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The Klippel-Feil syndrome is a congenital anatomical defect which occurs due to the failure of fusion of two or more cervical vertebrae at the neck region. Features include a short neck, low hairline at the back of the head, and restricted movement of the upper spine. This case study includes audiological test battery of a 3 years old with Klippel-Feil syndrome with features of hearing impairment, severely dysplastic internal acoustic meatus [IAM] along with delayed speech and language development. A detailed audiological evaluation was done and the management options were been further discussed. Key words: Klippel-Feil syndrome, hearing loss, CI, ABI.

Purpose The current study aimed to compare the specificity of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in isolation and in combination, with varying pass/refer criteria for DPOAE technology. Method A longitudinal, repeated-measures design was employed. The current study sample comprised 91 of the initial 325 participants who returned for the repeat screening and diagnostic audiological assessment within a risk-based newborn hearing screening program. Results TEOAE screening had the highest specificity in comparison to DPOAE screening at the initial and repeat screening, irrespective of differences in DPOAE pass/refer criteria. DPOAE screening had a slightly higher specificity, with a three out of six rather than the four out of six frequency pass criteria. Conclusions Pass/refer criteria alone do not influence referral rates and specificity. Instead, consideration of other factors in combination with these criteria is important. More research is required in terms of the sensitivity and specificity of OAE screening technology using repeated-measures and diagnostic audiological evaluation as the gold standard.

Introduction de Lange Syndrome is an autosomal dominant disorder which was initially described by Vrolik (1849) in a child with severe oligodactayly. Case Report A case of 2y2m/Female child came for speech and hearing evaluation. Audiological examination (BOA, DPOAE, ABR /BAER) and Speech-Language Evaluation, Psychological Examination were done by expertise clinicians. Previously, the child was diagnosed with de Lange Syndrome. Audiological evaluation diagnosed the child to have moderately severe hearing loss. After speech and language evaluation the child was detected with speech language disorder. After psychological evaluation the child was diagnosed with severe developmental delay and having low IQ range. Discussion de Lange syndrome is an autosomal dominant developmental disorder characterized by the sample number of characteristics which requires more rehabilitation options have to be planned. Unfortunately, there is dearth of literature that addresses the characteristics, assessment and intervention of individuals with de Lange syndrome.

BackgroundTraumatic brain injury (TBI) is a pathology frequently causing mortality or serious sequelae. About 20% of individuals with TBI will have some degree of auditory alteration. The aim of the present study was to use behavioural and electrophysiological assessments to analyse the hearing of a patient with TBI.Case reportA young male adult who had suffered severe TBI caused by a motorcycle accident was evaluated. The patient underwent a peripheral hearing evaluation and electrophysiological assessment. Pure tone audiometry revealed profound sensorineural hearing loss in the left ear and normal hearing in the right. In the electrophysiological assessment, an ABR click test showed the presence of a response in the right ear at 80 dB HL but no response in the left ear at 90 dB HL. Evaluation of the Middle Latency Response revealed the presence of both an electrode effect (C3) and an ear effect (A1). The P300 wave showed an event-related potential within normal limits in the right ear and no responses in the left.ConclusionsThe present case study verifies the importance of assessing the peripheral and central auditory nervous system in cases of patients with a history of TBI. It reinforces the need for diagnosis and audiological monitoring of these patients.

Introduction Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage. Objectives The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints. Methods The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions. Results Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases. Conclusion Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.

O aumento nos níveis de bilirrubina no neonato pode provocar efeitos tóxicos no sistema auditivo, podendo levar à perda auditiva. O objetivo desta revisão foi verificar o impacto da hiperbilirrubinemia na audição de recém-nascidos, relacionando os achados audiológicos aos níveis séricos de bilirrubina. Realizou-se uma revisão sistemática de literatura durante o mês de outubro de 2017, utilizando-se os termos hyperbilirubinemia, jaundice, infant, newborn e hearing loss, nas bases de dados periódicos Capes, Medline e Bireme (SciELO, BBO). Foram identificados 827 estudos, dentre os quais 59 foram selecionados para leitura do texto na íntegra, resultando na seleção de sete artigos que atendiam aos critérios de inclusão e foram considerados relevantes para a amostra deste trabalho. Em todas as pesquisas revisadas, o potencial evocado auditivo de tronco encefálico foi o principal exame audiológico realizado. Em todos os estudos foram observadas alterações nos resultados audiológicos de neonatos com hiperbilirrubinemia. Não houve consenso quanto aos níveis séricos de bilirrubina que podem causar alterações auditivas, porém, a relação entre as alterações audiológicas e os níveis sanguíneos de bilirrubina foi positiva. Percebeu-se a necessidade de estabelecer valores de referência para os níveis de bilirrubina considerados críticos para a ocorrência de alterações audiológicas, assim como de acompanhamento audiológico dos neonatos com hiperbilirrubinemia. The increase in bilirubin levels in newborns can cause toxic effects on the auditory system, which can lead to hearing loss. This review aimed to verify the impact of hyperbilirubinemia in the hearing of newborns, relating audiological findings to serum levels of bilirubin. A literature review was conducted during October 2017, using the terms “hyperbilirubinemia”, “jaundice”, “infant”, “newborn” and “hearing loss”, on databases CAPES journals, MEDLINE and BIREME (SciELO, BBO). 827 studies were identified and 59 were selected for full-text reading, resulting in the selection of seven articles that met the inclusion criteria and were considered relevant to the sample of this study. All the reviewed studies performed brainstem auditory evoked potential as the main test for audiological evaluation. Changes in the audiological findings of neonates with hyperbilirubinemia were observed in all studies. There was no consensus on the serum bilirubin levels that may cause auditory changes; however, the relationship between hearing disorders and blood levels of bilirubin was positive. We identify the need to establish reference values for bilirubin levels considered critical for the occurrence of hearing disorders as well as the audiological follow-up of neonates with hyperbilirubinemia.

To evaluate ordinary behavioral pattern suppression performance of individuals with tinnitus under disruptive effect using Stroop Color Word Interference Test-TBAG Form (SCWT), and to determine the impact of acoustic stimulus on this performance. 40 individuals with subjective tinnitus at Slight and higher severity according to Tinnitus Handicap Inventory (THI) (16 females, 24 males; mean age: 42.02 ± 10.00) (Study group), and 40 healthy individuals (Control group) (18 females, 22 males; mean age: 38.85 ± 10.25) were included in this study. All individuals were subjected to audiological evaluation. SCWT was applied with and without acoustic stimulus (NB noise), and test completion durations were recorded. It was determined that the duration for completion of 5 sections of SCWT, both in the presence of and without acoustic stimulus, was longer in the Study group than the control group. In the presence of acoustic stimulus, it took longer for the individuals with tinnitus to complete sections 4 and 5, and the control group to complete sections 3, 4 and 5 in SCWT in comparison with the lack of acoustic stimulus. It was determined that SCWT performance of the individuals with tinnitus was worse than the individuals without tinnitus, both in the presence of and without acoustic stimulus. It was found that SCWT performances of both groups with acoustic stimulus were better than their test performances without acoustic stimulus.

