Association between failure in otoacoustic emissions and risk indicator for hearing loss
Associação entre falha nas emissões otoacústicas e indicador de risco para deficiência auditiva
Kátia de Cássia Botasso; Maria Cecília Pinheiro Marconi Lima; Carlos Roberto Silveira Correa
Abstract
Purpose: to describe the results of a neonatal hearing health program and verify whether there is an association between the presence of risk indicators for hearing loss and failure in the tests and diagnosis.
Methods: a one-cohort, observational, retrospective study with secondary data contained in a spreadsheet concerning the family’s sociodemographic condition, clinical history, and examination results of 7,800 participants who were submitted to hearing screening between 2010 and 2016. Absolute frequency and percentages were used in the description of the first and second stages. In the association between risk indicators and failures in the otoacoustic emissions, the odds ratio, confidence interval, and significance level at 0.5% were used.
Results: the risk indicators in 8 out of the 12 infants presented with hearing loss were ototoxic medication and intensive care unit (ICU) stay, whereas the likelihood of failure in the otoacoustic emissions occurred along with 11 indicators. The likelihood of a diagnosis of hearing loss was 13 times greater when there was a risk indicator, 18 times greater when an ototoxic medication had been used, and 16.62 times greater when they stayed in ICUs.
Conclusion: the results show that knowing the indicators leads to considering the actions the team in charge should take.
Keywords
Resumo
Objetivo: descrever os resultados de um programa de saúde auditiva neonatal e verificar se há associação entre presença de indicador de risco para perda auditiva e falhas nos testes e no diagnóstico.
Métodos: trata-se do estudo de uma coorte, observacional e retrospectiva, com dados secundários contidos em planilha eletrônica sobre condições sociodemográficas da família, história clínica e resultados dos exames de 7.800 participantes que realizaram a Triagem Auditiva, de 2010 a 2016. Na descrição da primeira e segunda etapa, utilizou-se frequência absoluta e valores percentuais. Na associação entre indicador de risco com falhas nas EOA, utilizaram-se Odds Ratio, Intervalo de Confiança e nível de significância 0,5%.
Resultados: dos 12 lactentes com perda auditiva, oito apresentaram como indicador de risco, a medicação ototóxica e permanência em UTI, sendo que a chance de falhar nas EOA ocorreu com onze indicadores. A chance do diagnóstico de perda auditiva foi 13 vezes maior quando há indicador de risco, 18 vezes maior quando usou medicação ototóxica e 16,62 vezes maior com permanência em UTI.
Conclusão: os resultados mostram que conhecer os indicadores levará à reflexão de ações a serem adotadas pela equipe responsável.
Palavras-chave
Referencias
1. Joint Committee on Infant Hearing. Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(4):898-921.
2. Joint Committee on Infant Hearing. Year 2019 position statement: Principles and guidelines for early hearing detection and intervention programs. J Early Hear Detect Interv. 2019;4(2):1-44.
3. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Diretrizes de Atenção da Triagem Auditiva Neonatal. Brasília: Ministério da Saúde; 2012.
4. Kemp DT. Stimulated acoustic emissions from within the human auditory system. J Acoust Soc Am. 1978;64(5):1386-91.
5. Glattke TJ, Robinette MS. Transiently evoked otoacoustic emissions. In: Robinette MS, Glattke TJ (eds). Otoacoustic emissions: clinical applications. 3rd ed. New York: Thieme; 2007. p. 95-115.
6. Brik RK, Zarur AL, Almeida MG, Lima MCPM. Triagem auditiva neonatal. In: Lopes Filho O (org). Tratado de Fonoaudiologia. 2ª ed. Ribeirão Preto: Tecmedd; 2005. p. 487-98.
7. Griz S, Pimentel MR, Ramos C, Menezes D, Barbosa C. Neonatal hearing screening: follow-up in Recife, PE, Brazil. Braz J Otorhinolaryngol. 2010;76(1):114-20.
8. Lima MCPM, Rossi TRF, Correa CRS, Castilho AM, Monteiro CBM, Botasso KC. Neonatal hearing screening: a 10-year experience of the Universal Neonatal Hearing Screening program in a public hospital. Rev Paul Pediatr. 2015;33(3):338-44.
9. Januário GC, Lemos SMA, Friche AAL, Alves CRL. Quality indicators in a neonatal hearing screening service. CoDAS. 2015;27(3):255-63.
10. Hilu LTP, Zeigelboim BS. O conhecimento, a valorização e as expectativas das puérperas em relação à triagem auditiva neonatal. Rev. CEFAC. 2007;9(4):563-72.
