Abstract
Newborns and young children with serious medical problems pose a challenge to the
success of universal newborn hearing screening. The need for ototoxic medications
to rescue the critically ill child increases the risk for hearing loss that is already
high due to the underlying disease. Congenital cytomegalovirus infection, aggressive
life support including extracorporeal membrane oxygenation, and platinum-based chemotherapy
to treat childhood cancer are cause to closely monitor hearing once health care attention
turns from rescue to recovery. Algorithms for surveillance for hearing loss help reduce
the time delay between the adventitious onset of hearing loss and the diagnosis and
intervention. Understanding the relative risk for hearing loss for the individual
child can help clinicians counsel families regarding the anticipated need for audiologic
intervention. Assuring adequate hearing habilitation includes objective verification
of audiologic interventions, as this young and ill patient population often cannot
communicate the appropriateness of hearing aid settings. The use of FM systems is
quite often necessary given the steeply sloping configuration of ototoxic hearing
loss, and candidacy for cochlear implant may be complicated, but certainly not contraindicated,
in children with complex medical histories.
Keywords
CMV - ECMO - aminoglycosides - chemotherapy - ototoxicity - UNHS
