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Background and Aim: N-acetylcysteine, a glutathione precursor and reactive oxygen species scavenger, is reported to be effective in reducing noise-induced hearing loss. Many workers in industry are exposed simultaneously to noise and chemical pollutants such as carbon monoxide. We investigated effectiveness of N-acetylcysteine in protecting the cochlea from simultaneous noise and carbon monoxide damages.
Methods: Twelve rabbits were exposed simeltaneously to 100 dB sound pressure level of broad band noise and carbon monoxide 8 hours a day for 5 days. One hour before exposure, experimental group received 325 mg/kg of N-acetylcysteine while normal saline was administered for the control group. The protective effect of N-acetylcysteine was evaluated 3 weeks after exposure by histological assessment of the hair cells.
Results: Simultaneous exposure to noise and carbon monoxide resulted in a considerable damage to the outer hair cells however, the inner hair cells and the pillar cells remained intact. Use of N-acetylcysteine in the experimental group significantly reduced the extent of outer hair cell loss.
Conclusion: N-acetylcysteine attenuates simultaneous noise and carbon monoxide induced hair cell damage in rabbits.
Ke

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Background and Aim: To date, the function of auditory efferent system remains unclear. There is evidence that medial olivocochlear bundle receives descending input from the cortex. In this study, the effect of auditory selective attention on stimulus-frequency otoacoustic emissions (SFOAE) was analyzed to investigate the modification of peripheral auditory system by auditory cortex activity in frequency specific mode.
Methods: Thirty-six normal hearing adult subjects with their age ranging from 18 to 30 years (mean age: 21.9 years) participated in this cross-sectional study. Contralateral suppression of stimulus-frequency otoacoustic emissions was recorded in the right ear at 2 KHz. In order to eliminate the auditory attention, subjects were instructed to read a text. Besides, in order to evaluate the effect of auditory attention on contralateral suppression, subjects were instructed to detect target tones in background noise at 1000, 2000, and 4000 KHz.
Results: A significant increase at contralateral suppression of stimulus-frequency otoacoustic emissions was observed in auditory selective attention conditions (p≤0.001). The largest magnitude of stimulus-frequency otoacoustic emissions suppression was seen at 2 KHz.
Conclusion: The results of this study indicated that the activities of medial olivocochlear bundle enhanced by contralateral auditory selective attention increase the magnitude of stimulus-frequency otoacoustic emissions suppression. In fact, these results provided evidence for influence of auditory cortex on the peripheral auditory system via corticofugal pathways in a frequency specific way.

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Background and Aim: In view of improvement in therapeutic outcome of cancer treatment in children resulting in increased survival rates and the importance of hearing in speech and language development, this research project was intended to assess the effects of cisplatin group on hearing ability in children aged 6 months to 12 years.
Methods: In this cross-sectional study, hearing of 10 children on cisplatin group medication for cancer who met the inclusion criteria was examined by recording auditory brainstem responses (ABR) using the three stimulants of click and 4 and 8 kHz tone bursts. All children were examined twice: before drug administration and within 72 hours after receiving the last dose. Then the results were compared with each other.
Results: There was a significant difference between hearing thresholds before and after drug administration (p<0.05). Right and left ear threshold comparison revealed no significant difference.
Conclusion: Ototoxic effects of cisplatin group were confirmed in this study. Insignificant difference observed in comparing right and left ear hearing thresholds could be due to small sample size. auditory brainstem responses test especially with frequency specificity proved to be a useful method in assessing cisplatin ototoxicity.

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Background and Aim: A negative deflection with a 3-4 ms latency period has been reported to exist within the auditory brainstem response of some patients with profound hearing loss following a strong acoustic stimulus. This deflection, namingly the n3 or the acoustically evoked short latency negative response is assumed to be a vestibular-evoked potential, especially of saccular origin. Since the myogenic potential is also saccular in origin, the purpose of the present study was to investigate the relationship between these two tests in adults with profound hearing loss.
Methods: The present cross sectional study was performed on 20 profoundly deaf volunteers(39 ears) who aged between 18-40 years old, randomly selected from available deaf adults in Tehran. The auditory brainstem response of all subjects was recorded following a 1000 Hz tone burst in 70-100dB nHL. Subjects were also tested for vestibular evoked myogenic potential.
Results: Only 34 of 39 ears recorded myogenic potential that negative response was recorded in 27 of 34 ears with normal p13 and n23. In seven ears with normal p13 and n23, the negative response was absent. In 3 ears with no p13 and n23, the negative response was observed, and two none.
Conclusion: In view of the high prevalance of the negative response in profoundly deaf ears with normal p13 and n23, it could be concluded that the negative response can be used when for any reason, it is not possible to record myogenic potential and be considered as a new test in vestibular test battery.

