Newborn hearing screening is a type of screening test
for the early detection of hearing loss. It can recognize
with good accuracy newborns affected by hearing
impairment allowing an early diagnosis and intervention
and avoiding cognitive and linguistic deficits [1-6].
The incidence of bilateral sensorineural hearing loss
(SNHL) in Sicily is 2.35 cases per 1000 newborns; this
value increases to 2.95 if we consider also unilateral SNHL
[2,3] and to 10 cases per 1000 births among infants at risk
[7-9].
A correct newborn hearing screening programme is
based on different protocols depending on the presence/
absence of audiologic risk factor

Cocuzza, S

La Mattina, E

Martinelli, S

MARTINES, Enrico

MARTINES, Francesco

MUCIA, Marianna

SALVAGO, Pietro

The Italian Journal of Pediatrics

PubMed

Archivio istituzionale della ricerca - Università di Palermo

MEETING ABSTRACT Open AccessEssential of audiology: screening and post-screeningFrancesco Martines1*, Pietro Salvago1, Salvatore Cocuzza2, Eleonora La Mattina3, Martinelli Stefano4,Marianna Mucia3, Enrico Martines3From 70th Congress of the Italian Society of Pediatrics, Joint National Meeting SIP, SICuPP, SITIPPalermo, Italy. 11-14 June 2014Newborn hearing screening is a type of screening testfor the early detection of hearing loss. It can recognizewith good accuracy newborns affected by hearingimpairment allowing an early diagnosis and interventionand avoiding cognitive and linguistic deficits [1-6].The incidence of bilateral sensorineural hearing loss(SNHL) in Sicily is 2.35 cases per 1000 newborns; thisvalue increases to 2.95 if we consider also unilateral SNHL[2,3] and to 10 cases per 1000 births among infants at risk[7-9].A correct newborn hearing screening programme isbased on different protocols depending on the presence/absence of audiologic risk factors:• Newborns without risk factors: [1-3]Initial Hearing Screening (Step I): The initialscreening should be performed using Transient-Evoked Otoacoustic Emissions (TEOAEs) in the birthcenters as close to discharge as possible, preferably 12hours or more after birth. It is recommended that aninfant be referred for a re-screening (step 2) if s/hedoes not pass the initial screening or results cannot beobtained in one or both ears.Re-screening (Step II): The re-screening should beperformed in a second level center using TEOAEs andAutomated Auditory Brainstem Response (AABR). Ifan infant does not pass the re-screening or if resultscannot be obtained in one or both ears, s/he shall bereferred to the regional third level center for diagnosticaudiological evaluation.• Newborns with risk factors (JCIH 2007) [7-10]Initial Hearing Screening (Step I): The Initial Hear-ing Screening should be performed in a second levelcenter using TEOAEs and AABR. If an infant does notpass the initial screening or if results cannot beobtained in one or both ears, s/he shall be referred tothe regional third level center for diagnostic audiologi-cal evaluation.Screening variablesActually TEOAEs have a sensitivity of 100% and a specifi-city of about 70-95%. A higher TEOAEs specificity valuedepends on [1,2,11]:• Timing of TEOAEs recording• Trained and qualified personnel• PASS/REFER criteriaLimitations of screeningAudiologic screening does not identify:• Post-natal SNHL (prelingual or perilingual) ,mainly related to genetic causes [12,13]• ANSD (Auditory Neuropathy Spectrum Disorder):the main risk factors associated to ANSD are severejaundice, prematurity, respiratory distress, ototoxicdrugs (used to treat neonatal infections), genetic muta-tions (e.g. OTOF gene). The diagnosis of ANSD isusually based on the combination of absent or abnor-mal ABR with normal TEOAESs and/or cochlearmicrophonics (CM) [14].Authors’ details1Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentalee Neuroscienze Cliniche, (BioNeC), Sezione di Otorinolaringoiatria. Via delVespro, 129 – 90127 Palermo, Italy. 2Università degli Studi di Catania,Dipartimento di Specialità Medico-Chirurgiche, Clinica Otorinolaringoiatrica,Via Santa Sofia, 68, 95125 Catania, Italy. 