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Key Points: Question: Can the traditional Chinese version of the hearing handicap inventory for elderly screening (HHIE-S) checklist screen for age-related hearing loss (ARHL) in elderly individuals? Findings: In this cross-sectional study of 1696 Taiwanese patients who underwent annual government-funded geriatric health checkups, the Chinese version of the HHIE-S had a sensitivity of 76.9% and a specificity of 79.8% with a cutoff score greater than 6 for identifying patients with disabled hearing loss (defined as a PTA > 40 dB). Meaning: The traditional Chinese version of the HHIE-S is an effective test to detect ARHL and can improve the feasibility of large-scale hearing screening among elderly individuals. Purpose: The traditional Chinese version of the hearing handicap inventory for elderly screening (TC-HHIE-S) was translated from English and is intended for use with people whose native language is traditional Chinese, but its effectiveness and diagnostic performance are still unclear. The purpose of this study was to evaluate the validity and reliability of the traditional Chinese version of the HHIE-S for screening for age-related hearing loss (ARHL). Methods: A total of 1696 elderly people underwent the government’s annual geriatric medical examination at community hospitals. In this cross-sectional study, we recorded average conducted pure-tone averages (PTA) (0.5 kHz, 1 kHz, 2 kHz, 4 kHz), age, sex, and HHIE-S data. Receiver operating characteristic (ROC) curve analysis was used to identify the best critical point for detecting hearing impairment, and the validity of the structure was verified by the agreement between the TC-HHIE-S and PTA results. Results: The HHIE-S scores were correlated with the better-ear pure-tone threshold averages (PTAs) at 0.5–4 kHz (correlation coefficient r = 0.45). The internal consistency of the total HHIE-S score was excellent (Cronbach’s alpha = 0.901), and the test-retest reliability was also excellent (Spearman’s correlation coefficient = 0.60, intraclass correlation coefficient = 0.75). In detecting disabled hearing loss (i.e., PTA at 0.5–4 kHz > 40 dB), the HHIE-S cutoff score of > 6 had a sensitivity of 76.9% and a specificity of 79.8%. Conclusions: The traditional Chinese version of the HHIE-S is a valid, reliable, and efficient tool for large-scale screening for ARHL.

Purpose In 2015 a new regulation and guidelines for the universal newborn hearing screening by AABR measurement have been implemented in Hungary. The aim of our study was to analyse (1) the past 5 years of data from our diagnostic centre about the incidence and types of congenital hearing losses, and (2) the first experiences with the National Newborn Hearing Screening Registry, started in 2019, and (3) the influence of the screening on the pediatric cochlear implant program. Methods 1269 children referred to our diagnostic centre between 2017 and 2021 were investigated. A third AABR measurement and full audiological evaluation were performed. Furthermore, one-year period data of the screening registry, and the number of implanted children at or under the age of 3 were analysed using the national databases. Results Altogether 276 newborns (22% of the referred cases after the two-stage screening) had hearing loss, 134 (49%) out of them was conductive origin, almost twice frequent in male as in female. Permanent sensorineural hearing impairment was found in 142 (51%), 58 (40%) of them had bilateral, severe to profound hearing loss, occurring more frequently in male as in female. The national digital registration of the screening data within 12 months concerned 68%. The number of early cochlear implantation in one year increased from 1 to 23 children in the past 15 years. Conclusion A third AABR after the two-stage screening increased the efficiency and filtered the 78% false-positive cases. The audiological diagnostics verified and typed the hearing losses ensuring the early intervention.

Background: This systematic review examined the outcomes (age of identification and intervention, developmental outcomes, cost-effectiveness, and adverse effects on parents) of universal newborn hearing screening (UNHS) for children with permanent congenital hearing loss (PCHL). Materials and methods: Multiple electronic databases were interrogated in March and April 2020 with further reports identified from article citations and unpublished literature. UNHS reports in English with comparisons of outcomes of infants who were not screened, and infants identified through other hearing screening programs. Results: 30 eligible reports from 14 populations with 7,325,138 infants screened through UNHS from 1616 non-duplicate references were included. UNHS results in a lower age of identification, amplification, and the initiation of early intervention services and better language/literacy development. Better speech perception/production were shown in younger, but not in older, children with early identification after UNHS. No significant findings were found for behavior problems and quality of life. UNHS was found to be cost-effective in terms of savings to society. In addition, no significant parental harm was noted as a result of UNHS. Conclusions: In highly developed countries, significantly better outcomes were found for children identified early through UNHS programs. Early language development predicts later literacy and language development.

