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HEAD TO TOE EXAMINATION
OF NEWBORN
ENT ASPECTS
Prof.Dr.M.Bharathimohan

HEARING ASSESSMENT IN CHILDREN
Hearing assessment in children can be done by
1. Behavioral methods &
2. Physiological methods
Behavioral assessment includes
3. Behavioral observation audiometry (BOA) – 0 to 6months
4. Visual reinforcement audiometry (VRA) – 6 months to 2 ½ years
5. Conditioned play audiometry – 2 1/2 to 6 years
Physiological assessment includes
6. Otoacoustic emission (OAE)
7. Impedance audiometry
8. Auditory brain stem response (ABR)

Joint
Committee
on Infant
Hearing
2019
• Physiological screening should be completed
by 1month
• Audiological diagnosis by 2 months
• Enrollment in Early Intervention by 3 months
• States who meet 1-3-6 benchmark should
strive to meet 1-2-3 benchmark

SOUND
INTENSITY
INFANT
RESPONSES

Breathing and
Feeding
Abnormalities
in Newborn
• Choanal Atresia
• Cleft Lip and Palate

Bedside
diagnosis
•Neonatologist is the first
person to see baby
•5 FG tube passed in both
nostrils to confirm diagnosis
for patency

Cleft
Lip
• Birth defect which results in unilateral or bilateral opening in the
upper lip between the mouth and nose.
• Types : U/L - Microform, Incomplete and Complete
• Limited to lip- orbicularis oris +/- • A- nasal sill intact B- defect extends to nasal sill

Cleft
Palate
• Breach in continuity of palate or a furrow in the palatal vault. A
defect in the roof of mouth due to lack of tissue development.
• Types : Isolated submucous and soft palate, Incomplete cleft,
Complete Cleft.

• C- soft palate and hard palate upto alveolar Ridge.
• D- complete soft and hard palate with fusion of septum to left maxillary
ridge.
Cleft
palate

Problems
Associated
• Airway Obstruction
• Sleep disturbances
• Failure to Thrive - swallowing
problems, regurgitation,
aspiration, LRTIs, pneumonia
• SAM - reduced feeding
• Hearing Loss - OME / ET
dysfunction

Timeline of
Surgical
Intervention

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HEAD TO TOE EXAMINATION OF NEWBORNS.pptx

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