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Essential of audiology: screening and post-screening
Italian Journal of Pediatrics volume 40, Article number: A55 (2014)
Newborn hearing screening is a type of screening test for the early detection of hearing loss. It can recognize with good accuracy newborns affected by hearing impairment allowing an early diagnosis and intervention and avoiding cognitive and linguistic deficits [1–6].
The incidence of bilateral sensorineural hearing loss (SNHL) in Sicily is 2.35 cases per 1000 newborns; this value increases to 2.95 if we consider also unilateral SNHL [2, 3] and to 10 cases per 1000 births among infants at risk [7–9].
A correct newborn hearing screening programme is based on different protocols depending on the presence/absence of audiologic risk factors:
Initial Hearing Screening (Step I): The initial screening should be performed using Transient-Evoked Otoacoustic Emissions (TEOAEs) in the birth centers as close to discharge as possible, preferably 12 hours or more after birth. It is recommended that an infant be referred for a re-screening (step 2) if s/he does not pass the initial screening or results cannot be obtained in one or both ears.
Re-screening (Step II): The re-screening should be performed in a second level center using TEOAEs and Automated Auditory Brainstem Response (AABR). If an infant does not pass the re-screening or if results cannot be obtained in one or both ears, s/he shall be referred to the regional third level center for diagnostic audiological evaluation.
Initial Hearing Screening (Step I): The Initial Hearing Screening should be performed in a second level center using TEOAEs and AABR. If an infant does not pass the initial screening or if results cannot be obtained in one or both ears, s/he shall be referred to the regional third level center for diagnostic audiological evaluation.
Limitations of screening
Audiologic screening does not identify:
ANSD (Auditory Neuropathy Spectrum Disorder): the main risk factors associated to ANSD are severe jaundice, prematurity, respiratory distress, ototoxic drugs (used to treat neonatal infections), genetic mutations (e.g. OTOF gene). The diagnosis of ANSD is usually based on the combination of absent or abnormal ABR with normal TEOAESs and/or cochlear microphonics (CM) .
Ballacchino A, Mucia M, Cocuzza S, Ferrara S, Martines E, Salvago P, Sireci F, Martines F: Newborn hearing screening in Sicily: Lesson learned. Acta Medica Mediterranea. 2013, 29: 731-734.
Martines F, Porrello M, Ferrara M, Martines M, Martines E: Newborn hearing screening project using transient evoked otoacoustic emissions: Western Sicily experience. Int J Pediatr Otorhinolaryngol. 2007, 71: 107-112. 10.1016/j.ijporl.2006.09.011.
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Maggio M, Maggio O, Mucia M, Martines F, Carmuco A, Noto G, Puccio R: The scholastic integration process of the impaired child in the province of Palermo: a cognitive survey. Acta Medica Mediterranea. 2006, 22: 159-162.
Maggio M, Martines F, Mucia M, Maggio O: A multifactorial pattern for the understanding of the psychological development of the child with impaired hearing and its clinical-therapeutic implications. Acta Medica Mediterranea. 2006, 22: 41-44.
Martines F, Martines E, Ballacchino A, Salvago P: Speech perception outcomes after cochlear implantation in prelingually deaf infants: The Western Sicily experience. Int J Pediatr Otorhinolaryngol. 2013, 77: 707-713. 10.1016/j.ijporl.2013.01.023.
Martines F, Salvago P, Bentivegna D, Bartolone A, Dispenza F, Martines E: Audiologic profile of infants at risk: Experience of a Western Sicily tertiary care centre. Int J Pediatr Otorhinolaryngol. 2012, 76: 1285-1291. 10.1016/j.ijporl.2012.05.020.
Salvago P, Martines E, Martines F: Prevalence and risk factors for sensorineural hearing loss: Western Sicily overview. Eur Arch Otorhinolaryngol. 2013, 270: 3049-56. 10.1007/s00405-013-2379-2.
Martines F, Martines E, Mucia M, Sciacca V, Salvago P: Prelingual sensorineural hearing loss and infants at risk: Western Sicily report. Int J Pediatr Otorhinolaryngol. 2013, 77: 513-518. 10.1016/j.ijporl.2012.12.023.
American Academy of Pediatrics, Joint Committee on Infant Hearing: Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007, 120: 898-921.
Bentivegna D, Salvago P, Agrifoglio M, Ballacchino A, Ferrara S, Mucia M, Sireci F, Martines F: The linkage between upper respiratory tract infections and otitis media: evidence of the ‘united airways concept. Acta Medica Mediterranea. 2012, 28: 287-290.
Bartolotta C, Salvago P, Cocuzza S, Fabiano C, Sammarco P, Martines F: Identification of D179H, a novel missense GJB2 mutation in a Western Sicily family. Eur Arch Otorhinolaryngol. 2014, 271: 1457-67. 10.1007/s00405-013-2613-y.
Martines F, Salvago P, Bartolotta C, Cocuzza S, Fabiano C, Ferrara S, La Mattina E, Mucia M, Sammarco P, Sireci F, Martines E: A genotype–phenotype correlation in Sicilian patients with GJB2 biallelic mutations. Eur Arch Otorhinolaryngol. 2014, DOI 10.1007/s00405-014-2970-1
Martines F, Salvago P: Hyperbilirubinemia, Auditory Neuropathy and Prelingually Deafness: Evidence Linking. Neonatal Care: New Research. Edited by: Novinka; Fabian Koubek & Junica Linser. 2013, 79-97.
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Martines, F., Salvago, P., Cocuzza, S. et al. Essential of audiology: screening and post-screening. Ital J Pediatr 40, A55 (2014). https://doi.org/10.1186/1824-7288-40-S1-A55
- Hearing Loss
- Sensorineural Hearing Loss
- Otoacoustic Emission
- Hearing Screening
- Cochlear Microphonic