Objectives: determining the frequency distribution of hearing disorders among the student of public elementary school by Otoscopy, Puretone Audiometry, Impedance Audiometiy and questionnaires.
Methods and Materials:This study was carried out in a cross - sectional descriptive survey - on 1200 students (600 girls and 600 boys) among the student of primary school of Neishabbor, academic year 1376-77
Results:1- Otoscopy examination abnormal conditions of external ear canal was found in 14.1% of cases mostly impacted ceruman (13.6%) Abnormal conditions of tympanic membrane (0.4%) and foreign body 0.16%. Abnormal conditions of external ear canal was statistically unmeaningful. (P V=0 .8)
2- Impedance Audiometiy: 5. 75% Abnormal tympanograms were observed, mostly type C (3.15%)
3- Pure Tone Audiometry: An overall 5.5% hearing loss was found in this population including 3% bilateral and 1.25% unilateral hearing loss. Only conductive hearing loss was found in this population (2.7% in right ear and 3.5% in left ear), PV=0.9.Hearing loss observed mostly in girls but the difference was slight.Family background showed no effects on the hearing disorders.9.8% of cases were in need of medical care and 0.3% were in need of rehabilitation services.Only 28.8% of parents, 36.3% of teachers and 40.9% of afflicted students were aware of the problem.

Methods and Materials:This cross - sectional analytical study examines the clinical utility of the external ear resonance (EER) peak amplitude measurement as an index of the possible middle ear effusions. The EER peak amplitude and frequency of 180 ears in 98 children of 7-9 years old were recorded. 120 of them (30 girls & 30 boys) had normal hearing and showed type A tympanograms. The remomder (60 ear of 38 boys) showed type B tymoanograms. These children were examined at the clinic of audiology department, rehabilitation faculty, Tehran University of medical sciences and health services, year 1376 hijri.The tests included: 1) Otoscopy, 2) Pure tone air - condition test, 3)Tympanometry and 4) E.E.R peak amplitude and frequency measurement through test - retest.
Results: 1- The average of E.E.R peak frequency for normal hearing girls, normal hearing boys and hearing impaired boys is 3206 Hz (SD=564), 3202 Hz (SI)- 634) and 2953 (SD=37l) respectively.
2- The average of E.E.R peak amplitude is 16.0 dB SPL (SD=2.6), 16.6 dB SPL (SD= 3.0) and 23.5 dB (SD=3.0) for normal hearing girls, normal hearing boys and hearing impaired boys respectively.
3- The correlation of the mean of E.E.R peak amplitude and frequency for two normal groups, girls and boys, is not significant (p>0.0l).
4- The mean test/retest variability in the E.E.R peak amplitude is 16.0 dB SPL and 3.1 Hz for frequency. These results indicate high validity and consistency of E.E.R characteristics measurements.
5- E.E.R peak amplitude is significantly ccre1ated with the presence of type B tympanogram (p-0.00) we find a 6.9 dB SPL increase in average E.E.R peak amplitude in boys with type B tympanograms in comparison to boys with
type A results but correlation of average E.E.R peak frequency of two groups is significant too (p=0.00).
* The results are valid only within the context of this research.
* The results of this research have been compared with similar studies in abroad.

Method and Materials: This cross - sectional survey is carried out in pediatric clinic department of audiology faculty of rehabilitation, TMSU, on spring 1998. 102 top grade ranking children with normal hearing threshold

Results:1- The thresholds were not significantly different at any frequency (P>0.05) in test re-test trials.
2- The test minus re-test threshold for individual ears showed clinically reliable and acceptable range 0-10dB SPL for at least
99.74% of the ears at all frequencies.
3- The threshold differences between right & left cars in two test sessions were not significantly different (P>0.05) except for 14KHz.
4- High- frequency threshold in two test sessions showed no significant difference between girls & boys at all frequencies (P>0.05) (except for 16 & 20 KHz in right ear and 10 KHz in left ear).
Conclusion: This test can be used for evaluation of individual high-frequency threshold in all frequency as test re-tests tria1. Moreover, this test may use as a beneficial tool for monitoring different endogenous and exogenous auditory pathologies.
Consideration: it is found that this research is valid only among situation of this project. Any generalization needs further research.

