Listen from ear to ear : tips of the month, 07/01/2011, v.1 no.1

              blood.
Severe hyperbilirubinemia can result in damage to the auditory nerve and/or brainstem nuclei in the auditory system, neurons in the cochlear nuclei, in particular are severely damaged. It can involve lesions of the basal gan-glia and can effect the oculomotor system, vesti-bular systems and the cerebellum. Many infants and children diagnosed with a hearing disorder referred to as Auditory Neuropathy Spectrum Disorder (a topic covered in later newsletters) have a history of hyper-bilirubinemia.
Clinicians need to be aware of risk factors for hearing loss and the need for follow-up hearing screenings. The Joint Committee on Infant Hearing (JCIH) set forth risk factors for hearing loss (birth-28 days)
*Family history of hear-ing loss
*Placement in a level II or III nursery
*Infant had exchange transfusion
*Infant had serum bilirubin level of > 15mg/dL
*Infant suspected of hav-ing a congenital infection (neonatal herpes, cmv, rubella, toxoplasmosis, syphilis)
*Infant has craniofacial anomalies(such as pinna/
ear canal abnormality, cleft lip/palate, hydro-cephalus). A frequent question asked by hearing screening clinicians is “How is bilirubin and hearing loss related???”
The definition of bilirubin: Pigment in bile created during the break-down of hemoglobin, which is then excreted from the body. Bilirubin can build up in the blood, causing the skin to take on the yellow discoloration known as jaundice. If bilirubin gets too high, it can be treated. Photother-apy is usually very effec-tive. At high, more ex-treme levels, an exchange transfusion may be used, to rapidly remove the toxic bilirubin from the
How is bilirubin and hearing loss related????
Follow-up protocol for risk factors for late-onset hearing loss
The Oklahoma Newborn Hearing Screening Program sends an initial letter to fami-lies and primary care provid-ers recommending follow up for babies that either do not pass the initial screening or for babies who pass but have a risk factor for late onset hear-ing loss. For babies with risk factors, another letter is sent out at 5 months of age recom-mending another hearing screening by six months of
age. The Joint Committee on Infant Hearing (JCIH) Posi-tion Statement 2007 recom-mends that infants who pass the initial screening but have a risk factor should have at least one diagnostic audiol-ogy assessment by 24-30 months of age. Early and more frequent assessments may be indicated for a child with cytomegalovirus infec-tion, syndromes associated with progressive hearing
loss, postnatal infections, for children who received extra-corporeal membrane oxy-genation (ECMO) or chemo-therapy and when there is caregiver concern, or a fam-ily history.
OSDH Newborn Hearing Screening Program
Patricia Burk, M.S., CCC-SLP,LSLS Cert. AVT, Program Coordinator
Debbie Earley, M.S.,CCC-A, Follow-up/Audiology Coordinator
405-271-6617
Listen from Ear to Ear
Tips of the Month
July 1, 2011 NewbornScreen@health.ok.gov
Volume 1, Issue 1
UPCOMING EVENTS FOR FAMILIES:
Bring your box Workshop
Help families learn about the
accessories that their child has for their cochlear im-plant and how to use them
August 4, 6-8 p.m.
August 5, 10 a.m.-Noon
Integris Cochlear Implant Clinic
3434 NW 56th
Suite 101
Oklahoma City, OK
Call to register
405-947-6030
AABR tip: For low electrode impedances, try one drop of saline on electrode. Another option is baby wash or NuPrep on a small piece of gauze and scrub skin gently. Alcohol may dry skin out too much.
*If you have a specific topic or question you would like to ask, we want to know!
*Submit your questions for future newsletters!
*If you have specific questions about hearing loss, equipment etc, contact us anytime!