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Identification and Management of Conductive Hearing Loss in Infants

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29 June 2009

Abstract: Main objectives of this research are to monitor, evaluate and improve universal newborn hearing screening program (UNHS) in identifying and management (audiology and medical) of infants with otitis media with effusions (OME). The paper also deals with the prevalence of OME in neonates, incidence of OME in Aboriginal and Torres Strait Islander (ATSI) and non-ATSI neonates, audiological and medical management in those infants diagnosed with or without middle ear diseases following referral.

This research was conducted at Audiology Department of The Townsville Hospital in conjunction with the Queensland Health Healthy Hearing Program.

A chart review of infants referred by neonatal hearing screening was done. Tympanometry, otoacoustic emissions and ABR testing were performed on both ears. Audiological findings following (i) referral from screening (ii) review and (iii) medical management will be presented along with (iv) comparison of ATSI and non-ATSI infants.

Results indicated that prevalence of transient conductive hearing loss was more than 1 ½ times that of sensorineural hearing loss. More males had conductive hearing loss than females. Prevalence was 4 times greater in ATSI than non ATSI babies. Presence of risk factors like prematurity or low birth weight did not increase the prevalence of conductive hearing loss. Conductive loss or conductive component was persistent in 53% of babies during follow up and management included grommets, examination under anaesthesia, antibiotics and observation with repeat evaluation.

OME is a common cause for UNHS referral and should be looked for prior to definitive diagnostic hearing testing. There is a need to promote discussion on (i) identification of OME and its management in neonates and (ii) develop some agreed standard for identification of middle ear and or conductive component before surgical intervention to allow definitive diagnostic testing as it is much easier to confirm SN hearing loss in infants without OME.

 

Sreedevi Aithal, MSc, MPH, MAudSA(CC)

Audiology Department, The Townsville Hospital, Queensland Health, Qld

 

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