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Original Article | ONLINE FIRST

Children With Sensorineural Hearing Loss After Passing the Newborn Hearing Screen

Kavita Dedhia, MD; Dennis Kitsko, DO; Diane Sabo, PhD; David H. Chi, MD
JAMA Otolaryngol Head Neck Surg. 2013;139(2):119-123. doi:10.1001/jamaoto.2013.1229.
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Objectives  To identify and describe the findings of children who passed their newborn hearing screen (NHS) and were subsequently found to have childhood hearing loss.

Setting  Academic tertiary care center.

Design  Retrospective medical chart review.

Methods  With approval of the institutional review board, hospital records were reviewed for children diagnosed as having hearing loss. We identified 923 children with hearing loss from 2001 to 2011. Patients who passed the NHS with subsequent hearing loss were included.

Results  Seventy-eight patients were included in our study. The suspicion of hearing loss in patients who passed the NHS was most often from parental concerns (n = 28 [36%]) and failed school hearing screens (n = 25 [32%]). Speech and language delay and failed primary care physician screens accounted for 17% and 12%, respectively. Configuration of the audiogram was bilateral symmetric (n = 42 [54%]), bilateral asymmetric (n = 16 [21%]), and unilateral (n = 20 [26%]) loss. Thirty-seven patients (47%) had severe or profound hearing loss. The etiology was unknown in 42 patients (54%); the remaining was attributed to genetics (n = 13 [17%]), anatomic abnormality (n = 11 [14%]), acquired perinatal (n = 9 [12%]), and auditory neuropathy (n = 3 [4%]).

Conclusions  This is the largest study to characterize children with hearing loss who passed the NHS. In our review, parental concerns and school hearing screens were the most common method to diagnose hearing loss after passing the NHS. Families and primary care physicians may have a false sense of security when patients pass the NHS and overlook symptoms of hearing loss. This study raises the question whether further screens would identify hearing loss in children after passing the NHS.

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Figures

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Figure 1. Reason for initial otolaryngology consultation for hearing loss. PCP indicates primary care physician; TTP, tympanostomy tube placement. Regarding the last 2 columns on the right, 2 children were identified after routine audiograms following TTP, and 1 child was identified after a head computed tomography demonstrated an enlarged vestibular aqueduct. A subsequent audiogram confirmed sensorineural hearing loss.

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Grahic Jump Location

Figure 2. Cause of hearing loss.

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