Cribado neonatal de la sordera mediante otoemisiones acústicas evocadas

Cubells Fuentes, J.M.; Gairí Tahull, J.M.

doi:10.1016/S1695-4033(00)77503-5

Información del artículo

Objetivo

Describir la puesta en marcha de un programa de detección precoz de la sordera en época neonatal y en un hospital privado.

Material y métodos

En el período comprendido entre el 1 de agosto de 1994 y el 31 de julio de 1999 se estudiaron 1.750 recién nacidos procedentes de la nursery y de la unidad de neo-natología de nuestro centro, mediante la técnica de las oto-emisiones acústicas provocadas (OEA), practicadas a partir de las 24 h de vida, tras obtener la autorización de los padres.

Resultados

La cobertura (número de niños a los que se practican las OEA respecto al total de recién nacidos vivos) ascendió del 6% en 1994 al 37,5% en 1999. Se detectaron seis hipoacu-sias neurosensoriales de rango leve-moderado con unos resultados globales del 4%o de hipoacusias y del 2,3 %o de hipoacusias bilaterales.

Conclusiones

En este trabajo se demuestra que es posible detectar la sordera en período neonatal mediante OEA y su efectividad. También se comprueba la dificultad de alcanzar un cribado universal, debido a la falta de concienciación de la población, lo cual hace necesario la participación de los gobiernos y los estamentos médicos oficiales en la tarea de legislar dichos programas de detección y en concienciar a la población.

Palabras clave:

Otoemisiones acústicas provocadas

Cribado neonatal

Hipoacusia

Objectives

To describe the implementation of a program for the early detection of deafness in newborn infants in a private hospital.

Materials and methods

Between August 1, 1994 and July 31, 1999, 1,750 neonates from the nursery and neonatology unit of our hospital were studied using evoked acoustic emissions (EAE). Screening was performed after the first 24 hours of life and after parent consent had been obtained.

Results

The coverage (number of neonates screened using otoa-coustic emissions compared with the total number of live births) increased from 6% in 1994 to 37.5% in 1999. Six mild-moderate neurosensory hypoacusis were detected; overall results were 4 % hypoacusis and 2.3 % bilateral hy-poacusis.

Conclusions

This study demonstrates that hardness of hearing can be detected at birth by means of EAE. Because of lack of awareness in the general population, universal screening is difficult. Consequently, governments and medical organizations should legislate for such screening programs and should make the general population aware of them.

Keywords:

Evoked otoacoustic emissions

Neonatal screening

Hy-poacusis

El Texto completo está disponible en PDF

Bibliografía

[1.]

Mehl A L, Thomson V. Newborn hearing screening: The Great Omission. Pediatrics 1998; 101(1). URL: http://www.pediatrics.org./cgi/content/full/101/1/e4

[2.]

M.P. Richardson, T.J. Williamson, A.W. Lenton, M.J. Tarlow, P.T. Rudd.

Otoacoustic emissions as a screening test for hearing impairment in children.

Arch Dis Child, 72 (1995), pp. 294-297

Medline

[3.]

K.R. White, A.B. Maxon.

Universal screening for infant hearing impairement-simple,beneficial and presently justified.

Int J, 32 (1995), pp. 201-211

[4.]

B.R. Vohr, L.M. Carty, P.E. Moore, K. Letourneau.

The Rhode Island Hearing Assessment Program: Experience with statewide.

J Pediatr, 133 (1998), pp. 353-357

Medline

[5.]

C. Yoshinaga-Itano, A. Sedey, M. Apuzzo, D. Carey.

Day, Coulter D. Efficacy of Early Identification on the Development of Deaf and Hard of Hearing Infants and Toddlers.

Semin Hear, 16 (1995), pp. 115-123

[6.]

A. Morant Ventura, M.ÁaI. Pitarch Ribes, F.J. García Callejo, J. Marco Algarra.

Retraso en el diagnóstico de hipoacusia en niños. Justificación para instaurar modelos de cribaje.

An Esp Pediatr, 51 (1999), pp. 49-52

Medline

[7.]