3Università degli Studi di Palermo,* Correspondence: francesco.martines@unipa.it1Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentalee Neuroscienze Cliniche, (BioNeC), Sezione di Otorinolaringoiatria. Via delVespro, 129 – 90127 Palermo, ItalyFull list of author information is available at the end of the articleMartines et al. Italian Journal of Pediatrics 2014, 40(Suppl 1):A55http://www.ijponline.net/content/40/S1/A55 ITALIAN JOURNAL OF PEDIATRICS© 2014 Martines et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F.),Sezione di Audiologia. Via del Vespro, 129 – 90127 Palermo, Italy. 4AziendaOspedaliera ‘Ospedale Niguarda Cà Granda’ – U.O.C. Neonatologia e TerapiaIntensiva Neonatale. Piazza Ospedale Maggiore, 3 - 20162 Milano, Italy.Published: 11 August 2014References1. Ballacchino A, Mucia M, Cocuzza S, Ferrara S, Martines E, Salvago P, Sireci F,Martines F: Newborn hearing screening in Sicily: Lesson learned. ActaMedica Mediterranea 2013, 29:731-734.2. Martines F, Porrello M, Ferrara M, Martines M, Martines E: Newborn hearingscreening project using transient evoked otoacoustic emissions: WesternSicily experience. Int J Pediatr Otorhinolaryngol 2007, 71:107-112.3. Martines F, Bentivegna D, Ciprì S, Costantino C, Marchese D, Martines E: Onthe threshold of effective well infant nursery hearing screening inWestern Sicily. Int J Pediatr Otorhinolaryngol 2012, 76:423-427.4. Maggio M, Maggio O, Mucia M, Martines F, Carmuco A, Noto G, Puccio R:The scholastic integration process of the impaired child in the provinceof Palermo: a cognitive survey. Acta Medica Mediterranea 2006, 22:159-162.5. Maggio M, Martines F, Mucia M, Maggio O: A multifactorial pattern for theunderstanding of the psychological development of the child withimpaired hearing and its clinical-therapeutic implications. Acta MedicaMediterranea 2006, 22:41-44.6. Martines F, Martines E, Ballacchino A, Salvago P: Speech perceptionoutcomes after cochlear implantation in prelingually deaf infants: TheWestern Sicily experience. Int J Pediatr Otorhinolaryngol 2013, 77:707-713.7. Martines F, Salvago P, Bentivegna D, Bartolone A, Dispenza F, Martines E:Audiologic profile of infants at risk: Experience of a Western Sicilytertiary care centre. Int J Pediatr Otorhinolaryngol 2012, 76:1285-1291.8. Salvago P, Martines E, Martines F: Prevalence and risk factors forsensorineural hearing loss: Western Sicily overview. Eur ArchOtorhinolaryngol 2013, 270:3049-56.9. Martines F, Martines E, Mucia M, Sciacca V, Salvago P: Prelingualsensorineural hearing loss and infants at risk: Western Sicily report. Int JPediatr Otorhinolaryngol 2013, 77:513-518.10. American Academy of Pediatrics, Joint Committee on Infant Hearing: Year2007 position statement: principles and guidelines for early hearingdetection and intervention programs. Pediatrics 2007, 120:898-921.11. Bentivegna D, Salvago P, Agrifoglio M, Ballacchino A, Ferrara S, Mucia M,Sireci F, Martines F: The linkage between upper respiratory tractinfections and otitis media: evidence of the ‘united airways concept.Acta Medica Mediterranea 2012, 28:287-290.12. Bartolotta C, Salvago P, Cocuzza S, Fabiano C, Sammarco P, Martines F:Identification of D179H, a novel missense GJB2 mutation in a WesternSicily family. Eur Arch Otorhinolaryngol 2014, 271:1457-67.13. Martines F, Salvago P, Bartolotta C, Cocuzza S, Fabiano C, Ferrara S,La Mattina E, Mucia M, Sammarco P, Sireci F, Martines E: A genotype–phenotype correlation in Sicilian patients with GJB2 biallelic mutations.Eur Arch Otorhinolaryngol 2014, DOI 10.1007/s00405-014-2970-1.14. Martines F, Salvago P: Hyperbilirubinemia, Auditory Neuropathy andPrelingually Deafness: Evidence Linking. In Neonatal Care: New ResearchNovinka; Fabian Koubek & Junica Linser 2013, 79-97.doi:10.1186/1824-7288-40-S1-A55Cite this article as: Martines et al.: Essential of audiology: screening andpost-screening. Italian Journal of Pediatrics 2014 40(Suppl 1):A55.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submitMartines et al. Italian Journal of Pediatrics 2014, 40(Suppl 1):A55http://www.ijponline.net/content/40/S1/A55Page 2 of 2

