med 18

 

F. Techniques

1. Both OAE and AABR screening systems can be automated: An individual only needs to be appropriately

trained to set up and apply the equipment. A computer

processes the incoming information and gives a readout

of the result, usually as “pass” or “refer.”

2. Care should be taken to attempt screening in a relatively quiet environment, as well as ensuring that the

infant is resting comfortably and the ear canals are free

from obvious debris, to avoid false “refer” result.

G. Specific Protocols

1. For infants admitted to neonatal intensive care unit

(NICU) for more than 5 days: the Joint Committee on

Infant Hearing recommends ABR technology as the

Fig. 54.1. An infant undergoing OAE screening. only appropriate screening technique for use in the

Fig. 54.2. An infant undergoing AABR screening.

Table 54.1 High-Risk Registry Associated

with Hearing Loss in Childhood

• Illness or condition that requires admission of 5 days or longer to NICU

• Exposure to any of the following treatment regardless of NICU duration

of stay

• Extracorporeal membrane oxygenation

• Ventilator

• Ototoxic medication

• Loop diuretics

• Hyperbilirubinemia requiring exchange transfusion

• Stigmata or other findings associated with a syndrome known to include

sensorineural or permanent conductive hearing loss

• Family history of permanent childhood sensorineural hearing loss

• Craniofacial anomalies, including those with morphologic abnormalities of the pinna and ear canal and temporal bone anomalies

• In utero infection, such as cytomegalovirus, herpes, toxoplasmosis, or

rubella

• Parental or caregiver concern regarding hearing, speech, language, and

developmental delay

• Postnatal infections associated with sensorineural hearing loss, including

bacterial meningitis

• Syndromes associated with progressive hearing loss, such as neurofibromatosis, osteopetrosis, and Usher syndrome

• Neurodegenerative disorders, such as Hunter syndrome, or sensory

motor neuropathies, such as Friedreich ataxia and Charcot-Marie-Tooth

syndrome

• Head trauma

• Chemotherapy

From American Academy of Pediatrics, Joint Committee on Infant Hearing. Year

2007 position statement: principles and guidelines for early hearing detection and

intervention programs. Pediatrics. 2007;120:898.