Page 93 - Portuguese Journal - SPORL - Vol 61. Nº1

Table 2
Periods of reevaluation according to the clinical entity or ORL consultation with audiological evaluation
suggested by the Joint Committee on Infant Hearing
Until 9 months
1 Family history of hearing loss in childhood
(extend if late onset)
2 ECMO
3 Intrauterine CMV infection
Until school age
Culture-confirmed infections associated with sensorineural deafness, in particular (3-6 months intervals)
4 bacterial and viral meningitis (especially herpes and chickenpox) and severe neonatal
sepsis
5 Intrauterine Zica infection (mother and child with laboratory findings) AEP at 1 M and 4-6 M
6 Other intrauterine infections (herpes, rubella, syphilis, toxoplasmosis, chickenpox)
7 NICU: hospitalization > 5 days or hyperbilirubinemia requiring exchange transfusion
8 Aminoglycosides > 5 days (gentamicin, tobramycin, streptomycin)
9 Neonatal distress
Craniofacial anomalies, namely those involving the external ear, EAC, or temporal
10
bone
Physical changes associated with syndromes that usually include conductive/ Until 9 months
11 sensorineural deafness, such as the congenital white forelock
(Waardenburg syndrome)
Neurodegenerative diseases (Hunter syndrome, leukodystrophies) or sensory-motor
12
neuropathies (Friedreich ataxia, Charcot-Marie-Tooth syndrome)
Syndromes associated with hearing loss (neurofibromatosis, branchiootorenal
13 syndrome, osteopetrosis, Usher syndrome, Waardenburg syndrome, Alport syndrome,
Stickler syndrome, Pendred syndrome, Jervell and Lange-Nielsen syndrome)
14 Chemotherapy (especially platinum derivatives)
< 3 months after
Cranial trauma requiring hospitalization, especially involving the skull base or occurrence
15
temporal bone fracture
16 Otitis media, recurrent or persisting for more than 3 months
Caregiver’s concern about hearing loss or delayed speech/discourse development Immediate
17
or learning difficulties
Abbreviations: ECMO, Extracorporeal membrane oxygenation; CMV, Cytomegalovirus; APGAR, Appearance, Pulse, Grimace, Activity,
Respiration; EAC, External Auditory Canal
* Suggested alteration to the current recommendations.

hyperbilirubinemia requiring exchange transfusion should be preferentially assessed
transfusion, neonatal distress and suspicion with AEP. 6
or confirmation of syndromes or neurological
diseases associated with hearing loss, due to 3. Algorithm for hearing screening of newborns
the risk of worsening of hearing in this period or children at risk (Algorithm 1) (figure 1)
that may be missed in the first evaluation. In According to the clinical standards currently in
6
cases in which the parents, speech therapists, place in Portugal , all NBs should be assessed
2
educators, or other professionals that follow for the existence of risk factors for childhood
the child’s development suspect a problem, deafness (Table 1). Thus, UNHS can be divided
the audiological evaluation may be further into screening of children at risk and those
extended. We emphasize that children not at risk of hearing loss. NBs not at risk of
at risk due to intrauterine Zika infection, hearing loss should be evaluated with AEP or
hospitalization in the NICU > five days, or OAE in the first month of life, as is currently
hyperbilirubinemia requiring exchange recommended in Portugal. In cases In which
2

Volume 61 . Nº1 . March 2023 93