The peak concentrations of ser‐um total bilirubin and hearing condition among the three groups were analyzed .Results There were 85 neonates with normal hearing (65 .38% ,85/130) ,45 with hearing loss (33 .85% ,45/130 .For 88 ears ,there were 2 cases of single ear and 43 cases of both ears) ,including 11 cases of mild - moderate group (22 ears ,24 .44% ,11/45) and 34 cases with severe - extreme group (66 ears ,75 .56% ,34/45) .There were 16 neonates (32 ears) met the crite‐rion of auditory neuropathy (12 .31% ,16/130) .The difference of the peak concentrations of serum total bilirubin a‐mong the three groups was statistically significant (F=16 .525 ,P=16 .525) .And positive correlation was observed between ABR threshold and peak serum total bilirubin concentration (r=0 .584 ,P<0 .001) .Conclusion The ma‐jor feature of the neonate with severe hyperbilirubinemia need to be exchanged transfusion was extremely severe sen‐sorineural hearing loss in both ears ;and the higher probability of serious hearing loss with the higher peak concen‐trations of serum total bilirubin .

A Follow-up Analysis of 573 Cases of Hyperbilirubinemia after Treatment / 听力学及言语疾病杂志

Objective To share the analysis results of follow -up after treatment of hyperbilirubinemia hear-ing .Methods 573 cases of neonatal hyperbilirubinemia by jaundice intervention method was divided into exchange transfusion group (67 cases ,bilirubin concentration range of 344 .2~1 107 .2 μmol/L ,457 .9 μmol/L on average) and therapy group (506 cases ,bilirubin concentration in the range of 205 .2~ 572 .6 μmol/L ,average 285 .2 μmol/L) .The auditory brainstem response ,distortion product otoacoustic emission hearing detection and immittance method were used .The two groups of hearing loss were compared with 836 cases of normal controls .Results The observation group showed that hearing disorder morbidity rate was 3 .49% (20/573) ,for the control group ,the hearing loss morbidity rate was 0 .24% (2/836) .There was a statistically significant difference between the two groups (P<0 .05) .For the exchange transfusion group ,hearing losses accounted for 25 .37% of the overall change (17/67) .For the phototherapy group ,the hearing losses accounted for 0 .59% of the overall (3/506) phototherapy , showing statistically significant difference between the two groups (P<0 .05) .There were hearing impairment with bilateral severe (80% ,16/20) and retrocochlear lesions (65% ,13/20) .Conclusion The bilirubin concentration in blood transfusion for the children tended to have hearing impairment ,more in bilateral severe and retrocochlear le-sions ,hearing loss was irreversible .

Clinical observation and analysis of paranasal sinus bronchitis in children / 临床儿科杂志

Objectives To investigate the treatment and curative effect on paranasal sinuses and bronchitis in children. Methods Treatment of 62 cases of paranasal sinuses and bronchiolitis was retrospectively analyzed. Antibiotics was used in conventional treatment group (n=23). On top of conventional treatment, conventional plus topical treatment group (n=39) was additionally treated with nasal inhaled corticosteroids, sinus puncture, adenoid or tonsil surgery, etc. Results In conventional treatment group and conventional plus topical treatment group, the total effective rate of treatment for more than 8 weeks was 86.96%and 100.00%respectively, the effective rate for those treated for 4-8 weeks was 39.13%and 61.54%respectively. There was signiifcant difference in the effective rate of treatment for more than 8 weeks and for 4-8 weeks (both P<0.05) between two groups. Signiifcant difference also existed between the effective rate of treatment for more than 8 weeks and for 4-8 weeks (P<0.05) in each group. Conclusions Childhood sino-bronchitis should be treated not only with conventional treatment, but also with cor-rect topical treatment for local pathological changes in nasal sinus and nasopharynx. Longer treatment is needed for children with recurrent chronic sino-bronchitis.

Audiology and etiology of infants who failed to pass newborn hearing screening / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the audiological and etiological characteristics of infants failed to pass hearing screening. METHODS 126 infants received audiological diagnostic tests,including auditory brainstem response(ABR),40 Hz auditory event related potential(40 Hz AERP),distortion product otoacoustic emissions(DPOAE),tympanometry and acoustic reflex. The degrees and types of the hearing loss,and etiological characteristics were analyzed. RESULTS Among 126 infants (252 ears),61 were diagnosed with sensorineural hearing loss(48.41%),48 were conductive hearing loss(38.09%),and 17 were found to have normal ABR thresholds(13.49%). The hearing loss was associated with various factors,including history of infection during pregnancy(21 cases),threatened abortion(9 cases),pregnancy with age at or over 35(6 cases),extension of pregnancy(7 cases),history of systematic diseases(10 cases),history of neonatal jaundice(13 cases),history of asphyxia and hypoxia(18 cases),premature and low birth weight neonates(8 cases),neonatal diseases (8 cases),family history of deafness(5 cases),craniofacial deformity(3 cases),central nervous system disorder(6 cases),and 9 cases were second child. CONCLUSION The infants who failed to pass hearing screening have various etiology characteristics in hearing loss. The infants associated with risk factors were mostly found to have sensorineural hearing loss.