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Pädaudiologische Diagnostik im ersten Lebensjahr

Klinische Verläufe, Risikofaktoren und Mittelohrfunktion

Pedaudiological diagnostics in the first year of life

Clinical follow-up, risk factors, and middle ear function

  • Phoniatrie und Pädaudiologie
  • Published:
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Zusammenfassung

Das universelle Neugeborenenhörscreening (UNHS) fordert die Abklärung auffälliger Hörbefunde in den ersten 3 Lebensmonaten. Die Machbarkeit dieser Forderung soll überprüft, die Hörprüfmethoden sollen bewertet werden. Ausgewertet wurden 617 Patientenakten (329 m., 288 w.), darunter 246 Kinder mit auffälligem UNHS, 393 mit Risikofaktoren. Bei 459 Kindern (74%) wurde mit Kontrollscreening der AABR („automated auditory brainstem responses“) eine sprachrelevante Schwerhörigkeit ausgeschlossen, bei 129 (21%) eine Schwellen-BERA („brainstem evoked response audiometry“) durchgeführt: Davon wiesen 20 (16%) normale, 109 (84%) erhöhte Schwellen auf. Hörgeräte erhielten 91 (83%), eine Ergusstherapie 11 (10%). Schwerhörig waren 18% aller Kinder, 24% der UNHS-Auffälligen und 34% der UNHS-Auffälligen mit Risikofaktoren. Kraniofaziale Dysmorphien, Frühgeburten < 32. SSW und Syndrome waren häufig mit Schwerhörigkeit assoziiert. Eine Kontroll-BERA ergab bei 3 (von 14) Kindern eine Verbesserung zur Normalhörigkeit. Pathologische Befunde des Mittelohrs wurden bei Kontrollen häufiger. Die 226-Hz- und die 1-kHz-Tympanometrie haben unterschiedliche Spezifität (95,5 vs. 85,5%) und Sensitivität (32,5 vs. 57,1%). Die Abklärung innerhalb von 3 Monaten ist möglich, bei Kindern mit Risikofaktoren jedoch eine Herausforderung.

Abstract

The universal neonatal hearing screening (UNHS) program demands detection of hearing loss within the first 3 months of life. Practicability and different screening methods should be evaluated. Thus, 617 patients (329 m., 288 w.) were analyzed; 246 children were referred in the UNHS, 389 with risk factors. In 459 children (74%), automated auditory brainstem response (ABR) screening in our department excluded hearing loss, thereof 129 (21%) underwent diagnostic auditory brainstem-evoked audiometry responses: 20 (16%) showed normal and 109 (84%) elevated ABR thresholds. A total of 91 children (83%) received hearing aids and 11 children (10%) treatment of middle ear effusion. Hearing loss was diagnosed in 18% of all children, 24% with UNHS referral and 34% with both referral and risk factors. Craniofacial anomalies, premature birth < 32 weeks of pregnancy, and syndromes were the most frequent risk factors. Reevaluation by ABR showed an improvement to normal hearing in 3 (of 14) children. The 226 Hz compared to 1,000 Hz-tympanometry showed different specificity (95.5 vs. 85.5%) and sensitivity (32.5 vs. 57.1%). Diagnosis within 3 months is possible, but very challenging in children with risk factors.

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Literatur

  1. Adachi N, Ito K, Sakata H, Yamasoba T (2010) Etiology and one-year follow-up results of hearing loss identified by screening of newborn hearing in Japan.  Otolaryngol Head Neck Surg  143:97–100

    Article  PubMed  Google Scholar 

  2. Baldwin M (2006) Choice of probe tone and classification of trace patterns in tympanometry undertaken in early infancy. Int J Audiol 45:417–427

    Article  PubMed  Google Scholar 

  3. Bess FH, Schwartz DM,  Redfield NP  (1976) Audiometric, impedance, and otoscopic findings in children with cleft palates. Arch Otolaryngol 102:465–469

    Article  PubMed  CAS  Google Scholar 

  4. Bielecki I, Horbulewicz A, Wolan T (2011) Risk factors associated with hearing loss in infants: an analysis of 5282 referred neonates.  Int J Pediatr Otorhinolaryngol  75:925–930

    Article  PubMed  Google Scholar 

  5. Browning GG, Rovers MM, Williamson I et al (2010) Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children.  Cochrane Database Syst Rev (10):CD001801

    Google Scholar 

  6. Coenraad S, Goedegebure A, Goudoever JB van et al (2010) Risk factors for sensorineural hearing loss in NICU infants compared to normal hearing NICU controls. Int J Pediatr Otorhinolaryngol 74:999–1002

    Article  PubMed  CAS  Google Scholar 

  7. Coenraad S, Toll MS, Hoeve HL, Goedegebure A (2011) Auditory brainstem response morphology and analysis in very preterm neonatal intensive care unit infants. Laryngoscope 121:2245–2249

    Article  PubMed  Google Scholar 

  8. Declau F, Boudewyns A, Van den Ende J et al (2008) Etiologic and audiologic evaluations after universal neonatal hearing screening: analysis of 170 referred neonates. Pediatrics 121:1119–1126

    Article  PubMed  Google Scholar 

  9. Foulon I, Naessens A, Foulon W et al (2008) A 10-year prospective study of sensorineural hearing loss in children with congenital cytomegalovirus infection. J Pediatr 153:84–88

