Every year, March 3 is "National Ear Love Day", and this year is the 23rd Disease Day, and the theme of the publicity is "Caring for Hearing Health, Listening to the Wonderful Future". Hearing damage is often irreversible, so caring for the ears and protecting the hearing is important for each of us.
In recent years, with the full opening of the two-child policy, the number of newborns with birth defects has continued to grow every year. Among them, the incidence of hearing impairment in newborns is about 3%, and about 30,000 newborns suffer from hearing impairment every year.
What does neonatal hearing impairment mean?
Neonatal hearing impairment refers to the fact that due to various reasons, people have difficulty hearing, cannot hear or hear speech sounds and environmental sounds, such as some babies within 1 year old, and the call of parents is completely unanswered. There are four main cases:
Mild: hearing loss of 20-40 dBHL, manifested by difficulty communicating in a low voice;
Moderate: hearing loss of 41-60 dBHL, showing general difficulty in talking, or difficulty hearing loud speech;
Severe: hearing loss of 61-80 dBHL, manifested by shouting directly into the ear, barely audible, or tightly heard only a few words;
Extremely severe: Hearing loss ≥ 81dBHL, manifested as complete inaudible, shouting into the ear and not hearing any sound or word.
There are 3 common causes of hearing impairment in newborns that need attention
1. Genetic factors: This is the main cause of hearing impairment in newborns, accounting for more than half of all deaf patients, and most of them are still difficult to treat sensorineural deafness. For couples with a family history of deafness, the fetus should be diagnosed with a deafness gene before deliverance to facilitate early intervention.
2. Infection during pregnancy: Some female friends do not pay attention during pregnancy, and may be infected with rubella, measles, toxoplasma and other diseases, which may damage the baby's hearing. However, it can be avoided by vaccination before pregnancy, and one thing to note is that once an infection occurs during pregnancy, avoid using ototoxic drugs during treatment so as not to aggravate the symptoms.
3. Perinatal sudden factors: female friends have hypoxia, premature birth, jaundice and other conditions in the perinatal period, which will also cause sensorineural deafness in the fetus. Therefore, newborns should be closely observed after birth and problems should be dealt with in a timely manner.
How is newborn hearing screening and diagnosis carried out?
Newborns born in a general ward should be screened for otoacoustic emission within 48 to 72 hours. Those who fail to pass are then screened in the hospital within 28-42 days. If they do not pass, they should be referred to a designated hearing diagnosis centre for another hearing diagnosis within 3 months of age.
Newborns admitted to intensive care units need to be screened for hearing before discharge, automatic auditory brainstem responses and ear acoustic emission tests are required, and those who fail are referred directly.
Due to the requirements of different places, some regions will take heel blood for deafness genetic screening 3 days after the birth of newborns. Regardless of whether the hearing screening is passed or not, newborns who fail the genetic screening for deafness need to go to the outpatient clinic for genetic counseling from a professional doctor.
Newborn hearing screening results are "failed", how should parents respond?
At present, there are many newborns who have not passed the initial hearing screening, and parents are worried, but this does not mean that there is a permanent hearing impairment. Newborns who fail the initial screening need to be screened further, within 42 days of birth and within 3 months of age.
If the initial and re-screenings are still not passed, a series of hearing assessments are required for infants and young children, including ear acoustic emission, otoscopy, acoustic conductivity, behavioral audiometry and other related tests. In addition, especially in infants whose parents have a history of deafness, imaging tests and genetic diagnosis are also required. This allows you to determine the type, cause, and severity of hearing loss, which will help the doctor determine the next course of treatment.
For infants and young children diagnosed with congenital deafness, hearing aids or cochlear implants can be tested as soon as possible, different cochlear implants have different fees, and families in need can also apply for fee assistance, which should consult local policies.
If drug-induced deafness is found, lifetime ototoxic drugs, such as the common aminoglycoside antibiotics, should also be prevented from drug-induced deafness among family members. If there is late-onset deafness, it can be improved through life guidance, such as paying attention to preventing colds, avoiding strenuous exercise, avoiding head trauma, and avoiding or delaying the occurrence of deafness.
On the day of "National Ear Love Day", we call on everyone to pay attention to hearing health. In particular, before the husband and wife are trying to conceive, they should screen whether they are deaf gene carriers, and scientifically prepare for pregnancy under the guidance of doctors, so as to reduce the reproduction of deaf children. Newborn hearing screening should also be paid attention to in the postpartum period, and early detection and early intervention should be paid.
bibliography:
[1] Zhao Pengjun, Shen Xiaoming. Newborn hearing screening[J].Chinese Women's and Child Health Research,2001,40(003):56-58.
[2] Tu Bin. Incidence of neonatal hearing impairment and analysis of risk factors[J].Journal of Baotou Medical College,2019,35(8):2.