• Clinical and Experimental Pediatrics
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• 제50권1호
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• pp.7-13
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• 2007

Hearing loss in newborns is the most frequently occurring birth defect. If hearing impaired children are not identified and managed early, it is difficult for many of them to acquire the fundamental language, social and cognitive skills that provide the foundation for later schooling and success in society. All newborns, both high and low risk, should be screened for hearing loss in the birth hospital prior discharge (Universal Newborn Heaing Screening, UNHS). Objective physiologic measures must be used to detect newborns and very young infants with hearing loss. Recent technological developments have produced screening methods and both evoked otoacoustic emission (EOAE) and auditory brainstem response (ABR) have been successfully implemented for UNHS. Audiologic evaluation should be carried out before 3 months of age and infants with confirmed hearing loss should receive intervention before 6 months of age. All infants who pass newborn hearing screening but who have risk indicators for other auditory disorders and/or speech and language delay receive ongoing audiologic surveillance and monitoring for communication development. Infants with sensorineural hearing loss are managed with hearing aids and receive auditory and speech-language rehabilitation therapies. Cochlear implants can be an outstanding option for certain children aged 12 months and older with severe to profound hearing loss who show limited benefit from conventional amplifications.

• 재활복지공학회논문지
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• 제10권1호
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• pp.1-7
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• 2016

본 연구는 경산지역 남녀 고등학생을 대상으로 하고, 재검대상자 비율을 통해 청각 선별의 필요성을 고찰하고자 한다. 연구 대상은 여자 고등학생 359명, 남자 고등학생 205명 등 모두 564명으로 하였다. 청각선별은 고막운동성계측(tympanometry)과 자동화 이음향방사(automated otoacoustic emission; AOAE)를 이용하였다. 재검대상자 중 위양성 소견을 보인 여학생 8명(2.228%) 11귀와 남학생 9명(4.39%) 10귀를 제외하면 최종 재검대상자는 여학생이 9명(2.5%), 남학생이 19명(9.268%)으로 각각 관찰되었다. 고막운동도와 AOAE는 남녀 사이 차이가 나타나지 않았다. 결론적으로 청소년 청각선별은 이관 성장 발달에도 불구하고 순음청 각선별로 확인하기 어려운 난청을 선별하기 위하여 고막운동성계측을 시행할 필요가 있고, 위양성 결과를 낮추기 위한 노력이 필요하다.

• 재활복지공학회논문지
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• 제11권1호
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• pp.73-79
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• 2017

언어 습득 이후 성인 난청은 진행 속도가 느려서 발견이 어렵다. 이들은 적절한 도구를 제공하면 자발적이고 적극적인 평가가 가능하다. 스마트 폰도 도구들 중 하나이며, 설문이나 애플리케이션을 이용하여 효과적인 평가가 가능하다. 이 연구에서는 순음청각선별(pure tone screening, PTS)을 위한 스마트 폰 앱을 개발 후 이의 효과성을 검증하기 위해, 난청자각 설문조사방법(hearing handciap inventory, HHI)을 동시에 진행한 후 결과를 비교하여 진행 속도가 느린 지연성 후천성 난청 발견을 위한 도구로서 가능성을 확인하고자 한다. 대상은 10대부터 80대 사이 남녀 22명으로 하였다. 가청역치 평균(PTAs)은 두 귀 같은 주파수 가청역치 중 좋은 것을 선택(최량청력, best hearing)하였다. HHI의 민감도와 특이도는 난청 자각 여부나 PTAs_4 kHz를 기준으로 하였다. 두 검사 간 비교는 App_PTS의 PTAs와 HHI 점수 사이의 상관관계를 단순회귀 분석하였다. 민감도와 특이도는 두 기준 모두에서 1.000으로 관찰되었다. 최량청력 PTAs_4 kHz와 HHI 사이에는 통계적으로 유의한 관계를 보였다(R-square= 0.951, p= .000). 설문을 이용한 청각선별은 정량적 계측을 통해 구현한 스마트 폰 애플리케이션 기반 청각선별과 높은 상관관계를 보였다. 따라서 app_PTS는 개인 친화적 도구로 생애 주기별 청각선별에 유용하게 사용할 수 있을 것이다.

