[Controlling retests in a universal hearing screening program]. / Control de las repeticiones en un programa de cribado auditivo universal.

INTRODUCTION: To evaluate the influence of several factors in the need for retesting in the first stage of a universal auditory screening program, a prospective and statistic study is presented, specially remarking the differences found between two health systems (public and private). PATIENTS AND METHODS: 18,073 children born in the 1999-2004 period were included in the study, in the context of a universal screening protocol based on Otoacoustic emissions and ABR, and distributed into three groups depending on their place of birth (A: public hospital; B: private hospital; C: children from other region). RESULTS: Significant differences were found between the groups (7.3% retesting in the public system and 2.4% in the private), explained by the fact that in the first group the test was performed in 74.9% of cases within 3 days after birth (when the need for repetition was 7,7%), and in the other groups the exploration was delayed up to 4-10 days in most cases (when retesting was performed only in 4.9%). DISCUSSION AND CONCLUSIONS: Proportion of retesting in the first stage of a universal screening program is an important factor for the cost estimation of these protocols. We assume that the age at testing varies significantly this factor, and on the contrary, we know that precocious exploration (before the child leaves the hospital) increases the program covering. Therefore we conclude that the test should be delayed only in health systems needing to save resources or not able to test before discharge, and not in those wanting to guarantee the maximum covering.

[Validation parameters of otoemissions with Echocheck]. / Parámetros de validación de otoemisiones con el Echocheck.

GOALS: There are several papers that support the use of Echocheck system to exclude neonatal hypoacusis, but none of them compare it with the ILO systems, neither compare the internal parameters obtained versus those from a colour coded system. We are trying to demonstrate that both techniques are equivalent and valid. METHODS: Acoustic otoemissions were studied in four hundred and ninety four (494) newborn ears using Echocheck. They were classified as Normal, Not valid, No EOAEs and Invalid using a colour coded system. After this they were compared with the internal results registered by the system. On the other hand, otoemissions were obtained using both methods (Echocheck and ILO-88) in 135 ears and the results compared. RESULTS: The correlation between the results obtained through the colour coded system and those obtained from the internal register was absolute for those parameters previously determined. For the comparison between both systems, results did coincide in all cases except for two, in which there were only results with ILO and not with Echocheck. CONCLUSIONS: The validity of the test using this new system as well as the comparison of the results with those obtained from ILO systems has been demonstrated, therefore its use has been recommended for the early detection of hypoacusis in newborn due to the fact that it is simple to perform.

Parámetros de validación de otoemisiones con el Echocheck® / Eoaes (evoked oto acoustic emissions) validation parameters with Echocheck®

Objetivos: Aunque existen trabajos que demuestran la utilidad del Echocheck® en el despistaje de la hipoacusia en neonatos, ninguno lo compara con los sistemas ILO® ni tampoco han sido cotejados los resultados que el aparato muestra mediante un código de colores con los parámetros internos que genera. Se pretende demostrar que ambas técnicas son equivalentes y válidas. Métodos: Se estudiaron mediante otoemisiones acústicas 494 oídos de recién nacidos vivos usando el sistema Echocheck. Se clasificaron en Normales, No Válidos, Falta e Inválidos según un código de colores. Posteriormente se cotejaron con los resultados internos registrados por el aparato. Por otra parte se detectaron las otoemisiones en 135 oídos con ambos sistemas y se compararon los resultados obtenidos. Resultados: La correlación entre los resultados externos determinados mediante el código de colores y los registros internos fue absoluta según los parámetros previamente determinados. En la comparación mediante los dos sistemas, los resultados coincidieron excepto en dos pruebas en las que faltaron las otoemisiones con el Echocheck estando presentes con el ILO. Conclusiones: Queda demostrada la validez de la prueba con este nuevo sistema, así como la equiparación de sus resultados con los obtenidos por los sistemas ILO®, recomendándose su uso para la detección precoz universal de todos los recién nacidos vivos por la sencillez de su manejo (AU)

GOALS: There are several papers that support the use of Echocheck system to exclude neonatal hypoacusis, but none of them compare it with the ILO systems, neither compare the internal parameters obtained versus those from a colour coded system. We are trying to demonstrate that both techniques are equivalent and valid. METHODS: Acoustic otoemissions were studied in four hundred and ninety four (494) newborn ears using Echocheck. They were classified as Normal, Not valid, No EOAEs and Invalid using a colour coded system. After this they were compared with the internal results registered by the system. On the other hand, otoemissions were obtained using both methods (Echocheck and ILO-88) in 135 ears and the results compared. RESULTS: The correlation between the results obtained through the colour coded system and those obtained from the internal register was absolute for those parameters previously determined. For the comparison between both systems, results did coincide in all cases except for two, in which there were only results with ILO and not with Echocheck. CONCLUSIONS: The validity of the test using this new system as well as the comparison of the results with those obtained from ILO systems has been demonstrated, therefore its use has been recommended for the early detection of hypoacusis in newborn due to the fact that it is simple to perform (AU)

[Otoacoustic emissions screening as early identification of hearing loss in newborns]. / Otoemisiones acústicas como prueba de cribado para la detección precoz de la hipoacusia en recién nacidos.

The aim of this study was to examine the results of transient evoked otoacoustic emissions (TEOAE) as screening test for hearing impairment in newborn infants. We examined 9.951 of 11.405 infants born in our city from January 1st, 1995, to December 31st, 1998. A TEOAE test was performed prior to discharge and repeated one week later in cases who failed the first TEOAE. In case of suspected hearing loss auditory brainstem response (ABR) was performed 3 months later. Hearing loss was defined as ABR threshold > 20 dB. 157 infants (1.5%) were identified with hearing loss. Screening with TEOAE was sufficiently sensitive in identification of congenital hearing impairment and the efficacy increased with the experience.

[Early detection of hearing loss in neonates by using transient evoked otoacoustic emissions]. / Detección precoz de hipoacusia en recién nacidos mediante otoemisiones acústicas evocadas transitorias.

OBJECTIVE: A precocious diagnosis of infantile deafness is essential to avoid its implications in the family and the social and employment future of those that suffer from them. The discovery of new tests that can be used for auditory screening, such as otoacoustic emission, has opened new perspectives in this field. PATIENTS AND METHODS: Universal screening was performed including neonates born in our area. We studied 7,153 children (296 with indicators of risk) born between 1995 and 1997. Our protocol was based on transient evoked otoacoustic emissions as the screening method and brainstem auditory evoked potentials as the diagnostic procedure. RESULTS: Two out of 1000 ears studied presented serious/deep deafness and 1.39 per 100 had some type of hearing loss. The incidence of pathology was higher among ears of children with risk factors: 1.8 per 100 had serious/deep deafness and 7.59 per 100 some type of hearing loss. CONCLUSIONS: Transient evoked otoacoustic emission is an effective method when used in infantile auditory screening, since it is objective, bloodless and quick. Its correlation with auditory evoked potentials is very high, which proves their reliability. The best moment to perform this test (OAE) is when the discharge from the hospital is certified. We believe that universal screening is necessary, although a much higher incidence of deafness is encountered among children with risk factors. The establishment of programs for the precocious detection of infantile deafness should not be delayed.