[Clinical protocol: audiological assessment of infants in Russian Federation. Part II]. / Protokol audiologicheskogo obsledovaniya detei pervogo goda zhizni v Rossiiskoi Federatsii. Chast' II.

This is the second part of the previously published clinical protocol of audiological assessment in infants. The goal of the protocol is unification approaches to audiological diagnosis of the infants. The following sections were included in the second part of the protocol: behavioral testing in infants, testing sequence, duration of the examination and necessity in follow-up, hearing assessment in special cases (premature children, children with congenital infections, after meningitis, with external ear abnormalities, single-sided deafness, with hydrocephalus and shunts, with auditory neuropathy spectrum disorder, with mild hearing loss and otitis media with effusion), medical report.

[Clinical protocol: audiological assessment of infants in Russian Federation. Part I]. / Protokol audiologicheskogo obsledovaniya detei pervogo goda zhizni v Rossiiskoi Federatsii. Chast' I.

The clinical protocol of audiological assessment in infants was prepared by the workgroup of Russian pediatric audiologists from different regions. The goal of the protocol is unification approaches to audiological diagnosis of the infants. The protocol has been developed according the evidence based medicine principles, by reviewing current scientific publications on the topic and taking into account the order of providing medical services and other clinical practice guidelines. When direct evidence was not available, both indirect evidence and consensus practice were considered in making recommendations. This guideline is not intended to serve as a standard to dictate precisely how the child should be diagnosed. This guideline is meant to provide the evidence base from which the clinician can make individualized decisions for each patient. The first part of the protocol covers following sections: equipment, staff requirements, timing of the diagnostics, case history and risk factors, preparing the child for the appointment, sedation and general anesthesia, otoscopy, tympanometry and acoustic reflex, otoacoustic emissions, skin preparing, electrode montage, choosing the stimulators, auditory brainstem responses on broadband and narrow-band stimuli, on bone conducted stimuli, auditory steady-state responses, masking, combined correction factors.

[Epidemiological study of hearing impairments in children: prevalence, structure, amplification, and social factors]. / Epidemiologiya narushenii slukha u detei: rasprostranennost', struktura, aspekty slukhoprotezirovaniya i sotsial'nye faktory.

For the first time, a detailed epidemiological study of hearing impairments (HI) in the children's population of St. Petersburg (n=3098) was conducted. The data on the incidence of HI in children, the distribution of children depending on the degree of hearing loss, HI type, the presence of additional disorders, risk factors for hearing loss were obtained. Only 19% of children with HI were diagnosed in accordance with modern requirements of early care - at the age of 3 months. In children who underwent universal newborn hearing screening the average age of diagnosis was significantly lower than in children who were not screened. Only 54% of HI children use hearing aids (HA) or cochlear implants. Among the children who do not use HA, the main number is children with mild and moderate hearing loss, unilateral hearing loss and otitis media with effusion. A significant part of them should be considered as candidates for amplification according to current recommendations. The average interval between diagnosis and amplification was 15.7 months. Only 5% of children from the entire population of children with HI received early intervention in accordance with the modern time standard: 1 month (detection) - 3 months (diagnosis) - 6 months (amplification). The problems of organizing an effective care for HI children and the directions of its development are discussed: improving newborn hearing screening; introduction the system of informing the citizens and doctors of related specialties (pediatricians, neurologists) in the field of prevention, diagnosis and rehabilitation of HI in children; expansion of genetic testing of children; reducing time of waiting and improving the quality of HA provided to handicapped children.