European Consensus Statement on Neonatal Hearing Screening.European Consensus Development Conference on Neonatal Hearing Screening, 15-16 May 1998, Milan

[8.]

NIH Consensus Statement. Early Identification of Hearing Impairement in Infants and Young Children.

National Institutes of Health, 11 (1993), pp. 1-3

[9.]

Joint Committee on infant Hearing 1994 Position Statement.

Pediatrics, 95 (1995), pp. 152-155

Medline

[10.]

H.M. Bantock, S. Croxson.

Universal hearing screening using transient otoacoustic emissions in a community health clinic.

Arch Dis Child, 78 (1998), pp. 249-252

Medline

[11.]

D. Welch, K.A. Greville, P.R. Thorne, S.C. Purdy.

Influence of Acquisition Parameters on the Measurement of Click Evoked Otoacoustic Emissions in Neonates in a Hospital Environment.

Audiology, 35 (1996), pp. 143-157

Medline

[12.]

P.M. Watkin.

Outcomes of neonatal screening for hearing loss by otoacoustic emissions.

Arch Dis Child, 75 (1996), pp. 158-168

[13.]

T. Finitzo, W. Crumley C.

The role of the pediatrician in hearing loss.

Pediatr Clin North Am, 46(1) (1999), pp. 15-34

Medline

[14.]

K.R. White, T.R. Behrens.

The Rhode Island Hearing Assessment Project: Implications for Universal Newborn Hearing Screening.

Semin Hear, 14 (1993), pp. 1-121

[15.]

Y.S. Sinninger, K. Doyle J.

The Case for early identification of hearing loss in children.

Pediatr Clin North Am, 46 (1999), pp. 1-14

Medline

[16.]

L.C. Cox.

Otoacoustic emissions as a screening tool for sensorineural hearing loss.

J Pediatr, 130 (1997), pp. 685

Medline

[17.]

J.L. Northern, D. Hayes.

Universal Screening for infant hearing impairement: Necesary, Beneficial and Justifiable. Bulletin of the American Academy of Audiology.

Reprinted from Audiology Today May/June, 6 (1994), pp. 2

[18.]

A.M. Oudesluys-Murphy, H.L.M. van Straaten, R. Bholasingh, G.A. van Zaten.

Neonatal hearing screening.

Eur J Pediatr, 155 (1996), pp. 429-435

Medline

[19.]

D. Aidan, P. Lestang, P. Avan, P. Bonfils.

Characteristics of Transient- evoked Otoacoustic Emissions (TEOAEs) in Neonates.

Acta Otolaryngol (Stockh), 117 (1997), pp. 25-30

[20.]

Committee on Environmental Health, 1996-1997. Ruido: un peligro para el feto y recién nacido.

Pediatrics (ed. esp.), 44 (1997), pp. 295-299

[21.]

Helping your Hard of Hearing Child Succeed. http://www.agbell.org/topics/hohchild.html

[22.]

P.M. Watkin.

Neonatal otoacoustic emission screening and the identification of deaffness.

Arch Dis Child, 74 (1996), pp. 16-25

[23.]

Screening newborns for hearing loss- The time is HEAR. http:// www.agbell.org/langbein.html

[24.]

Wessex Universal Neonatal Hearing Screening Trial Group. Controled trial of universal neonatal screening for early identification of permanent childhood hearing impairement.

Lancet, 352 (1998), pp. 1957-1964

Medline

[25.]

Factors predictive of successful outcome of deaf and hard-of-hearing children of hearing parents. http://www.colorado.edu/slhs/mdnc/efficacy.html

[26.]

K.R. White, B.R. Vohr, T.R. Behrens.

Universal newborn hearing screening using transient evoked otoacoustic emissions: results of the Rhode Island hearing assessment project.

Sem Hear, 14(1) (1993), pp. 18-29

[27.]

T. Finitzo, K. Albrigth, J. O’Neal.

The newborn with Hearing loss: Detection in the nursery.

Pediatrics, 102 (1998), pp. 1452-1460