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A study of incidence of hearing loss in newborn, designing a protocol and methodology to detect the same in a tertiary health-care center

Background: Hearing impairment can have a negative impact on an individual's social, educational, and emotional life. If not detected early, it can affect the speech and language development. This delay in diagnosis and intervention can be mitigated by mandatorily implementing newborn hearing screening protocols. Objective: The primary objective of this study was to find the incidence of hearing loss in normal and high-risk neonates and recommend a protocol for the detection of hearing loss in the neonate. Materials and Methods: The study was carried out in a tertiary care teaching hospital over a period of 12 months. A total of 1000 babies including 693 normal and 307 high-risk babies were enrolled into the study. All neonates underwent otoacoustic emission (OAE) within the first 3 days of birth. Those who failed in this test underwent repeated OAE after 6 weeks, followed by brain stem-evoked response audiometry (BERA) if the second OAE was negative. Results: Of 307 high-risk babies, 48 showed absent OAE on initial screening. On follow-up, 10 babies still showed absent OAE. BERA was positive for hearing loss in five and normal in the other five babies. Among 693 normal neonates, 71 had absent OAE during the first test. On subsequent OAE test, seven babies failed whose BERA showed hearing loss in five and normal hearing in two babies. Conclusion: A proper protocol and methodology is required for the early detection of hearing loss so that rehabilitation can be started at the earliest. In this study, the incidence of hearing loss is found to be more in high-risk neonates as compared to normal ones. As OAE is simple and quick, it is preferred for screening, but BERA is required for the definitive diagnosis.