Essential of audiology: screening and postscreening

Francesco Martines

Pietro Salvago

Salvatore Cocuzza

Eleonora La Mattina

Martinelli Stefano

Marianna Mucia

Enrico Martines

Crossref

Italian Journal of Pediatrics

Essential of audiology: screening and post-screening

Springer - Publisher Connector

MEETING ABSTRACT Open Access
Essential of audiology: screening and post-
screening
Francesco Martines1*, Pietro Salvago1, Salvatore Cocuzza2, Eleonora La Mattina3, Martinelli Stefano4,
Marianna Mucia3, Enrico Martines3
From 70th Congress of the Italian Society of Pediatrics, Joint National Meeting SIP, SICuPP, SITIP
Palermo, Italy. 11-14 June 2014
Newborn hearing screening is a type of screening test
for the early detection of hearing loss. It can recognize
with good accuracy newborns affected by hearing
impairment allowing an early diagnosis and intervention
and avoiding cognitive and linguistic deficits [1-6].
The incidence of bilateral sensorineural hearing loss
(SNHL) in Sicily is 2.35 cases per 1000 newborns; this
value increases to 2.95 if we consider also unilateral SNHL
[2,3] and to 10 cases per 1000 births among infants at risk
[7-9].
A correct newborn hearing screening programme is
based on different protocols depending on the presence/
absence of audiologic risk factors:
• Newborns without risk factors: [1-3]
Initial Hearing Screening (Step I): The initial
screening should be performed using Transient-
Evoked Otoacoustic Emissions (TEOAEs) in the birth
centers as close to discharge as possible, preferably 12
hours or more after birth. It is recommended that an
infant be referred for a re-screening (step 2) if s/he
does not pass the initial screening or results cannot be
obtained in one or both ears.
Re-screening (Step II): The re-screening should be
performed in a second level center using TEOAEs and
Automated Auditory Brainstem Response (AABR). If
an infant does not pass the re-screening or if results
cannot be obtained in one or both ears, s/he shall be
referred to the regional third level center for diagnostic
audiological evaluation.
• Newborns with risk factors (JCIH 2007) [7-10]
Initial Hearing Screening (Step I): The Initial Hear-
ing Screening should be performed in a second level
center using TEOAEs and AABR. If an infant does not
pass the initial screening or if results cannot be
obtained in one or both ears, s/he shall be referred to
the regional third level center for diagnostic audiologi-
cal evaluation.
Screening variables
Actually TEOAEs have a sensitivity of 100% and a specifi-
city of about 70-95%. A higher TEOAEs specificity value
depends on [1,2,11]:
• Timing of TEOAEs recording
• Trained and qualified personnel
• PASS/REFER criteria
Limitations of screening
Audiologic screening does not identify:
• Post-natal SNHL (prelingual or perilingual) ,
mainly related to genetic causes [12,13]
• ANSD (Auditory Neuropathy Spectrum Disorder):
the main risk factors associated to ANSD are severe
jaundice, prematurity, respiratory distress, ototoxic
drugs (used to treat neonatal infections), genetic muta-
tions (e.g. OTOF gene). The diagnosis of ANSD is
usually based on the combination of absent or abnor-
mal ABR with normal TEOAESs and/or cochlear
microphonics (CM) [14].
Authors’ details
1Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale
e Neuroscienze Cliniche, (BioNeC), Sezione di Otorinolaringoiatria. Via del
Vespro, 129 – 90127 Palermo, Italy. 2Università degli Studi di Catania,
Dipartimento di Specialità Medico-Chirurgiche, Clinica Otorinolaringoiatrica,
Via Santa Sofia, 68, 95125 Catania, Italy. 3Università degli Studi di Palermo,
* Correspondence: francesco.martines@unipa.it
1Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale
e Neuroscienze Cliniche, (BioNeC), Sezione di Otorinolaringoiatria. Via del
Vespro, 129 – 90127 Palermo, Italy
Full list of author information is available at the end of the article
Martines et al. Italian Journal of Pediatrics 2014, 40(Suppl 1):A55
http://www.ijponline.net/content/40/S1/A55
© 2014 Martines et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F.),
Sezione di Audiologia. Via del Vespro, 129 – 90127 Palermo, Italy. 4Azienda
Ospedaliera ‘Ospedale Niguarda Cà Granda’ – U.O.C. Neonatologia e Terapia
