International Pediatric Otolaryngology Group (IPOG) Consensus Recommendations: Hearing Loss in the Pediatric Patient
International Journal of Pediatric Otorhinolaryngology
Liming, B. J., Carter, J., et al. (2016).
International Journal of Pediatric Otorhinolaryngology, 90, 251-258.
<div>This guideline provides consensus-based recommendations on the screening, diagnosis, and treatment of hearing loss and auditory neuropathy spectrum disorder (ANSD) in infants and children. </div>
International Pediatric Otolaryngology Group
<div>Additional hearing assessment recommendations include the following:</div>
<ul>
<li>Audiogram and physical exam should be completed for all types of hearing loss.</li>
<li>CT scans can be considered for children with persistent conductive hearing loss.</li>
<li>Cytomegalovirus (CMV) testing should be considered for children with sensorineural hearing loss.</li>
<li>Genetic testing should be considered when syndromic hearing loss is suspected. </li>
<li>Children experiencing middle ear effusion should be observed for three months.</li>
</ul>
<div>For infants without risk factors, screening should include otoacoustic emissions (OAEs). Additional auditory brainstem response (ABR) screening should be administered in patients with absent or diminished OAE responses.</div>
<div>Referral for temporal bone magnetic resonance imaging should be made for unilateral ANSD and considered for bilateral ANSD. Referral for genetic testing should be offered when ANSD is identified.</div>
<div>For infants at higher-risk for ANSD, screenings should include both otoacoustic emissions (OAE) and auditory brainstem response (ABR). Risk factors include:</div>
<ul>
<li>congenital TORCH infections (i.e., toxoplasmosis, other infections, rubella, cytomegalovirus, herpes);</li>
<li>birth weight below 1500 grams;</li>
<li>hyperbilirubinemia requiring exchange transfusion;</li>
<li>ototoxic medications for greater than five days;</li>
<li>bacterial meningitis;</li>
<li>mechanical ventilation greater than five days;</li>
<li>head trauma;</li>
<li>neurodegenerative disorders;</li>
<li>neonatal intensive care unit (NICU) stay greater than five days; and</li>
<li>family history of hearing loss.</li>
</ul>
