title: Neonatal hearing screening: what we have achieved and what needs to be improved.
abstract: OBJECTIVE
  To review the literature on neonatal hearing screening and its weaknesses with regard to missed follow-ups and delayed diagnosis and management.
  
  
  RESULTS
  The implementation of newborn hearing screening programs has indeed lowered the mean age of hearing loss identification and many deaf children are now diagnosed at an early age of some months. However, the present collection of 32 studies published in the International Journal of Pediatric Otorhinolaryngology revealed that late-onset deafness, auditory neuropathy, and the alarming percentage of newborns who fail the initial testing and then are lost to follow-up are major weaknesses of neonatal hearing screening programs. It seems that parents may be satisfied of hearing screening but in a significant percentage of them do not bring their children for follow-up or further testing due to phycho-social or other reasons. In addition, the same collection revealed that socioeconomic factors may have a significant influence on the effectiveness of hearing screening programs in the developed and developing countries, where improvements in health care politics, tracking system and public awareness is crucial for successful program implementation.
  
  
  CONCLUSIONS
  Neonatal hearing screening programs have changed the whole picture of congenital deafness as age identification has significantly fallen with a very positive effect on timely management. However, the selected and proposed 32 related articles published in the International Journal of Pediatric Otorhinolaryngology show that there are still serious weakness in the neonatal hearing screening that need improvements in order to achieve an efficient and cost-effective system of deafness identification.
authors.affiliation: Department of Otorhinolaryngology, 125 Anakous Street, 14342 Athens, Greece. Electronic address: nikolop@med.uoa.gr.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Nikolopoulos
mesh_terms: D003362:Cost-Benefit Analysis; D003638:Deafness / Q000175:diagnosis; D034381:Hearing Loss / Q000175:diagnosis; D006313:Hearing Loss, Central / Q000175:diagnosis; D006320:Hearing Tests; D006801:Humans; D007231:Infant, Newborn; D059012:Lost to Follow-Up; D015997:Neonatal Screening
keywords: Cost-effective; Hearing; Neonatal; Results; Screening; Weakness