Hearing Screening In Nicu Graduates

Introduction

NICU graduates are at a high risk for developing sensorineural hearing defects. Babies having following conditions are at higher risk and should be referred for hearing testing:

• Family history of hereditary childhood hearing loss.

• Birth weight of less than 1500 grams.

• Intrauterine infection - cytomegalovirus, rubella, syphilis, herpes, toxoplasmosis etc.

• Bacterial meningitis, encephalitis.

• Hyperbilirubinemia (high enough to warrant exchange transfusion)

• Craniofacial anomalies with malformations of the ear and abnormalities of palate & lips.

• Ototoxic drugs (aminoglycosides, loop diuretics)

• Mechanical ventilation required for 5 days or more.

• Central nervous system insult- birth asphyxia, intracranial hemorrhage, neonatal seizures etc.

Infants at risk should have the screening alone prior to discharge. Some infants may require re-screening after a month, especially premature infants. Infants with bacterial meningitis, syndromes, and ototoxic medications require evaluation at least every 6 months till 3 years of age and at appropriate intervals later.

Screening Tests:

• BERA: This is reliable only after 34 weeks of gestation.

• EOAE (Evoked otoacoustic emission): It is less desirable as a primary screening test.