Children with sensorineural hearing loss after passing the newborn hearing screen.

Objectives: To identify and describe the findings of children who passed their newborn hearing screen (NHS) and were subsequently found to have childhood hearing loss.
Setting: Academic tertiary care center.
Design: Retrospective medical chart review.
Methods: With approval of the institutional review board, hospital records were reviewed for children diagnosed as having hearing loss. We identified 923 children with hearing loss from 2001 to 2011. Patients who passed the NHS with subsequent hearing loss were included.
Results: Seventy-eight patients were included in our study. The suspicion of hearing loss in patients who passed the NHS was most often from parental concerns (n = 28 [36%]) and failed school hearing screens (n = 25 [32%]). Speech and language delay and failed primary care physician screens accounted for 17% and 12%, respectively. Configuration of the audiogram was bilateral symmetric (n = 42 [54%]), bilateral asymmetric (n = 16 [21%]), and unilateral (n = 20 [26%]) loss. Thirty-seven patients (47%) had severe or profound hearing loss. The etiology was unknown in 42 patients (54%); the remaining was attributed to genetics (n = 13 [17%]), anatomic abnormality (n = 11 [14%]), acquired perinatal (n = 9 [12%]), and auditory neuropathy (n = 3 [4%]).
Conclusions: This is the largest study to characterize children with hearing loss who passed the NHS. In our review, parental concerns and school hearing screens were the most common method to diagnose hearing loss after passing the NHS. Families and primary care physicians may have a false sense of security when patients pass the NHS and overlook symptoms of hearing loss. This study raises the question whether further screens would identify hearing loss in children after passing the NHS.