Etiological diagnosis in the hearing impaired newborn: Proposal of a flow chart

Objective: Most industrialized countries have introduced some form of universal newborn hearing screening program. Both identification and rehabilitation of hearing loss in newborns have evolved to an acceptable standard and the need for a standardized etiological protocol is emerging. Methods: Extensive literature search to determine which investigations can help identifying the cause of congenital hearing loss and how to limit extensive testing in these children by taking into account the most prevalent causes. Findings: A stepwise approach to detect the cause of hearing loss in children with congenital sensorineural hearing loss was developed. Conclusion: In general it is advised to first rule out Cx26/Cx30 and infectious causes (cytomegalovirus and, if indicated, toxoplasmosis and rubella), and to preserve more extensive investigations for those children in whom these causes do not explain the hearing loss. (C) 2010 Elsevier Ireland Ltd. All rights reserved.