Hearing test: Difference between revisions

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The following are examples of simple assessment of development in early hearing and understanding.
The following are examples of simple assessment of development in early hearing and understanding.
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{{PediNeuroLogic Exam}}
{{PediNeuroLogic Exam}}

Revision as of 13:13, 16 May 2016

Embryology - 29 Mar 2024    Facebook link Pinterest link Twitter link  Expand to Translate  
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Introduction

Newborn hearing test

The incidence of significant permanent hearing loss is approximately 1-3/1000 newborns. Neonatal hearing screening is carried out in the USA, UK and in Australia (2002 NSW Statewide Infant Screening Hearing Program, SWISH) There is a general guide giving a timetable for a number of simple responses that a neonate should make if hearing has developed normally (More? Neonatal Hearing Check List).


State Wide Infant Screening Hearing Program (SWISH) a newborn hearing testing program using an automated auditory response technology (AABR). Program was introduced in NSW Australia in 2002 across 17 area health service coordinators. It is thought that in NSW 86,000 births/year = 86-172 babies potentially born with significant permanent hearing loss.


Automated Auditory Brainstem Response (AABR) uses a stimulus which is delivered through earphones and detected by scalp electrodes. The test takes between 8 to 20 minutes and has a sensitivity 96-99%.


Hearing Links: Introduction | inner ear | middle ear | outer ear | balance | placode | hearing neural | Science Lecture | Lecture Movie | Medicine Lecture | Stage 22 | hearing abnormalities | hearing test | sensory | Student project

  Categories: Hearing | Outer Ear | Middle Ear | Inner Ear | Balance

Historic Embryology - Hearing 
Historic Embryology: 1880 Platypus cochlea | 1892 Vertebrate Ear | 1902 Development of Hearing | 1906 Membranous Labyrinth | 1910 Auditory Nerve | 1913 Tectorial Membrane | 1918 Human Embryo Otic Capsule | 1918 Cochlea | 1918 Grays Anatomy | 1922 Human Auricle | 1922 Otic Primordia | 1931 Internal Ear Scalae | 1932 Otic Capsule 1 | 1933 Otic Capsule 2 | 1936 Otic Capsule 3 | 1933 Endolymphatic Sac | 1934 Otic Vesicle | 1934 Membranous Labyrinth | 1934 External Ear | 1938 Stapes - 7 to 21 weeks | 1938 Stapes - Term to Adult | 1940 Stapes | 1942 Stapes - Embryo 6.7 to 50 mm | 1943 Stapes - Fetus 75 to 150 mm | 1946 Aquaductus cochleae and periotic (perilymphatic) duct | 1946 aquaeductus cochleae | 1948 Fissula ante fenestram | 1948 Stapes - Fetus 160 mm to term | 1959 Auditory Ossicles | 1963 Human Otocyst | Historic Disclaimer


neonatal diagnosis

Some Recent Findings

  • Universal Neonatal Hearing Screening - Experience in a Tertiary Care Hospital in Southern India[1] "The neonates were subjected to a two stage sequential screening using the BERAphone. Neonates suspected of hearing loss underwent confirmatory testing using auditory steady state response audiometry and serological testing for TORCH infections and connexin 26 gene. ...Universal neonatal hearing screening using BERAphone is a feasible service, vital for early identification and rehabilitation of neonatal hearing loss. The estimated prevalence of confirmed hearing loss was comparable to that in literature. Overcoming the large numbers of loss to follow-up proves to be a challenge in the implementation of such a program." India Statistics
  • Cost-effectiveness analysis of a national neonatal hearing screening program in China[2] "In 2009, the Chinese Ministry of Health recommended scale-up of routine neonatal hearing screening - previously performed primarily only in select urban hospitals - throughout the entire country. A decision analytical model for a simulated population of all live births in china was developed to compare the costs and health effects of five mutually exclusive interventions: 1) universal screening using Otoacoustic Emission (OAE) and Automated Auditory Brainstem Response (AABR); 2) universal OAE; 3) targeted OAE and AABR; 4) targeted OAE; and 5) no screening. Disability-Adjusted Life Years (DALYs) were calculated for health effects. Based on the cost-effectiveness and potential health outcomes, the optimal path for scale-up would be to start with targeted OAE and then expand to universal OAE and universal OAE plus AABR." China Statistics
  • Incidence and Pattern of Hearing Impairment in Children with ≤ 800 Gram Birth Weight in British Columbia, Canada[3] "The incidence and severity of hearing impairment in a cohort of extremely low birth weight children increased significantly from 5% to 13% (p= 0.01) over a 24 year period. Comorbidities were common. Potentially modifiable causes are explored."
  • Overview of newborn hearing screening activities in Latin America[4] "In spite of several barriers, NHS programs have been implemented in at least some facilities and regions in Latin America. Additional efforts are needed to expand NHS activities in Latin America." Canada Statistics

