Medical Referral Patterns and Etiologies for Children With Mild-to-Severe Hearing Loss

Paul D Judge; Erik Jorgensen; Monica Lopez-Vazquez; Patricia Roush; Thomas A Page; Mary Pat Moeller; J Bruce Tomblin; Lenore Holte; Craig Buchman

doi:10.1097/AUD.0000000000000682

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Medical Referral Patterns and Etiologies for Children With Mild-to-Severe Hearing Loss

Journal article

Open access

Peer reviewed

Medical Referral Patterns and Etiologies for Children With Mild-to-Severe Hearing Loss

Paul D Judge, Erik Jorgensen, Monica Lopez-Vazquez, Patricia Roush, Thomas A Page, Mary Pat Moeller, J Bruce Tomblin, Lenore Holte and Craig Buchman

Ear and hearing, Vol.40(4), pp.1001-1008

07/2019

DOI: 10.1097/AUD.0000000000000682

PMCID: PMC6551312

PMID: 30531261

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https://www.ncbi.nlm.nih.gov/pmc/articles/6551312View

Open Access

Abstract

To (1) identify the etiologies and risk factors of the patient cohort and determine the degree to which they reflected the incidence for children with hearing loss and (2) quantify practice management patterns in three catchment areas of the United States with available centers of excellence in pediatric hearing loss. Medical information for 307 children with bilateral, mild-to-severe hearing loss was examined retrospectively. Children were participants in the Outcomes of Children with Hearing Loss (OCHL) study, a 5-year longitudinal study that recruited subjects at three different sites. Children aged 6 months to 7 years at time of OCHL enrollment were participants in this study. Children with cochlear implants, children with severe or profound hearing loss, and children with significant cognitive or motor delays were excluded from the OCHL study and, by extension, from this analysis. Medical information was gathered using medical records and participant intake forms, the latter reflecting a caregiver's report. A comparison group included 134 children with normal hearing. A Chi-square test on two-way tables was used to assess for differences in referral patterns by site for the children who are hard of hearing (CHH). Linear regression was performed on gestational age and birth weight as continuous variables. Risk factors were assessed using t tests. The alpha value was set at p < 0.05. Neonatal intensive care unit stay, mechanical ventilation, oxygen requirement, aminoglycoside exposure, and family history were correlated with hearing loss. For this study cohort, congenital cytomegalovirus, strep positivity, bacterial meningitis, extracorporeal membrane oxygenation, and loop diuretic exposure were not associated with hearing loss. Less than 50% of children underwent imaging, although 34.2% of those scanned had abnormalities identified. No single imaging modality was preferred. Differences in referral rates were apparent for neurology, radiology, genetics, and ophthalmology. The OCHL cohort reflects known etiologies of CHH. Despite available guidelines, centers of excellence, and high-yield rates for imaging, the medical workup for children with hearing loss remains inconsistently implemented and widely variable. There remains limited awareness as to what constitutes appropriate medical assessment for CHH.

Medical History Taking

United States - epidemiology

Humans

Child, Preschool

Hospitalization - statistics & numerical data

Infant

Male

Catchment Area, Health

Case-Control Studies

Intensive Care Units, Neonatal

Female

Retrospective Studies

Ophthalmology

Child

Severity of Illness Index

Oxygen Inhalation Therapy - statistics & numerical data

Risk Factors

Neurology

Genetics, Medical

Hearing Loss, Bilateral - etiology

Radiology

Respiration, Artificial - statistics & numerical data

Referral and Consultation

Hearing Loss, Bilateral - epidemiology

Aminoglycosides - therapeutic use

Details

Title: Subtitle: Medical Referral Patterns and Etiologies for Children With Mild-to-Severe Hearing Loss
Creators: Paul D Judge - Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA
Erik Jorgensen - Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
Monica Lopez-Vazquez - Department of Otolaryngology-Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Patricia Roush - Department of Otolaryngology-Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Thomas A Page - Department of Allied Health Sciences, University of North Carolina, Chapel Hill, North Carolina, USA
Mary Pat Moeller - Center for Childhood Deafness, Boys Town National Research Hospital, Omaha, Nebraska, USA
J Bruce Tomblin - Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
Lenore Holte - Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
Craig Buchman - Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
Resource Type: Journal article
Publication Details: Ear and hearing, Vol.40(4), pp.1001-1008
DOI: 10.1097/AUD.0000000000000682
PMID: 30531261
PMCID: PMC6551312
NLM abbreviation: Ear Hear
ISSN: 0196-0202
eISSN: 1538-4667
Publisher: United States
Grant note: R01 DC009560 / NIDCD NIH HHS
Language: English
Date published: 07/2019
Academic Unit: Communication Sciences and Disorders; Iowa Neuroscience Institute
Record Identifier: 9984070289202771

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