Bilirubin-Induced Audiologic Injury in Preterm Infants

Olds, Cristen; Oghalai, John S.

doi:10.1016/j.clp.2016.01.006

Cited by 27 publications

(25 citation statements)

References 90 publications

(104 reference statements)

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“…ANSD is reported to affect 6.5% to 15% of newborns with hearing loss [9, 10]. It is associated with a wide range of etiologies and risk factors including premature birth, hyperbilirubinemia, genetic mutations and cochlear nerve deficiency (CND) [11–14]. …”

Section: Introductionmentioning

confidence: 99%

Clinical role of electrocochleography in children with auditory neuropathy spectrum disorder

Fontenot

Giardina

Teagle

et al. 2017

International Journal of Pediatric Otorhinolaryngology

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OBJECTIVES To assess electrocochleography (ECochG) to tones as an instrument to account for CI speech perception outcomes in children with auditory neuropathy spectrum disorder (ANSD). MATERIALS & METHODS Children (<18 years) receiving CIs for ANSD (n=30) and non-ANSD (n=74) etiologies of hearing loss were evaluated with ECochG using tone bursts (0.25–4 kHz). The total response (TR) is the sum of spectral peaks of responses across frequencies. The compound action potential (CAP) and the auditory nerve neurophonic (ANN) in ECochG waveforms were used to estimate nerve activity and calculate nerve score. Performance on open-set monosyllabic word tests was the outcome measure. Standard statistical methods were applied. RESULTS On average, TR was larger in ANSD than in non-ANSD subjects. Most ANSD (73.3%) and non-ANSD (87.8%) subjects achieved open-set speech perception; TR accounted for 33% and 20% of variability in the outcomes, respectively. In the ANSD group, the PTA accounted for 69.3% of the variability, but there was no relationship with outcomes in the non-ANSD group. In both populations, nerve score was sensitive in identifying subjects at risk for not acquiring open-set speech perception, while the CAP and the ANN were more specific. CONCLUSION In both subject groups, the TRs correlated with outcomes but these measures were notably larger in the ANSD group. There was also strong correlation between PTA and speech perception outcome in ANSD group. In both subject populations, weaker evidence of neural activity was related to failure to achieve open-set speech perception.

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Section: Introductionmentioning

confidence: 99%

Clinical role of electrocochleography in children with auditory neuropathy spectrum disorder

Fontenot

Giardina

Teagle

et al. 2017

International Journal of Pediatric Otorhinolaryngology

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“…Auditory complications, a disabling neurological nding in kernicterus, are typically characterized by varying degree of auditory neuropathy/dys-synchrony (AN/AD) ranging from central auditory processing di culties with normal hearing to severe AN/AD with absent auditory brainstem responses, and possibly accompanying severe hearing loss and deafness. In fact, the brainstem cochlear nuclei are said to be one of the rst structures affected by elevated total bilirubin, followed by the auditory nerve [58,59] . So we performed hearing tests for the 103 patients with brainstem auditory evoked potential (BAEP) [60] devices.…”

Section: Discussionmentioning

confidence: 99%

“…Although neonatal jaundice is quite common, affecting 60%-80% of newborns overall [1] . Mainly, with the high accumulation of unconjugated bilirubin, severe patients (their bilirubin's concentration >20mg/dL) may suffer from bilirubinencephalopathy or kernicterus, and bilirubun-induced neurological dysfunction (BIND) [2] , which will cause permanent damage to the basal ganglia, hippocampus, hypothalamus, cerebellar neurons, brainstem [3,4] , etc. Clinical manifestation includes lethargy, poor response, fever, apnea, convulsion, auditory complications and so on [2] .…”

Section: Introductionmentioning

confidence: 99%

Analysis on the MRI and BAEP Results of Neonatal Brain with Different Levels of Bilirubin

