Until 1990 a hearing screening program had never been implemented in Greece. In 1991 the first one was designed and put into practice by the E.N.T. department of Children's Hospital "P. & A. Kyriakou", in Athens. It was based on high-risk criteria, that means only newborns at risk for hearing loss were screened. At the beginning, this program included high risk neonates from the NICU of our hospital, but one year later the high risk population of a state maternity clinic was added in the program, as well. During the first two years (1991 and 1992) conventional auditory brainstem responses (ABR) had been employed.

      Since 1993 -when our department was provided with an otoacoustic emission instrument (ILO88, running software v3.92, Otodynamics, UK)- the neonates have been examined by both auditory brainstem responses and click-evoked otoacoustic emissions (TEOAEs) in order to evaluate the reliability of OAE recordings. Today, it is our institution's policy to screen neonatal population with TEOAEs and ABR because of the small but real risk of pure retrocochlear lesions found in this population. In the mean time, our Department was accepted as a full member in AHEAD, organizing conferences and participating in a number of scientific meetings. Many studies concerning the use of otoacoustic emissions have also been published in Greek and European medical press.

      During the past five years, several Maternity Clinics and E.N.T. departments have also developed similar screening programs. Today, a hearing screening program has already been implemented in the following centers:

1. E.N.T. and N.I.C.U. Department, Children's Hospital of Athens "P. & A. Kyriakou" (targeted neonatal hearing screening)

2. N.I.C.U. of "Elena's" State Maternity Clinic, Athens (targeted screening)

3. E.N.T. Department, University of Thessaloniki (targeted screening)

4. E.N.T. Department, University of Ioannina (targeted screening)

5. "Iaso" Maternity Clinic of Athens (universal screening)

6. "Mitera" Maternity Clinic of Athens (targeted or selective screening)

7. E.N.T. Department, Children's Hospital of Athens "Ag. Sofia" (targeted screening)

      Most of these centers evaluate hearing status using mainly TEOAEs. However, a truly universal screening is employed only at one maternity clinic ("Iaso", method used TEOAEs) the rest of the hospitals performing a targeted or selective screening. More than 30,000 neonates have been screened in our country so far, and most of them were examined during the last two years. Nevertheless, all these efforts still remain of limited extent and include a relative small amount of live births.

      On the other hand, recent bibliography clearly states that the whole neonatal population should be screened for hearing impairment. This was the reason that prompted us to design a nation-wide hearing screening program, which should include the whole neonatal population (both NICU and well-baby nursery neonates). The E.N.T. Department of Children's Hospital "P. & A. Kyriakou" has already proposed to the Greek ministry of Health a one-year pilot screening program with the participation of four maternity clinics, NICU and E.N.T. departments, in Athens and Thessaloniki. The instrumentation chosen for this purpose was "Echocheck" by Otodynamics, since it has been previously clinically tested with success in our Department. The units needed have already been bought (partly financed by private businessmen) and sent to the hospitals. The results of the pilot program will be used in order to organize and implement a universal hearing screening program throughout our country, as soon as possible. One of the targets of this program is to adjust the cost of the TEOAEs test, which nowadays varies arbitrarily from 20 to 60 EURO.

      The status of neonatal hearing screening in Greece is continuously changing, since the staff of many hospitals become better informed about the advantages of early identification of hearing impairment. Additional private maternity units and state hospitals show their strong interest in participating in a nation-wide project.

      We hope that the situation will soon change for the better and I will be glad to present any progress in this field in the near future.

Date of the Report : February 2002
Contact: Ioannis Psarommatis , MD, Ph.d
Address: CHILDREN'S HOSPITAL OF ATHENS "P. & A. KYRIAKOU" E.N.T. Department, Thivon & Livadias St. 115 27, Goudi, Athens, Greece.
FAX: 0030107790072
Email:  ipsarommatis@hotmail.com