Assessing Tracheostomy as a Risk Factor for Hearing Loss in Neonates with Bronchopulmonary Dysplasia

Objectives: This study compares the risk of hearing loss in children with bronchopulmonary dysplasia (BPD) based upon whether the child required tracheostomy. Method: A retrospective chart review was conducted that included all children diagnosed with BPD from 2013–2020 at a single tertiary medical institution. Primary outcome was presence of hearing loss. Children without follow-up audiogram were excluded from analysis. Risk comparison was made using hazard analysis; Cox regression model controlled for exposure to ototoxic medications. Results: There were 177 infants diagnosed with BPD who had sufficient follow-up for inclusion. Thirty-two children (18%) underwent tracheostomy placement. Children with tracheostomy were at significantly higher risk of developing hearing loss, with 13/32 (41%) demonstrating hearing loss during follow-up, compared with 16/145 (11%) of children without tracheostomy, p value \u3c 0.001. Cox regression model found that children with tracheostomy were 5.9 times more likely to develop later onset hearing loss than children without tracheostomy, p value 0.011. Most patients diagnosed with hearing loss were shown to have mild conductive hearing loss. Conclusion: Among children with BPD, those who required tracheostomy were at significantly higher risk of developing hearing loss, including later onset hearing loss. In this study, the hearing loss observed was typically mild and conductive in nature. Families of children with tracheostomy should be counseled regarding this risk and recommendations for otologic and hearing surveillance