The Mayo Clinic Health System in Albert Lea recently received new electrophysiology equipment, called Eclipse. The clinic received the equipment in April with help from the Naeve Health Care Foundation.
“It’s a piece that allows us to test hearing in infants and children,” said Jill Gruenwald, clinical lead in audiology at Mayo Clinic.
The decision was made after the Joint Committee on Infant Hearing recommended that all infants undergo hearing screening no later than 1 month. Before getting the equipment the first Gruenwald could see patients was when they were 2 or 3 years old.
She said newborn hearing screening was universal and she wanted it for all babies.
“If you don’t pass your hearing screening, … you should have a full hearing test at 3 months of age, and if we can confirm permanent hearing loss on that full hearing test, they recommend intervention for the hearing loss. no later than 6 months of age,” Gruenwald said.
According to Gruenwald, this course of action was called the 1-3-6 plan.
“We hope this will lead to earlier diagnosis of hearing loss in Albert Lea’s children,” Gruenwald said.
And because babies can’t take a traditional hearing test, doctors can now put sticky pads on a baby’s face and behind their ear, with an earphone inserted into the ear that emits sounds.
“These stickers allow us to pick up the response of the nerve to the sound we play,” she said. “Since we can pick up on the response of the nerve, we can kind of estimate what hearing might be like.”
Dana McCray is the Mayo Healthcare System Audiologist at Albert Lea.
“It’s a way to measure hearing sensitivity without the traditional in-cab tests where you press the button and hear a beep,” she said. “There are electrodes placed on the skin, on the forehead, behind the ears, and there are insert earphones, little spongy earphones, which are placed in the ear canal.”
Different types of stimuli, whether clicks, tones or chirps, are sent to the headphones.
“The auditory system basically produces five brain waves that we measure through these electrodes, and we’re looking for those specific five waves to fall in a particular amount of time,” she said.
And the Eclipse will allow McCray to measure these waveforms and determine hearing status at different auditory frequencies. And if waves are missing or reduced, hearing loss may be suspected.
She said from her experience that 50-60% of children who get re-screened do well.
“The reason a baby fails, more often than not, is that there’s fluid in the ear canal, it’s called vernix,” she said. “It’s part of the birth fluid, and it just gets into the baby’s ears and although nurses and staff try to clear the ear canals for testing, sometimes it takes a little extra effort,” she said. declared. “If there’s vernix in the ear canal, we might get a failing result.”
McCray also uses it to measure hearing in infants and young children. The test is called an auditory brainstem response, which helps predict what a traditional audiogram would look like.
“We use it as a predictor for possible hearing aid or other medical purposes,” she said.
And that would be when the Eclipse equipment would be used, usually when a baby is sleeping.
“I have a recliner in my office that mom will sit in, or dad, holding the baby,” she said. “We want to try to get as many results as possible with natural sleep.”
And if the baby is fussy, McCray will perform a sedated ABR test, where the child will be placed under light anesthesia.
If the results are normal, parents and a pediatrician are notified. But if hearing loss is detected, they will be examined by an otolaryngologist who may or may not order further tests.
“We want to make sure they’re medically cleared before we put hearing aids or any other necessary treatment…on a child who has a hearing loss,” she said.
The Eclipse device is used in comprehensive testing, and if permanent hearing loss is confirmed, intervention will begin when a child is six months old at the latest.
Gruenwald also stressed the importance of early intervention for children who have hearing loss, and said the earlier the intervention, the better their outcomes for speech learning, language learning and hearing family and friends.
Gruenwald said a baby’s first hearing test usually happens before the child even comes out. And babies who don’t pass are referred to specialists, who will attempt the same screening themselves. And if they don’t pass, they’ll use the Eclipse.
“We try to bring a baby in at a time of day when they’re sleepier because we like babies to sleep during the test or be as quiet as possible,” she said. “…The parent or caregiver will hold the baby in a recliner.”
Stickers will then be placed on the baby’s face and neck, and a clicking earpiece will go into the ear.
The duration of the test depends on the baby’s mood, and Gruenwald said if a baby arrives already tired, the test can be completed in 20 to 30 minutes.
“But if the baby is fussy, crying, or fidgety, we schedule the appointment in a two-hour slot just so there’s enough time to let the babies settle in if they’re upset,” a- she declared. “Sometimes they’re restless and playful, and sometimes we just have to wear them down a bit until they’re a bit calmer.”
Gruenwald said that by getting this new equipment, former (usually younger) patients who were routed to Austin or Mankato can stay closer to home.
“We are investing heavily in [ears, nose and throat] and audiology at Albert Lea so that this community doesn’t have to travel so far to get the care they need,” Gruenwald said.
McCray had similar feelings.
“As an audiologist and as a physician, I’m really grateful to have the equipment,” McCray said. “It really opens up a lot of clinical opportunities to just expand the service and do a lot of different things audiologically for the community, whether you’re an infant or an adult.
According to McCray, two out of every 1,000 children in America have some type of measurable hearing loss.