Auditory perceptual and visual-spatial characteristics of subjective tinnitus evoked by eye gaze were studied in two adult human subjects. This uncommon form of tinnitus occurred approximately 4-6 weeks following neurosurgery for gross total excision of space Occupying lesions of the cerebellopontine angle and hearing was lost in the operated ear. In both cases, the gaze evoked tinnitus was characterized as being tonal in nature, with pitch and loudness percepts remaining constant as long as the same horizontal or vertical eye directions were maintained. Tinnitus was absent when the eyes were in a neutral head referenced position with subjects looking straight ahead. The results and implications of ophthalmological, standard and modified visual field assessment, pure tone audio metric assessment, spontaneous otoacoustic emission testing and detailed psychophysical assessment of pitch and loudness are discussed.

Tinnitus from the Latin word tinnire meaning ringing is the perception of sound within the human ear in the absence of corresponding external sound. The most common cause is noise induced hearing loss. Tinnitus may be induced by an acoustic trauma or a permanent noise in the workplace. In case that Tinnitus is induced by acoustic trauma the site of lesion is commonly the base of the cochlea. Tinnitus in the senile population is mostly accompanying presbycusis. Although the incidence of permanent tinnitus following noise exposure is high, little is published about this issue. In the current article we are aimed at studying the prevalence of tinnitus in Minoo and other manufactures.

Background: Facial schwannoma is a rare tumor arising from any part of the nerve. Probable symptoms are partial or facial weakness, hearing loss, visible mass in the ear, otorrhea, loss of taste, rarely pain, and sometimes without any symptoms. Patients should undergo a complete neurotologic history, examination with documentation of facial and auditory function, specially C.T. scan or M.R.I. Surgery is the only treatment option although the decision of when to remove facial schwannoma in the presence of normal facial function is difficult.
Case: A 19-year-old girl with all above symptoms in the right side except loss of taste is diagnosed having facial schwannoma with full examination, audiometric, and radiological tests. She underwent surgery. In follow-up facial function were mostly restored.
Conclusion: The need for careful assessment of patients with Bell's palsy cannot be overemphasized. In spite of the negative results if still there is any suspicoin, total facial nerve exploration is necessary.

Background and Aims: As the hearing aid technology progressively promotes toward replacing analog hearing aids with digital and programmable ones, comparison of the patient satisfaction of those kinds of hearing aids by means of a valuable tool seems so necessary. So, the aim of this study was to compare self-reported benefit of analog, digitally controlled programmable and digital hearing aids for reducing disability caused by hearing impairment in mild to severe sensorineural hearing impaired persons.
Materials and Methods: This cross-sectional study was performed on 90 persons with mild to severe sensorineural hearing loss dividing into three groups: 43 subjects were fitted with digital, 15 with programmable, 23 with analog hearing aids. After pure tone audiometry, Abbreviated profile of hearing aid benefit (APHAB) was completed before and one month after using hearing aids to determine the benefit of them.
Results: Global APHAB mean scores for digital, programmable and analog hearing aids were 49.05, 33.19 and 39.53, respectively. Ease of Communication subscale mean scores were 53.46 for digitals, 37.66 for programmables and 39.09 for analogs. Background noise subscale mean scores for digital programmable and analog hearing aids were 46.36, 25.53 and 35.31, respectively. Global and also both subscale mean scores showed significant difference between digital hearing aids and programmable and analog ones. There was no significant difference between reverberation subscale mean scores of three groups.
Conclusion: It seems digital hearing aids may be more beneficial to reduce disability caused by hearing loss than analog and programmable hearing aids are.

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.

Background and Aim: Internal Evaluation means assessment of abilities and potentials. To promote the quality of education, research, health and finally rehabilitation is one of the most important roles and responsibilities of the universities. Promotion of quality of the theoretical and practical education for the Audiology students provides this major with its final goal that is to serve society. The purpose of this study was to evaluate the strength, weaknesses, opportunities and threats (SWOTs) of the Audiology department and to identify the ways of diminishing weaknesses and threats.
Materials and Methods: This descriptive cross-sectional study was conducted on undergraduates, postgraduates, graduates, academic staff, and the director of Audiology department in 9 areas, including management flowchart, educational programs, instructional methods and curriculum models, students, educational areas and equipments, graduate, academic staff, research, and treatment. Data were collected by questionnaires. Results were analyzed descriptively and were expressed in raw and percentage.
Results: The scores of areas in two measures were as follows: management flowchart 4.36 (87.31%), educational programs 4.17 (83.58%), instructional methods and curriculum models 4.01 (80.26%), students 3.43 (68.60%), educational areas and equipment 3.60 (72.11%), from the view of undergraduates, post graduates, faculties, graduates 3.60 (72.03%), academic staff 4.03 (80.6%), research 3.52 (70.4%), and treatment 4.54 (90.80%). The highest score was, therefore, of the treatment area and the lowest belonged to the educational area and equipments. The score of the Audiology department, as the main factor was 3.89 out of 5 which was 77.88%.
Conclusion: Audiology group total score indicates the desirable status that can be promoted to the most desirable if SWOTs are considered.