    Article  PubMed  Google Scholar 

  10. Gemeinsamer Bundesausschuss (2008) Richtlinie zum Neugeborenen-Hörscreening. http://www.g-ba.de/informationen/beschluesse/681. Zugegriffen: 19.06.2008

  11. Guastini L, Mora R, Dellepiane M et al (2010) Evaluation of an automated auditory brainstem response in a multi-stage infant hearing screening. Eur Arch Otorhinolaryngol  267:1199–1205

    Article  PubMed  Google Scholar 

  12. Hoth S, Neumann K, Weissschuh H et al (2009) Universelles Neugeborenenhörscreening. Methodische Aspekte. HNO 57:29–36

    Article  PubMed  CAS  Google Scholar 

  13. Joint Committee on Infant Hearing (2007) Position statement. Pediatrics 120:898–921

    Article  Google Scholar 

  14. Korver AM, Konings S, Dekker FW et al (2010) Newborn hearing screening vs later hearing screening and developmental outcomes in children with permanent childhood hearing impairment. JAMA 304:1701–1708

    Article  PubMed  CAS  Google Scholar 

  15. Limberger A, Bohnert A, Lippert K et al (2010) Hochfrequenztympanometrie im neuen Licht. 23. Wissenschaftliche Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie. http://www.egms.de/static/de/meetings/dgpp2006/06dgpp53.shtml. Zugegriffen: 31.07.2012

  16. Lombardi G, Garofoli F, Stronati M (2010) Congenital cytomegalovirus infection: treatment, sequelae and follow-up. J Matern Fetal Neonatal Med 23(Suppl 3):45–48

    Article  PubMed  Google Scholar 

  17. Morimoto N, Taiji H, Tsukamoto K et al (2010) Risk factors for elevation of ABR threshold in NICU-treated infants. Int J Pediatr Otorhinolaryngol 74:786–790

    Article  PubMed  Google Scholar 

  18. Neumann K, Gross M, Böttcher P et al (2006) Effectiveness and efficiency of a universal newborn hearing screening in Germany. Folia Phoniatr Logop 58:440–455

    Article  PubMed  Google Scholar 

  19. Newton V (2001) Adverse perinatal conditions and the inner ear. Semin Neonatol 6:543–551

    Article  PubMed  CAS  Google Scholar 

  20. Rogers DJ, Boseley ME, Adams MT et al (2010) Prospective comparison of handheld pneumatic otoscopy, binocular microscopy, and tympanometry in identifying middle ear effusions in children. Int J Pediatr Otorhinolaryngol  74:1140–1143

    Article  PubMed  Google Scholar 

  21. Rohlfs AK, Wiesner T, Drews H et al (2010) Interdisciplinary approach to design, performance, and quality management in a multicenter newborn hearing screening project. Discussion of the results of newborn hearing screening in Hamburg (part II). Eur J Pediatr 169:1453–1463

    Article  PubMed  Google Scholar 

  22. Schreiner MS, Downes JJ, Kettrick RG et al (1987) Chronic respiratory failure in infants with prolonged ventilator dependency. JAMA 258:3398–3404

    Article  PubMed  CAS  Google Scholar 

  23. Shahnaz N, Miranda T, Polka L (2008) Multifrequency tympanometry in neonatal intensive care unit and well babies. J Am Acad Audiol 19:392–418

    Article  PubMed  Google Scholar 

  24. Shott SR (2006) Down syndrome: common otolaryngologic manifestations. Am J Med Genet C Semin Med Genet 142C:131–140

    Article  PubMed  Google Scholar 

  25. Takata GS, Chan LS, Morphew T et al (2003) Evidence assessment of the accuracy of methods of diagnosing middle ear effusion in children with otitis media with effusion. Pediatrics 112:1379–1387

    Article  PubMed  Google Scholar 

  26. Vossen AC, Kroes AC et al (2011) Implementing neonatal screening for congenital cytomegalovirus: addressing the deafness of policy makers. Rev Med Virol 21:54–61

    Article  PubMed  Google Scholar 

  27. Wiesner Th, Gross M, Nawka T et al (2011) Phoniatrisch-pädaudiologischer Konsensus zu einem universellen Neugeborenen-Hörscreening in Deutschland 2.1. http://www.dgpp.de/cms. Zugegriffen: 31.07.2012

  28. WHO (o J) World Health Organization Grades of hearing impairment. http://www.who.int/pbd/deafness/hearing_impairment_grades/en/index.html. Zugegriffen: 31.07.2012

  29. Young NM, Reilly BK, Burke L (2011) Limitations of universal newborn hearing screening in early identification of pediatric cochlear implantat candidates. Arch Otolaryngol Head Neck Surg 137:230–234

    Article  PubMed  Google Scholar 

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  1. Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Deutschland

    J.W. Rumstadt, A. am Zehnhoff-Dinnesen, A. Knief, D. Deuster, P. Matulat, K. Rosslau &  C.-M. Schmidt

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  1. J.W. Rumstadt
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  2. A. am Zehnhoff-Dinnesen
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  3. A. Knief
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  4. D. Deuster
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  6. K. Rosslau
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  7. C.-M. Schmidt
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Correspondence to C.-M. Schmidt.

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Rumstadt, J., am Zehnhoff-Dinnesen, A., Knief, A. et al. Pädaudiologische Diagnostik im ersten Lebensjahr. HNO 60, 919–926 (2012). https://doi.org/10.1007/s00106-012-2570-6

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  • DOI: https://doi.org/10.1007/s00106-012-2570-6

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