Automated Auditory Brainstem Response

(AABR) uses a stimulus which is delivered through earphones and detected by scalp electrodes. The test takes between 8 to 20 minutes and has a sensitivity 96-99%. The basis of a neonatal hearing test that uses a trigger stimulus delivered through earphones and subsequent brain electrical activity then detected by scalp electrodes. Then by computer analysis, averaging all the electrical activity following the trigger, peaks emerge reflecting signal passage activity through brain stem nuclei in the hearing central neural pathway. The infant test takes between 8 to 20 minutes, has a sensitivity 96-99%, and unlike other childhood auditory testing does not require a subject response. An increased absolute latency has been seen to occur in premature infants related to decreased myelinization affecting the electrical conduction delays up to the brainstem.

An alternative and simple test (pass/refer) used at a later stage is otoacoustic emission testing.

  • waves I and II - arise ipsilaterally to the stimulus and reflect the action potential of the auditory nerve.
  • waves III, IV and V - receive contralateral inputs.

Otoacoustic Emission Testing

(OAE) The basis of a simple infant hearing test of the inner ear. A small probe containing both a speaker producing "clicks" and a microphone to detect cochlea responses is placed inside the ear canal. Acoustic energy produced by vibration of the hair cells in response to the clicks is detected by the microphone within the probe. A more complex test that can be used at an earlier stage is the automated auditory brainstem response.

Neonatal Hearing Check List

The timing and types of responses listed below reflect only a rough guide for the general population. Abnormalities in neurological, visual or motor skill development can also affect responses.

  • Birth to 3 months - Reacts to loud sounds, Quiets to familiar voices or sounds, Makes cooing noises, Responds to speech by looking at speaker’s face
  • 3 to 6 months - Turns eyes or head toward sounds, Starts to make speech-like sounds, Laughs and makes noises to indicate pleasure and displeasure
  • 6 to 9 months - Babbles, ‘dada’‘ma-ma’‘baba’, Shouts/vocalises to get attention, Will often respond to ‘no’ and own name, Responds to singing and music
  • 9 to 12 months - Imitates speech sounds of others, Understands simple words, eg ‘ball’,‘dog’, ‘daddy’, Turns head to soft sounds, First words emerge
  • 12 to 18 months _ Appears to understand some new words each week, Follows simple spoken instructions, eg ‘get the ball’, Points to people, body parts or toys when asked, Continually learns new words to say although may be unclear
  • 18 to 24 months - Listens to simple stories or songs, Combines two or more words in short phrases eg ‘more juice’

Hearing check list text based upon NSW Health Pamphlet - Why does my baby need a hearing check?

Neural Exam

The following are examples of simple assessment of development in early hearing and understanding.