Background and Aim: Blocking of the adenosine receptor in central nervous system by caffeine can lead to increasing the level of neurotransmitters like glutamate. As the adenosine receptors are present in almost all brain areas like central auditory pathway, it seems caffeine can change conduction in this way. The purpose of this study was to evaluate the effects of caffeine on latency and amplitude of auditory brainstem response(ABR).
Materials and Methods: In this clinical trial study 43 normal 18-25 years old male students were participated. The subjects consumed 0, 2 and 3 mg/kg BW caffeine in three different sessions. Auditory brainstem responses were recorded before and 30 minute after caffeine consumption. The results were analyzed by Friedman and Wilcoxone test to assess the effects of caffeine on auditory brainstem response.
Results: Compared to control group the latencies of waves III,V and I-V interpeak interval of the cases decreased significantly after 2 and 3mg/kg BW caffeine consumption. Wave I latency significantly decreased after 3mg/kg BW caffeine consumption(p<0.01).
Conclusion: Increasing of the glutamate level resulted from the adenosine receptor blocking brings about changes in conduction in the central auditory pathway.

Background and Aim: In neural response telemetry (NRT), intracochlear electrodes stimulate the auditory nerve and record the neural responses. The electrical stimulation send to the auditory nerve by an electrode and the resulted response, called electrically evoked compound action potential (ECAP), is recorded by an adjacent electrode. The most important clinical applications of this test are evaluation and monitoring the intra and postoperative responses of auditory nerve and help to primary setting of speech processor. The aim of this study was evaluating of the potential&aposs threshold changes in three monthes after receiving the devise in pediatric cochlear implant recipients.
Materials and Methods: This longitudinal study evaluated the potential&aposs threshold in four given electrodes in four sessions after receiving the device by approximately one months intervals in children implanted in Amir Alam and Hazrat-e-Rasoul hospitals in 2007, July to December.
Results: ECAP mean threshold level of each electrode did not significantly change in differnent sessions, while there was significant difference between apical and basal electrodes&apos responses in every session(p<0.001).
Conclusion: The reliabiliy of the responses result in more certainty of clinician to fit the speech processor for a long time. Better responses in apical electrodes may lead to develope an effective coding strategy.

Background and Aim: Vestibular evoked myogenic potentials (VEMP) originate from the saccule and the inferior vestibular nerve. In this study, the prevalence of VEMP and latency of the p13 and n23 were compared between three groups of individuals, including symptomatic and asymptomatic Meniere's disease cases and normal participants.

Methods: This study was conducted on 42 cases with the mean age of 40.48 years thirty were Meniere's disease patients, of which 19 were symptomatic and 11 were asymptomatic twelve were normal participants. The VEMP were recorded with 500 Hz tone bursts at 120 dBpeSPL. Then the prevalence and latency of the waves were analyzed and compared in the three above mentioned groups.

Results: The prevalence of VEMP in symptomatic Meniere's disease patients (52.6%) was significantly less than asymptomatic individuals (90.9%) and also normal subjects (100%)(p<0.05). There was no significant difference between latencies of the waves in these three groups (p>0.05). The latency of p13 for symptomatic, asymptomatic and normal participants was 16.41, 15.20 and 14.14 ms, respectively and the latency of n23 for these groups was 20.25, 18.77 and 18.50 ms, respectively.

Conclusion: In Meniere's disease, after medical management, the succule probably regains normal function resulting in re-existence of VEMP. It seems that there is no change in the latency of the waves, most likely due to involvement of the inner ear and intactness of the nerve. VEMP may be a useful test for diagnosis of Meniere's disease and additionally for monitoring the trend of medical management.

