International Journal of Pediatric Otorhinolaryngology
Screening for delayed-onset hearing loss in preschool children who previously passed the newborn hearing screening
Section snippets
Background
Universal newborn hearing screening (UNHS) has been successfully implemented in many countries [1] and has contributed to a significant reduction in the average age of confirmation of hearing loss (declining from 24–30 months to 2–3 months) [2]. Early detection of hearing disability in children is associated with better outcomes in communication development [3], [4], [5], [6], [7]. However, not every hearing impairment can be detected at birth, as deafness can be acquired, delayed in onset or
Study design
The present study was a cross-sectional, representative cluster-sample survey of 3–6-year-old children living in the city of Shanghai. A sample of 22,361 (94% response of 23,788) nursery school children from five residential areas spread throughout the city [Changshou (Putuo District); Zhongyuan (Yangpu District); Yanghang (Baoshan District); Tangqiao (Pudong New District); and Liangcheng (Hongkou District)] was targeted for screening. The study did not include Down Syndrome and other children
Results
Of the 22,316 children, 912 children had moved to Shanghai from other provinces and had not undergone UNHS at birth, 19 children already had a hearing loss diagnosis through the UNHS program, and three children had been diagnosed with hearing loss before our study. These children were consequently excluded, resulting in 21,427 children deemed eligible for our study (11,103 boys, 10,324 girls). The mean age was 4.89 ± 1.11 years. All agreed to undergo PA screening.
Of these, 445 children (2.08%)
Discussion
Our current analysis is based on the “delayed-onset hearing loss” concept of hearing loss occurring after birth. It is defined simply by onset time and includes late-onset, progressive, and acquired hearing loss. A target child's hearing is deemed normal in the perinatal period, but deteriorates thereafter.
In the present analysis, the percentages of children with bilateral moderate delayed-onset hearing loss was 0.23/1000; with bilateral mild delayed-onset hearing 0.33/1000; and for unilateral
Conclusion
In our study, the detection rate of delayed-onset hearing loss was 0.75/1000 in 3–6-year-olds who had previously passed the newborn hearing screening. This rate suggests that preschool hearing screening should be recommended for early detection of delayed-onset hearing loss. Audiological assessment restricted to children with risk factors would have missed the larger part of delayed-onset hearing loss in this population. It would be better to extend the time range of hearing screening to the
Acknowledgements
We thank Ms. Xiaoxin X.U., MD, for the advice on the use of statistical data in this manuscript, and thank all the children and their parents for participating in the study. This study received funding from the Science and Technology Commission of the Shanghai Municipality (08411954500, 08XD1402900), the Ministry of Education (20090073110084), and the School of Medicine of Shanghai Jiaotong University (BXJ0918).
The Collaborative Study Group consisted of: Yuli MA, MD (Putuo District Women and
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