title: Hearing Loss in Newborns with Cleft Lip and/or Palate.
abstract: BACKGROUND
  This study aims to review the results of hearing screens in newborns with cleft deformities.
  
  
  METHODS
  A retrospective audit of 123 newborns with cleft deformities, born between 1 April 2002 and 1 December 2008, was conducted. Data on the results of universal newborn hearing screens (UNHS) and high-risk hearing screens, age at diagnosis, severity/type of hearing loss and mode of intervention were obtained from a prospectively maintained hearing database.
  
  
  RESULTS
  Thirty-one of 123 newborns (25.2%) failed the first automated auditory brainstem response (AABR). Seventy percent of infants (56 out of 80) who passed the UNHS failed the high-risk hearing screens which was conducted at 3 to 6 months of age. Otolaryngology referral rate was 67.5% (83/123); 90.3% of 31 newborns who failed the first AABR eventually required otolaryngology referrals. Incidence of hearing loss was 24.4% (30/123; 25 conductive, 2 mixed and 3 sensorineural), significantly higher than the hospital incidence of 0.3% (OR: 124.9, 95% CI, 81.1 to 192.4, P <0.01). In terms of severity, 8 were mild, 15 moderate, 5 severe, 2 profound. Eighteen out of 30 infants (60%) were detected from the high-risk hearing screens after passing the first AABR.
  
  
  CONCLUSIONS
  These newborns had a higher risk of failing the UNHS and high-risk hearing screen. There was a higher incidence of hearing loss which was mainly conductive. Failure of the first AABR was an accurate predictor of an eventual otolaryngology referral, suggesting that a second AABR may be unnecessary. High-risk hearing screens helped to identify hearing loss which might have been missed out early on in life or which might have evolved later in infancy.
authors.affiliation: Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
authors.forename: Enrica E K
authors.initials: EE
authors.lastname: Tan
authors.forename: Karen Y M
authors.initials: KY
authors.lastname: Hee
authors.forename: Annie
authors.initials: A
authors.lastname: Yeoh
authors.forename: Sok Bee
authors.initials: SB
authors.lastname: Lim
authors.forename: Henry K K
authors.initials: HK
authors.lastname: Tan
authors.forename: Vincent K L
authors.initials: VK
authors.lastname: Yeow
authors.forename: Lourdes Mary
authors.initials: LM
authors.lastname: Daniel
mesh_terms: D002971:Cleft Lip / Q000150:complications*; D002972:Cleft Palate / Q000150:complications*; D034381:Hearing Loss / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening; D012189:Retrospective Studies