[Results of applying a universal protocol for early detection of hypoacusia in newborn infants for 42 months].
OBJECTIVE
We present the results from applying over a period of three and a half years a universal newborn hearing screening programme aimed at the early detection of hearing loss. Our goal has been to diagnose and treat all unilateral or bilateral permanent hearing losses > or =40 dB nHL.


METHODS
The detection strategy consists of two screening phases with transient evoked otoacoustic emissions (TEOAE) and one diagnostic phase with auditory brainstem responses (ABR). ABR tests were performed on newborns "not passing" the TEOAE screening, as well as those with risk factors for hearing loss.


RESULTS
Of 4568 live newborns (NB), we evaluated 97.6 %. Of these, 3.7 % presented risk factors for hearing loss. The first TEOAE was "passed" in both ears by 91.7 % of the newborns; after the second TEOAE, only 1.3 % of cases were referred to the diagnostic phase. We detected 2.7/1000 cases of severe/profound bilateral hearing loss.


CONCLUSIONS
This programme was designed for early application of appropriate treatment. Although it is possible to reach the objectives of screening and diagnosis of newborn hearing loss, the intervention stage is much more complicated. This is because intervention depends on different disciplines that must act in co-ordination, as well as multiple environmental and family factors that are difficult to control. Therapeutic effectiveness still remains our challenge and a motive for discussion in fully justifying early congenital hearing loss screening programmes.
Benito Orejas
José I
JI
Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. jibenito@ono.com
Ramírez Cano
Beatriz
B
Morais Pérez
Darío
D
Fernández-Calvo
José L
JL
Almaraz Gómez
Ana
A
D002675:Child, Preschool; D002985:Clinical Protocols; D042241:Early Diagnosis; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000592:standards*