BACKGROUND Ototoxicity is defined as the pharmacological adverse reaction affecting the inner ear or auditory nerve, characterized by cochlear or vestibular dysfunction. Cisplatin used most frequently in the treatment of malignancies is an ototoxic agent. Evidence has shown that early detection of toxicity through prospective ototoxicity monitoring allows for consideration of treatment modifications to minimize or prevent permanent hearing loss and balance impairment. We wanted to conduct audiological evaluation of patients on chemotherapy with Cisplatin to evaluate the development of hearing loss and report. METHODS A retrospective study was conducted over a period of 3 years. All patients were subjected to thorough ENT examination, audiological evaluation including air and bone thresholds, pure tone average, speech discrimination and DPOAE. In addition, complete haemogram, liver and renal function tests were performed to evaluate the fitness for chemotherapy. Serial audiograms are taken at the end of each cycle up to 06 cycles of chemotherapy. Follow-up audiograms are taken at 03 months and 06 months after completion of chemotherapy. RESULTS Audiological evaluation among the 72 patients before the commencement of chemotherapy showed that 52 patients had normal hearing with air thresholds ranging from 10 to 20 dB with a mean of 14.45 ± 1.05 dB, bone thresholds ranging from 05 to 10 dB with a mean of 09.45 ± 0.35 dB. The pure tone average was ranging from 15 to 20 dB with a mean of 17.15 ± 1.75 dB. The speech discrimination score was 80 to 85%. The DPOAE values were present and normal in all the patients (100%). Among the 52 patients with normal hearing 07/52 (13.46%) had developed moderate hearing loss and among the 20 patients with pre-existing hearing loss, 04 / 20 (20%) patients had developed severe sensorineural hearing loss in this study. CONCLUSIONS Among the 52 patients with normal hearing 07 / 52 (13.46%) had developed moderate hearing loss and among the 20 patients with pre-existing hearing loss, 04 / 20 (20%) patients had developed severe sensorineural hearing loss in this study. Hence audiologic monitoring is important in patients undergoing Cisplatin chemotherapy and post-chemotherapy auditory monitoring is essential to rehabilitate the patients with sensorineural hearing loss.

Objective To identify demographic and audiometric predictors of bothersome tinnitus within a large clinical cohort. Study design Retrospective chart review. Setting Tertiary care hospital. Patients 51,989 English-speaking patients between 18 and 80 years of age that received initial audiometric evaluations at the Massachusetts Eye and Ear Infirmary between the years 2000 and 2016. Main outcome measures Patients were categorized according to whether or not tinnitus was the primary reason for their visit. The likelihood of tinnitus as a primary complaint (TPC) was evaluated as a function of age, sex, and audiometric configuration. Patient-reported tinnitus percepts were qualitatively assessed in relation to audiometric configuration. Results Approximately 20% of adults who presented for an initial hearing evaluation reported TPC. The prevalence of TPC increased with advancing age until approximately 50 to 54 years, and then declined thereafter. In general, men were significantly more likely to report TPC than women. TPC was statistically associated with specific audiogram configurations. In particular, TPC was most prevalent for notched and steeply sloping hearing losses, but was relatively uncommon in adults with flat losses. Patients with frequency-restricted threshold shifts often reported tonal tinnitus percepts, while patients with asymmetric configurations tended to report broadband percepts. Conclusions The probability of seeking audiological evaluation for bothersome tinnitus is highest for males, middle-aged patients, and those with notched or high-frequency hearing losses. These findings support the theory that tinnitus arises from sharp discontinuities in peripheral afferent innervation and cochlear amplification, which may induce topographically restricted changes in the central auditory pathway.

Background: The sensitivity and specificity of the clinical audiological evaluation in newborns are debatable compared to neurophysiological methods of a hearing evaluation. This study aimed to determine the sensitivity and specificity of the cochleopalpebral reflex as a clinical test for hearing screening in newborns. Methods: A case-control study was designed. Newborns discharged from a neonatal intensive care unit (NICU) were included. Brainstem evoked auditory potentials were recorded. A wooden rattle was used to explore the cochleopalpebral reflex. The sensitivity and specificity of the cochleopalpebral reflex were calculated. Continuous data were analyzed with Student’s t-test, with statistically significant p-values < 0.05. Results: We selected 450 newborns who were divided into two groups: group A, with bilateral sensory neural hearing loss (n = 150), and group B, with normal hearing (n = 300). Group A showed a significantly lower gestation age at birth (p = 0.005) compared to group B (32.5 ± 2.6 vs. 34.4 ± 3.5 weeks). In group A, the cochleopalpebral reflex’s sensitivity was 80% using the wooden rattle. In group B, the specificity was 98%. Conclusions: The NICU discharged newborns’ clinical hearing evaluation is not enough to exclude hearing loss. Although it may be the only diagnostic tool for hearing loss in some settings, its limitations should be considered.

We are reporting a casewith hearing loss following krait snake bite.Casewasdiagnosed as snake bite and treated in the emergency department and after stabilising she was referred to the oto-rhinolaryngology department for evaluation of sudden hearing loss. Audiological evaluation was carried out to identify degree, type of hearing loss and site of lesion. Puretone audiometry showed bilateral moderate sensory neural hearing loss. Thediagnosis was confirmed with Transient evokedotoacoustic emissions and Click evoked auditory brainstem response testing. From theaboveaudiologicaltests it is evident that the snake bite victim has cochlear hearing loss. This could be due to the venom carried away from the wound by the lymphatics and then is circulated by the bloodstream throughout the body.

Objectives To provide an introduction to the role of audiological evaluations with special reference to patients with skull base disease. Design Review article with case-based overview of the current state of the practice of diagnostic audiology through highlighting the multifaceted clinical toolbox and the value of mechanism-based audiological evaluations that contribute to otologic differential diagnosis. Setting Current state of the practice of diagnostic audiology. Main Outcome Measures Understanding of audiological evaluation results in clinical practice and value of contributions to interdisciplinary teams to identify and quantify dysfunction along the auditory pathway and its subsequent effects. Results Accurate auditory information is best captured with a test battery that consists of various assessment crosschecks and mechanism-driven assessments. Conclusion Audiologists utilize a comprehensive clinical toolbox to gather information for assessment, diagnosis, and management of numerous pathologies. This information, in conjunction with thorough medical review, provides mechanism-specific contributions to the otologic and lateral skull base differential diagnosis.

