High prevalence of sensorineural hearing loss among survivors of neonatal congenital diaphragmatic hernia

Objective: This study aimed to determine the prevalence of sensorineural he aring loss (SNHL) in 2-5-year-old survivors with neonatal respiratory failu re due to congenital diaphragmatic hernia (CDH) with or without the need fo r extracorporeal membrane oxygenation (ECMO). Study Design: The study design was a prospective, multicenter, longitudinal outcome study of consecutively surviving neonates admitted to a single ter tiary intensive care unit. Setting: The study was conducted at four audiologic departments affiliated with tertiary-level intensive care follow-up programs. Patients: Thirty-seven surviving children receiving neonatal intensive care from February 1989 through January 1995 for neonatal respiratory failure d ue to CDH were studied. Excluded were 15 children with early death and 1 ch ild lost to follow-up. Intervention: The initial treatment depended on the severity of neonatal re spiratory failure: ECMO-treated (n = 31,20 survivors) (death before ECMO in itiation, 2) and non-ECMO treated (n = 20, 17 survivors, another survivor l ost to follow-up). Main Outcome Measure: Early childhood audiologic test results were measured . Results: Sensorineural hearing loss was found in almost 60% of subjects: EC MO-treated, 12 (60%) of 20; non-ECMO-treated, 10 (59%) of 17. Of the 22 chi ldren with SNHL, 16 had mild- to-moderate low-frequency sloping to moderate -to-severe high-frequency loss. Of the remaining, six had severe-to-profoun d loss at 500 Hz and above. Seventeen children had normal responses to soun d as newborns or in infancy. Five children were not tested. Documented prog ression was found in nine children. Twenty children currently are using amp lification, and 2 have had cochlear implantation. Conclusions: Or children with CDH in this area presenting early with severe neonatal respiratory failure, SNHL developed in 60% by 2-5 years of lift. Ongoing monitoring of the hearing status of children with CDH is imperative .