Analysis On The Hearing Impairment Of The Newborns In The Neonatal Intensive Care Unit

Objective The newborns hearing impairment in the neonatal intensive care unit(NICU) were analyzed in order to understand their hearing disorder incidence, to study risk factors of the hearing impairment, to pay attention to reduce the disease occurs, so that the clinical basis for early intervention could be provided.Methods681newborns were hearing screened and diagnosed with two-stage hearing screening program from NICU between March2008and February2009. The first test of transient evoked otoacoustic emission(TEOAE) screening was performed before the newborns discharged after birth3-5d from the NICU. At the age of42d were rescreening with TEOAE and automated auditory brainstem response (AABR), whether they passed or not passed the first TEOAE screening. If failing to pass the rescreening, the newborns were asked for further diagnostic evaluations including auditory brainstem response (ABR) and immittance test within three months. Abnormal newborns were diagnosed by ABR within six months again.The newborns with hearing impaired entered into intervention after two times of diagnoses. The pass criteria of ABR were the presence of wave V in response to36dB nHL click stimuli. Only newborns demonstrating considerably elevated thresholds (≥70dB nHL), absent or atypical ABR in combination with normal TEOAE and normal tympanogram were considered as suffering with AN. High risk factors of hearing loss were analyzed by stepwise regression method Logistic SPSS18.0statistical software. Results The initial TEOAE screening was681cases.42day-TEOAE and AABR rescreening was593cases, accounting for87.08%.34abnormal cases were asked to be done with ABR diagnosis.Actually ABR diagnosis was28cases, accounting for82.35%.14cases were diagnosed by hearing impairment.The hearing impairment rate was2.06%, including2cases of AN, and the incidence of AN was0.29%. Hearing impairment risk factors were divided into three types. The first was only single risk factor:preterm (118cases), accounting for17.33%; suffocation (65cases), accounting for9.55%; and full-term small for gestational age (10cases), accounting for1.47%: lung disease(127cases), accounting for18.65%; sepsis (18cases); accounting for2.64%;without confirmed hearing disorder; Hyperbilirubinemia (50cases), accounting for7.34%, four cases of hearing impairment confirmed; intracranial disease (5cases). accounting for0.73%, two of whom were diagnosed as hearing impairment. The second type was two kinds of risk factors combined were185cases, accounting for27.17%. four cases of whom were diagnosed with hearing impairment. The third type was three or more than three kinds of above risk factors combined were103cases, accounting for15.12%, four cases of whom confirmed with hearing impaired newborns. The data of NICU neonatal hearing loss risk factors was analyzed with Logistic regression analysis.The major risk factors had hyperbilirubinemia, intrauterine infection, craniofacial morphological malformations and premature birth. The risk factors of two cases of children with auditory neuropathy were severe hyperbilirubinemia and hypoxic-ischemic encephalopathy.Conclusion The total incidence rate of Neonatal hearing impairment in the NICU group was2.06%, which was consistent with that reported in the literatures.The incidence rate of AN (0.29%)was lower than those reported in the literatures. Two-stage screening method was suitable NICU newborns hearing screening model.We should pay attention to the role of AABR screening and avoid missing diagnosis.