Zhongxing

Ding

Wang

et al. 2020

Preprint

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Background：To explore whether there is abnormality of neonatal brains’ MRI and BAEP with different bilirubin levels, and to provide an objective basis for early diagnosis on the bilirubin induced subclinical damage on brains.Methods: To retrospectively analyze the clinical data of 103 neonatal patients, who had been hospitalized in Neonatology Department of Taicang First People’s Hospital from March 2013 to September 2015, to conduct routine brain MRI examination , BAEP testing and to analyze BAEP and MRI image results of the neonatal patients, who were divided into three groups based on the levels of total serum bilirubin concentration (TSB), 16 cases in mild group (TSB:0.0~229.0μmol/L), 49 cases in moderate group (TSB: 229.0~342.0μmol/L) and 38 cases in severe group (TSB≥342.0μmol/L); Results: We found as follows: A. Comparison of the bilirubin value of the different group : 1. The bilirubin value of the mild group is 171.99±33.50 μmol/L, the moderate group is293.98±32.09 μmol/L, and the severe group is 375.59±34.25 μmol /L . And the comparison of bilirubin values of the three groups of neonates (P＜0.01) indicates the difference is statistically significant (P＜0.01). 2. The bilirubin value of the pre-term group is 289.70±85.38μmol/Land the full-term group is 310.36±72.32 μmol/L, but the comparison of the bilirubin values between pre-term group and full-term group indicates that the difference is not statistically significant (P＞0.05).3. The bilirubin value of the normal brain MRI group(82) is 305.55±74.54 μmol/L and the abnormal brain MRI group is 303.56±83.04μmol/L; the comparison of bilirubin values between the two groups indicates that the difference is not statistically significant(P＞0.05). B. The weight value of the ﹤2500g group is 2.04±0.21 and the ≥2500ggroup is 3.39±0.46; the weight comparison of the two groups indicates that the difference is statistically significant (P＜0.01). C. Comparison of the abnormal MRI of the different groups: 1.The brain MRI result's abnormal ratio of the mild group is 31.25%, the moderate group is 16.33% and the severe group is 21.05%, but the comparison of brain MRI results of the three neonates groups indicates that the difference is not statistically significant (P＞0.05). 2.The brain MRI result's abnormal ratio of the pre-term is 30.77% and the full-term group is 16.88%, but the comparison of brain MRI results between prem-term group and full-term group indicates that the difference is not statistically significant (P＞0.05). 3.The brain MRI result's abnormal ratio of the ﹤2500g group is 37.50% and the ≥2500g group is 17.24%; but the comparison of brain MRI results of two neonates groups indicates that the difference is not statistically significant(P＞0.05). D. Comparison of abnormal MRI signal values of globus pallidus on T1WI in different groups: 1. The comparison of normal group signal values with that of mild group (p < 0.05), with that of moderate group and with that of severe group (p < 0.01) indicates that the difference is statistically significant; 2. The comparison of signal values between mild and moderate groups (p < 0.05) and between mild group and severe group (p < 0.01) indicates that the difference is statistically significant; 3. The comparison of signal values between moderate group and severe group indicates that the difference is statistically significant(p < 0.05). E. Comparison of BAEP testing results in groups: 1. There were 27(26.21%) cases in abnormalities of the BAEP results of all 103cases bilirubin patients. 2. There were 15(18.29%) cases in abnormalities of the BAEP result of the 82 cases normal brain MRL , 2(40%) cases in abnormalities of the BAEP result of the 5 cases abnormal MRI in mild bilirubin group, 4（50%） cases in abnormalities of the BAEP result of the 8 cases abnormal MRI in moderate bilirubin group and 6（75%）cases in abnormalities of the BAEP result of the 8 cases abnormal brain MRI in severe bilirubin group. 3. After one month review of the BAEP result, there was 0（0.00%） abnormal case in the normal MRI and the mild group; there were 1（20%） abnormal case in the moderate group and 2（25%） cases in the severe group. Conclusion: At low level of bilirubin, central nervous system damage may also occur and can be detected as abnormality by MRI and BAEP. Meanwhile, MRI and BAEP can also provide early abnormal information for the judgment of central nervous system damage of the children with NHB who have no acute bilirubin encephalopathy (ABE) clinical features, and provide clues for early treatment and early intervention.

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“…28 However, some neonates with hyperbilirubinemia may develop bilirubin-induced neurologic dysfunction (BIND), including acute bilirubin encephalopathy, isolated neural pathway dysfunction and kernicterus. 29 Neuronal damage caused by bilirubin deposition is most likely to occur in specific regions, such as the basal ganglia, globus pallidus, hypothalamic nuclei, and hippocampus. 30 The auditory nerve pathway is very sensitive to the toxicity of bilirubin and can lead to slight or even complete HL.…”

Section: Hyperbilirubinemiamentioning

confidence: 99%

Change to Hearing Loss–Related Risks and Screening in Preterm Infants

2020

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Hearing loss is one of the most common congenital defects in infancy; it increases speech and language delays and adversely affects academic achievement and socialemotional development. The risk of hearing loss in premature infants is higher than that in normal newborns, and because of the fragility of the auditory nervous system, it is more vulnerable to different risk factors. The hearing screening guidelines in current use were proposed by the American Academy of Pediatrics and updated in 2007, but there are no uniform guidelines for hearing screening in preterm infants. This review focuses on the risk factors related to hearing loss in premature infants, hearing screening strategies, and reasons for failure. The aim is to provide a more comprehensive understanding of hearing development in preterm infants to achieve early detection and early intervention. At the same time, attention should be paid to delayed auditory maturation in preterm infants to avoid excessive intervention. Key Points

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Bilirubin-Induced Audiologic Injury in Preterm Infants

Cited by 27 publications

References 90 publications

Clinical role of electrocochleography in children with auditory neuropathy spectrum disorder

Clinical role of electrocochleography in children with auditory neuropathy spectrum disorder

Analysis on the MRI and BAEP Results of Neonatal Brain with Different Levels of Bilirubin

Change to Hearing Loss–Related Risks and Screening in Preterm Infants

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