HEARING IMPAIRMENT IN INFANTS AFTER MENINGITIS - DETECTION BY TRANSIENT EVOKED OTOACOUSTIC EMISSIONS

Objective: To evaluate the feasibility and cost-effectiveness of using transient evoked otacoustic emissions (TEOEs) to assess hearing in in fants recovered from meningitis. Methods: Recordings of TEOEs and visu al reinforcement audiometry (VRA)were performed in a prospective study of 39 children aged 6 to 24 months recovering from a purulent meningi tis. Patients with no TEOEs, or whose VRA findings were abnormal, were also tested by impedance audiometry and recording of auditory brain-s tern responses (ABRs) after treatment of any secretory otitis media. C osts were compared with those of a previous protocol including VRA, im pedance audiometry, and ABR for al children. Results: A total of 29 ch ildren had TEOEs in both ears and normal VRA findings. Ten children la cked TEOEs in one or both ears; 9 of them had otitis media with effusi on. Further examination by PRA and ABR led to the diagnosis of bilater al sensorineural hearing loss in 2.6% (1/39) of patients and unilatera l sensorineural hearing loss ire 7.7% (3/39) of patients. Cost analysi s revealed that this protocol costs about half the previous one. Concl usion: Recording TEOEs appears to be a feasible and cost-effective hea ring screening test for infants recovered from meningitis. If TEOEs ar e absent, impedance audiometry, ABR recordings, and audiometric evalua tion techniques are needed to distinguish between conductive and senso rineural hearing loss and to assess hearing thresholds precisely.