12 month Behaviour 18 month Behaviour 30 month Behaviour
<html5media height="290" width="320">File:12mo 02.mp4</html5media> <html5media height="290" width="320">File:18mo 02.mp4</html5media> <html5media height="290" width="320">File:30mo 02.mp4</html5media>
Movie Source - Paul D. Larsen  
Movies from the PediNeuroLogic Exam website are used by permission of Paul D. Larsen, M.D., University of Nebraska Medical Center and Suzanne S. Stensaas, Ph.D., University of Utah School of Medicine. Additional materials were drawn from resources provided by Alejandro Stern, Stern Foundation, Buenos Aires, Argentina; Kathleen Digre, M.D., University of Utah; and Daniel Jacobson, M.D., Marshfield Clinic, Wisconsin. The movies are licensed under a Creative Commons Attribution-NonCommerical-ShareAlike 2.5 License.
Links: Neural Exam Movies | Movies



Cite this page: Hill, M.A. (2024, March 29) Embryology Hearing test. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Hearing_test

What Links Here?
© Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G

Hearing Loss Risk Factors

The following selected genetic and environmental conditions have been identified as risk factors for hearing loss.

  • syndrome known to be related to hearing loss
  • close family history of congenital hearing impairment (parent / sibling)
  • congenital abnormality of the head / neck (excluding minor pits/ ear tags)
  • maternal infections during pregnancy such as HIV, TORCH - (Toxoplasmosis, Other (syphilis, varicella), Rubella, CMV, Herpes)
  • meningitis / encephalitis
  • jaundice requiring exchange transfusion
  • ventilation greater than 5 days (excluding continuous positive airway pressure)
  • amino glycoside antibiotic therapy for greater than 3 days

Australia

  • New South Wales - State Wide Infant Screening Hearing Program (SWISH) was introduced in NSW Australia in 2002 across 17 area health service coordinators.
  • Victoria - Victorian Infant Hearing Screening Program (VIHSP) provides statewide newborn hearing screening to babies born at all Victorian maternity hospitals.

Latin America

The following data and modified text is from a recent review describing newborn hearing screening (NHS) activities in Latin America.[4]

  • Chile - since July 2005, Chilean law has required targeted hearing screening using otoacoustic emissions (OAE) and auditory brainstem response (ABR) technology for all premature newborns born before 32 weeks and weighing less than 1500 g who are discharged from the 28 facilities with a neonatal intensive care unit.
  • Costa Rica - since 2004, a few centers have been providing NHS services using OAE to screen some high-risk children.
  • Guatemala - does not have legislation requiring NHS. In 2004, high-risk targeted NHS was implemented in one hospital in the capital city, and a second site was established in 2008. These NHS programs were started with donated OAE equipment and there were plans to expand as additional (donated) equipment became available. In 2008, the OAE equipment in the first hospital broke, and as of June 2009 it had not been repaired, which left only one hospital performing hearing screenings.
  • Mexico - since February 2005, a national law was passed requiring hearing screening for all newborns and audiological evaluation. In July 2007, the program at HGM was expanded to include all newborns. Some NHS programs have been implemented in a few public and private hospitals around the country.
  • Panama - since 2000, Panama has offered targeted NHS in some public and private birthing hospitals. There is no NHS law in place, but a local group is advocating for implementation of universal NHS.
  • Puerto Rico - (Puerto Rico is a USA territory) and receives directives regarding health care initiatives from the U.S. government. An NHS program, Programa de Cernimiento Auditivo Neonatal Universal, operates in all birthing hospitals. The program was initiated in January 2000 and became required by law in December 2003.
  • Uruguay - in 2000, Uruguay started implementing targeted and universal NHS in a limited number of public and private hospitals. Several hospitals in the capital city of Montevideo and one hospital in the city of Paysandú offer NHS.

References

  1. <pubmed>24277966</pubmed>
  2. <pubmed>23341887</pubmed>| PLoS One.
  3. <pubmed>21824192</pubmed>
  4. 4.0 4.1 <pubmed>21484013</pubmed>



Search PubMed: neonatal hearing diagnosis | neonatal diagnosis | neonatal screening | Automated Auditory Brainstem Response | Otoacoustic Emission Testing


External Links

External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.


Glossary Links

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Cite this page: Hill, M.A. (2024, March 29) Embryology Hearing test. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Hearing_test

What Links Here?
© Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G