Background Agricultural activities and exposure to pesticides increase the risk of hearing loss and might reduce cholinesterase activity. Objective To describe and analyze the correlation between hearing screening and plasma and erythrocyte cholinesterase activity relative to rural workers exposed to pesticides. Methods Cross-sectional, quantitative, descriptive and explanatory study conducted with 71 rural workers exposed to pesticides. Data were collected by means of an instrument to characterize exposure to pesticides, hearing screening and blood samples to measure plasma and erythrocyte cholinesterase activity. Results Each participant used three different pesticides, on average, glyphosate being the most frequently mentioned. About 60.6% of the sample exhibited hearing abnormalities and 32.4% complained of tinnitus. Erythrocyte cholinesterase activity was within the normal range in all the cases; one single participant exhibited reduced plasma cholinesterase activity. There was not significant correlation between the hearing screening and cholinesterase levels. Conclusion Audiological evaluation should be included in the assessment of rural workers. Monitoring workers exposed to pesticides should not be restricted to cholinesterase activity alone, because this method is insufficient to detect actual exposure to pesticides.

Objective: to evaluate vitamin D levels in patients with tinnitus and to assess subjectively the efficacy of its supplementation in case of deficiency.Methodology: 35 adult complaint of bilateral tinnitus with the age range from 20 to 50 years were included. All had bilateral normal audiological evaluation. Vitamin D level was assessed and those that had deficiency received supplementation for 3 months. Tinnitus handicap inventory (THI) was taken for the first time to all participants and another time for those received vitamin D supplementation after the 3 months regiment, and comparing the results.Result: From the 35 participants there was 30 subjects had vitamin D deficiency (85.71 %). THI before treatment showed larger numbers in scale 3 then 2, 1, 4 with no patients with scale 5.while THI after treatment showed larger numbers in scale 1 then 2 & 3 with no patients with scale 4 & 5. There was no significant correlation between THI score & Vitamin D level and the age of the participant or the duration of the complaint.Conclusion & recommendations: vitamin D deficiency is common among tinnitus patients. The result of vitamin D supplementation is promising in cases of idiopathic tinnitus. We recommend doing vitamin D assay in patients with idiopathic tinnitus and hence giving vitamin D supplementation in case of deficiency trying to improve the quality of life.

Background This study aimed to report the surgical outcomes of retrograde mastoidectomy with canal wall reconstruction using a bone graft that secured in place using glass ionomer cement (GIC) in adult patients with acquired cholesteatoma. Results This study was conducted on 50 adult patients with acquired cholesteatoma who underwent retrograde mastoidectomy with a reconstruction of canal wall using a bone graft from the mastoid cortex. The preoperative and postoperative audiological evaluation was done; in addition, non-echoplanar (EPI) diffusion-weighted MRI was obtained at least 1 year postoperatively to detect recidivism of cholesteatoma. Recidivism of cholesteatoma was observed in 4/50 ears (8%) using diffusion-weighted MRI and confirmed during revision mastoidectomy. The audiological assessment showed a marked and statistically significant improvement of preoperative ABG from 30 to 21 dB in addition to the improvement of preoperative AC from 42 to 33 dB. ABG of 20 dB or less was achieved in 50% of the ears. No reaction occurred to GIC in all the ears. Conclusions Retrograde mastoidectomy with canal wall reconstruction with bone graft was associated with a low rate of recidivism and significant improvement of the hearing. GIC is safe and effective in stabilization of bone graft in canal wall reconstruction.

To do the audiological evaluation of patients with hypothyroidism and to assess status of hearing after thyroxin replacement therapy (TRT). Two groups were included: a hypothyroidism group (HG, n = 50), and a control group (CG, n = 50). Parameters studied: anominesic data, duration of hypothyroidism, comorbidities, cochleovestibular symptoms, biochemical and hormonal exams (TSH, FT4 and FT3), pure tone audiometry, impendence audiometry and BERA as where required. Mean age of the patients in HG was 26.5 ± 10.4 years. Male/Female ratio was 2.39. All HG patients had altered TSH values and 8% had diminished T4 values. Cochleovestibular symptoms were more common in hypothyroid patients (48%) than control (20%) p value. Pure Tone Audiometric threshold was found higher in 34% of cases. Sensorineural hearing loss was most common (76.46%) compared to conductive and mixed hearing loss. BERA showed significant prolonged absolute peak latency of wave III, inter peak latency (IPL) of wave I–III and reduced amplitude of wave Ia and Va. After thyroxine replacement therapy there was statistically significant improvement in hearing threshold in 46.42% ears (p

Made available in DSpace on 2018-11-12T17:26:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-05-01. Added 1 bitstream(s) on 2018-11-12T17:34:48Z : No. of bitstreams: 1 S1516-18462018000300281.pdf: 351686 bytes, checksum: e2928d3515589009beb4dac20e90965e (MD5) RESUMOObjetivo: descrever os efeitos imediatos do atraso na retroalimentação auditiva sobre as disfluências típicas da gagueira, em indivíduos com gagueira.Métodos: estudo transversal e experimental. Foram analisados trinta indivíduos, de oito a 46 anos, diagnosticados com gagueira do desenvolvimento persistente. Os participantes deveriam apresentar, no mínimo, 3% de disfluências típicas da gagueira e gagueira leve de acordo com o Instrumento de Gravidade da Gagueira. Os procedimentos realizados foram: avaliação audiológica, avaliação da fluência em duas situações de escuta - com retroalimentação auditiva habitual e atrasada - e o Instrumento de Gravidade da Gagueira. O software Fono Tools foi utilizado para provocar o efeito de atraso. A análise dos dados foi realizada por meio da aplicação de testes estatísticos pertinentes.Resultados: não houve diminuição da maioria das disfluências típicas da gagueira. Houve redução estatisticamente significante das repetições de palavras e do fluxo de sílabas por minuto.Conclusão: o atraso na retroalimentação auditiva ocasionou como efeito imediato a redução das repetições de palavras e da taxa de articulação em sílabas por minuto. ABSTRACTObjective: to describe the immediate effects of delayed auditory feedback on stuttering-like disfluencies in people who stutter.Methods: a cross-sectional and experimental study. The effect of delayed auditory feedback was analyzed in thirty individuals, from eight to 46 years old, diagnosed with persistent developmental stuttering. Participants should present at least 3% of stuttering-like disfluencies and mild stuttering according to the Stuttering Severity Instrument. The following procedures were used: audiological evaluation, fluency evaluation in two listening situations - with Non-altered and delayed auditory feedback - and the Stuttering Severity Instrument. The Fono Tools software was used to cause the delay effect. Data analysis was performed using pertinent statistical tests.Results: there was no decrease in most stuttering-like disfluencies. There was a statistically significant reduction in word repetition and flow of syllables per minute.Conclusion: the delay in auditory feedback caused, as an immediate effect, the reduction of word repetition and speech rate, in syllables per minute. Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Filosofia e Ciências Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Filosofia e Ciências

