Some infants go on to develop sensorineural hearing loss (SNHL) despite having passed the universal newborn hearing screen (UNHS), show study findings.
"This study raises the question whether further screens would identify hearing loss in children after passing the UNHS," say David Chi (Children's Hospital of Pittsburgh, Pennsylvania) and colleagues.
In a prospective review of children's hospital records, the team identified 923 children who developed SNHL between 2001 and 2011. Of these children, 314 had undergone the UNHS and 78 were found to have passed it, yet they developed SNHL at a later stage.
As reported in JAMA Otolaryngology - Head and Neck Surgery, the mean age of diagnosis for SNHL ranged from 1 month to 10 years, with a mean age of 4 years and 6 months.
In the group who passed the UNHS but were later diagnosed with SNHL, the condition was most commonly identified by parents (36% of cases), followed by failed school hearing screens (32%), speech and language delay (17%), and finally by physician hearing screens (12%).
"Parents, paediatricians, and family physicians may have a false sense of security from a normal hearing screen result and may overlook signs of hearing loss," suggest Chi et al. "This may account for why only 9 of the referrals (12%) were after failed screenings from the primary care physician's office."
Hearing loss in the children diagnosed with SNHL after passing the UNHS was classed as profound in 26 (33%) cases, while a mild loss occurred in 25 (32%), a moderate loss in 16 (21%), and a severe loss in 11 (14%).
The majority of patients (42; 54%)who had passed the UNHS had bilateral symmetric SNHL, 20 (26%) had unilateral hearing loss, and 16 (21%) had bilateral asymmetric hearing loss.
"This study highlights the importance of recognizing the possibility that children who passed the UNHS may have hearing loss," warn Chi and team. Children with later-onset SNHL have a later diagnosis of hearing loss, leading to a later intervention and potentially increased speech and language delay and cognitive and social impairment.
"Parents and medical care providers should recommend further audiologic testing in children with speech and language delay regardless of passing the UNHS," say the researchers. And further studies to investigate the use of additional hearing screens are required, they conclude.
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