Background The prevalence of refugees in Turkey has increased since the onset of the Syrian conflict. Refugees, as a demographic group, confront a spectrum of health challenges attributable to variables including malnutrition, restricted access to medical services, and unmanaged chronic health conditions. This study aims to investigate the hearing screening results among Syrian children in Ankara to assess the need for additional measures to raise awareness and to identify factors that may affect the hearing health of this population. Methods A total of 438 Syrian children ( n  = 876 ears), with a mean age of 7.41 ± 2.71 years, who attended the International Association for Asylum and Solidarity With Refugees centers, were enrolled in the study. Each child underwent otoscopic examination, tympanometry, and pure-tone audiometry screening. Results Of the tested ears, 225 (25.6%) exhibited abnormal otoscopic findings, 181 (20.7%) had tympanometry types other than type A, and 30 (3.4%) did not pass the pure tone audiometry screening. Of the 276 completed case history forms, 133 individuals reported relevant medical histories. Among them, 78 (58.6%) were consanguineous offspring, 10 (7.5%) had a family history of hearing impairment, 51 (38.3%) were currently experiencing flu, 42 (31.6%) had a history of recurrent flu, and 22 (16.5%) experienced otalgia. Notably, blast exposure was reported in 5 individuals (3.7%), and 6 individuals (4.5%) had mothers with a history of pregnancy complications. Conclusion Refugees represent a demographic cohort susceptible to various risk factors associated with hearing impairment. However, the findings of this study indicate that refugee children residing in Ankara exhibit normal hearing screening results. This outcome may be ascribed to factors such as having access to healthcare services and heightened awareness within the community.

Early identification of hearing loss through newborn hearing screening followed by an early start of intervention has proven to be effective in promoting speech and language development in children with hearing loss. During the COVID-19 pandemic, newborn hearing screening was postponed for a group of newborns in the Netherlands. Therefore, meeting the guidelines for early identification was at risk. In this study, we examine parental attitudes, beliefs, and experiences concerning the hearing screening during the COVID-19 pandemic. Our results indicated that parents (n = 1053) were very positive about newborn hearing screening and their experiences with the screening, even during the COVID-19 pandemic. Parents’ beliefs on the information provision around newborn hearing screening were more inconsistent. The results showed that parents with a postponed hearing screening felt less informed about the hearing screening than parents without a postponed screening. Furthermore, child and family characteristics affected how parents experienced newborn hearing screening. Parents with a premature child were more worried about the hearing abilities of their child before the screening took place. The results also indicate that deafness in the family might lead to parental worries around newborn hearing screening.

Background To evaluate the incidence of hearing loss in neonates in our secondary care hospital under pilot UNHS programme. To assess association between various risk factors and neonatal hearing loss. Methods Prospective, observational cohort study was done in a secondary level hospital in North India after ethical approval, for 1 year. Inclusion criteria are as follows: neonates born in hospital during study period, consenting to testing. Exclusion criteria are as follows: sick neonates, non-consenting parents. Neonates underwent TEOAE at 48 h of birth; those failing retested at 1 month. Neonates failing 2nd stage are tested after 3 months using BERA. Neonates were evaluated for the presence of maternal/neonatal high-risk factors. Results Out of 506 neonates, 143 passed 1st OAE screening, 363 were refer, and referral rate is 71.7%. A total of 341/345 neonates passed 2nd stage; 4 were diagnosed with hearing loss on BERA at 3 months. (18 neonates lost to follow-up, excluded from final cohort.) Overall incidence of hearing loss was 0.82%, 1.08% for males and 0.44% for females ( p  = 0.87, NS). One-hundred nine neonates were high risk (prematurity, 36; consanguinity, 4; caesarean section for relevant indications, 68; craniofacial abnormalities, 1). Incidence of hearing loss for high-risk group was 1.83% and 0.53% for well-born neonates ( p  = 0.19, NS). Conclusion Incidence of hearing loss in our district in North India is as follows: 8.2 per 1000 live births for well neonates, 18.3 per 1000 live births for high-risk neonates, and respective overall national incidence rates were 1.59 to 8.8 per 1000 and 7 to 49 per 1000. UNHS programmes must be implemented in all hospitals; protocol may be varied according to local population profile and resources available.