Background and Aim: Previous studies suggest that auditory stimulus frequency in normal subjects contribute to both P300 amplitude and latency measures. As occipital cortex devotes to other modalities including auditory inputs, the purpose of this study was to determine the effects of stimulus frequency in early blind subjects.
Methods: fifteen early blind subjects (8 males and 7 females) with mean age of 25.13±4.27 years were tested. Cognitive potential P300 was recorded in response to high (1000/2000 Hz ) and low (250/500 Hz) frequencies auditory stimuli using an oddball task in 70 dB nHL. While participants answered to target stimulus, amplitude and latency of P300 was recorded.
Results: With high frequency stimuli, mean amplitude in early onset blind subjects obtained 14.13 ±5.53µv and was 17.59±8.17µv with low frequency. With high and low frequency, mean latency of P300 obtained 295.60±31.33ms and 317.38±21.71ms respectively.
Comparison of results between two stimuli showed that there were statistically significant differences between amplitudes (p=0.008) and latencies (p=0.001) of cognitive potential P300.
Conclusion: Changing low frequency to high frequency results in decreasing both amplitude and latency. It seems that auditory stimuli frequency affect the P300 parameters in blind subjects.

Background and Aim: Conventional balance tests such as electronystagmography and videonystagmography, which are vision-dependant, are not practical in blind patients. Instead, vestibular evoked myogenic potential , not needing any vision, seems to be a more appropriate test for evaluating the vestibular system, in these patients. This study aimed to assess the prevalence and the latencies of p13 and n23 waves among congenitally blind and sighted participants evaluated by vestibular evoked myogenic potential.
Methods: In a cross-sectional study, vestibular evoked myogenic potential was recorded for 20 sighted and 20 congenitally blind subjects, aged 18 to 30 years old, using 500 Hz-tone bursts (95 dBnHL).
Results: Vestibular evoked myogenic potentials responses were present in all (100%) of the participants. Considering the results of the both ears, there was no significant difference between mean p13 and n23 latencies of the two groups (p>0.05).
Conclusion: Formation of vestibular evoked myogenic potentials reflex arc and neural pathway in congenitally blind patients is similar to sighted individuals hence, the development of this pathway is independent of the visual system. Vestibular evoked myogenic potentials test is a useful test to assess vestibular function of the blinds.

Background and Aim: Although the ability of speech perception has been improved in implanted subjects with recent progress in technology, cochlear implantation alone is not enough and more aural rehabilitation is necessary. The aim of this study was to assess improvement of speech perception in children with cochlear implant.
Methods: Fourteen cochlear implanted children with a mean age of 5.5 years participated in this study. Auditory training was performed in 10 to 43 sessions. Speech recognition and perception were evaluated every 3 months. Third evaluation was done only for 4 patients.
Results: Mean total score of the first evaluation was 43.21%, of the second was 63.76%, and of the third evaluation was 78%. All children obtained complete score for sound awareness at the first evaluation. In environmental sounds discrimination, 71.3%, 84.36%, and 100% answered completely to the questions of three evaluations respectively. In speech sounds discrimination, 34.7% in the first, 57.04% in the second, and 85% in the third evaluation obtained the complete score, and in auditory memory, complete responses were 21% for the first, 57.12% for the second, and 83% for third evaluation. In story rephrasing and comprehension, no one answered to questions completely. However, 12.83% obtained the complete score in the second and third evaluations. There were statistically significant differences between the first and the second evaluation (p=0.002(.
Conclusion: Sound awareness ability seems to be achieved rapidly. Development of speech and environmental sound discrimination abilities, particularly speech comprehension which is the most important skill, need more impressive training.

Background and Aim: Auditory temporal processing reveals an important aspect of auditory performance, in which a deficit can prevent the child from speaking, language learning and reading. Temporal resolution, which is a subgroup of temporal processing, can be evaluated by gap-in-noise detection test. Regarding the relation of auditory temporal processing deficits and phonologic disorder of children with dyslexia-dysgraphia, the aim of this study was to evaluate these children with the gap-in-noise (GIN) test.
Methods: The gap-in-noise test was performed on 28 normal and 24 dyslexic-dysgraphic children, at the age of 11-12 years old. Mean approximate threshold and percent of corrected answers were compared between the groups.
Results: The mean approximate threshold and percent of corrected answers of the right and left ear had no significant difference between the groups (p>0.05). The mean approximate threshold of children with dyslexia-dysgraphia (6.97 ms, SD=1.09) was significantly (p<0.001) more than that of the normal group (5.05 ms, SD=0.92). The mean related frequency of corrected answers (58.05, SD=4.98%) was less than normal group (69.97, SD=7.16%) (p<0.001).
Conclusion: Abnormal temporal resolution was found in children with dyslexia-dysgraphia based on gap-in-noise test. While the brainstem and auditory cortex are responsible for auditory temporal processing, probably the structural and functional differences of these areas in normal and dyslexic-dysgraphic children lead to abnormal coding of auditory temporal information. As a result, auditory temporal processing is inevitable.

