Changes in tonal audiometry in children with progressive sensorineural hearing loss and history of Neonatal Intensive Care Unit discharge. A 20 year long-term follow-up

Int J Pediatr Otorhinolaryngol. 2017 Oct:101:235-240. doi: 10.1016/j.ijporl.2017.08.022. Epub 2017 Aug 29.

Abstract

Objective: Newborns from Neonatal intensive care units (NICU) are at high-risk for sensorineural hearing loss (SNHL) a follow-up is needed for early diagnosis and intervention. Our objective here was to describe the features and changes of SNHL at different periods during a follow-up of almost 20 years.

Methods: Risk factors for SNHL during development were analyzed. The audiological examination included: Brainstem auditory evoked potentials (BAEP), and Transient evoked otoacoustic emissions (TEOAE). At birth; tonal audiometry (between 125 and 8000 Hz), and tympanometry were performed at 5, 10, 15, and 20 years of age.

Results: Sixty-five percent of cases presented bilateral absence of BAEP. At 5 years of age, the most frequent SNHL level was severe (42.5%), followed by moderate (22.5%), and profound level (20%), in all cases, the SNHL was symmetrical with a predominance of lesion for the high frequencies. Exchange transfusion was associated with a higher degree of SNHL (OR = 6.00, CI = 1.11-32.28, p < 0.02). In 55%, SNHL remained stable, but in 40% of the cases it was progressive. At the end of the study six cases with moderate loss progressed to the severe level and seven cases with severe level progressed to profound.

Conclusions: Forty percent of infants with SNHL discharged from NICU may present a progression in the hearing loss. Exchange transfusion was associated with a higher degree of SNHL. NICU graduates with SNHL merit a long-term audiological follow-up throughout their lifespan.

Keywords: Brain stem auditory evoked potentials; High-risk newborns; Neonatal intensive care unit; Otoacoustic evoked emissions; Progressive sensorineural hearing loss; Tonal audiometry.

MeSH terms

  • Acoustic Impedance Tests / methods
  • Adolescent
  • Audiometry / methods*
  • Child
  • Child, Preschool
  • Evoked Potentials, Auditory, Brain Stem / physiology
  • Female
  • Follow-Up Studies
  • Hearing Loss, Sensorineural / diagnosis*
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal / statistics & numerical data*
  • Male
  • Neonatal Screening
  • Otoacoustic Emissions, Spontaneous / physiology
  • Patient Discharge / statistics & numerical data*
  • Risk Factors
  • Young Adult