title: Incidence and factors associated with sensorineural and conductive hearing loss among survivors of congenital diaphragmatic hernia.
abstract: OBJECTIVE
  The reported incidence of sensorineural hearing loss (SNHL) in long-term survivors of congenital diaphragmatic hernia varies widely in the literature. Conductive hearing loss (CHL) is also known to occur in CDH patients, but has been less widely studied. We sought to characterize the incidence and risk factors associated with SNHL and CHL in a large cohort of CDH patients who underwent standardized treatment and follow-up at a single institution.
  
  
  METHODS
  We retrospectively reviewed charts of all CDH patients in our pulmonary hypoplasia program from January 2004 through December 2012. Categorical variables were analyzed by Fisher's exact test and continuous variables by Mann-Whitney t-test (p≤0.05).
  
  
  RESULTS
  A total of 112 patients met study inclusion criteria, with 3 (2.7%) patients diagnosed with SNHL and 38 (34.0%) diagnosed with CHL. SNHL was significantly associated with requirement for ECMO (p=0.0130), prolonged course of hospitalization (p=0.0011), duration of mechanical ventilation (p=0.0046), requirement for tracheostomy (p=0.0013), and duration of loop diuretic (p=0.0005) and aminoglycoside therapy (p=0.0003).
  
  
  CONCLUSIONS
  We have identified hearing anomalies in over 30% of long-term CDH survivors. These findings illustrate the need for routine serial audiologic evaluations throughout childhood for all survivors of CDH and stress the importance of targeted interventions to optimize long-term developmental outcomes pertaining to speech and language.
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Partridge
authors.affiliation: The Center for Childhood Communication, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Bridge
authors.affiliation: The Center for Childhood Communication, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Donaher
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Herkert
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Grill
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Enrico
authors.initials: E
authors.lastname: Danzer
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Marsha
authors.initials: M
authors.lastname: Gerdes
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Casey H
authors.initials: CH
authors.lastname: Hoffman
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Jo Ann
authors.initials: JA
authors.lastname: D'Agostino
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Judy C
authors.initials: JC
authors.lastname: Bernbaum
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Rintoul
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Peranteau
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Alan W
authors.initials: AW
authors.lastname: Flake
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: N Scott
authors.initials: NS
authors.lastname: Adzick
authors.affiliation: The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: hedrick@email.chop.edu.
authors.forename: Holly L
authors.initials: HL
authors.lastname: Hedrick
mesh_terms: D001299:Audiometry; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000453:epidemiology* / Q000209:etiology; D006319:Hearing Loss, Sensorineural / Q000453:epidemiology* / Q000209:etiology; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications* / Q000401:mortality; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
keywords: Conductive hearing loss; Congenital diaphragmatic hernia; Neurodevelopmental outcomes; Sensorineural hearing loss