Prevalence of Childhood Permanent Hearing Loss after Early Complex Cardiac Surgery

To estimate the prevalence of childhood permanent hearing loss (PHL) after early cardiac surgery. This prospective observational (1996-2015) study after complex cardiac surgery with cardiopulmonary bypass at ≤6 weeks of life reports audiology follow-up by registered pediatric-experienced audiologist...

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Bibliographic Details
Published in:	The Journal of pediatrics Vol. 198; pp. 104 - 109
Main Authors:	Bork, Karin T., To, Beatrice P., Leonard, Norma J., Douglas, Charlotte M., Dinon, Diana A., Leonard, Elizabeth E., Valeriote, Hope A., Usher, Laurie F., Robertson, Charlene M.T.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-07-2018
Subjects:	Age Factors Cardiac Surgical Procedures Cardiopulmonary Bypass Child, Preschool conductive hearing loss Female Hearing Loss - diagnosis Hearing Loss - epidemiology Heart Defects, Congenital - complications Heart Defects, Congenital - mortality Heart Defects, Congenital - surgery Humans Infant Infant, Newborn infants Male neonates pediatrics Prevalence Prospective Studies Risk Factors risk indicators sensorineural hearing loss sensorineural hearing loss ECMO infants SV NICU neonates conductive hearing loss risk indicators CCS PHL pediatrics dB HL PTA
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Summary:	To estimate the prevalence of childhood permanent hearing loss (PHL) after early cardiac surgery. This prospective observational (1996-2015) study after complex cardiac surgery with cardiopulmonary bypass at ≤6 weeks of life reports audiology follow-up by registered pediatric-experienced audiologists at 6-8 months postsurgery, age 2 years, and as required throughout and thereafter to complete diagnoses. PHL at any frequency (500-4000 Hz) is defined as responses of >25-decibel hearing level in either ear. PHL was evaluated by type (conductive or sensorineural), pattern (flat or sloping), and severity (mild to profound). Survival rate was 83.4% (706 of 841 children) with a 97.9% follow-up rate (691 children); 41 children had PHL, 5.9% (95% CI 4.3%, 8.0%). By cardiac defect, prevalence was biventricular, 4.0% (95%CI 2.5%, 6.1%); single ventricle, 10.8% (95%CI 6.8%, 16.1%). Eighty-seven (12.6%) of 691 had syndromes/genetic abnormalities with known association with PHL; of these, 17 (41.5%) had PHL. Of 41 children, 4 had permanent conductive, moderate to severe loss (1 bilateral); 37 had moderate to profound sensorineural loss (29 bilateral with 20 sloping and 9 flat), 6 with cochlear implant done or recommended. Infants surviving complex cardiac surgery are at high risk for PHL. Over 40% with PHL have known syndromes/genetic abnormalities, but others do not have easily identifiable risk indicators. Early cardiac surgery should be considered a risk indicator for PHL.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	0022-3476 1097-6833
DOI:	10.1016/j.jpeds.2018.02.037