• Clinical and Experimental Pediatrics
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• 제60권11호
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• pp.353-358
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• 2017

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

• 말소리와 음성과학
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• 제1권2호
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• pp.51-59
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• 2009

This study was designed to investigate the effects of neonatal hearing screening program (NHSP) information on parental satisfaction with the Parent Satisfaction Questionnaire with Neonatal Hearing Screening Program (PSQ-NHSP) by Mazlan et al. (2006). The PSQ-NHSP consisted of four aspects including: information, personnel in charge of the hearing test, appointment activity, and overall satisfaction in the neonatal hearing screening program. A total of 106 parents (50 in the experimental group and 56 in the control group) participated in this study in one general hospital and two delivery clinics. The fifty parents in the experimental group received information and counseling with educational materials before filling out the PSQ-NHSP, but the fifty-six parents in the control group did not receive any counseling or education materials before completing the PSQ-NHSP. The PSQ-NHSP demonstrated excellent internal consistency reliability (${\sigma}=0.914$). The results of the study were as follows. First, the overall satisfaction ($3.77{\pm}0.81$) and personnel in charge of hearing test ($3.52{\pm}0.79$) aspects showed higher rates of satisfaction than the appointment activity aspect ($3.51{\pm}0.80$) for total subjects. Second, the overall parental satisfaction rate of the experimental group ($4.15{\pm}0.50$) was significantly higher than that of the control group ($3.09{\pm}0.53$) in all items. Lastly, thirty-two participants (30%) made at least one comment in response to the open-set items. A total of 29 comments were related to satisfaction with participating in the NHSP and II comments were related to dissatisfaction. In conclusion, to improve parental satisfaction it is important to provide parents with education and information about the NHSP before the test. In addition, PSQ-NHSP was found to be a useful instrument for identifying the benefits and shortfalls of the NHSP.

• 재활복지공학회논문지
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• 제10권4호
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• pp.273-278
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• 2016

청각선별에서 반응 역치는 검사 환경 잡음, 청각기관 생리적 특성, 과도한 음원 노출 등에 따라 다르게 나타난다. 이 연구 목적은 청각선별을 통과한 소아의 주파수별 가청역치에 대한 정보를 획득하는데 있다. 연구 대상은 언어치료센터와 지역아동센터에 다니는 3.3세부터 16.3세($9.01{\pm}2.52$) 사이의 110명으로 하였고, 이들의 소아 청각 선별 결과를 후향적으로 분석하였다. 청각선별은 고막운동성계측(Tympanometry), 등골근반사(acoustic reflex threshold), 자동화 이음향방사(automated otoacoustic emission), 순음청각선별(pure tone screening)을 시행하였다. 대상자들은 모두 청각선별 정상 기준에 포함되었다. 주파수별 가청역치 차이는 반복측정 분산분석 하였다. 결과: 가청역치 평균은 500, 1,000, 2,000, 4,000 Hz의 순서로 우측 귀 $16{\pm}6.49$, $11.5{\pm}4.79$, $6.86{\pm}4.99$, $5.95{\pm}6.65$ dB HL, 좌측 귀 $15.68{\pm}6.01$, $9.95{\pm}5.24$, $5.72{\pm}5.21$, $5.63{\pm}7.04$ dB HL로 각각 관찰되었다. 주파수 사이에는 500Hz와 1,000, 2,000, 4,000 Hz(p=.000), 1,000과 2,000, 4,000 Hz(p=.000)로 유의한 차이가 있었다.

