Summary of the Clinical Practice Guideline

Article Citation

International Pediatric Otolaryngology Group (IPOG) Consensus Recommendations: Hearing Loss in the Pediatric Patient

Liming, B. J., Carter, J., et al. (2016).
International Journal of Pediatric Otorhinolaryngology, 90, 251-258.
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International Pediatric Otolaryngology Group

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Article Details

Description

This guideline provides consensus-based recommendations on the screening, diagnosis, and treatment of hearing loss in children.

Recommendations from This Guideline

What are Recommendations?

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Screening

In order to capture infants with auditory neuropathy spectrum disorder, both otoacoustic emissions (OAE) and auditory brainstem response (ABR) screenings should be used for high-risk patients, which include those with:

  • congenital TORCH infections (i.e., toxoplasmosis, other infections, rubella, cytomegalovirus, herpes);
  • birth weight < 1500 g;
  • hyperbilirubinemia requiring exchange transfusion;
  • ototoxic medications for greater than five days;
  • bacterial meningitis;
  • mechanical ventilation greater than five days;
  • head trauma;
  • neurodegenerative disorders;
  • neonatal intensive care unit (NICU) stay greater than five days; and
  • family history of hearing loss.

Assessment

Temporal bone magnetic resonance imaging should be completed for unilateral auditory neuropathy spectrum disorder (ANSD) and considered for bilateral ANSD. Genetic testing should be offered when ANSD is identified.

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Screening

For infants without risk factors, screening should include otoacoustic emissions (OAEs) with additional auditory brainstem response (ABR) screening administered for absent or diminished OAE responses.

Keywords: Automated Auditory Brainstem Response (ABR), Otoacoustic Emissions (OAEs)

Assessment

Additional hearing assessment recommendations include:

  • audiogram and physical exam should be completed for all types of hearing loss;
  • CT scans can be considered for children with persistent conductive hearing loss;
  • cytomegalovirus (CMV) testing should be considered for children with sensorineural hearing loss;
  • genetic testing should be considered when syndromic hearing loss is suspected; and 
  • observation for three months should occur for children experiencing middle ear effusion.

Keywords: Genetic Hearing Loss, Comorbid Diseases and Disorders, Follow-Up/Timing, Disorders of the Ear, Behavioral Audiometry, Risk Factors, Referral, Infectious Diseases (e.g. Cytomegalovirus/Meningitis)

Service Delivery

Additional hearing assessment recommendations include:

  • audiogram and physical exam should be completed for all types of hearing loss;
  • CT scans can be considered for children with persistent conductive hearing loss;
  • cytomegalovirus (CMV) testing should be considered for children with sensorineural hearing loss;
  • genetic testing should be considered when syndromic hearing loss is suspected; and 
  • observation for three months should occur for children experiencing middle ear effusion.

Keywords: Genetic Hearing Loss, Comorbid Diseases and Disorders, Follow-Up/Timing, Disorders of the Ear, Behavioral Audiometry, Risk Factors, Referral, Infectious Diseases (e.g. Cytomegalovirus/Meningitis)

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