Middle ear effusion and newborn hearing screening

Karawani, Hanin; Matanis, Wisam; Na’ara, Shorook; Gordin, Arie

doi:10.1007/s00405-022-07524-2

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…The 29% rate of spontaneous MEE clearance was similar to an earlier finding by Karawani and colleagues, who recorded a resolution rate of 26% in 46 newborns in Israel [ 17 ]. The prognosis of acquired MEE, which is mainly attributed to infectious otitis, is reportedly much more favourable [ 18 ].…”

Section: Discussionsupporting

confidence: 88%

Neonatal hearing screening - does failure in TEOAE screening matter when the AABR test is passed?

Gellrich,

Gröger,

Echternach

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Newborns who fail the transient evoked otoacoustic emissions (TEOAE) but pass the automatic auditory brainstem response (AABR) in universal newborn hearing screening (UNHS), frequently have no further diagnostic test or follow-up. The present study aimed to investigate whether hearing loss might be missed by ignoring neonatal TEOAE failure in the presence of normal AABR. Methods A retrospective analysis was conducted in newborns presenting between 2017 and 2021 to a tertiary referral centre due to failure in the initial UNHS. The main focus was on infants who failed TEOAE tests, but passed AABR screening. The clinical characteristics and audiometric outcomes were analysed and compared with those of other neonates. Results Among 1,095 referred newborns, 253 (23%) failed TEOAE despite passing AABR screening. Of the 253 affected infants, 154 returned for follow-up. At 1-year follow-up, 46 (28%) achieved normal audiometric results. 32 (21%) infants had permanent hearing loss (HL) confirmed by diagnostic ABR, 58 (38%) infants had HL solely due to middle ear effusion (MEE), and for 18 (12%) infants HL was suspected without further differentiation. The majority of permanent HL was mild (78% mild vs. 13% moderate vs. 9% profound). The rate of spontaneous MEE clearance was rather low (29%) leading to early surgical intervention in 36 children. The profile of the risk factors for hearing impairment was similar to that of newborns with failure in both, TEOAE and AABR; however, there was a stronger association between the presence of risk factors and the incidence of HL (relative risk 1.55 vs. 1.06; odds ratio 3.61 vs. 1.80). Conclusion In newborns, the discordance between a “refer” in TEOAE and a “pass” in AABR screening is associated with a substantial prevalence of hearing impairment at follow-up, especially in the presence of risk factors.

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Section: Discussionsupporting

confidence: 88%

Neonatal hearing screening - does failure in TEOAE screening matter when the AABR test is passed?

Gellrich,

Gröger,

Echternach

et al. 2023

Eur Arch Otorhinolaryngol

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“…The prevalence of an HL derived from MEE, with or without AOM, varies by age [8,9]. MEE in children necessitates further hearing evaluations and may also prolong the identification of a sensorineural HL (SNHL).…”

Section: Introductionmentioning

confidence: 99%

The Complexity of Hearing Aid Fitting: Children with Congenital Hearing Loss and Middle Ear Dysfunction

Priner,

Brand

2023

Children

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Background: The early diagnosis of hearing loss (HL) and hearing rehabilitation facilitate language and communication development. Some children exhibit mixed HL due to middle ear effusion (MEE) or acute otitis media (AOM). Mixed HL can affect HL evaluation and hearing aid (HA) fitting. The present study retrospectively evaluated the prevalence of MEE/AOM among children with congenital sensorineural HL (SNHL) who were fitted with HAs and its effect on the HA fitting. Methods: Thirty-six HA fittings carried out between 2017 and 2020 at one rehabilitation center were examined. Medical and audiological information was retrieved for children between 6 and 32 months old. The number of appointments and HA fitting times were recorded. Results: Twenty-eight children were included in the study. Eighteen children, in addition to SNHL, had a conductive component resulting from MEE/AOM. The children with these pathologies required significantly more HA fitting sessions and hearing tests, fewer real ear to coupler difference (RECD) measurements and longer HA fitting periods. Conclusion: The findings indicate that a large number of children fitted with HAs have an additional conductive component that makes the fitting process longer. Since early rehabilitation is necessary for language development, otolaryngologists should be aware of the adverse effects of MEE/AOE on the HA fitting process. It is important to inform parents that when there is a conductive component, the HA fitting process may take longer and that treatment by an otolaryngologist is vital. This study stresses the importance of multidisciplinary cooperation for optimal HA fitting.

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A Comparison of 226- and 1000-Hz Probe Tone Tympanometry With Myringotomy Findings in Infants

Gellrich,

Eder,

Echternach

et al. 2024

Am J Audiol

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Purpose: This study aimed to verify the diagnostic value of tympanometry with 226- and 1000-Hz probe tones in infants by comparing tympanometry results with the gold standard of the middle ear state assessed by myringotomy. Furthermore, clinically useful predictors for false peaked tympanograms despite the presence of middle ear fluid should be identified. Method: Pre-operative 226- and 1000-Hz tympanograms were retrospectively compared with intraoperative findings of the tympanic cavity after myringotomy in 111 infants (217 ears) aged ≤ 12 months. In addition to the shape of tympanograms, demographic and clinical characteristics, the results of other audiometric measurements, and the viscosity of middle ear fluid, if present, were evaluated in several subgroups. Results: The sensitivity and specificity of 1000-Hz tympanometry for middle ear effusion (MEE) detection were 97%–98% and 71%–84%, respectively, whereas standard tympanometry with a 226-Hz probe tone achieved a poor sensitivity of 43%–61% and a specificity of 81%–97%. Younger age, low viscosity of the middle ear fluid, and female sex were associated with an increased risk of false peaked 226-Hz tympanograms despite MEE. Furthermore, larger equivalent outer ear canal volumes were linked to false peaked 226-Hz tympanograms. Conclusions: The comparison of myringotomy findings and 226- and 1000-Hz tympanometry confirms the superiority of high-frequency tympanometry in infants younger than 12 months. Although this study identified some vague predictors of potentially false peaked 226-Hz tympanograms, the assessment of the middle ear state by 226-Hz tympanometry remains unreliable in young infants.

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Middle ear effusion and newborn hearing screening

Cited by 4 publications

References 31 publications

Neonatal hearing screening - does failure in TEOAE screening matter when the AABR test is passed?

Neonatal hearing screening - does failure in TEOAE screening matter when the AABR test is passed?

The Complexity of Hearing Aid Fitting: Children with Congenital Hearing Loss and Middle Ear Dysfunction

A Comparison of 226- and 1000-Hz Probe Tone Tympanometry With Myringotomy Findings in Infants

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