• Clinical and Experimental Pediatrics
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• 제49권10호
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• pp.1056-1060
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• 2006

목 적 : 청각 장애는 정상 신생아 출생 1,000명 당 2-7명의 높은 발병률을 보이는 것으로 알려져 있으나, 임상적으로 조기발견이 어려워 평균 2-2.5세에 발견된다. 청각은 언어 및 인지발달에 중요한 영향을 미치므로 청각 장애의 조기 발견을 위한 신생아 청력 선별검사의 중요성이 강조되고 있다. 이에 연구자들은 정상 신생아를 대상으로 시행한 선별검사의 결과를 분석하여 신생아에서의 청각 장애의 빈도를 파악하고, 선별검사의 효용성을 알아보고자 하였다. 방 법 : 2004년 7월부터 2005년 6월까지 성균관대학교 의과대학 삼성제일병원 신생아실에서 출생한 신생아 8,664명중 보호자의 신청에 의해 신생아 청력 선별검사를 시행한 정상 신생아 7,171명과 위험인자를 가진 47명 등 총 7,218명을 대상으로 하였다. 신생아 청력 선별검사는 $ALGO^{(3)}$ Newborn hearing screener를 이용하여 35 dB의 청각 자극에 대한 AABR을 시행하였다. 출생 2일째 1차 검사를 시행하였고, 1차 검사에서 통과하지 못한 경우 신생아실 퇴원 전 2차 검사를 시행하였으며 2차 검사에서 통과하지 못한 경우 생후 1개월에 삼성서울병원 이비인후과에서 추적검사를 시행하며 이후 추적관찰을 시행하였다. 결 과 : 선별검사를 받은 총 7,218명 중 7,163명이 정상 판정을 받았으며, 55명이 선별검사에서 재검 판정을 받아 재검율 0.8%이었다. 재검 판정자 중 생후 1개월에 추적 검사를 받지 않은 6명을 제외한 49명 중 정상으로 판정된 경우는 35명(71.4%)이었고, 청각 장애로 진단된 경우는 14명(28.6%)이었다. 추적검사에서 소실된 6명을 고려할 때 청각장애의 발생 빈도는 7,218명 중 14-20명이므로 1,000명 출생 당 1.9-2.8명으로 추정된다. 청각장애 14명 중 남:여 비율은 3.6:1이었으며 좌측이 장애인 경우가 64.3%로 우측(21.4%) 및 양측(14.3%)보다 높게 나타났다. 미숙아 등 위험 요인이 있는 47명 중 청각 장애인 경우는 8명(17.0%)으로 정상 신생아 7,171명에서의 발생 빈도(6명, 0.1%)보다 높았다. 청각 장애 14명 중 3명은 보청기로 치료를 시작하였으며, 나머지는 추적관찰 중에 있다. 결 론 : 신생아에서의 청각 장애의 비율은 신생아 1,000명당 1.9-2.8명으로 다른 연구자들의 연구와 비슷한 빈도를 나타내었다. 신생아에 대한 AABR은 신생아실에서 신속하게 시행할 수 있는 비침습적인 선별 검사이며, 보청기 등 조기치료를 가능하게 하는 유용한 검사로 판단된다.

• Journal of Audiology & Otology
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• 제24권1호
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• pp.40-47
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• 2020

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

• 대한청각학회지
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• 제24권1호
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• pp.40-47
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• 2020

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

• 농촌의학ㆍ지역보건
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• 제43권3호
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• pp.172-179
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• 2018

Objectives: To review the status of newborn hearing screening (NHS) and to investigate the effect of the examiners on NHS tests to help the quality control of NHS at a general hospital in a city. Methods: The charts of newborns from January 2015 to March 2016 and from August 2016 to October 2017 were retrospectively reviewed. We compared the results of tests performed by several examiners(group 1) with those performed by one audiologist (group 2) using the same automated auditory brainstem response test. Results: The screening rate and referral rate were not significantly different between group 1 and group 2. The confirmatory test rate was higher in the group 2, but it was not significant. In group 1, the number of tests performed 3 or more times in one ear at one time was significantly higher. The number of tests performed in only one ear at one time was higher in group 2. The screening rate within one month after birth was 64.21%, referral rate was 7.32%, confirmatory test rate within 3 months after birth was 21.74%, and the prevalence of hearing loss was 1.46%. Conclusions: There was no significant difference of results depending on the examiners. In order to make proper screening test, it is necessary to periodically educate the examiner and to instruct the examiner by the supervisor doctors.