Intensiva Neonatale. Piazza Ospedale Maggiore, 3 - 20162 Milano, Italy.
Published: 11 August 2014
References
1. Ballacchino A, Mucia M, Cocuzza S, Ferrara S, Martines E, Salvago P, Sireci F,
Martines F: Newborn hearing screening in Sicily: Lesson learned. Acta
Medica Mediterranea 2013, 29:731-734.
2. Martines F, Porrello M, Ferrara M, Martines M, Martines E: Newborn hearing
screening project using transient evoked otoacoustic emissions: Western
Sicily experience. Int J Pediatr Otorhinolaryngol 2007, 71:107-112.
3. Martines F, Bentivegna D, Ciprì S, Costantino C, Marchese D, Martines E: On
the threshold of effective well infant nursery hearing screening in
Western Sicily. Int J Pediatr Otorhinolaryngol 2012, 76:423-427.
4. Maggio M, Maggio O, Mucia M, Martines F, Carmuco A, Noto G, Puccio R:
The scholastic integration process of the impaired child in the province
of Palermo: a cognitive survey. Acta Medica Mediterranea 2006, 22:159-162.
5. Maggio M, Martines F, Mucia M, Maggio O: A multifactorial pattern for the
understanding of the psychological development of the child with
impaired hearing and its clinical-therapeutic implications. Acta Medica
Mediterranea 2006, 22:41-44.
6. Martines F, Martines E, Ballacchino A, Salvago P: Speech perception
outcomes after cochlear implantation in prelingually deaf infants: The
Western Sicily experience. Int J Pediatr Otorhinolaryngol 2013, 77:707-713.
7. Martines F, Salvago P, Bentivegna D, Bartolone A, Dispenza F, Martines E:
Audiologic profile of infants at risk: Experience of a Western Sicily
tertiary care centre. Int J Pediatr Otorhinolaryngol 2012, 76:1285-1291.
8. Salvago P, Martines E, Martines F: Prevalence and risk factors for
sensorineural hearing loss: Western Sicily overview. Eur Arch
Otorhinolaryngol 2013, 270:3049-56.
9. Martines F, Martines E, Mucia M, Sciacca V, Salvago P: Prelingual
sensorineural hearing loss and infants at risk: Western Sicily report. Int J
Pediatr Otorhinolaryngol 2013, 77:513-518.
10. American Academy of Pediatrics, Joint Committee on Infant Hearing: Year
2007 position statement: principles and guidelines for early hearing
detection and intervention programs. Pediatrics 2007, 120:898-921.
11. Bentivegna D, Salvago P, Agrifoglio M, Ballacchino A, Ferrara S, Mucia M,
Sireci F, Martines F: The linkage between upper respiratory tract
infections and otitis media: evidence of the ‘united airways concept.
Acta Medica Mediterranea 2012, 28:287-290.
12. Bartolotta C, Salvago P, Cocuzza S, Fabiano C, Sammarco P, Martines F:
Identification of D179H, a novel missense GJB2 mutation in a Western
Sicily family. Eur Arch Otorhinolaryngol 2014, 271:1457-67.
13. Martines F, Salvago P, Bartolotta C, Cocuzza S, Fabiano C, Ferrara S,
La Mattina E, Mucia M, Sammarco P, Sireci F, Martines E: A genotype–
phenotype correlation in Sicilian patients with GJB2 biallelic mutations.
Eur Arch Otorhinolaryngol 2014, DOI 10.1007/s00405-014-2970-1.
14. Martines F, Salvago P: Hyperbilirubinemia, Auditory Neuropathy and
Prelingually Deafness: Evidence Linking. In Neonatal Care: New Research
Novinka; Fabian Koubek & Junica Linser 2013, 79-97.
doi:10.1186/1824-7288-40-S1-A55
Cite this article as: Martines et al.: Essential of audiology: screening and
post-screening. Italian Journal of Pediatrics 2014 40(Suppl 1):A55.
Submit your next manuscript to BioMed Central
and take full advantage of: 
• Convenient online submission
• Thorough peer review
• No space constraints or color figure charges
• Immediate publication on acceptance
• Inclusion in PubMed, CAS, Scopus and Google Scholar
• Research which is freely available for redistribution
Submit your manuscript at 
www.biomedcentral.com/submit
Martines et al. Italian Journal of Pediatrics 2014, 40(Suppl 1):A55
http://www.ijponline.net/content/40/S1/A55
Page 2 of 2


https://iris.unipa.it/retrieve/handle/10447/96186/124935/Essential%20of%20audiology_screening%20and%20post%20screening%202014%20Italian%20J%20Pediatrics.pdf

Essential of audiology: screening and postscreening

Abstract

Similar works

Full text

Available Versions

Archivio istituzionale della ricerca - Università di Palermo

Crossref

Springer - Publisher Connector

Springer - Publisher Connector