CONDUCTIVE HEARING LOSS WITHINUNIVERSAL NEWBORN HEARING SCREENINGPROGRAMS: A SYSTEMATIC REVIEW

Abstract

Background Universal Newborn Hearing Screening (UNHS) attempts to identify children with a permanent, bilateral, moderate or greater hearing loss at birth. However, children who are referred from UNHS programs may have conductive hearing loss (CHL), sensorineural, or mixed hearing loss. The aim of this review was to investigate the prevalence, sub-classifications, audiological diagnosis, and medical management of CHL within UNHS programs. Material and Methods A systematic literature search was completed in the scientific databases PubMed, CINAHL, and Embase. Studies were reviewed with reference to the inclusion criteria, then graded to assess the internal and external validity, leaving 25 studies for review. Results The prevalence of conductive hearing loss ranged from 0.4% to 64.5%. ‘Genetic’ and ‘Permanent’ were the only two sub-classifications of CHL identified, with no uniform terminology evident. Given CHL is not a target condition of UNHS, audiological assessment was consistent with the diagnosis of Permanent Childhood Hearing Loss (PCHL). There was little evidence of audiological review, onward referrals, or medical management for CHL within UNHS programs. Of the evidence obtained, no alternative pathway was found for children identified with CHL through UNHS. Conclusions In view of the limited evidence for CHL within UNHS, further investigation into the prevalence, sub-classification, and appropriate management of CHL within a UNHS program is recommended to better guide evidence-based assessment and management of these children.