Hearing Loss and Medically Fragile Children
Fligor (2013) reports in 2009 (the most recent USA data available) Universal Newborn Hearing Screenings (UNHS) were completed on 97.4 percent of all newborns. Current estimates indicate congenital sensorineural hearing loss (SNHL) occurs in 3 to 4 children per 1,000 (live births). Of note, the number of high school graduates with permanent SNHL is approximately 19 per 1,000 (i.e., 15 more children per 1000 develop hearing loss by late adolescence).
Fligor notes that 1 percent of newborns are infected with cytomegalovirus (CMV) at birth, however, 90 to 95 percent of those (infected) do not have signs of CMV at birth. Of those children infected and with signs of CMV (at birth), SNHL occurs 41 percent of the time, and in those infected without signs of CMV, SNHL occurs 7 percent of the time. Of note, the median age of hearing loss onset in the symptomatic group was 33 months, and in the asymptomatic group the median age of SNHL onset was 44 months. Therefore, CMV is responsible for SNHL in 4,300 children per year (USA) and 1,440 of them had normal hearing at birth.
For children in the neo-natal intensive care unit, 1 to 3 percent are likely to have SNHL. For children who undergo extracorporeal membrane oxygenation (ECMO, a form of prolonged heart-lung bypass), 7.5 percent (average) have SNHL. Of note, of 111 neonatal ECMO graduates (see Fligor and colleagues, 2005) 26 percent had SNHL. For children undergoing platinum-based chemotherapy, some 60 percent develop SNHL.
For More Information, References, and Recommendations
Fligor BJ. (2013) Early Diagnosis and Management of Hearing Loss in Medically Fragile Children. Seminars in Hearing 23(1):27-36.