Objective To establish the feasibility of a systematic, community health worker (CHW)‐based hearing screening program that gathers Health Insurance Portability and Accountability Act‐compliant electronic data (otoscopic images of tympanic membrane and audiometric evaluation) on a smartphone in an effort to streamline treatment options in resource‐limited communities. Methods This is a cross‐sectional study in which four schools were screened in Port‐au‐Prince, Haiti, during in April 2018. A total of 122 subjects (61% female) aged 5‐17 years underwent an initial brief audiometric screen followed by a more comprehensive air conduction audiometric evaluation if they failed their initial screen. Participants with more than 35‐dB loss in any frequency on their comprehensive audiometric evaluation received endoscopic otoscopy. Results Seventy‐five percent of subjects (91/122) passed their initial screen. Of those who failed, 9% (4/44 ears) had a severe or profound hearing loss on comprehensive evaluation. Abnormal otoscopic findings (11/36 ears, 31%) included are cerumen impaction (n = 6), myringosclerosis (n = 3), tympanic membrane perforation (n = 1), and tympanic membrane retraction (n = 1). The average duration of the initial testing was 100 seconds (SD = 74 seconds), whereas the duration of comprehensive testing was 394 seconds (SD = 175 seconds). Extrapolating from these data, we estimate that a group of seven trained CHWs could gather formal audiologic and otologic data points for 100 children per hour using this protocol. Conclusions A systematic approach that utilizes local resources (CHWs) and existing infrastructure (cell phones and the Internet) can significantly reduce the burden of hearing healthcare specialists while simultaneously facilitating early diagnosis and management of disabling hearing loss in low‐resourced settings. Level of evidence Level 4.

Purpose The benefits of concurrent newborn hearing and genetic screening have not been statistically proven due to limited sample sizes and outcome data. To fill this gap, we analyzed outcomes of newborns with genetic screening results. Methods Newborns in China were screened for 20 hearing-loss–related genetic variants from 2012 to 2017. Genetic results were categorized as positive, at-risk, inconclusive, or negative. Hearing screening results, risk factors, and up-to-date hearing status were followed up via phone interviews. Results Following up 12,778 of 1.2 million genetically screened newborns revealed a higher rate of hearing loss by three months of age among referrals from the initial hearing screening (60% vs. 5.0%, P  < 0.001) and a lower rate of lost-to-follow-up/documentation (5% vs. 22%, P  < 0.001) in the positive group than in the inconclusive group. Importantly, genetic screening detected 13% more hearing-impaired infants than hearing screening alone and identified 2,638 (0.23% of total) newborns predisposed to preventable ototoxicity undetectable by hearing screening. Conclusion Incorporating genetic screening improves the effectiveness of newborn hearing screening programs by elucidating etiologies, discerning high-risk subgroups for vigilant management, identifying additional children who may benefit from early intervention, and informing at-risk newborns and their maternal relatives of increased susceptibility to ototoxicity.

Early intervention for newborns who are deaf or hard-of-hearing leads to improved language, communication, and social–emotional outcomes. Universal physiologic newborn hearing screening has been widely implemented across the United States with the goal of identifying newborns who are deaf or hard-of-hearing, thereby reducing time to diagnosis and intervention. The current physiologic newborn hearing screen is generally successful in accomplishing its goals but improvements could be made. In the past ten years, genetic testing has emerged as the most important etiological diagnostic test for evaluation of children with deafness and congenital cytomegalovirus has been recognized as a major cause of childhood deafness that may be treatable. A comprehensive newborn hearing screen that includes physiologic, genetic, and cytomegalovirus testing would have multiple benefits, including (1) identifying newborns with deafness missed by the current physiologic screen, (2) providing etiologic information, and (3) possibly decreasing the number of children lost to follow up. We present a framework for integrating limited genetic testing and cytomegalovirus screening into the current physiologic newborn hearing screening. We identify needed areas of research and include an overview of genome sequencing, which we believe will become available over the next decade as a complement to universal physiologic newborn hearing screening.

Recent technological advances have made feasible universal newborn hearing screening and therefore early detection of permanent childhood hearing impairment. Over the past three years, new information has been published on whether early intervention is beneficial, the possibility of harm arising from newborn screening, and its cost. Dramatic progress has been made in the large scale implementation of universal screening in many parts of the western world.