Introdução: O desenvolvimento tecnológico em Audiologia possibilita a criação e aplicação de ferramentas voltadas à reabilitação da pessoa com deficiência auditiva. Todavia, os recentes avanços ainda não abrangem todas as competências necessárias para atender às demandas específicas de pessoas com múltiplas deficiências. Objetivo: Avaliar a tecnologia de rastreamento ocular como auxílio à intervenção interdisciplinar para a reabilitação auditiva de pessoas com múltiplas deficiências no Sistema Único de Saúde - SUS. Método: Trata-se de um estudo de caso, descritivo, exploratório, de natureza qualiquantitativa. Foram realizadas: elaboração de um banco de imagens e construção de um software para o gerenciamento de imagens; aplicação de pilotos para adequação da metodologia; aplicação dos procedimentos desenvolvidos na reabilitação auditiva em seis usuários com múltiplas deficiências. Resultados: O software desenvolvido gerencia 244 imagens validadas, que utilizadas em conjunto com a tecnologia de rastreamento ocular, possibilitou a aplicação da entrevista social e anamnese otorrinolaringológica diretamente aos usuários, assim como, a avaliação audiológica básica, indicação de prótese auditiva, terapia fonoaudiológica e psicológica. As tecnologias propostas foram utilizadas de maneira interdisciplinar, e possibilitaram maior inserção dos usuários em seu processo terapêutico. Conclusão: Este estudo apontou que é viável a associação do software de imagens à tecnologia assistiva de rastreamento ocular para uso em uma parcela de pessoas com múltiplas deficiências, possibilitando obtenção de respostas e maior participação durante a realização dos procedimentos em saúde auditiva.

Introdução: O zumbido pode estar presente em indivíduos com audição normal. Objetivo: Analisar e comparar o zumbido e o incômodo provocado em indivíduos com e sem perda auditiva. Métodos: A amostra foi composta por pacientes que apresentaram zumbido crônico, com audição normal ou perda auditiva. A avaliação foi feita por médico otorrinolaringologista e fonoaudiólogo (avaliação audiológica e questionário Tinittus Handicap Inventory –THI). Resultados: A amostra foi composta por 50 indivíduos com zumbido crônico, divididos em dois grupos (com e sem perda auditiva). As idades variaram entre 29 e 69 anos (média 52,50±9,64 anos). Os grupos eram semelhantes quanto à sexo, idade e localização do zumbido, diferenciando-se somente no que se refere a presença de perda auditiva. Em relação à pontuação no THI, encontrou-se diferença entre os grupos nas escalas funcional, emocional e no THI total. A acufenometria evidenciou diferença entre os grupos no pitch e loudness do zumbido. Conclusão: Indivíduos com perda auditiva apresentaram pontuação maior na escala funcional e emocional, assim como no somatório total do questionário THI evidenciando maior incômodo provocado pelo zumbido. Além disso, o zumbido em tais indivíduos apresentou pitch mais agudo e loudness maior do que encontrados nos indivíduos sem perda auditiva.

Background Aging process is associated with central auditory changes, which may explain some understanding difficulties in elderly. It may be evaluated with the dichotic digits (DD) test, a widely used experimental paradigm for studying interhemispheric interactions. Purpose This study was performed to evaluate dichotic integration ability in the elderly and children populations by comparing it with adults who acted as reference. Research design The study design was a cross-sectional one. It was conducted in Ain Shams University, Faculty of Medicine, Demerdash Hospital, Audiology Unit, for a period of 4 years. The study comprised 75 participants divided into three groups: the adult group, the elderly group, and the pediatric group. Data collection and analysis Basic Audiological Evaluation and the DD test in the free recall condition were carried out in all participants. Results Results of this study suggest that central auditory processing concerning dichotic integration is different in children and elderly individuals when compared with adults. Moreover, there was no significant difference between elderly patients and children. The age had a direct correlation with DD test scores in children, but an inverse correlation in the elderly. Conclusion Dichotic integration as measured using the DD test is similar in the elderly and children, but in opposite directions with regard to its change with age progress.

Background. Bacterial meningitis is one of the most common causes of hearing loss. Hearing loss develops within the first few days following the onset of meningitis, highlighting the importance of early audiology referrals. Post-meningitis hearing loss may lead to cochlear ossification, making traditional cochlear implantation impossible. Objectives. To determine the duration of time from meningitis diagnosis to audiology referral. A second objective was to determine the prevalence and severity of meningitis-related sensorineural hearing loss (SNHL) at Red Cross War Memorial Children’s Hospital (RCWMCH), a paediatric tertiary hospital in Cape Town, South Africa (SA). Methods. A retrospective folder review of all children diagnosed with meningitis and referred for audiological evaluation was conducted over an 18-month period between 1 January 2015 and 30 June 2016. Descriptive statistical methods were used for data analysis. Results. The total number of inpatients diagnosed with unspecified meningitis at RCWMCH between January 2015 and June 2016 was 345. The total number diagnosed with bacterial meningitis was 68. Only 16 children with meningitis (23.5%) were referred to the Department of Audiology at RCWMCH over the 18-month period. Twelve children had confirmed bacterial meningitis. All the children had up-to-date immunisations. The mean (standard deviation) time from diagnosis to audiology referral was 17 weeks (16.9; range 1 - 60). The overall prevalence of hearing loss was 42.8%. Four children (28.5%) were diagnosed with severe to profound SNHL. Conclusions. Less than a quarter of all children diagnosed with bacterial meningitis at RCWMCH over the 18-month study period were referred to audiology. Frequent delays in referrals for audiological assessment following meningitis were noted. This may indicate a lack of awareness on the part of doctors. Healthcare practitioners need to be made aware of the need for prompt audiological testing for children with meningitis. In SA, local guidelines for early diagnosis and monitoring of hearing in children who have had meningitis should be developed in order to improve hearing outcomes.

INTRODUÇÃO: A presbiacúsia acarreta dificuldades na interpretação do sinal sonoro com uma influência acrescida na perceção do discurso na presença de ruído. Pretende-se estudar as habilidades do processamento auditivo central na discriminação da fala no ruído, em pessoas idosas.MATERIAL E MÉTODOS: A amostra foi constituída por 20 sujeitos, com idades compreendidas entre os 67 e os 92 anos. Todos realizaram otoscopia, timpanograma, audiograma tonal simples e teste de fala no ruído. Este estudo é do tipo descritivo-correlacional e transversal.RESULTADOS: A curva audiométrica apresenta declínio significativo (p < 0,001) com o aumento das frequências testadas, a partir da frequência dos 500 Hz, apresentando o ouvido esquerdo melhores resultados do que o ouvido direito, com significância estatística (p = 0,043), apenas nos 250 Hz. No teste de fala no ruído, os resultados do ouvido esquerdo evidenciaram uma média de acertos de 21,5% na relação sinal/ruído de 10 dB, tendo um aumento significativo (p < 0,001) na relação sinal/ruído de 15 dB cuja média de acertos foi 26,3%. O ouvido direito exibe uma média de acertos de 17,3% e de 27,85% na relação sinal/ruído de 10 dB e de 15 dB respetivamente, com um aumento significativo (p = 0,002) na relação sinal/ruído de 15 dB.CONCLUSÃO: Tendo em conta os resultados, em que o teste de fala no ruído apresenta uma média de acertos inferior aos 50% em ambos os ouvidos, chegámos à conclusão que quanto menor for a relação sinal/ruído maiores as dificuldades na compreensão da fala. Assim, a avaliação audiológica da pessoa idosa deve incluir a avaliação periférica e central.

