Universal newborn hearing screening with automated auditory brainstem response (AABR) in Hungary: 5-year experience in diagnostics and influence on the early intervention

Abstract

Purpose In 2015 a new regulation and guidelines for the universal newborn hearing screening by AABR measurement have been implemented in Hungary. The aim of our study was to analyse (1) the past 5 years of data from our diagnostic centre about the incidence and types of congenital hearing losses, and (2) the first experiences with the National Newborn Hearing Screening Registry, started in 2019, and (3) the influence of the screening on the pediatric cochlear implant program. Methods 1269 children referred to our diagnostic centre between 2017 and 2021 were investigated. A third AABR measurement and full audiological evaluation were performed. Furthermore, one-year period data of the screening registry, and the number of implanted children at or under the age of 3 were analysed using the national databases. Results Altogether 276 newborns (22% of the referred cases after the two-stage screening) had hearing loss, 134 (49%) out of them was conductive origin, almost twice frequent in male as in female. Permanent sensorineural hearing impairment was found in 142 (51%), 58 (40%) of them had bilateral, severe to profound hearing loss, occurring more frequently in male as in female. The national digital registration of the screening data within 12 months concerned 68%. The number of early cochlear implantation in one year increased from 1 to 23 children in the past 15 years. Conclusion A third AABR after the two-stage screening increased the efficiency and filtered the 78% false-positive cases. The audiological diagnostics verified and typed the hearing losses ensuring the early intervention.

Diagnostic outcome of referred neonatal hearing screening in a secondary healthcare center at Elmahalla , Gharbia, Egypt.

“…Among neonates with hearing loss, 4 neonates (33.4%) had unilateral profound SNHL, 3neonates (25%) had bilateral profound SNHL, 3 neonates (25%) had unilateral moderate SNHL, 1neonate (8.3%) had bilateral moderate SNHL and1 neonate (8.3%) received a diagnosis of auditory neuropathy. Gáborján et al (10) in their study about neonatal hearing screening in Hungary, using ABR in diagnosis stage they found that regarding the severity of the hearing loss (from 102 children) mild, moderate, severe and profound hearing loss were diagnosed in 12%, 31%, 9% and 48% respectively). Sabbagh et al (11) in their study about the neonatal hearing screening revealed that of 24 hearing-impaired newborns, (62.5%) had bilateral hearing loss and (37.5%) had unilateral HL where mild hearing loss (20-39 dB) was (12.5%) , moderate hearing loss (40-55 dB) in (20.8%) neonates, severe hearing loss (70-90 dB) in (37.5%), and profound hearing loss (>90 dB)in (29.2%) neonates.…”

Referral rate and false-positive rates in a hearing screening program among high-risk newborns

“…Even though this is a viable solution for well babies, in a setup involving two-stage AABR protocol in high-risk newborns, this solutions becomes redundant. But recently, a study from Hungary reported using a third AABR test to reduce false-positive results following the two-stage AABR protocol [ 36 ]. Even though this could be a missing link in reducing false-positivity rate of two-stage AABR programs, implementing it on a larger scale might still not be cost-effective.…”

A funkcionális halláscsökkenés felismerése és komplex diagnosztikája

“…Az objektív vizsgálatok minden életkorban fontos szerepet játszanak az audiológiai differenciáldiagnosztikában. Bizonyos életkorokban, például csecsemők és kisgyermekek esetében csak ilyen vizsgálatok alapján mondhatunk objektív véleményt a hallásról [16], így a szubjektív elemek kiküszöbölhetők. A stapediusreflex és az otoakusztikus emisszió mérésének indokolt esetekben minél szélesebb körben történő alkalmazása és értékelése az audiológiai differenciáldiagnosztikában ma már alapvető.…”