DIAGNOSIS AFTER A UNIVERSAL NEONATAL SCREEN
Verschuure J, Willis-Lorrier RMS, Homans N, Brocaar MP, de Gier HHW, Hoeve LJ.
Hearing and Speech Center, ENT department, Erasmus MC.
Goal: The universal neonatal screen has been implemented in the Netherlands in a three-tier testing procedure. All fails are referred to Audiological Centers. In the South-western region all fails are referred to our Childrens’ Hospital. In this presentation we present the diagnostic procedure of the refers.
Materials and methods: Diagnostic tests in our Children’ Hospital are clinical ABR, OAE and 1000-Hz tympanometry. They are seen by an ENT specialist and an audiologist in a combined session. ABR results are identified according to the found I-V interval as neurally mature or not; conductive losses by the horizontal shift of the level-latency curves and the threshold by the lowest level at which a response was found. If no peak I could be identified the distinction between neural maturation and conductive loss is uncertain. Therefore the first visit may be inconclusive and subsequent visits are necessary. We present data on the first and the last visit.
Results: Over the years about 350 children were assessed. We included the children born up to 1st April 2008. We found no pathology initially in about 8% of the cases; in the end this was so in about 20% of the cases.
Conductive losses were found in about 25%. Sensorineural losses were found in about 50% of the cases. About 15% showed no ABR responses and these children are considered candidates for cochlear implantation if the effect of hearing aid fitting is negative. The initial group inconclusive ended up in all categories. Causes of the hearing losses will be presented. They include genetic causes, syndromes, maternal infections, ome, etc.
Conclusion: The diagnostic analysis is complicated requiring audiological, ent and genetic skills. In our setting this requires the close cooperation of a pediatric ent specialist and a pediatric audiological specialist.
E-mail: j.verschuure@erasmusmc.nl
