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Newborn hearing screening
- 2. Wilson criteria for hearing screening • The condition should be an important health problem. • There should be test that easy to perform and interpret and acceptable ,accurate and reliable. • There should be accepted treatment recognized for disease • Treatment should be more effected if started early. • There should be policy on who should be treated.
- 3. Introduction • Hearing loss at birth leading to • Delayed language development • Difficulty with behavior and psychosocial interaction
- 4. Definition • Normal hearing has threshold of 0-25 Db • The extant of hearing loss is defined by measuring the hearing threshold in decibel at various frequencies. • WHO classifies • Mild 25-40dB • Moderate 41-55dB • Moderately Severe 56-70dB • Severe 71-90 Db • Profound 90 Above
- 5. Classification • Conductive hearing loss Abnormalities in outer r middle ear • Sensorineural hearing loss Abnormalities in cochlea or auditory neural pathway • Most neonatal hearing impairment is CAUSED BY SNHL
- 6. Rationale for newborn hearing Screening • Earlier detection and intervention • Early intervention can improve speech and language development and educational achievement in affected patient
- 7. Outcome • NatherLands Detected by newborn screening versus screening at 9 months • Newborn screening group higher scores for development social development ,gross motor development and quality of life testing when evaluated at 3 to 5 years of age
- 8. Outcome • Study from Australia reported better scores- receptive expressive language, receptive recovery who were diagnosed earlier due to UNHS, then patient selectivity screen based on identifying risk factor or paste on the opportunistic detection for hearing loss.
- 9. Screening test for hearing • The American academy of PEADITRICS task force on newborn and infant hearings defined • Affective neonatal hearing screening test as one that detects hearing loss of less than 35 decibel in better ear and his reliable in infants less than 3 months of age
- 10. • Two electrophysiological techniques near these criteria • Automated auditory brain stem response (AABR) • Auto acoustic emission (OAE)
- 11. Screening test for hearing • Both in expansible- portable- reproducible and automated • They evaluate the periphery auditory system and cochlea • Cannot assess activity in highest level of Central auditory system • These tests alone or not sufficient to diagnose hearing loss
- 12. Difference between the ABR and AABR • AABR are measured the summation of action potential from the VIII nerve to inferior calculus of midbrain in response to click stimulus difference between AABR and ABR • ABR is a screening tool automatic pass fail response . • ABR diagnostic test provide the quantitative data waveform interpreted by train Audiologist
- 13. Technique • The AABR utilize click stimuli presented at 35 decibel • Three surface electrodes forehead ,nape and forehead detect wave from recording generated by auditory brainstorm response to click stimuli • The morphology and latency of wave form are compared with normal and pass or fail leading is generated • The examiner does not see the way form • ABR required 4 to 15 minutes for testing
- 15. ABR versus OAE • Test time required less patient preparation time and shorter test time • Test can be performed when infant is awake feeding or sucking on a pacifier • OAE sensitive to background noise and noise generated by baby • False positive increase with OAE is caused by the WAX occuluding the external auditory canal
- 16. Auditory Neuropathy • AABR detect the auditory neuropathy in infants • • OAE will not detect the auditory neuropathy • AABR should always be used to screen hearing in friends who are at risk of AN (infants with hypoxia ,prematurity have a Hyperbilirubinemia or neurological impairment.