[Two-tier screening process (TEOAE/AABR) reduces recall rates in newborn hearing screening]. / Sequenzielles Neugeborenen-Hörscreening (TEOAE/AABR) reduziert Recall-Rate. Erfahrungen in einem Berliner Perinatalzentrum.

BACKGROUND: 1-2/1,000 newborns are affected by connatal permanent hearing impairment. Clinical diagnosis is often delayed. This demands newborn hearing screening (NHS). Some questions regarding the optimal method remain unsolved. METHODS: The newborns in the obstetrical department (low-risk group) are tested by automated transitory evoked otoacustic emissions (TEOAE). TEOAE-fail is followed by automated auditory brainstem response (AABR) examination. All sick newborns admitted to the pediatric department (high-risk group) are primarily tested using AABR. Pathological AABR-testing leads to pedaudiological diagnostic work-up. RESULTS: In the low-risk group, 82 out of 1,584 newborns failed TEOAE-testing (recall 5.18%). Only 5 of these patients failed consecutive AABR examination (recall 0.32%). Permanent hearing loss was finally confirmed in 3 children (0.13%). 10 out of 755 newborns in the high-risk group failed AABR-testing (1.32%). In 6 of these children, hearing loss was confirmed (0.79%). CONCLUSION: A two-tier screening process as described is able to reduce recall rate, overall expenses and parental anxiety.

Further improvements in the transport of high-risk neonates.

The transport incubator used since 1972 was modified for the CPAP method (continuous positive airway pressure). A very generous indication for the use of this ventilatory assistance in the presence of very early clinical signs of respiratory distress syndrome before or during the transport into the Children's Hospital has contributed towards improving the survival rate of infants with a birth weight of 1001-1500 grams to 84,8% and for those below 1000 grams to 39,4%.