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Background and Aim: Ocular vestibular-evoked myogenic potential (oVEMP) is a novel vestibular function test. This short-latency response can be recorded through contracting extraocular muscles by high-intensity acoustic stimulation and can be used to evaluate contralateral ocular-vestibular reflex. The aim of this study was to record and compare the amplitude, latency, asymmetry ratio and occurrence percentage of oVEMP (n10) and cervical VEMP (p13) responses in a group of normal adult subjects.
Methods: We carried out a cross-sectional study on 20 adult subjects&apos mean age 22.18 years, SD=2.19 with normal hearing sensitivity and no history of vestibular diseases. oVEMP and cVEMP responses in both ears were recorded using air conducted stimuli 500 Hz short tone burst, 95 dB nHL via insert earphone and compared.
Results: cVEMP was recorded in all subjects but oVEMP was absent in two subjects. Mean amplitude and latency were 140.77 μv and 15.56 ms in p13 and 3.18 μv and 9.32 ms in n10. There were statistically significant differences between p13 and n10 amplitudes (p<0.001).
Conclusion: This study showed that occurrence percentage and amplitude of oVEMP were less than those of cVEMP. Since these two tests originate from different sections of vestibular nerve, we can consider them as parallel vestibular function tests and utilize them for evaluation of vestibular disorders.

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Background and Aim: Sound conditioning is exposure to a non-traumatic, moderate level of sound which increases inner ear resistance against further severe noise. In this study, we aimed to survey the effect of sound conditioning on auditory brainstem response (ABR) threshold shifts using click stimulus, and the effect of the frequency of conditioning on hearing protection.
Methods: Fifteen guinea pigs were randomly divided into 3 groups. Two conditioned groups were exposed to 1 kHz, and 4 kHz octave band noise at 85 dB SPL, 6 hours per day for 5 days, respectively. On the sixth day, the animals were exposed to 4 kHz octave band noise at 105 dB SPL, for 4 hours. The control group was exposed to intense noise, 4 kHz at 105 Db SPL for 4 hours (without conditioning). After exposure, ABR thresholds using click were recorded an hour, and 7 days after noise exposure.
Results: The results of the ABR with click stimulus showed less thresold shifts in conditioned groups than control (p≤0.001). Comparison of the results of conditioned groups, showed less threshold shift by 4 kHz conditioning, however, this difference was not statistically significant (p>0.05).
Conclusion: Electrophysiological data of our study showed that sound conditioning has a protective effect against subsequent intensive noise exposure, and the frequency of conditioning does not have significant effect on ABR threshold shifts when using click stimulus.

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Background and Aim: Speech-evoked auditory brainstem responses were used in the assessment of subcortical encoding of the speech stimuli in the English language. These processes are affected by language background and experiences. Considering the language specific acoustic differences, the aim of current study was establishing the response norms in adult Persian-speakers and comparing the encoding of the speech syllable /da/ between Persian and English languages.

Methods: Auditory brainstem responses to speech syllable /da/ in the right ear, gained from 48 normal adults (25 women and 23 men) with the mean age of 22.70 with SD 2.05 years were recorded. After characterizing the onset elements, transition from consonant to vowel, the periodic portion and offset of response, the Persian dataset were compared with 95% confidence interval norms in the age range of 18-28 years.

Results: The response to speech syllable /da/ was successfully recorded in all of the subjects and main features of response were highly overlapped with published English norms.

Conclusion: Normative values for speech-evoked auditory brainstem responses in adult Persian speakers are presented in the current survey. Our findings suggest that the recommended procedure and more importantly, the scoring method based on English norms can be used in Persian speakers without replacing the original synthetic vowel /da/.

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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.