Introduction Frequency-following response with speech stimulus (FFR-speech) is a subcortical potential that satisfactorily evaluates the processing of verbal information. However, there still are differences in the literature regarding its analysis and stimulation protocol. Objective To compare two stimulation protocols for the capture of FFR-speech, to identify the percentage of occurrence of the waves among them and to compare it with the specialized literature, as well as to describe the interpeaks of its waves. Method Considering the eligibility criteria, the sample consisted of 30 normal-hearing adults, with no complaints of speech comprehension. All of them were submitted to a basic audiological evaluation, to brainstem auditory evoked potential with click stimulus, and to FFR-speech. In the latter, 2 types of stimulation were performed, 3 series of 1,000 sweeps, and 2 series of 3,000 sweeps, for subsequent analysis of the resulting wave, in which we tried to mark the peak V followed by valleys A, C, D, E, F, and O. Results Differences in latency and interpeaks were not found between the protocols. In general, a higher occurrence of waves in the stimulation of 2 series of 3,000 sweeps was observed, but only the A valley presented a significant difference. When the values of the waves were compared with the literature, the V and A waves showed fewer occurrences in the present study. Conclusion The protocol of 2 series of 3,000 sweeps was better for FFR-speech in the studied equipment, considering the higher occurrence of waves, even though it is inferior to the specialized literature. Furthermore, it was possible to describe interpeak values and to observe no difference between the studied protocols

Background: The most common complaint of patients affected by chemotherapy-induced hearing loss is difficulty understanding speech in noisy environments despite the use of hearing aids. Cochlear dead regions, those areas with damaged or absent inner hair cells and dendrites, may account for this type of hearing loss. However, it is unknown whether this condition is associated with cisplatin agents. Objective: The aim of this study was to determine whether cisplatin is associated with hearing loss and cochlear dead regions. Methods: This prospective cross-sectional study was conducted in patients participating in routine audiological monitoring during and after chemotherapy treatment. Adults undergoing audiological evaluation who had completed chemotherapy treatment were invited to participate. Patients were divided into 3 groups according to pure tone thresholds. Group 1 patients had thresholds over 70 dB (HL) at 2,000 Hz and higher frequencies. Group 2 patients had thresholds below 70 dB (HL) up to 2,000 Hz. Patients in the control group had normal thresholds at all frequencies. The threshold equalizing noise test (TEN[HL]) was used to identify cochlear dead regions by repeating thresholds in the presence of TEN noise played from a compact disc. The presence of cochlear dead regions was established when the masked threshold was 10 dB or greater above the TEN level and 10 dB or greater above the absolute threshold at any frequency. Results: Twelve patients were included in study group 1, 10 patients in study group 2, and 7 patients in the control group. Cochlear dead regions were present in all patients with hearing loss and in none of the control group. For groups 1 and 2, mean differences between absolute and masked thresholds were 21 and 16 dB at 500 Hz; 22 and 15 dB at 1,000 Hz; 31 and 17 dB at 2,000 Hz; 32 and 20 dB at 3,000 Hz; and 31 and 21 dB at 4,000 Hz, respectively. Nevertheless, analysis of variance testing with Bonferroni analysis showed a difference between groups 1 and 2 only at 2,000, 3,000, and 4,000 Hz. Conclusion: We found unresponsive or dead cochlear regions in patients who had undergone cisplatin chemotherapy even among patients with mild to moderate hearing loss.

Koklear implantlar konvansiyonel amplifikasyondan fayda göremeyen ileri-çok ileri derecede sensorinöral tip işitme kaybına sahip bireylerde kullanılan ve işitsel sinirin doğrudan elektriksel olarak uyaran sistemlerdir. Koklear implantasyon biyoteknoloji ve tıp dünyasındaki en önemli gelişmelerden birisidir. Çünkü koklear implantasyon kişilere kaybettikleri veya hiç sahip olmadıkları işitme duyusunun yerini tutacak kazanım sağlamakta ve kişilerin yaşam kalitelerine büyük katkıda bulunmaktadır. Bu derlemede; koklear implantasyonun odyolojik, preoperatif, intraoperatif ve postoperatif değerlendirme ve takip süreçleri ile ilgili bilgiler kendi klinik tecrübelerimiz ile harmanlanarak sunulmuştur.

This chapter discusses the classical audiological dimensions – thresholds, discrimination, recruitment, and adaptation – as well as air and bone conduction tests, immittance tests, otoacoustic emissions, and electrical response audiometry. The patterns for different types of hearing loss are also presented, taking into consideration the neurotological aspects of audiological diagnosis.

Objectives Hearing loss is a serious problem in infants and children because it may interfere with the development of typical speech, verbal language, and auditory and communication skills. By measuring hearing ability (thresholds) as early as possible, even as early as during infancy, effective treatment can be administered. These treatments may significantly reduce the handicap associated with hearing loss. However, at times during behavioral auditory tests, observers cannot determine whether or not an accurate threshold was obtained. To support the use of infant audiometry for accurate diagnosis, audiologic behavioral responses may be obtained by selecting stimuli that interest infants, e.g., their mothers’ voices. Methods We evaluated 30 infants who were presented to our hospital for behavioral auditory assessment in 2016. The infants' ages ranged from 4 months to 3 years and 6 months. The mean age was 1 year and 10 months ±10 months (±standard deviation). The infants' hearing thresholds for their mothers' voices and warble tones at 250–4000 Hz were measured. Auditory brainstem response (ABR) had already been evaluated in 24 infants. Relationships between mother's voice and warble tone or ABR thresholds as well as responses to the initial stimuli and stimuli at the threshold were investigated. These responses were classified into four grades (no response, uncertain response, possible positive response, and positive response), and the response to mother's voice and warble tone were subsequently compared. Results Mother's voice thresholds significantly correlated with all warble tone thresholds. In the relationship between the mother's voice threshold and average hearing levels of 500, 1000, and 2000 Hz, two infants were outliers. In these infants, the average hearing levels were relatively higher than the mother's voice thresholds. Judging from their ABR thresholds, the mother's voice thresholds were valid and the average hearing levels were worse than their original assessed hearing ability. The responses to mothers' voices were more distinct than those to warble tones, both for initial stimuli presentation and the determined threshold. Conclusions Audiologic behavioral responses to mothers' voices were clearer than those for warble tones. Evaluations that use the mother's voice threshold are useful for estimating hearing levels in infants.

