Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand

Watcharapol Poonual,1 Niramon Navacharoen,2 Jaran Kangsanarak,2 Sirianong Namwongprom3 1Clinical Epidemiology Program, 2Department of Otolaryngology, 3Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Objective: To define the risk factors for hearing loss in infants (aged 3 months) under universal hearing screening program. Materials and methods: A total of 3,120 infants (aged 3 months) who underwent hearing screening using a universal hearing screening program using automated otoacoustic emission test between November 1, 2010 and May 31, 2012 in Uttaradit Hospital, Buddhachinaraj Hospital, and Sawanpracharuk Hospital (tertiary hospitals) located in Northern Thailand were included in this prospective cohort study. Results: Of the 3,120 infants, 135 (4.3%) were confirmed to have hearing loss with the conventional otoacoustic emission test. Five of these 135 infants (3.7%) with hearing loss showed test results consistent with auditory brainstem responses. From the univariable analysis, there were eleven potential risk factors associated with hearing deterioration. On multivariable analysis, the risk factors independently associated with hearing loss at 3 months were birth weight 1,500–2,500 g (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1–2.6), APGAR score <6 at 5 minutes (RR 2.2, 95% CI 1.1–4.4), craniofacial anomalies (RR 2.5, 95% CI 1.6–4.2), sepsis (RR 1.8, 95% CI 1.0–3.2), and ototoxic exposure (RR 4.1, 95% CI 1.9–8.6). Conclusion: This study concluded that low birth weight, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure are the risk factors for bilateral hearing loss in infants (aged 3 months) and proper tests should be performed to identify these risk factors. As an outcome, under the present circumstances, it is suggested that infirmary/physicians/general practitioners/health action centers/polyclinics should carry out universal hearing screening in all infants before 36 weeks. The public health policy of Thailand regarding a universal hearing screening program is important for the prevention of disability and to enhance people's quality of life. Keywords: infant, universal hearing screening, risk factors, bilateral ears, cohort stud

Bacterial meningitis complicating suppurative otitis media and sinusitis

Bacterial meningitis is still the most common intracranial complication both of otitis media and sinusitis. Although the widespread use of sinusitis and otitis, is hat greatly reduced the morbidy and mortality of this infection. We report a case of bacterial meningitis after the simultaneous intracranial extension of an ethmoidal-sphenoidal sinusitis and an otomastoiditis