Hearing loss in Neonates
Professor of Pediatrics, ID ,
Shahid Beheshti University of Medical Science ,
The identification of a specific cause of
hearing loss in neonates facilitates optimal management.
The frequency of the various cause of hearing
loss changed over the past 30 years, the greatest victories in the
areas of prevention of hearing loss have been in the infectious
After vaccination for HIb and Rubella decreased
hearing loss we hop that beginning vaccination for HIb and Rubella
Resulted in hereditary causes and NICU
graduates contributing most children with hearing loss , in addition
CMV remain a common cause of hearing loss in children.
Prenatal factors accounted for perhaps 2% of
the children with hearing loss in the ealy 1970s, in the next
decade, approximately 13% of children with hearing loss had been of
LBW whereas 4% had Prenatal causes thereby increasing the percentage
of children with hearing loss who were NICU graduates to 17% in the
next decade 1983-1992 the percentage of children with hearing loss
identified by NICU admission increased further with 19% children
being of LBW and 8%
in neonates through age 28 days:
weight less than 1500 gr
at a serum level, requiring exchange transfusion.
scores of 0-4 at 1 minute or 0-6 at 5 minutes
Ventilation lasting 5 days
medications , aminoglycosides used multiple dose or combination
CMV, Rubella , Herpes , Syphilis and Toxoplasmosis .
abnormalities of the pinna and ear canal
Persistent Pulmonary Hypertension and ECMO , Extracorporeal
Membrane Oxygenation: that 8 of 10 neonates who developed hearing
loss after discharge from the NICU had PPHN, and 6 of the 8 had
required ECMO, these findings suggest that neonates who have been
treated with ECMO and with PPHN are at increased risk for
late-onset hearing loss and need special monitoring.
Toxic Syndrome , hearing loss has been described in association with
prenatal exposure to alcohol, trimethadione.
induced hearing loss
Evaluation of cause of hearing loss include :
good pregnancy ,labor, delivery history ,medical history, family
history, physical examination and laboratory tests.