Background and Aim: Navigation information is processed and stored in different brain areas such as hippocampus. Since multiple pathways has been reported between vestibular nuclei and hippocampus and also cognitive dysfunction specifically in spatial memory is induced by vestibular deficits, it can be assumed that vestibular system stimulation ameliorates spatial memory. The aim of study was to evaluate the effect of galvanic vestibular stimulation on normal individual’s spatial memory.

Methods: In this experimental-interventional study, sixty 18-30-years-old women were randomly allocated in intervention and control groups. Intervention group undergone subthreshold bilateral bipolar galvanic vestibular stimulation and control group received sham stimulation. Stimulation was presented for 15 minutes. Corsi Block Tapping (CBT) test scores were compared before and after subthreshold bipolar galvanic vestibular stimulation exposure or no stimulation in each group and between groups.

Results: All test parameters were the same in both groups before stimulation (p<0.050). There were significant improvement in block span, total score and learning score in intervention group after galvanic vestibular stimulation (p<0.050), no significant difference in delayed score (p=0.600). Learning score was improved (p=0.003) and delayed score was deteriorated (p=0.010) in control group. Percentages of block span and total score in intervention group were significantly different compared to the other group (p<0.050).

Conclusion: Galvanic vestibular stimulation improves short-term and long-term spatial memory. This test may inherently have learning effect that is not influenced by stimulation.

Background and Aim: Since utricle is the main damaged organ in benign paroxysmal positional vertigo (BPPV), ocular vestibular evoked myogenic potential (oVEMP) may be an appropriate method to evaluate the utricule dysfunction and the effect of disease recurrence rate on it. This study aimed to record myogenic potential in patients with benign paroxysmal positional vertigo.

Methods: In a cross-sectional study, ocular myogenic potential was recorded in 25 healthy subjects and 20 patients with benign paroxysmal positional vertigo using 500 Hz-tone bursts (95 dB nHL).

Results: In the affected ear, mean amplitude was lower and mean threshold was higher than those in the unaffected ear and in the normal group (p<0.05). Mean amplitude asymmetry ratio of patients was more than the healthy subjects (p<0.001). There was no statistical difference between the two groups regarding mean latencies of n10 and p15 (p>0.05). Frequencies of abnormal responses in the affected ears were higher than in unaffected ears and in the normal group (p<0.05). Furthermore, the patients with recurrent vertigo showed more abnormalities than the patients with non-recurrent (p=0.030).

Conclusion: In the recurrent benign paroxysmal positional vertigo, ocular vestibular evoked myogenic potential showed more damage in the utricle, suggesting this response could be used to evaluate the patients with benign paroxysmal positional vertigo.

Background and Aim: Creatine plays an important role in the regulation of cellular energy in high energy demand organs such as the inner ear. It is also believed to play a protective role. This article reviewed the mechanisms and effects of creatine on the auditory and vestibular systems.

Recent Findings: Creatine transporters and creatine kinase enzymes are involved in converting creatine to creatine phosphate. Phosphate is a fuel cell available in the cochlear and vestibular hair cells and the protective cells, striavascularis, peripheral and central neural pathways to the auditory cortex. It provides essential ATP for auditory and vestibular system performance. Creatine kinase prevents cochlear damage by regulating the metabolism of energy in marginal layers of the striavascularis and preventing free radical production in stressful situations. It also plays an important role in vestibular compensation. Creatine kinase dysfunction leads to an increase in the threshold of auditory brainstem potentials and a reduction in vestibular performance. The use of creatine improves vestibular evoked myogenic potentials and neurologic symptoms.

Conclusion: Creatine and creatine kinase protein is essential for normal hearing and balance function and sensitivity. Creatine kinase deficiency impairs the functioning of these two systems however, creatine consumption may boost the sensitivity of the vestibular system and neurological performance. Effects of the creatine consumption on the auditory system have not yet been examined.