Will children have no hearing problems after passing the hearing screening?

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In the otolaryngology department of the hospital, we often see young mothers asking the doctor with their children in tears: My baby clearly passed the newborn hearing screening, and all the examinations were normal when he was discharged. Why is he diagnosed now? Is it neurological hearing loss? Did the doctor make a wrong diagnosis?


Will children have hearing problems after passing the hearing screening?

Under normal circumstances, a passing hearing test means that there is no problem with the baby's hearing. However, since hearing screening may have false negatives, even if the hearing screening passes, parents must observe their children's clinical manifestations in life.


Although the hearing screening passes, there is no guarantee that the child’s hearing will be completely normal in the future. For example, some hereditary hearing loss will gradually cause hearing loss in children during childhood. Generally, the hearing test is normal at birth, but as the child grows up and develops into childhood, hereditary hearing loss will occur, and the process of hearing loss will gradually occur, so continuous observation is still required.

In addition, it is recommended that the hearing screening time be 48 hours after the child is born, and the secretions from the child's external auditory canal should be cleaned as much as possible before the examination, so as not to affect the examination results and reduce the probability of false positives. Even if it fails, it does not mean that the child must have hearing impairment, and further examination is needed to confirm the diagnosis.

Why do children still have hearing loss? The reason is:
01. Passing the hearing screening cannot rule out the possibility that the child has delayed hearing loss. Hearing loss can occur in people of all ages. Genetic factors, diseases, the use of ototoxic drugs, etc. may cause a child's originally normal hearing to decline. Therefore, as the child ages, the incidence of hearing loss increases. Therefore, "passing" the hearing screening can only reflect the current situation at the time of the screening, but cannot reflect the child's lifelong hearing status, nor can it be considered that the child has been away from diseases that affect hearing.
If the hearing screening passes, children with mild hearing loss and auditory neuropathy may be missed. Currently, the main screening method used in our country is otoacoustic emissions (OAE). This method is simple, fast, non-invasive and can be performed in the delivery room, so most hospitals in my country use this method. But its limitation is that it cannot detect children with auditory neuropathy; in addition, for mild cases (26-40dBHL) The detection rate of hearing loss is also not high. Therefore, some cases may be missed. It should be noted that this limitation is caused by the technology itself and has nothing to do with the operation.

03. If the hearing screening is passed, it cannot be ruled out that the child does not have an enlarged vestibular aqueduct. An enlarged vestibular aqueduct is an anatomic abnormality of the inner ear. The hearing performance of children with enlarged vestibular aqueduct can range from normal, mild, moderate, severe, to profound hearing loss. Hearing screening cannot detect abnormalities in the anatomy of the auditory system, so whether a newborn has an enlarged vestibular aqueduct cannot be detected by hearing screening. Such newborns can pass the hearing screening at birth.


Once parents have doubts about their child’s hearing and speech-language development level, they must promptly go to a professional institution for audiological testing to reduce progressive and delayed onset Sexual hearing impairment has an irreversible impact on children's hearing and speech development.