Effect of Continuous Positive Airway Pressure on Auditory Function in neonates

Abstract

Hearing is paramount for child development; it provides adequate individual integration into a society where oral communication predominates. Hearing disorders may result in language impairment and slower cognitive, intellectual, cultural and social development. Thus, hearing loss should be detected as early as possible so that language and social functioning may develop as normally as possible. The incidence of hearing loss in neonates is 2-4 cases in every 1000 live births. Hearing loss, especially in mild and moderate forms, may not be recognized before the second year, but may produce great defects in conversational abilities. The application of mechanical ventilation to the newborn since mid-1960s has presumably allowed the survival of seriously ill infants who would previously have died, and who have had a variety of illnesses, not necessarily primarily respiratory. It could represent a new source of childhood handicap, it seems important to determine its extent and severity in a neonatal intensive care referral unit as artificial ventilation becomes widely used, and survival rates improve. Furthermore, the application of mechanical ventilation can significantly damage the peripheral segment of the hearing track and prolonged ventilation is often a risk factor of hearing loss in infants. Noise intensities in the post-nasal space in the neonates on CPAP at the lowest flow rate (5 literes/min) was significantly higher across the frequency range than for those on conventional ventilation. This study aimed to examine auditory functions in newborns after discontinuation of continuous positive airway pressure (CPAP) and To determine the relation between the auditory function and different variables during CPAP. The study is a Case control, prospective study that was conducted in the neonatal intensive care unit (NICU) of Ain Shams University in the period from . It included 30 newborns admitted to NICU and requiring nasopharengeal CPAP. the study was approved by the ethical committee of pediatric department faculty of medicine Ain Shams university and An informed conscent from the parents of neonates before enrollment in the study was taken. Thirty Newborn included in the study as cases group >= 34 weeks gestation on nasopharengeal CPAP and control group were Thirty newborns gestational age and sex matched were included as control group. Visual examination of the external auditory meatus and tympanic membrane was performed using a Welch Allyn Halogen Otoscope. Otoscopic examination was used to confirm that the outer ear was free of debris, and that canals were clear and patent for later procedures (ABR assessment) using: MAICO MB11 WITH BERAphone. In the current analysis, the distribution of risk factors among the 2 studied groups was as follows the most frequent was stay >5days in the neonatal intensive care unit the second came exposure to ototoxic drugs and then neonatal sepsis . Both groups were negative for other risk factors like consanguinity, family history of hearing loss, craniofacial anomalies and mechanical ventilation . No statistically significant difference was detected between both study group and control group regarding gestational age and length of stay, birth weight, sex, mode of delivery and APGAR score.