Artikel
Pedaudiologic Findings after Severe Neonatal Hyperbilirubinemia (HBE)
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Autoren
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Andreas Nickisch
- Kinderzentrum Muenchen, Muenchen, Germany
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Claudia Massinger
- Kinderzentrum Muenchen, Muenchen, Germany
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Birgit Ertl-Wagner
- Institut für klinische Radiologie, LMU-Großhadern Campus, Muenchen, Germany
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Hubertus von Voss
- Kinderzentrum Muenchen, Muenchen, Germany
| Veröffentlicht: | 8. August 2007 |
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Gliederung
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Introduction: Neonatal HBE of more than 20mg/dl (HBE20) increases the risk of hearing damages.
Method: 15 children after HBE20 (HBE between 22.6 to 45.6 mg/dl) and/or known kernicterus determined by MRI, were examined for hearing disorders between the age of 2 and 9 years and were compared to a control group (HBE between 12.5 to 19.4 mg/dl). The control group was matched with the HBE20-children by week of gestation at birth. Behavioral audiometry (BA), otoacoustic emissions (TEOAE) and brainstem audiometry (BAEP) were used for all the children.
Results: Four of the 15 HBE20-children suffered from total deafness in BA without any BAEP-responses; of these, TEOAE were measured in 1 child, but not in the other 3 children. A further 4 children presented hearing thresholds, which were much better in BA than in BAEP (3 without any BAEP- or TEOAE-responses, 1 child with a BAEP-threshold of 100dB and measurable TEOAE). Only 1 child had a cochlear hearing loss with agreeing results in BA, BAEP and TEOAE. One child had a unilateral deafness (same results in BAEP, TEOAE and BA). In 5 children, BA was unobtrusive (3 children with TEOAE, but without any BAEP-response; the other 2 children with normal results in both TOAE and BAEP). An auditory neuropathy (AN) was detected in a total of 8 children. In the control group only 2 children presented a (cochlear) hearing loss at all; none had an AN.
Conclusion: In the HBE20-group nearly 90 percent of the children exhibited hearing dysfunctions. AN was detected in more than 50 percent of the HBE20-group with strongly differing results in BA ranging from normal hearing reactions to total deafness. After HBE20, initially detected TEOAE can vanish in some cases. Audiological diagnostics in children with HBE20 require objective investigations of hearing functions (TOAE and BAEP), but these findings can only be fully evaluated using BA. A TEOAE screening is often insufficient after HBE20. Detailed pedaudiologic testing is critical for all children with HBE20.
