Les étiologies de la perte auditive chez le nourrisson et des mesures nouvelles pour évaluer l’amélioration de l’ouïe engendrée par les audioprothèses
Abstract
A clinical battery of audiologic tests was developed to provide objective and functional measures of an infant’s benefit from amplification in the under-8 month-old population. Two retrospective studies assessed the evolution of risk indicators and etiologies of hearing loss in the newborn population. Three studies were completed to assess salivary cortisol changes in infants in response to auditory stimuli, audiologic behavioral testing, and the use of three caregiver surveys on auditory development. These studies revealed a change in the risk indicators for hearing loss from a high-risk hearing screening program (1985-2001) to a Universal Newborn Hearing Screening program (2001-2011). UNHS has not significantly decreased the age of identification of hearing loss in the at-risk population, although it has provided identification of hearing loss in the not-at-risk population. Etiological data on infants identified through UNHS reveals that nearly half of the population remains without a diagnosis for the hearing loss. Improved technology, including imaging and genetic testing, has greatly increased our knowledge regarding etiology and prognosis for hearing loss. A clinical battery of salivary cortisol assessment, early behavioral testing, and caregiver surveys provides a well rounded evaluation in infants 3-8 months old with hearing loss and provides a solid picture of the infants’ benefit from amplification and level of development compared to normal hearing peers. These findings provide the clinical audiologist with critical information to assess benefit from amplification and to establish cochlear implant candidacy along an appropriate timeline in young infants with hearing loss.