Introduction Universal Neonatal Hearing Screening (UNHS) includes as its main objective, that all Newborns (NB) receive an audiological evaluation during their first month of life. Objective To determine the prevalence of hearing loss in a population of healthy NB in a tertiary care hospital in Mexico City. Material and methods A prospective cross-sectional study was designed. The period was from October 1, 2011 to May 15, 2019. UNHS was performed with a flowchart in three phases using Transient Evoked Otoacoustic Emissions and Brainstem auditory evoked potentials. Data were analyzed using descriptive statistics. Results 14,000 NB were evaluated, 28,000 ears. Gender was distributed in n = 7038 (50.3%) males and n = 6962 (49.7%) females. The mean age at the time of the first UNHS study was 48.3 ± 22.2 days. Hearing loss was confirmed in n = 31 (0.22%) NB, in 20 (64%) of the cases with hearing loss there were no documented audiological risk factors. Conclusions The prevalence of hearing loss was 2.2 per 1000 NB in a tertiary care hospital in Mexico City. Diagnosis and early habilitation of hearing loss in NB constitute quality indicators in health care and guarantee the best prognosis for NB with hearing loss.

INTRODUCTION Cholesteatoma of the ear is a common disease encountered by otologists all over the world. Congenital, primary acquired and secondary acquired are the terms described to denote the types of cholesteatoma. All the above types cause deafness but the correlation between the type and degree of hearing loss remains doubtful. AIM To evaluate the hearing loss in all types of cholesteatoma patients and analyse the association between nature of hearing loss and the type of cholesteatoma. MATERIALS AND METHODS The present study is a cross-sectional cohort study of cholesteatoma patients undergoing surgery. Air, bone conduction thresholds, PTA, air bone gaps and preoperative ossicular status were studied and analysed in all types of cholesteatoma. RESULTS One hundred and sixty two patients aged between 8 and 65 were included in the study. Nineteen patients had congenital cholesteatoma, 58 had primary cholesteatoma and 85 had secondary cholesteatoma. All patients had increased air, bone conduction thresholds, PTA thresholds and large air bone gaps on pure tone audiometry, whereas secondary cholesteatoma patients showed higher mean values for loss of hearing across all frequencies compared to other types. CONCLUSIONS The correlation between losses of hearing and damage caused by cholesteatoma of all types especially acquired secondary type was evident from this study showing higher degrees of loss of hearing in all frequencies and larger air bone gap.

Objective The purpose of this study was to compare between Valvassori and Cincinnati criteria and to correlate between vestibular aqueduct measurements made in axial plane with those made in 45° oblique reformats. Patients and methods The study group included 61 children with LVAS. All participants were subjected to full Audiological evaluation and MDCT scanning in axial plane. The axial data were transferred to workstation for post-processing with multiplanar reformatting software in order to obtain the 45° oblique reformats. Vestibular aqueduct measurements were made at 4 points: midpoint and operculum in both the axial plane and 45° oblique reformats. Results 100% (122 ears) were diagnosed according to Cincinnati criteria, while 81% (99 ears) of children with LVAS fit Valvassori criterion, and 19% were (23 ears) missed. There were statistically significant correlations among the diameters of the VA in the axial plane (midpoint and operculum) and their counterparts in the 45° oblique reformats. Values equal to or greater than 1.2 mm in the midpoint and 1.3 mm in the operculum are proposed to be the criteria to diagnose LVA in the 45° oblique reformats. Conclusion Cincinnati criteria are more sensitive than Valvassori criteria in the diagnosis of LVAS.

INTRODUCTION Interpersonal communication, day to day activities, learning language and acquiring grades in the school are important parts in the life of school going children. Unilateral or bilateral Loss of hearing affects education and the child feels handicapped socially, emotionally, and scholastically. Such children lose grades and retained in the same class affecting them emotionally. The present study was conducted in order to find out the various causes of unilateral Sensorineural Hearing Loss (USNHL) in children and to study role of various audiological findings in diagnosing the cause of impaired hearing in children. AIMS AND OBJECTIVES To find out the possible etiological causes and study the role of various audiological tests in finding the causes of unilateral impaired hearing in children. MATERIALS AND METHODS A prospective study was conducted in the Department of ENT of a tertiary Hospital attached to a Medical College in Warangal, Telangana. A total of 346 children aged between 4 and 15 years attended presenting with complaints of impaired hearing. Among them 73 children with unilateral sensorineural deafness were included in the study. After a thorough ENT examination subjective tests like pure tone audiometry and behavioral observation audiometry and objective tests like impedance audiometry, Oto-acoustic emissions (OAE), and brainstem evoked response audiometry (BERA) were performed. RESULTS While identifying the possible etiological cause of USNHL, OAE revealed 56.16% REFER and 43.83% PASS results. Impedance audiometric results showed 71.22% as Type A Tympanogram. Pure tone audiometric results were mostly showed severe and profound hearing losses together accounting to 87.66%. BERA findings were mostly on severe and profound hearing loss (90.40%). No children with syndromic or cranio-facial abnormalities were found. CONCLUSIONS A prospective Hospital based study of school children with USNHL showed acquired nature of the condition with moderate to severe hearing loss. No accompanying syndromic or cephalo-facial anomalies were noted as the cause of USNHL.

The p.V37I (c.109G>A) mutation in the GJB2 gene is the common frequent cause of congenital deafness; however, its pathogenicity is debated. The present study investigated the prevalence of p.V37I in Chinese infants and young children and associated clinical characteristics. The subjects of the present study were screened for mutations in GJB2 (235delC, 299delAT, 176dell6, 35delG), SLC26A4 (IVS7-2A>G, 2168A>G), GJB3 (538C>T), and in the mitochondrial 12S rRNA gene (1555A>G, 1494C>T). Subjects with p.V37I underwent an audiological evaluation. GJB2 exon sequencing revealed that 20 subjects had p.V37I compound heterozygous mutations, one of whom had a family history; the mutations included c.235delC/p.V37I (n = 12), c.299AT/p.V37I (n = 7), and c.176del16/p.V37I (n = 1). Of the 20 subjects, 12 were referred for Universal Newborn Hearing Screening (UNHS). Nine of the 20 subjects had mild hearing loss in the better ear and 5 had moderate hearing loss in the better ear while 4 had normal hearing. Among subjects with the c.235delC/p.V37I mutation, 5 had mild hearing loss and 2 had moderate hearing loss while 3 had normal hearing. Among subjects with the c.299AT/p.V37I mutation, 3 had mld hearing loss and 3 had moderate hearing loss while 1 had normal hearing. One subject with the c.176del16/p.V37I mutation had mild hearing loss. Few studies have reported on the clinical characteristics of Chinese infants with p.V37I compound heterozygous mutations identified via screening for deafness genes and GJB2 sequencing. The c.235delC/p.V37I mutation was the most prevalent mutation found in subjects. The degree of hearing loss associated with p.V37I compound heterozygous mutations was mainly mild to moderate.

