High prevalence of sensorineural hearing loss among survivors of neonatal congenital diaphragmatic hernia. Western Canadian ECMO Follow-up Group.
OBJECTIVE
This study aimed to determine the prevalence of sensorineural hearing loss (SNHL) in 2-5-year-old survivors with neonatal respiratory failure due to congenital diaphragmatic hernia (CDH) with or without the need for extracorporeal membrane oxygenation (ECMO).


METHODS
The study design was a prospective, multicenter, longitudinal outcome study of consecutively surviving neonates admitted to a single tertiary intensive care unit.


METHODS
The study was conducted at four audiologic departments affiliated with tertiary-level intensive care follow-up programs.


METHODS
Thirty-seven surviving children receiving neonatal intensive care from February 1989 through January 1995 for neonatal respiratory failure due to CDH were studied. Excluded were 15 children with early death and I child lost to follow-up.


METHODS
The initial treatment depended on the severity of neonatal respiratory failure: ECMO-treated (n=31, 20 survivors) (death before ECMO initiation, 2) and non-ECMO treated (n=20, 17 survivors, another survivor lost to follow-up).


METHODS
Early childhood audiologic test results were measured.


RESULTS
Sensorineural hearing loss was found in almost 60% of subjects: ECMO-treated, 12 (60%) of 20; non-ECMO-treated, 10 (59%) of 17. Of the 22 children with SNHL, 16 had mild- to-moderate low-frequency sloping to moderate-to-severe high-frequency loss. Of the remaining, six had severe-to-profound loss at 500 Hz and above. Seventeen children had normal responses to sound as newborns or in infancy. Five children were not tested. Documented progression was found in nine children. Twenty children currently are using amplification, and 2 have had cochlear implantation.


CONCLUSIONS
Of children with CDH in this area presenting early with severe neonatal respiratory failure, SNHL developed in 60% by 2-5 years of life. Ongoing monitoring of the hearing status of children with CDH is imperative.
Robertson
C M
CM
Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital Site, Capital Health Authority, Edmonton, Alberta.
Cheung
P Y
PY
Haluschak
M M
MM
Elliott
C A
CA
Leonard
N J
NJ
D001299:Audiometry; D002675:Child, Preschool; D018450:Disease Progression; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006548:Hernia, Diaphragmatic / Q000150:complications*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000150:complications* / Q000628:therapy; D017741:Survivors