Epidemiology of unilateral sensorineural hearing loss with universal newborn hearing screening.

OBJECTIVES/HYPOTHESIS Compare the epidemiology of pediatric unilateral sensorineural hearing loss before and after implementation of universal newborn hearing screening in Missouri. STUDY DESIGN Inception cohort. METHODS Charts of 134 children born between January 1, 1990 and December 31, 2007, diagnosed with unilateral sensorineural hearing loss at a single institution in Missouri were reviewed to determine the effects of universal newborn hearing screening on age of detection and etiology of hearing loss. RESULTS Mean age of detection declined from 4.4 (standard deviation [SD] 1.8) to 2.6 (SD 2.6) years of age, whereas the rate of detection by 6 months of age increased from 3% to 42%. The majority (58%) of cases had normal hearing at birth. The most common etiological category was unknown (41%) before screening and congenital (45%) after screening. The use of magnetic resonance imaging has increased by 21% (2-fold), whereas use of computed tomography has declined by 8% since 2002. Yields of connexin, Pendred, electrocardiogram, and syphilis testing were 0/48 and 2/31 before and after screening, respectively. CONCLUSIONS Implementation of universal newborn hearing screening in Missouri is associated with a decrease in age of detection of unilateral sensorineural hearing loss. The majority of cases are either not present or not detectable at birth. The combination of hearing status at birth and imaging findings suggests that the majority of cases are congenital rather than of unknown etiology.