Page 94 - Portuguese Journal - SPORL - Vol 61. Nº1

Figure 1
Algorithm 1. Scheme of organization for conducting hearing screening in newborns and children with
risk factors for hearing loss

Abbreviations: AEP, Auditory Evoked Potentials; OAE, Otoacoustic emissions; C, Consultation; D, Days; W, Weeks; M, Months;
ORL, Otorhinolaryngology; UNHS, Universal Neonatal Hearing Screening; GFM, General and Family Medicine
a response is detected through these methods if hearing loss is confirmed, because of the
at 40 dB HL or less, the NB is referred to the risk of progression to labyrinthitis ossificans.
4,6
family physician or pediatrician for follow-up, All other at-risk NBs should undergo AEP
as described in algorithm II. NBs without a and OAE in the first month of life and their
response at 40 dB HL or more in AEP or OAE audiological evaluation should be finished at
should undergo AEP and OAE before reaching three months , because the combined use
4,6
the age of three months to confirm moderate of AEP and OAE may reduce the rate of false
to profound deafness, because the combined negatives in these subgroups. In at-risk cases
3
use of AEP and OAE may reduce the rate of false in which moderate-profound deafness is not
negatives in this subgroup. In cases in which confirmed, the children should be reevaluated
3
moderate to profound deafness is confirmed, according to the intervals indicated in Table 2.
complete AEP, tympanogram, and behavioral In cases in which there is no evoked response
tests should be ordered and the child should be at 40 dB HL or more in one or both ears,
referred for a childhood deafness consultation the clinical guideline is the same as for NBs
for subsequent etiological investigation and without risk of hearing loss who similarly did
clinical guidance regarding hearing and not demonstrate a response in UNHS at birth.
social and family rehabilitation. NBs at risk of Children of any age, who throughout their
RN bacterial meningitis should be evaluated development, have one of the risk factors
with AEP and OAE before being discharged for hearing loss listed in Table 1 should be
from the hospital and referred for a childhood screened in the same way as NBs at risk, as
deafness consultation within less than 15 days shown in Table 2.

94 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery