Audiology

Determination of mismatch negativity in 4 to 9-Year-old children by tonal stimulation

Seyyed Ali Akbar Tahaei

Background and Aim: Mismatch negativity (MMN) is one of auditory evoked potentials that occurs about 100-250 ms after stimulus onset. The MMN waveform is elicited by a discriminateable change in a sequence of repetitive homogenous stimuli. This change can be in intensity level, frequency, or duration of auditory stimuli. The purpose of this study was to obtain MMN waveform using tonal stimuli and to investigate its changes during changes in age.
Materials and Methods: The study was prescriptive-analytic cross-sectional. The participants were sixty children aged 4 to 9 year.The Stimuli were at 80 dB pe SPL. A 1000Hz tone and a 1500 Hz tone were used as standard and deviant stimuli, respectively. Probability of deviant stimuli was 20%. Trials were recorded using surface electrode placed at four locations on the head.
Results: The MMN waveform does not exist in 22.5% of the children. Also, determining of MMN peak in 22.5% was not exactly possible. In other subjects, a significant negative correlation was observed between latency of MMN and age, but not for age and amplitude for this negativity.
Conclusion: This study confirms that the MMN may not be seen in normal people. Also there are maturational changes in MMN waveform.

Investigation of tinnitus characteristics in 36 patients with subjective tinnitus with unknown etiology

Mahdi Bakhshaee

Background and Aim: Tinnitus represents the perception of sound without an external stimulus. The prevalence of tinnitus ranges from 3% to 30%. In most cases its etiology is unknown. Tinnitus can be classified as pulsatile or nonpulsatile. Nonpulsatile form is the most common form and almost exclusively subjective in nature. There is a range of condition attributed to nonpulsatile high frequency tinnitus (acoustic neuroma, Meniere&aposs disease, ototoxic agents, noise exposure...). There are many studies about form, site, loudness, and frequency of tinnitus and how it can affect the quality of patient life.
Materials and methods: This was a descriptive and analytic study. Thirty-six patients (23 men and 13 women) with mean age 53.1 year old with subjective tinnitus evaluated in pezhvak audiometric clinic in Mashhad .The data consisting of age sex, loudness, frequency form and site of tinnitus. Evaluation of affects of tinnitus on the quality of life and habits was performed with a tinnitus questionnaire (TQ).
Results: Tinnitus was unilateral in 64% of cases right site was more common. Mean pitch was 7.03 kHz and average loudness was 3.8 dB SPL. SDS was in normal range in all of patients. There was a high frequency sensory neural hearing loss (above the 4 kHz) in most of the patients. The greatest score (60.3%) of TQ related to intrusiveness aspect. Sleep disorder has the lowest score (39/3%). Global score was 52.4%.
Conclusion: Nonpulsatile subjective tinnitus has a broad range of etiology with unknown mechanism in most cases and without any history of underlying disease in a large group of patients. This symptom mostly involves the patients` lifestyle that is intrusiveness aspect in comparison with the other aspects including sleep, hearing and somatic complaints. There is no cure for most patient and more studies are needed in the future.

Comparison study of the stuttered words type in stuttering children and adults

Mohammad Rahim Shahbodaghi

Background and Aim: Since knowing the mechanisms which evoke non-fluency is the first step in the treatment of stuttering, and there are very few researches in Persian which consider the role of the linguistic factors behind stuttering , this study is an attempt to provide answers to some of numerous questions about stuttering by comparing the stuttered words` type in stuttered children and adults.
Materials and Methods: In this study stuttered people were divided into 5 age groups as follows: 3-6, 7-9, 10-12, 13-16, and older than 17 years old. Each group had ten participants. Forty-two of the 50 participants were male , and the youngest person was 3 years old and the eldest one was 32 years old. The study method involved recording at least 5 minuets of spontaneous speech of every one who was diagnosed of suffering from stuttering by two speech and language pathologists. The percent of non-fluency on every word&aposs type was determined where a content word was followed or preceded by a function word (Function-Function-Content words and Function-Content words contexts). Then these findings were analyzed by Kruskal-Wallis and Mann-Whitney tests.
Results: The results of this study show while function words are dominantly more stuttered than content words in children less than 13 years old in Function-Function-Content words context, we consider more disfluency on content words and second function word by getting old. We consider more stuttering on function words in children less that 13 years old in Function-Content words context too and increased non-fluency on content word by growing up. Results also show meaningful differences between the fifth group and others in the amount of stuttering on second function word in the Function-Function-Content words contexts and also between the first group and the others in amount of non-fluency both on function and content words in Function-Content words context.
Conclusion: people who stutter from Farsispeakers populations exhibit almost differential patterns of disfluency in different ages. Young speakers who stutter are predominantly disfluent on function words. There is an exchange of disfluencies from function to content words as speakers get older. Disfluencies on both function and content words are so rarely in Function-Content words and Function-Function-Content words contents. These findings support the view that stuttering on function words in children is a way of getting time to complete the next content word&aposs plan. These exchange findings are similar to what is found in English and Spanish languages and explained by the EXPLAN model.

Preparation and evaluation of SKI-HI: A parent-infant auditory training program for under 3- year -old hearing impaird children

Mahin Sedaei

Background and Aim: Lack of early detection of and intervention for infants hearing loss results in a significant delay in speech and language development. So auditory rehabilitation plays an important role in improving the diminished communication ability. One of the most successful auditory training approaches is the SKI-HI parent-infant program. The purpose of this study was preparation and evaluation of Farsi-Language SKI-HI program for under 3-year-old hearing impaired children.
Materials and Methods: After translation and modification of the text of the program, fifteen under 3-year-old children with bilateral severe sensory hearing loss who were fitted with appropriate behind the ear hearing aids received intervention for 6 months. The levels of the auditory skills were measured pre and post intervention. Intervention Efficiency Index (IEI), Pretest Developmental Rate (PDR) and Proportional Change Index (PCI) were computed.
Results: The data indicated that there was a significant difference between means of IEI and PDR which were 0.87 and 0.31, respectively. PCI was 3.38 indicated that the children&aposs auditory skills developed at about 2.38 times higher rate after SKI-HI intervention than they did before. PCI confidence interval showed that development in the population is 1.46 to 3.30 times higher after SKI-HI intervention (with 95% probability) the rate of auditory skills.
Conclusion: The auditory training with Farsi-language SKI-HI Parent-Infant program may efficiently affect development of auditory skills of hearing impaired children.

Development and evaluation a Farsi language version of synthetic sentence identification test in normal individuals

Nariman Rahbar

Background and Aim: Central auditory processing disorders (CAPD) may have a variety of etiologies therefore, performing CAPD tests seem inevitable. Behavioral tests such as synthetic sentence identification (SSI) has gained considerable popularity because of high sensitivity to brainstem and cortical lesions, high diagnostic ability, cost-benefiting, and also limitations of electrophysiologic tests. The purpose of this study was to prepare a Farsi-language version of SSI and to perform a primary evaluation.
Materials and Method: Farsi SSI test was made and recorded on CD. Then sixty 20-to 35- year old normal-hearing participants were evaluated in audiology clinic, Faculty of Rehabilitation Sciences Iran University of Medical Sciences in three months.
Results: There is no significant difference between scores of Farsi and original versions of SSI. Gender has no significant effect on the scores.
Conclusion: According to this results, Farsi SSI is comparable to the original one. It can, therefore, be used in CAPD test battery.

The effect of learning disability on contralateral suppression of otoacoustic emissions in primary students

Saeid Sarough Farahani

Background and Aim: One of the most significant complaints of children with learning disability (LD) is difficulty in understanding speech in the presence of background noise. Different studies have shown that the medial olivocochlear bundle(MOCB) may play a role in hearing in noise. The MOCB function can be evaluated by the contralateral suppression of tone burst evoked otoacoustic emissions (TBEOAEs).The aim of the present study was to evaluate frequency specifications of MOCB by the contralateral suppression of TBEOAEs at 1,2,3 and 4 KHz in response to contralateral white noise in LD students.
Materials and Methods: This case-control study was conducted on 34 LD students aged 7-11 years and 31 normal students matched for age.The contralateral suppression of TBEOAEs was evaluated by comparing TBEOAEs amplitudes with and without contralateral white noise.
Results: In the absence of noise there was no significant difference between TBEOAEs amplitudes of two groups. In the presence of noise significant decrease was seen in TBEOAEs amplitudes at 1,2,3 and 4 KHz in both groups. In LD students the amount of this decrement at 1,2 and 4 KHz was lower than in the normal students.
Conclusion: A significant diminished suppression effect at 1,2 and 4 KHz in LD students indicates that at these frequency regions MOCB function was reduced. Therefore its suggested that the assessment of MOCB by evaluating the suppression effect of TBEOAEs included in the test battery approach used in the diagnostic of LD students.

Introducing and evaluating a Farsi - language version of the staggered spondaic word test in normal hearing subject

Fahimeh Hajiabolhassan

Background and Aim: The staggered spondaic word (SSW) test is potent to evaluate the function of the central auditory nervous system. As the Farsi version is not available, the purpose of this study was to prepare a Farsi language version of SSW (FLV-SSW), and to conduct a primary evaluation.
Materials and Methods: The Farsi-language version of SSW was first prepared and recorded on a tape. Fifty-eight normal hearing individuals with mean age 29.72 years were avaluated in Rehabilitation School of Iran University of Medical Sciences in 3 months.
Results: The mean scores of Raw SSW was 98.364 in the normal group. The minimum and maximum percentage of errors of Corrected SSW were -6 and 8 for each of the conditions, -4.75 and 5 for each ear and -3.88 and 3.75 for the entire test (total). The maximum number of reversals was one. There is no difference between males and females scores.
Conclusion: Based on the obtained results, the FLV-SSW test appears to have potential as a useful measure of central auditory processing but the generalization of this results needs further studies.

A study of managed care guideline of preoperative assessment in ENT ward at Bazarganan Hospital in Tehran

Amir Ashkan Nasiripour

Background and Aim: In recent years, attention of the health care managers is attracted to three factors including promotion of services quality, accessibility and procurement of financial resources of relevant organizations. The aim of this study is to consider the executive status of guideline of managed health care for preoperative assessments of ENT patients at Bazarganan Hospital in 2005.
Materials and Methods: The present research is conducted on 140 cases in descriptive form. The research information is collected by using a check list. Indexes and method of descriptive statistics are used for the data analysis and statistical study.
Results: Of one hundred and forty ENT patient records, in 136 (97%) of the cases American Society of Anesthesia criteria had been registered. Vital signs, patient histories and CBC were recorded in 137 (98%), 138 (99.5%) and 139 (98.3%) patients recordes, respectively. Eight (69.7%) over 60 years old cases had been X-rayed. EKG has been performed on all fifteen cases over 40 years old. Thirty nine (28%) recordes contained internist and cardiologist counselling.
Conclusions: Assessment of guidline indicates very good status. Application of managed care guidelines of preoperative assessment in ENT surgeries could play a crucial role in reducing complication of ENT surgeries and the improvement of the implication of the guidelines.

The oral diadochokinesis in normal-hearing and hearing-impaired adolescents

Zahra Soleymani

Background and Aim: Hearing loss results in impairment of muscles coordination and survival essential that are engaged in motor speech timing tasks. It will negatively affect the acquisition of speech sounds. The purpose of this study was to compare the oral diadochokinesis in normal-hearing and hearing - impaired adolescents
Materials and Methods: This research was conducted on sixty-one adolescents aged 15-18 years old. Forty-six had moderately severe, severe, or profound hearing loss and fifteen were normal. The time spent to perform each oral diadochokinesis tasks was measured by speech analyzer of Dr. speech software, version four.
Results: Results indicated that hearing - impaired performed significantly slower on all speech timing tasks than their normal hearing peers except those with moderately severe hearing-impaired group. There were significant differences between profound hearing-impaired group and both other groups.
Conclusion: The results of this study point out the motor speech problems in hearing impairment. The differences, in general, indicate that speech-timing coordination deficits are compromise with hearing loss degree.