Objective To evaluate the possible contribution of the saccular projections in generation ABR 500 Hz at high intensity by investigating the relationship between cVEMP and ABR 500 Hz in normal subjects and those with unilateral saccular dysfunction. Subjects Twenty dizzy adults with unilateral affected cVEMP compared to twenty healthy subjects. Methods All subjects were subjected to basic audiological evaluation (pure tone audiometry, speech audiometry and immittancemetry), cVEMP and ABR using 500 Hz tone burst at 90 dB nHL. The dizzy patients within the study group were subjected to VNG to exclude another vestibular affection. The results We found that patient’s abnormal cVEMPs response mostly had prolonged ABR 500 Hz wave V latency, whereas unaffected ears presented with normal findings. Conclusion Using ABR 500 Hz in the battery approach tests of vestibular assessment can produce valuable data for judgment on the site of a lesion.

Background: Post traumatic hearing loss is one of the most common problems encountered among trauma victims. It can manifest as conductive, sensorineural or mixed hearing loss. It is against this background that the study evaluated the clinical and audiological outcome of 47 patients of trauma.Methods: A descriptive longitudinal study was conducted over a period January 2017 to March 2018. Follow up was done after 3 months of discharge. Study consisted of 47 patients presenting with features of trauma related injuries. After carrying out systematic clinical, audiometric and radiological evaluation, patients were managed conservatively.Results: Of the 47 patients studied, 89.98% were related to road traffic accidents (RTAs); and 76.60% were under the influence of alcohol at the time of trauma. Among the 32 cases of the RTAs involving two wheelers, 29 patients (90.62%) were not using protective devices like helmet. Nearly 90% of patients had temporal bone fracture. Audiological evaluation confirmed hearing loss in 77% of patients at presentation. There was significant improvement of hearing thresholds with 51% attaining normal hearing at follow up with conservative management.Conclusions: Post traumatic hearing loss was very common, conductive hearing loss being the most common type. It resolved over a few days to few weeks post injury. Timely diagnosis and management with early steroid therapy showed encouraging results for patients with traumatic sensorineural hearing loss or mixed hearing loss.

Purpose The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). Method We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. Results In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. Conclusions Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

Early hearing detection and intervention (EHDI) refers to a system of care to ensure that infants who are deaf or hard of hearing receive early diagnosis and intervention. Components of this system include newborn hearing screening (NBS), follow-up diagnostic audiological evaluation (DAE), medical/otological assessment and treatment, audiological habilitation such as hearing aid fitting, and enrollment in early intervention services (EI). A significant barrier to achieving prompt diagnosis of and EI for every baby is lack of access to audiologists and speech-language pathologists (SLPs) with specific expertise in diagnosis, (re)habilitation, and intervention for infants who are deaf or hard of hearing. To improve access to services, clinicians are exploring the use of telepractice for specific components of the EHDI system. At Children's Hospital Colorado, we developed telepractice services that include two components of EHDI, DAE, and speech-language EI services. We discuss the development, implementation, outcomes, and advantages and disadvantages of telepractice for these components of an EHDI system.

INTRODUCTION: Age Related Hearing Loss (ARHL) is defined as loss of hearing in elderly persons not influe nced by the extraneous factors like noise trauma etc or intrinsic like CVS related diseases or endocrinal disorders like Diabetes. Also termed as Presbycusis it is defined as the loss of hearing due to age related changes taking place in the auditory syste m starting from the pinna to the cortical centers in the brain. It does not include any other factor contributing or initiating the pathological changes in the auditory system resulting in hearing loss. All these changes in the tissues are not pathological but truly age related. The threshold of hearing is defined as the pure tone average across the frequencies of 0.5 to 8 kHz. The severity of hearing loss is graded as profound hearing loss : more than 90dB , severe to severe loss : 71 - 90 dB or more ; Moderate to severe hearing loss : 56 - 70 , Moderate hearing loss : 41 - 55 dB HL ; Mild hearing loss : 26 - 40 dB HL. Present study is to evaluate hearing loss in persons aged above 65 years both of those attending the Hospital for loss of hearing and those screened in a sur vey. AIM: To evaluate the hearing thresholds in individuals aged above 65 years attending the Government General Hospital and among the people attending the hearing screening done in the city of Warangal. The study also includes the review of the literature on ARHL. MATERIALS AND METHODS: 185 individuals aged above 65 years are evaluated for hearing thresholds with the help of pure tone audiometry and speech audiometry. Among the 185 individuals 102 are patients attending the Department of ENT for the compla ints of loss of hearing. The remaining 83 individuals are from the survey conducted to screen for hearing loss in the city of Warangal for the population aged above 65 years. Demographic data about the 185 individuals is collected. Pure tone audiogram and speech audiometry is done in all the patients. CONCLUSIONS: PTA and SRT values are similar in both the groups. Early old age groups presented with mild to severe types of deafness and loss in lower frequencies. Late old aged people showed profound hearing l oss and increased thresholds in higher frequencies. SRT estimation seemed more sensitive than calculating PTA in the persons above 85 years. Females showed 5 to 10 dB lower PTA values than males in all ages.

Objective To standardize the results of vestibular evoked myogenic potentials (VEMPS) in young children. Methodology The study group consisted of thirty-two children, their age ranged between 3 and 12 years with no history of systemic or local inner ear disorder and not suffering from either vestibular or musculo-skeletal disorder. Full neuro-otological history was taken followed by audiological evaluation. VEMP was recorded from the sternomastoid muscle, using alternating acoustic clicks presented at 90 dB nHL, at a rate of 5 Hz, analysis time was 50 ms. Two hundred sweeps were collected, amplified and recorded with band pass filter of 10 Hz to 1.5 kHz. Results VEMP was recorded in all children waves. PI and NI were identified in all children while PII and NII were identified in 10.7% only. Difficulties were met while trying to evaluate younger ones less than 5 years as they were restless when they were evaluated with sedation, this resulted in the absence of response due to reduced muscle tone. Differences in latencies and amplitudes should be considered as latencies were shorter and amplitudes were lesser than those obtained in adults. Conclusion VEMP could be applied as a complementary test to evaluate saccular and inferior vestibular nerve function in children.