11. Sabbag JC, Lacerda ABM. Neonatal hearing screening in primary health care: a study of the coverage and gender variables. Rev. CEFAC. 2017;19(3):344-52.
12. Botasso KC, Lima MCPM, Correa CRS. High-risk indicator for hearing loss and its association with newborn hearing screening. Audiol Commun Res. 2015;20(2):157-63.
13. Costa LP, Silva AC. Newborn hearing screening: analysis of the failures and the high-risk factors. Rev. CEFAC. 2015;17(6):1812-20.
14. Rechia IC, Liberalesso PBN, Angst OVM, Mahl FD, Garcia MV, Biaggio EPV. Association between risk indicators for hearing loss and neonatal auditory screening. Rev. CEFAC. 2016;18(6):1314-24.
15. Al-Zubeidi HM, Al-Kandary N, Al-Muzaini AM. Outcome of newborn hearing screening at a tertiary maternity hospital in Kuwait. Int J Pediatr Otorhinolaryngol. 2017;98:125-9.
16. Yang J, Shi G, Lu J, Zheng Y. Screening for hearing loss in neonates at high risk of hearing loss: a clinical analysis. Int J Clin Exp Med. 2018;11(6):6216-21.
17. Oliveira TMT, Vieira ABC. Identification of high risk newborns for hearing loss and its association with neonatal hearing screening. Rev. CEFAC. 2015;17(2):418-24.
18. Cavalcanti HG, Melo LPF, Buarque LFSBP, Guerra RO. Overview of newborn hearing screening programs in Brazilian public hospitals. Braz J Otorhinolaryngol. 2014;80(4):346-53.
19. Ribeiro FG, Rocha DF, Resende LM, Castelo-Branco C. Evaluating the implementation of the Universal Neonatal Hearing Screening in a Brazilian state. Braz J Otorhinolaryngol. 2015;81(4):361-7.
20. Stadler SRD, Sleifer P. Risk indicators for hearing loss in a neonatal hearing screening program. Rev. CEFAC. 2015;17(5):1475-81.
21. Besen FH, Lacerda ABM, Peluso ETB, Ribas A. Newborn hearing screening: coverage and indicator risk for hearing loss. Rev. CEFAC. 2017;19(6):775-83.
22. Vilela S, Cavalcante JGS, Vieira EPV, Melo LP, Buarque LFSBP, Guerra RO. Prevalence of neonatal hearing loss in a public hospital in the Northeast of Brazil. Rev. CEFAC. 2015;17(3):697-705.
23. Barreira-Nielsen C, Futuro Neto HA, Gattaz G. Process of implementation of neonatal hearing screening in a public hospital. Rev Soc Bras Fonoaudiol. 2007;12(2):99-105.
24. World Health Organization. Childhood Hearing Loss: Strategies for prevention and care. World Health Organization: Geneva, Switzerland. 2016;1-28.
25. Garinis AC, Kemph A, Tharpe AM, Weitkamp JH, McEvoy C, Peter S et al. Monitoring neonates for ototoxicity. Int J Audiol. 2018;57(4):54-61.
26. Turchetta R, Conti G, Marsella P, Orlando MP, Picciotti PM, Frezza S et al. Universal newborn hearing screening in the Lazio region, Italy. Ital J Pediatr. 2018;44(1):104.
27. Gouveia FN, Corteletti LCBJ, Silva BCS, Araujo EJ, Amantini RCB, Oliveira EB et al. Unilateral and asymmetric hearing loss in childhood. CoDAS. 2020;32(1):e20180280.
28. Abraham ZS, Alawy K, Massawe ER, Ntunaguzi D, Kahinga AA, Mapondella KB. Prevalence of hearing loss and associated risk factors among children at Muhimbili National Hospital, Dar es Salaam, Tanzania. Tanzan J Health Res. 2018;20(2):1-8.
29. Kanji A, Khoza-Shangase K, Moroe N. Newborn hearing screening protocols and their outcomes: a systematic review. Int J Pediatr Otorhinolaryngol. 2018;115:104-12.
30. Kemp DT. Otoacoustic emissions, their origin in cochlear function, and use. Br Med Bull. 2002;63(1):223-41.
31. Prieve BA, Fitzgerald TS. Otoacoustic emissions. In: Katz J, Medwetsky L, Burkard R, Hood L (eds). Handbook of Clinical Audiology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 454-76.
32. Norton SJ, Gorga MP, Widen JE, Folsom RC, Sininger Y, Cone-Wesson B et al. Identification of neonatal hearing impairment: evaluation of transient evoked otoacoustic emissions, distortion product otoacoustic emissions, and auditory brainstem responses in neonates. Ear Hear. 2000;21(5):508-28.
33. Costa-Guarisco LP, Dalri MC, Alvarenga KF. Neonatal hearing screening: factors associated with the fail in the first test and the no return for the retest. Rev. CEFAC. 2016;18(1):21-34.
34. Kemp DT. Otoacoustic emissions: concepts and origins. In: Dhar S, Hall JW III (eds). Otoacoustic emissions: principles, procedures, and protocols. San Diego: Plural Publishing; 2012. p. 1-42.
35. Hall JW III. Introduction to otoacoustic emissions. In: Hall JW III (ed). New Handbook of Auditory Evoked Responses. Boston: Pearson Education; 2006. p. 403-45.
36. Gorga MP, Neely ST, Dierking DM. Otoacoustic emissions. In: Musiek FE, Rintelmann WF (eds). Contemporary Perspectives in Hearing Assessment. Boston: Allyn and Bacon; 1999. p. 165-98.
37. Robinette MS. Clinical application of transient evoked otoacoustic emissions. In: Robinette MS, Glattke TJ (eds). Otoacoustic emissions: clinical applications. 3rd ed. New York: Thieme; 2007. p. 117-43.
38. Kemp DT. Otoacoustic emissions, their origin in cochlear function, and use. Br Med Bull. 2002;63:223-41.
39. American Speech-Language-Hearing Association. Newborn hearing screening [Internet]. Rockvile: American Speech-Language-Hearing Association; 2015 [accessed 2020 Oct 10]. Available from: http://www.asha.org/public/hearing/Newborn-Hearing-Screening/
40. Sininger YS. The use of auditory brainstem response in screening and diagnosis of infants with hearing loss. In: Seewald RC, Bamford JM (eds). A Sound Foundation Through Early Amplification: Proceedings of the Second International Conference. Basel: Phonak; 2003. p. 103-12.
41. Hall JW III. Objective assessment of hearing. In: Northern JL (ed). Hearing Disorders. 3rd ed. Boston: Allyn and Bacon; 1996. p. 135-51.
42. Kemp DT. Otoacoustic emissions, their origin in cochlear function, and use. Br Med Bull. 2002;63(1):223-41.
43. Robinette MS, Glattke TJ (eds). Otoacoustic emissions: clinical applications. 3rd ed. New York: Thieme; 2007.
44. Norton SJ, Gorga MP, Widen JE, Folsom RC, Sininger Y, Cone-Wesson B et al. Identification of neonatal hearing impairment: summary and main conclusions. Ear Hear. 2000;21(5):529-35.
45. Vohr BR, Widen JE, Cone-Wesson B, Sininger YS, Gorga MP, Folsom RC. Identification of neonatal hearing impairment: characteristics of infants in the neonatal intensive care unit and well-baby nursery. Ear Hear. 2000;21(5):373-82.
46. Gorga MP, Norton SJ, Sininger YS, Cone-Wesson B, Folsom RC, Vohr BR et al. Identification of neonatal hearing impairment: distortion product otoacoustic emissions during the perinatal period. Ear Hear. 2000;21(5):400-24.
47. Folsom RC, Widen JE, Vohr BR, Cone-Wesson B, Gorga MP, Sininger YS et al. Identification of neonatal hearing impairment: auditory brainstem responses in the perinatal period. Ear Hear. 2000;21(5):425-44.
48. Sininger YS, Cone-Wesson B, Folsom RC, Gorga MP, Vohr BR, Widen JE et al. Identification of neonatal hearing impairment: receiver operating characteristic analysis of transient evoked otoacoustic emissions, distortion product otoacoustic emissions, and auditory brainstem responses. Ear Hear. 2000;21(5):445-54.
49. Widen JE, Folsom RC, Cone-Wesson B, Carty L, Vohr BR, Sininger YS et al. Identification of neonatal hearing impairment: combined outcome with normal-hearing and hearing-impaired newborns. Ear Hear. 2000;21(5):471-84.
50. Cone-Wesson B, Vohr BR, Sininger YS, Widen JE, Folsom RC, Gorga MP et al. Identification of neonatal hearing impairment: infants with hearing loss. Ear Hear. 2000;21(5):488-507.
51. Brasil. Ministério da Saúde. Portaria nº 54, de 22 de fevereiro de 2012. Aprova as Diretrizes de Atenção da Triagem Auditiva Neonatal. Diário Oficial da União. 2012 Feb 23; Sec 1: 54.
Submitted date:
22/08/2020
Accepted date:
18/01/2021
Facebook
Twitter
LinkedIn
Mendeley
Email