Author(s)
Natalie Quinn, BS
Olivia Chan, BS
Holly Gerth, AuD
Isaac Kistler, MS
Ursula Findlen, PhD
Tendy Chiang, MD
Affiliation(s)
Ohio State University College of Medicine
Abstract:
Educational Objective: After this presentation, participants should be able to provide improved anticipatory guidance to parents of children with bronchopulmonary dysplasia (BPD) regarding middle ear involvement and expected hearing status regardless of newborn hearing screening outcome.
Objectives: To assess the prevalence of middle ear involvement and hearing status among children with bronchopulmonary dysplasia (BPD).
Study Design: Single-institution, retrospective cohort study.
Methods: Patients aged 0-8 years admitted to our tertiary care center NICU, from 2017-2022, diagnosed with BPD were retrospectively reviewed. Patients were grouped by Jensen Grade BPD classifications: Grade I (less than or equal to 2L nasal cannula), Grade II (greater than 2L nasal cannula, CPAP, or BiPAP), and Grade III (invasive ventilation). Outcome variables included newborn hearing screening, audiology testing, presence of middle ear pathology, and time to tympanostomy tube placement. Descriptive statistics and Fisher’s exact test assessed differences.
Results: Of 1,077 records, 933 met inclusion criteria and were predominately male gender distribution, median gestational age of 27 weeks (IQR 25–29), and birth weight of 855 g (670–1,145 g). The cohort included 264 Grade I patients (28%), 512 Grade II (55%), and 157 Grade III (17%). NBHS results varied by Grade (P < 0.001), with Grade III observed to have higher rates of NBHS failure or deferral for diagnostic audiology, as did subsequent diagnostic results (P < 0.001), with Grade III observed to have more frequent sensorineural or mixed hearing loss. Chronic middle ear pathology was observed in 29% of Grade I, 25% of Grade II, and 28% of Grade III; for which surgical management was performed in 19%, 16%, and 23%, respectively. Time to ear tube placement from 36 weeks’ gestational age was longer in Grade I patients (23 weeks) compared to Grades II and III (both 19 weeks).
Conclusion: Among 933 infants with BPD, those classified as Grade III had higher rates of NBHS deferral or failure and more frequently presented with sensorineural or mixed hearing loss upon diagnostic evaluation. While the prevalence of middle ear pathology and surgical intervention was similar across grades, infants with Grade I experienced a longer time to ear tube placement compared to Grades II and III.