[Hearing screening with evoked otoacoustic emission in the neonatal period are logistically and economically feasible].
OBJECTIVE
To design, carry out and assess a protocol for the early diagnosis of hearing loss based on the detection of evoked otoacoustic emissions (EOAE) in the neonatal period.


METHODS
Five hundred twenty-five infants without risk factors for hearing loss were studied. A hearing screening protocol with EOAE was applied in the first 48 hours of life, with a second test on the fifth day of life, coinciding with phenylketonuria screening if the first test was negative. The diagnostic stage took place when the infants were aged 1 month.


RESULTS
A total of 98.8 % of the program was completed. In the initial test, bilateral EOAE were obtained in 458 infants. When the EOAE were performed during the first 24 hours after birth, 72.5 % of newborns achieved a satisfactory result. This percentage rose to 93.6 %, 97.9 % and 94.7 % when the test was delayed until discharge on, respectively, the second, the fifth and subsequent days of age (p < 0.01). All the infants who did not achieve a satisfactory result in the first test underwent a second one. A total of 87.5 % of the newborns who had failed the test within the first 24 hours passed it when it was repeated at 48 hours, at the time of discharge. A third screening was necessary in seven infants (six on the fifth day of life and one, together with auditory brainstem response [ABR], on 30 days of age). One infant showed absence of EOAE in the left ear in the three tests, as well as a threshold above 70 dB to obtain the V wave in the ABR performed at 1 and 3 months of age and was diagnosed with unilateral moderate deafness, representing a prevalence of hearing loss of 1.9 % of live newborns in the general population in our environment.


CONCLUSIONS
Universal hearing screening with EOAE is logistically and economically feasible. The use of a second test on the fifth day of age decreases the number of false positives, thus reducing economic cost and family anxiety, and improves recruitment, since it coincides with metabolic screening.
Unidad Neonatal. Servicio de Pediatría. Complejo Hospitalario Torrecárdenas. Almería. España. jtorre@arrakis.es
J
J
Díez-Delgado Rubio
J
J
Espín Gálvez
F
F
Lendinez Molinos
M A
MA
Ortega Montes M
J
J
Arcos Martínez
J
J
López Muñoz
D000465:Algorithms; D005072:Evoked Potentials, Auditory; D034381:Hearing Loss / Q000151:congenital / Q000175:diagnosis; D006320:Hearing Tests / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000191:economics; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity