Neonatal status and hearing loss in high-risk infants

Salamy, A.; Eldredge, Lynnette; Tooley, William H.

doi:10.1016/s0022-3476(89)80151-9

Cited by 117 publications

(65 citation statements)

References 16 publications

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“…Over the past two decades, there have been conflicting reports regarding the association between furosemide and SNHL in high-risk neonates. 7,28,29 Results from the current study associate exposure to furosemide with both SNHL and AN. Multivariate analysis suggests that this association is independent of exposure to aminoglycosides, vancomycin and dexamethasone.…”

Section: Discussionmentioning

confidence: 62%

“…These risk factors include positive family history, hyperbilirubinemia, exposure to ototoxic medications, hypoxia, birth asphyxia and intracranial hemorrhages, including intraventricular hemorrhage. [2][3][4][5][6][7] The exact anatomical location of abnormality or injury and the pathophysiology of AN are poorly understood. As such, there are no specific risk factors to distinguish AN from cochlear hearing loss.…”

Section: Introductionmentioning

confidence: 99%

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Extremely low birth weight infants are at high risk for auditory neuropathy

et al. 2007

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Auditory neuropathy (AN) is a condition in which transmission of sound to the brain is abnormal. This is reflected as an electrophysiologic profile of normal otoacoustic emissions (OAE), with abnormal auditory brainstem evoked responses (ABR). Functionally speech perception is impaired and management strategies remain controversial. AN can be missed if high-risk newborns are screened for hearing loss with only OAE testing. The rate of sensorineural hearing loss (SNHL) in high-risk nursery infants is 10 times greater compared with normal term newborns. Therefore, we hypothesize that infants from the neonatal intensive care unit (NICU) are at significantly higher risk for AN than normal term infants.Objective: The objective of this study is to establish a prevalence rate and characterize risk factors for NICU graduates who demonstrate the AN electrophysiologic profile.Study Design: This retrospective study examined infants admitted to the NICU at Kapi'olani Medical Center for Women and Children in Honolulu, HI from 1999 through 2003. Infants were screened with automated ABR. Diagnostic testing and OAE were performed before discharge if the ABR was abnormal. Hospital courses of 24 AN, 71 SNHL and 95 gestational age (GA)-matched control infants with normal hearing were reviewed.Result: With a SNHL prevalence of 16.7/1000, the rate for AN was 5.6/1000 NICU infants. Compared to infants with SNHL, infants with AN were significantly younger (GA 28.3±4.8 AN vs 32.9±5.2 weeks SNHL, P<0.0001) and smaller (BW 1318±894 AN vs 1968±1006 g SNHL).Nearly two-thirds of the AN infants were ELBW and had significantly longer hospital stays compared to SNHL infants of the same birth weight group. Exposure to furosemide, aminoglycosides, vancomycin or dexamethasone was associated with increased AN but not SNHL. Peak bilirubin level correlated with SNHL but not AN.Conclusion: Low birth weight NICU infants are at significant risk for AN. ELBW infants are at significantly higher risk for both AN and SNHL.Infants admitted to the NICU should be routinely screened by automated ABR and if abnormal, further evaluation should be started before hospital discharge. Early identification of AN will result in better understanding of this disorder and lead to the development of appropriate intervention strategies.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Extremely low birth weight infants are at high risk for auditory neuropathy

et al. 2007

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“…Salamy et al 21 avaliaram 224 crianças com idade gestacional de 24 a 34 semanas e baixo peso ao nascimento que ficaram internadas em unidade de terapia intensiva neonatal. Uziel & Piron 19 observaram que as EOAT foram mais difíceis de serem registradas em recém-nascidos com idade gestacional menor que 35 semanas, dando como justificativa pata tal ocorrência, o formato e tamanho reduzido dos condutos auditivos externos ou imaturidade das células ciliadas externas.…”

Section: Discussionunclassified

“…Este dado é condizente com vários autores, que defendem a importância da triagem auditiva neonatal e que observaram número de falhas sempre inferior ao número de respostas presentes 10,21,15,17,18,23,24,26,27,28 .…”

Section: Discussionunclassified

Emissão otoacústica evocada transitória: instrumento para detecção precoce de alterações auditivas em recém-nascidos a termo e pré-termo

Garcia

Isaac

Oliveira

2002

Rev. Bras. Otorrinolaringol.

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Introdução:O diagnóstico e a intervenção precoces nas alterações auditivas são de fundamental importância no desenvolvimento infantil. O registro das emissões otoacústicas tem sido largamente indicado, por ser um exame rápido, de fácil aplicação. Objetivo: Os objetivos do presente estudo foram avaliar a função auditiva periférica de recém-nascidos a termo e pré-termo adequados e pequenos para a idade gestacional, por meio da pesquisa das emissões otoacústicas transitórias, identificando a prevalência de alterações auditivas nesta população; verificar a influência das variáveis idade gestacional e peso ao nascimento, assim como de tipos de tratamento, ventilação mecânica, administração de medicamentos ototóxicos e permanência em incubadora e analisar os fatores que interferem nos programas de triagem auditiva neonatal. Forma de estudo: Clínico prospectivo. Material e método: Foram avaliadas 157 crianças, sendo 43 nascidas a termo, 79 pré-termo adequadas à idade gestacional e 35 pré-termo pequenas à idade gestacional. Resultado: Observou-se que recém-nascidos prematuros falham mais nas respostas das emissões otoacústicas. A prevalência de perda auditiva condutiva na população estudada foi de 29 orelhas para 1000 e para perda auditiva neurossensorial de 16 orelhas para 1000. As crianças de peso baixo ao nascimento foram as mais difíceis de serem avaliadas. As emissões otoacústicas transitórias foram observadas a partir de 27 semanas de idade gestacional. Os tipos de tratamentos utilizados foram fatores que influenciaram negativamente nas respostas das emissões otoacústicas nos grupos de prematuros. Conclusão: O trabalho de diagnóstico precoce da perda auditiva deve ser objetivo de equipe interdisciplinar -neonatologista, pediatra, otorrinolaringologista, fonoaudiólogo, enfermeiro e familiares -e deve ser seguido, imediatamente, por programas de intervenção precoce. There were appraised 157 children, whose 43 were born full term, 79 preterm adequate to gestacional age and 35 small preterm to gestacional age. It had been observed that premature neonates fail more in the answers from otoacoustic emissions. Cristiane Fregonesi Results:The prevalence of conductive hearing impairment in the population studied was from 29 ears to 1000 and for the sensory-neural hearing impairment from the 16 to 1000. The low weight children in the birth were the most difficult to be appraised. The transient otoacoustic emissions were observed from the beginning of 27 gestacional weeks old. The kinds of treatments used were factors that influenced negatively in the answers of the otoacoustic emissions in premature groups. Conclusion:The early diagnostic work of the hearing impairment must be objective of the interdisciplinary teamneonatologist, pediatrician, ear/nose and throat doctor, audiologist and speech-language pathologist, nurse and relatives -and must be followed, immediately, by the early interventions programs. ORIGINAL ARTICLE ARTIGO ORIGINALRev Bras Otorrinolaringol.

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“…12 Comorbid conditions, such as perinatal asphyxia, hypovolemia, shock, or sepsis, were supposed to augment aminoglycoside ototoxicity. [13][14][15] Although multiple factors may confound these clinical situations, significant decrease of blood pressure is observed in hypovolemia, shock, or sepsis. Cochlear blood flow was observed to be stopped when acute reduction of blood pressure was induced in animals.…”

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confidence: 99%

Transient ischemia/hypoxia enhances gentamicin ototoxicity via caspase-dependent cell death pathway

Kao

Tsai

Lai

et al. 2011

Laboratory Investigation

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Aminoglycoside ototoxicity is a common cause of drug-induced hearing loss. Toxicity is dose related, but some patients may still develop hearing loss even under safe dosage. Apart for genetic idiosyncrasy, indirect evidences imply that ischemia may increase the aminoglycoside ototoxic sensitivity because common clinical situations associated with cochlear ischemia such as noise, sepsis, and shock are known to augment the development of aminoglycoside ototoxicity. At present, a direct interaction of cochlear ischemia and aminoglycoside ototoxicity is still lacking. This study demonstrated a direct evidence of increased gentamicin (GM) ototoxic sensitivity in chronic guinea pig models of transient cochlear ischemia. No permanent auditory changes were observed after a single dose of GM (125 mg/kg) or after transient cochlear ischemia for 30 min. Persistent and significant auditory threshold shift was detected when GM was given after transient cochlear ischemia. Cochlear hair cells and spiral ganglion neurons are the major regions affected. Apoptosis contributes to hair cell death during acute interaction of ischemia and GM ototoxicity. Increased apoptotic cell death was also depicted when GM crossreacted with hypoxia in vitro, using cochlear cell lines. Generation of reactive oxygen species, loss of mitochondrial membrane potential, calcium release, and caspase-dependent apoptotic cell death were shown during the interaction of hypoxia and GM ototoxicity in vitro. This synergistic ototoxicity may be critical to aminoglycoside-induced hearing loss in clinical scenarios. The results should improve our understanding of the interacting mechanism and potential preventive strategy to aminoglycoside ototoxicity.

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Neonatal status and hearing loss in high-risk infants

Cited by 117 publications

References 16 publications

Extremely low birth weight infants are at high risk for auditory neuropathy

Extremely low birth weight infants are at high risk for auditory neuropathy

Emissão otoacústica evocada transitória: instrumento para detecção precoce de alterações auditivas em recém-nascidos a termo e pré-termo

Transient ischemia/hypoxia enhances gentamicin ototoxicity via caspase-dependent cell death pathway

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