[Two-tier screening process (TEOAE/AABR) reduces recall rates in newborn hearing screening].
BACKGROUND
1-2/1,000 newborns are affected by connatal permanent hearing impairment. Clinical diagnosis is often delayed. This demands newborn hearing screening (NHS). Some questions regarding the optimal method remain unsolved.


METHODS
The newborns in the obstetrical department (low-risk group) are tested by automated transitory evoked otoacustic emissions (TEOAE). TEOAE-fail is followed by automated auditory brainstem response (AABR) examination. All sick newborns admitted to the pediatric department (high-risk group) are primarily tested using AABR. Pathological AABR-testing leads to pedaudiological diagnostic work-up.


RESULTS
In the low-risk group, 82 out of 1,584 newborns failed TEOAE-testing (recall 5.18%). Only 5 of these patients failed consecutive AABR examination (recall 0.32%). Permanent hearing loss was finally confirmed in 3 children (0.13%). 10 out of 755 newborns in the high-risk group failed AABR-testing (1.32%). In 6 of these children, hearing loss was confirmed (0.79%).


CONCLUSIONS
A two-tier screening process as described is able to reduce recall rate, overall expenses and parental anxiety.
Helge
T
T
Klinik für Kinder- und Jugendmedizin, Klinikum Neukölln, Mariendorfer Weg 28, 12051 Berlin. thomas.helge@vivantes.de
Werle
E
E
Barnick
M
M
Wegner
C
C
Rühe
B
B
Aust
G
G
Rossi
R
R
D001300:Audiometry, Evoked Response; D042241:Early Diagnosis; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D006320:Hearing Tests / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis; D008297:Male; D015997:Neonatal Screening / Q000458:organization & administration*; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D010348:Patient Care Team; D015203:Reproducibility of Results; D018570:Risk Assessment; D012815:Signal Processing, Computer-Assisted