ABSTRACT
OBJECTIVE: To evaluate the feasibility and cost-effectiveness of using transient evoked otoacoustic emissions (TEOEs) to assess hearing in infants recovered from meningitis. METHODS: Recordings of TEOEs and visual reinforcement audiometry (VRA) were performed in a prospective study of 39 children aged 6 to 24 months recovering from a purulent meningitis. Patients with no TEOEs, or whose VRA findings were abnormal, were also tested by impedance audiometry and recording of auditory brain-stem responses (ABRs) after treatment of any secretory otitis media. Costs were compared with those of a previous protocol including VRA, impedance audiometry, and ABR for all children. RESULTS: A total of 29 children had TEOEs in both ears and normal VRA findings. Ten children lacked TEOEs in one or both ears; 9 of them had otitis media with effusion. Further examination by VRA and ABR led to the diagnosis of bilateral sensorineural hearing loss in 2.6% (1/39) of patients and unilateral sensorineural hearing loss in 7.7% (3/39) of patients. Cost analysis revealed that this protocol costs about half the previous one. CONCLUSION: Recording TEOEs appears to be a feasible and cost-effective hearing screening test for infants recovered from meningitis. If TEOEs are absent, impedance audiometry, ABR recordings, and audiometric evaluation techniques are needed to distinguish between conductive and sensorineural hearing loss and to assess hearing thresholds precisely.
Subject(s)
Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Meningitis, Bacterial/complications , Otoacoustic Emissions, Spontaneous , Acoustic Impedance Tests , Child, Preschool , Cost-Benefit Analysis , Evoked Potentials, Auditory, Brain Stem , Feasibility Studies , Female , Humans , Infant , Male , Prospective StudiesABSTRACT
No significant difference was found for the auditory thresholds at conversational and high frequencies between 42 children with congenital hypothyroidism treated with L-thyroxine and an age-matched control group, regardless of the cause of the thyroid failure or hormone level and the age at the start of treatment.