Failed newborn hearing screens as presentation for otitis media with effusion in the newborn population

Summary Objectives: Evaluate the prevalence of middle ear disease in infants failing a newborn hearing screening program. Review the outcomes of those infants diagnosed with or without middle ear disease after failed hearing screen. Design: Retrospective chart review of 76 patients referred to a tertiary care institution for evaluation of a failed newborn hearing screening test. Setting: Arkansas Children's Hospital, Little Rock, Arkansas. Results: Seventy-six patients were referred for failed OAEs and complete otolaryngology evaluation. Mean age at the time of referral was 3 months (0.25 years) old. OME was identified in 64.5% of the patients. ABR confirmed a suspected hearing loss in 15 patients (78.9%) without middle ear disease. Effusion resolved without surgical intervention in 65.3% of infants, while 17 (34.7%) of the infants required tubes. SNHL was subsequently identified in 11% of infants after resolution of the effusion. Conclusions: OME is a common cause of failed infant hearing screens, and should be looked for prior to definitive diagnostic hearing testing. OME resolves in the majority of infants, but tube insertion is necessary to allow for diagnostic testing in nearly one third of infants. The majority of infants without OME had SNHL confirmed. SNHL was also identified in 11% of infants with OME after resolution of the effusion.