title: Incidence of cochlear involvement in hyperbilirubinemic deafness.
abstract: Neonatal hyperbilirubinemia remains an important cause of childhood deafness, especially in developing countries. After neonatal hyperbilirubinemia, the auditory neural pathways, cochlea, or both may be affected. In this study, we aimed to determine the incidence of cochlear impairment and the appropriate means of hearing screening in hyperbilirubinemic neonates. A retrospective review of 1,032 pediatric patients with hearing loss revealed 67 cases (6.5%) of severe hyperbilirubinemia in the neonatal period. Thirty of these patients had neonatal hyperbilirubinemia as the single identifiable risk factor for hearing loss. In 26 of 30 cases (87%), otoacoustic emissions (OAEs) were absent, whereas in the remaining 4 cases (13%), robust emissions were detected despite an absent auditory brain stem response (ABR). Auditory screening of newborns with jaundice by OAEs possesses a significant risk of undiagnosed deafness. On the other hand, if the ABR is used as the single means of screening, auditory neuropathic conditions will probably be underlooked. Therefore, we recommend dual screening of hearing by ABR and OAEs in hyperbilirubinemic newborns.
authors.affiliation: Department of Otolaryngology, Istanbul School of Medicine, University of Istanbul, Turkey. coysu@doruk.net.tr
authors.forename: Cagatay
authors.initials: C
authors.lastname: Oysu
authors.forename: Ismet
authors.initials: I
authors.lastname: Aslan
authors.forename: Arif
authors.initials: A
authors.lastname: Ulubil
authors.forename: Nermin
authors.initials: N
authors.lastname: Baserer
mesh_terms: D002675:Child, Preschool; D015834:Cochlear Diseases / Q000150:complications*; D003056:Cochlear Nerve; D003638:Deafness / Q000175:diagnosis / Q000209:etiology*; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000150:complications*; D008297:Male; D015997:Neonatal Screening; D017084:Otoacoustic Emissions, Spontaneous; D012189:Retrospective Studies; D012307:Risk Factors; D000160:Vestibulocochlear Nerve Diseases / Q000150:complications*