Infant hearing screening.

PURPOSE OF REVIEW: Infant hearing screening has progressed markedly over the past year. Although uncommon in the past, now almost 95% of infants in the United States are screened for hearing loss. Recent literature has expanded on several important components of hearing screening. RECENT FINDINGS: A major revision of the American Academy of Pediatrics policy statement on infant hearing screening was published. This statement identifies a number of important principles and guidelines for infant hearing screening. Improvements in diagnostic techniques have been described including the need for auditory brainstem response screening in premature infants. Risk factors for congenital-hearing loss have been updated. An etiologic diagnosis for infants with hearing loss is increasingly possible with advances in genetics and molecular diagnosis. Finally, several articles provide further information on optimizing follow-up and diagnostic testing as well as early intervention. SUMMARY: Despite the challenges still present in infant hearing screening, screening continues to identify infants at a very young age, and improve the early communication skills of infants with hearing loss through early diagnosis and early intervention.

Health state preference scores for children with permanent childhood hearing loss: a comparative analysis of the QWB and HUI3.

PURPOSE: The aim of this study was to compare two preference-weighted, caregiver-reported measures of health-related quality of life for children with permanent childhood hearing loss to determine whether cost-effectiveness analysis applied to deaf and hard of hearing populations will provide similar answers based on the choice of instrument. METHODS: Caregivers of 103 children in Arkansas, USA, with documented hearing loss completed the Quality of Well-Being Scale (QWB) and the Health Utilities Index Mark 3 (HUI3) to describe the health status of their children. Audiology and other clinical measures were abstracted from medical records. Mean scores were compared overall and by degree of hearing loss. Linear regression was used to correlate preference scores with a four-frequency pure-tone average, cochlear implant status, and other factors. RESULTS: Mean preference scores for the QWB and HUI3 were similar (0.601 and 0.619, respectively) although the HUI3 demonstrated a wider range of values (-0.132 to 1.000) compared to the QWB (0.345-0.854) and was more sensitive to mild hearing loss. Both measures correlated with the pure-tone average, were negatively associated with comorbid conditions and positively associated with cochlear implant status. In the best fitting regression models, similar estimates for cochlear implant status and comorbid conditions were obtained from the two measures. CONCLUSIONS: Despite considerable differences in the HUI3 and the QWB scale, we found agreement between the two instruments at the mean, but clinically important differences across a number of measures. The two instruments are likely to yield different estimates of cost-effectiveness ratios, especially for interventions involving mild to moderate hearing loss.

Failed newborn hearing screens as presentation for otitis media with effusion in the newborn population.

OBJECTIVES: Evaluate the prevalence of middle ear disease in infants failing a newborn hearing screening program. Review the outcomes of those infants diagnosed with or without middle ear disease after failed hearing screen. DESIGN: Retrospective chart review of 76 patients referred to a tertiary care institution for evaluation of a failed newborn hearing screening test. SETTING: Arkansas Children's Hospital, Little Rock, Arkansas. RESULTS: Seventy-six patients were referred for failed OAEs and complete otolaryngology evaluation. Mean age at the time of referral was 3 months (0.25 years) old. OME was identified in 64.5% of the patients. ABR confirmed a suspected hearing loss in 15 patients (78.9%) without middle ear disease. Effusion resolved without surgical intervention in 65.3% of infants, while 17 (34.7%) of the infants required tubes. SNHL was subsequently identified in 11% of infants after resolution of the effusion. CONCLUSIONS: OME is a common cause of failed infant hearing screens, and should be looked for prior to definitive diagnostic hearing testing. OME resolves in the majority of infants, but tube insertion is necessary to allow for diagnostic testing in nearly one third of infants. The majority of infants without OME had SNHL confirmed. SNHL was also identified in 11% of infants with OME after resolution of the effusion.