Hearing loss in Neonates                                                            

Professor M.H. Soltanzadeh MD
Professor of Pediatrics, ID ,
Shahid Beheshti University of Medical Science ,
Tehran ,IRAN

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 Diseases.

After vaccination for HIb and Rubella decreased hearing loss we hop that beginning vaccination for HIb and Rubella in Iran.

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%

Hearing loss in neonates through age 28 days:

1-Birth weight less than 1500 gr

2-Hyperbilirubinemia at a serum level, requiring exchange transfusion.

3-Apgar scores of 0-4 at 1 minute or 0-6 at 5 minutes

4-Mechanical Ventilation lasting 5 days

5-Ototoxic medications , aminoglycosides  used multiple dose or combination with duretics

6-Bacterial Meningitis

7-TORCH :  CMV, Rubella , Herpes , Syphilis and Toxoplasmosis .

8-Morphologic abnormalities of the pinna and ear canal

9-Down Syndrome


11-PPHN, 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.

12-Prenatal Toxic Syndrome , hearing loss has been described in association with prenatal exposure to alcohol, trimethadione.

13-Otitis Media

14-Noise – induced hearing loss

15-Head trauma



Evaluation of cause of hearing loss include : good pregnancy ,labor, delivery history ,medical history, family history, physical examination and laboratory tests.

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