BACKGROUND Numerous studies have discussed cases of concomitant temporomandibular disorders (TMD) and otologic symptoms (OS). However, attempts to determine the true origin of these symptoms combined with assessments of the condition of the organ of hearing are relatively rare. This study aimed to evaluate the frequency and type of OS in patients with TMD, and attempted to determine the origin of the OS in the studied group of patients. MATERIAL AND METHODS 246 patients, aged 40.08±11.12 years (F=147, M=99) with TMD, from the Department of Oral Rehabilitation of Poznan University of Medical Sciences. METHODS dental history interviews and clinical examinations. There were 2 groups-G1 and G2-selected on the basis of the presence or absence of OS in the medical history stage. After audiological evaluation, 2 subgroups were identified: G1.1 and G1.2. RESULTS OS were observed in 36.18% (G1). In 48 patients (53.93%), the audiological evaluation found there was no impairment of the organ of hearing (G1.2). Audiological abnormalities were found in 46.07% (n=41) of the patients (G1.1). The OS which differentiated the 2 groups were a plugging sensation as well as otalgia (more frequent in group G1.2) and hearing impairment (more frequent in group G1.1). CONCLUSIONS 1. The OS which most frequently accompany with TMD were fullness and otalgia. 2. It is recommended that a subjective assessment of hearing loss in patients with TMD and concomitant OS should be included in the medical history stage. 3. Clicking and popping are significantly more frequent in patients without concomitant hearing impairment.

BACKGROUND: Exposure to noise beyond prescribed limits of WHO in terms of intensity and duration results in temporary and in a few permanent loss of hearing acuity. The effect of traffic noise in Police personnel of Kurnool city was assessed by questionnaire. MATERIALS AND METHODS: Seventy traffic police personnel posted in various traffic junctions of Kurnool City were asked to fill a questionnaire related to their hearing acuity. Ambient noise Levels at important traffic junctions were measured using portable precision digital sound level meter (Lutron - Model SL4010). RESULTS: Irritation and problem in hearing in the crowd was the main complaints seen in 27.14% of the study subjects. RTC bus stand recorded the highest value of 109.6dB. CONCLUSION: Legal framework should be imposed to maintain the noise levels in traffic within acceptable levels. Health education and personal protection devices should be provided to the traffic police and their

The aim of the study was to find out the predictive value of single monotic auditory steady-state response (ASSR) in hearing threshold estimation in children with severe to profound sensorineural hearing loss (SNHL). Forty-eight children (96 ears) with severe to profound SNHL were included. They were subjected to age-based audiological evaluation. Single monotic ASSR was obtained and analyzed for all children using test signals of 250, 500, 1000, 2000, and 4000 Hz, modulated in either ears at high rates of 67, 74, 81, 88, and 95 Hz, respectively, using GSI Audera evoked potential system. The number and percentage of ASSR detected were highest at 1000, 500, and 2000 Hz, respectively in all children. The ASSR thresholds obtained were statistically correlated with the behavioral audiometric thresholds at the corresponding frequencies. A considerable number of ears with no sound field thresholds or click auditory brainstem response responses showed ASSR. Single monotic ASSR, with high modulation frequencies, has shown to be a reasonable method for estimating hearing sensitivity in the mid-conventional audiometric frequencies in children with severe to profound SNHL.

Background: In the modern era mobile phone uses is constantly increasing day by day after its commercial availability from 1983. The mobile is an electromagnetic device which work on radiofrequency band, it receives and send signals.Methods: In this study we selected tertiary level centre students for hearing evaluation including higher frequency in chronic mobile user. Volunteers from medical college students between 20 to 30 were included who have been using mobile phone for more than a year.Results: Among the 200 subjects male candidates were 118 and female candidates were 82. Age of the volunteers was between 20 years and 30 years. After careful assessment of audiogram obtained from the volunteers segregation done in two groups, one with no hearing loss and other with hearing loss. 69% of total volunteers had no hearing impairments that is 138 volunteers where as 31% had hearing impairments that is 62 volunteers. If we compare these two groups the age of group having hearing loss was near 30 yearsConclusions: In our study we observed that pronged mobile phone uses predispose to the hearing loss at the dominant ear. This hearing loss was noticed on long term use of hearing and since it involve the unilateral ear we presumed mobile phone use is the responsible factor. We observed that more the duration of mobile phone use more will be hearing loss.

Background Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Approximately 20% of all dizziness is due to BPPV. Objective To assess the peripheral vestibular function in a group of patients with BPPV versus group of normal population by using the cervical vestibular evoked myogenic potential (cVEMP) and video head impulse test (vHIT). Materials and methods This is a comparative cross-sectional study. A total of 60 individuals [20 apparently healthy controls (40 ears) and 40 patients with BPPV, who initially were diagnosed by Dix–Hallpike test/supine roll test], were included in the study. All participants gave their written consent before participation in the study. The control as well as the study group was subjected to basic audiological evaluation and vestibular evaluation. Results Regarding the vHIT, there was a statistically significant difference between control and study groups regarding the left vertical canal gain and the asymmetry (P Conclusion Significant abnormal cVEMP in BPPV may indicate saccular involvement in the BPPV pathophysiology, which needs more research to prove or disprove it. Abnormal vHIT gain and asymmetry of the left vertical canal only needs more research in a large sample size.

Introduction Development of sensorineural hearing loss [SNHL] leads to severe handicap that affects patient’s job, home and life. Therefore, otologists should diagnose potentially treatable disorders to improve and/or even stabilize hearing. Aim of work Evaluation of intra-tympanic corticosteroids for the treatment of different types of SNHL. Subjects and methods Intra-tympanic injection of steroid under local anesthesia of 51 patients suffering from immune-mediated SNHL. Audiological evaluation was done pre & post-injection. Results Hearing improvement of 23.41 dB by pure tone audiometry occurred in 43.2% of patients. Speech discrimination scores had improved by 30.1% in 78.4% of patients. Conclusion Intra-tympanic steroid injection is a safe and promising tool for the treatment of immune-mediated SNHL.

Quantifying the improvement in quality of life (QoL) of cochlear implant (CI) patients over 60, its relation to audiometric benefits and the subjective impact on specific areas of life.An observational retrospective study was conducted on 26 individuals (17 male and 9 female) older than 60, all implanted in our unit between 1 January 1999 and 31 January 2009. And 10 patients (5 male and 5 female) aged between 40 and 60 were the control group. A full postoperative audiological evaluation was completed. Sociodemographic characteristics and history of hearing loss were collected. To evaluate QoL benefits, the Glasgow Benefit Inventory test and the Specific Questionnaire were filled in.Patients in the test and control groups had similar preoperative speech recognition levels. Preoperative audiometric thresholds were significantly worse in patients from 40 to 60 years of age although they scored better in speech recognition after implantation. Patients experienced significant improvement in their QoL in all areas, especially in general health, while they experienced a smaller improvement in social interaction. Age, duration of deafness, and years wearing the processor were statistically related to QoL regardless of audiometric benefit. Unilateral CI users and patients without tinnitus obtain better QoL although no statistical relation was found.Cochlear implantation improves QoL of patients over 60 by the mere fact of having been implanted, regardless of poorer audiological benefits. Older patients, with long-term deafness experience a greater improvement in QoL after implantation. The results of this study should aid other centers when counseling patients on the expected, daily functional benefits of cochlear implantation.