Resumen
Objetivos: Conocer los resultados del programa de detección precoz de hipoacusia en recién nacidos (RN) de nuestro hospital durante 2001 y 2004.
Pacientes y métodos: Se realizaron otoemisiones acústicas (OEA) a 2.461 (2001) y 2.549 RN (2004); si éstas eran negativas, se repetían antes de un mes. Los RN con la segunda otoemisión negativa eran remitidos al servicio de otorrinolaringología (ORL), completándose su valoración mediante potenciales auditivos troncoencefálicos.
Resultados: El 10% (n= 260) y el 5% (n= 145), respectivamente, no pasaron la primera OEA. Continuaron esta primera fase 234 (2001) y 144 (2004), y no pasaron la segunda OEA el 16% (n= 37) y el 24% (n= 35), generándose una remisión al servicio de ORL del 1,51 y el 1,37% cada año; 29 niños no completaron la fase diagnóstica. De los 72 RN con sospecha de hipoacusia, el 59,72% (n= 43) completó el programa, el 30,23% había estado ingresado, el 23,25% presentaba factores de riesgo y el 48,83% tenía OEA negativas bilaterales. En el servicio de ORL se confirmó la hipoacusia en 23 RN (53,48%): en un 57,14% era neurosensorial (un 62% en RN varones sin factores de riesgo; un 75% bilaterales y un 50% profundas) y en un 42,16% era de transmisión.
Conclusiones: Nuestra incidencia global de hipoacusia neurosensorial y de transmisión es de 4,54/1.000 RN, y para la neurosensorial profunda de 1,87/1.000 RN. El 71% de los hipoacúsicos eran RN sanos y sin factores de riesgo, predominando los varones. La capacidad de detección de las OEA fue significativamente mayor en 2004; las remisiones a ORL fueron adecuadas, las pérdidas de seguimiento en la primera fase escasas, pero elevadas en la de confirmación.
Abstract
Objectives: To examine the results of the program of early detection of hearing loss in newborn infants (NB) in our hospital during 2001 and 2004.
Patients and methods: Otoacoustic emissions (OAE) were evaluated in 2,461 (2001) and 2,549 NB (2004) and, if the results were negative, the evaluation was repeated before one month had elapsed. The NB with a second negative OAE test were sent to the otorhinolaryngology service (ORL), where their evaluation was completed, including assessment of the auditory brainstem response (ABR).
Results: The first OAE test was negative in 260 (10%) and 145 (5%) NB, respectively. In all, 234 (2001) and 144 (2004) continued this first stage; 37 (16%) and 35 (24%) NB, respectively, failed to pass the second OAE test, and 1.51% and 1.37% in each year were referred to ORL, whereas 29 children did not complete the diagnostic phase. Of the 72 NB with suspected auditory dysfunction, 59.72% (n= 43) completed the program, 30.23% had been admitted to the hospital, 23.25% had risk factors and 48.83% had bilateral negative results on OAE testing. The ORL service confirmed hearing loss in 23 NB (53.48%): sensorineural in 57.14% (62% were boys with no risk factors, and it was bilateral in 75% and profound in 50%) and conductive in 42.16%.
Conclusions: Our overall incidence of sensorineural and conductive hearing loss was 4.54/1,000 NB, and that of deep sensorineural hearing loss was only 1.87/1,000 NB. In all, 71% of the infants with hearing loss were normal and had no risk factors, and there was a male predominance. The capacity for detection of OAE was significantly greater in 2004; the referrals to ORL were appropriate, the rate of loss to follow-up was low in the first stage and elevated in the confirmation stage.
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