New Born Hearing Screening-An Essential Tool in Early Identification of Deafness in Children

Abstract

Background: Hearing impairment is one of the most critical sensory impairments. Universal Newborn Hearing Screening (UNHS) is a standard practice in most developed countries. However, in developing countries like INDIA many obstacles like unawareness, inaccessibility, lack of infrastructure reduce the sustainable rate of screening for early identification. This study aims to review the benefits and results of universal newborn hearing screening, to propose a standard protocol for screening of all newborns irrespective of high-risk infants, hospital/home deliveries.

Materials and Methods: This cross-sectional study conducted by Department of ENT, GMERS Medical College, Gandhinagar, Gujarat along with TARA foundation screened 31460 neonates, infants and children, between 2017 - 2018. All infants were initially screened with OAE, and those who failed were subjected to ABR/BERA.

Results: All children were screened with OAE as 1st stage screening procedure, out of which 4557 (14.48%) showed positive results. At 2nd stage OAE refer children were subjected to ABR, in which 1322 (29.01%) children were found having deafness which was confirmed by audiologist and otorhinolaryngologist. Out of the 1322 diagnosed with deafness, 746 (56.42%) patients had history of NICU admission, 268 (20.27%) patients had history of consanguineous marriage, while 308 (23.31%) patients had no risk factors. Thus highlighting the risk factors in congenital deafness detection, and the need for universal screening over selective high risk screening.

Discussion: Current recommendations are to screen all infants for hearing loss early in life for timely intervention. A two-step screening with OAE and ABR has to be implemented which can reduce the no of missing cases due to lost follow up. A new initiative ‘DHWANI on wheels’ has been implemented with OAE and ABR carried out by trained audiologists in a mobile van, to tackle the issue of inaccessibility and unawareness in remote areas.

Conclusion: As normal hearing is critical for speech and language development, UNHS is a strategy that enables to identify congenital hearing loss early and provide appropriate intervention as early as possible for optimal benefits.