title: The need for long-term audiologic follow-up of neonatal intensive care unit (NICU) graduates.
abstract: OBJECTIVE
  To evaluate the adequacy of newborn hearing screening in the identification of hearing loss in post-neonatal intensive care unit (NICU) infants.
  
  
  METHODS
  Eighty-two post-NICU infants who had initially passed automated auditory brainstem response (AABR) screening were studied prospectively between November 1997 and July 1999. Tympanometry and transient evoked otoacoustic emissions (TEOAE) were used to evaluate middle ear status and screen the hearing of subjects when they were seen routinely in the Mary L. Johnson Infant Development Clinic, where NICU graduates are followed at our institution. TEOAEs were not performed in subjects with abnormal tympanometry, defined as negative pressures greater than 200 daPa or flat tympanograms.
  
  
  RESULTS
  Of the 82 subjects, 31 (37%) had abnormal tympanometry in at least one ear, with 24 (29%) exhibiting abnormal values bilaterally. Two subjects were identified with delayed-onset or previously undiagnosed sensorineural hearing loss. One had a history of persistent pulmonary hypertension (PPHN) and extracorporeal membrane oxygenation. The other infant had no risk factors for sensorineural hearing loss.
  
  
  CONCLUSIONS
  Our data indicate that newborn hearing screening programs may not provide adequate vigilance for NICU graduates. The high incidence of abnormal middle ear status and the identification of delayed-onset hearing loss in an infant without known risk factors highlights the need for close audiologic and speech/language follow-up in the post-NICU population.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Pediatric Otolaryngology, Stanford University, Lucile Packard Children's Hospital at Stanford, 725 Welch Road, Palo Alto, CA 94304, USA.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Yoon
authors.forename: Melissa
authors.initials: M
authors.lastname: Price
authors.forename: Kimber
authors.initials: K
authors.lastname: Gallagher
authors.forename: Barry E
authors.initials: BE
authors.lastname: Fleisher
authors.forename: Anna H
authors.initials: AH
authors.lastname: Messner
mesh_terms: D000158:Acoustic Impedance Tests; D001300:Audiometry, Evoked Response; D002675:Child, Preschool; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D006320:Hearing Tests / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D015997:Neonatal Screening; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors