ENT
Pediatric Auditory Screening
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Pediatric Auditory Screening
, Pediatric Hearing Screening
Epidemiology
Incidence
sensorineural
Hearing
deficiency
Newborns: 1-5 per 1000 births
Age 24 Months: 1 per 25 children (20-50 decibel loss)
Identify
Hearing Loss
prior to age 6 months old
Significant benefit in language development
Causes
Infants (Sensorineural
Hearing Deficit
)
No risk factors in 50% of infants
Family History
In utero infection (CMV,
Rubella
)
Low birth weight (<1500 g)
Hyperbilirubinemia
(exchange levels)
Low
APGAR Score
s (<5 at 1 min, <6 at 5 min)
Persistent
Pulmonary Hypertension
Head Injury
causing loss of consciousness
Bacterial Meningitis
Ototoxic Medication
s
Aminoglycoside
s (potentiated by
Loop Diuretic
s)
Chemotherapeutic agents
Causes
Older children (Conductive
Hearing Deficit
)
Otitis Media with Effusion
(Most common)
Occlusive foreign body
Cholesteatoma
Ossicle disruption
Screening Tools
Infants
Evoked
Otoacoustic Emission
s (EOAE)
Sensitivity 50-100%,
Specificity
82%
Easily performed
Cost: inexpensive ($1 per exam)
Auditory
Brainstem
Evoked Responses (ABR)
Sensitivity 94%,
Specificity
89%
Cost: $30 per exam
Requires EEG type electrode
Response to auditory stimulation
Pre-school (Ages 3-5 years)
Pure tone
Audiometry
Fails if >20 decibel loss at any frequency
Acoustic immittance testing (
Tympanometry
)
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