The importance of otoscopic examination in the hearing screening of neonates

Abstract

Aim Permanent hearing loss in children is congenital in more than 80% of cases. Hearing screenings of newborns are important in the early determination of hearing loss. The aim of this study was to draw attention to the importance of a careful otoscopic examination before hearing screening in newborns.Methods In this retrospective study, the records of patients who underwent a hearing test according to the hearing screening program in our clinic between January 2015 and January 2017 were examined. Evaluation was made of patient data with findings such as vernix caseosa, impacted cerumen, serous otitis media, external otitis, and ear canal anomalies in the notes from the otoscopic examination conducted prior to the evoked otoacoustic emission (EOAE) test.Results The EOAE test was applied to 1417 patients immediately following otoscopic examination. The EOAE was normal in 1266 patients, while no response could be obtained from the ears bilaterally in 91 patients and unilaterally in 60 patients. After follow-up and treatment of patients with serous otitis, ear debris, or vernix caseosa determined in the otoscopic examination, hearing loss was determined with a repeated EOAE test as bilateral very advanced in 2 patients, unilateral very advanced in 1 patient, moderately advanced in 2 patients, at 30 dB in 5 patients, and hearing neuropathy was considered in 1 patient. Conclusion The significant improvement in hearing loss after treatment of vernix caseosa, cerumen, and serous otitis media has shown how important the otoscopic
examination as part of the initial hearing screening of newborns.

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