Method and Materials: This cross- sectional analytical survey is carried out in department of audiology, rehabilitation faculty, IUMS, 1997-1998 on 10 normal and 28 sensory damaged ears out of 27,8 to 40 years old male individuals were evaluated according to following critria:Hearing threshold up to 7OdBHL.Normal middle ear status.
Results: There is good correlation between kiessling&aposs procedure and R-N.A.L, P.O.G.O 11 and Lyharger procedures in determining gain of hearing aid in individuals with flat and raising audiogram. There is poor correlation between them in individuals with high frequency sensory hearing loss.
Conclusion: Kiessling&aposs procedure can he used instead of Lyharger, R-N.A.L, P.0.0.0 11 procedures in children, difficult to test and multihandicapped persons who are not able to cooperate in behavioral audiometry.

Watching a speaker's lips is like hearing speech by eye instead of by ear and markedly improves speech perception. In this review I summarise studies over the last sixty years about lip reading, it's issues, methodological problems, experimental and co relational studies, issues of cerebral lateralization, localization and cognitive and neuro psychologic function. Several studies on speech reading in general suggest that hearing impaired groups actually do not possess superior speech reading skills compared to normal controls. With function magnetic resonance imaging (FMRI) it was also found that the linguistic visual cues are sufficient to activate auditory cortex in the absence of auditory speech sounds. Here I presented data and arguments about all aspects of the phenomenon of lip reading and it's use in rehabilitation audio logy

Method & Material: This descriptive analytical survey was performed in pars Hospital, Tehran on 45 children (22 girls, 23 boys aged 2-5 years, 1377-78 (solar).Finding: In 2-3 years old group, accurdacy of PTA test (87/7%) was more than FNS test (66%). In 3-5 years old group, Specificity & NPV showed no significant differences, between two test.
Conclusion: Since the PTA showes greater possibility of false positive response than FNST, the accuracy of the latter test is greater the PTA.

Objective: This study was aimed to survey the hearing status of the patients with definite MS. The results of this study may help to confirm the diagnosis and to improve our knowledge of different aspects of this disease and to optimize the treatment and rehabilitative techniques.
Material & Methods: This study is performed in audiology clinic of rehabilitation science faculty of Iran medical science university as an assesive-analytic procedure in winter of 2000 in 40 MS patients (Referred from the MS clinic of Shohada Hospital) of 20 to 45 years old. All the patients have no history of otologic problems. The results of conventional audiologist tests (PTA, SRT, SDS, imittance audiometry) and ABR findings of MS patients were compared to the results of control group.
Results: The differences between the means of low, high and mid frequency PTAve in MS patients and control group were statistically significant (P<0.05). There was no significant difference between two groups in the speech test&aposs results, statistically. The results of ART test show statistically significant differences between experimental and control groups. The only differences in ABR results were seen for the absolute latency of the wave V and IPLs (I-V, III-V) between two groups. The amplitude ratio of V/I in MS patients 1.5 was within the normal range (0.5 to 2). There was a statistically significant relationship between mean of mid frequency PTAve and prolongation of absolute latency of the wave V. The relationship between ABR and SDS and also between ART and ABR were not statistically significant. Finally, the results of this study suggested that low, high and mid frequency PTAve, ART, absolute latency of the wave V, and IPLs III-V, I-V can be used ascomplementory method to confirm the diagnosis of MS with other conventional methods such as: MRI, CSF analysis, SEP and VEP.

Objective: A survey on hearing state of blind schoolboys in Tehran.
Method and Material: This cross-sectional descriptive survey was conducted on 640 ears of 320 blind schoolboys of 5-23 years old as a hearing screening in Tehran blind schools, 2000-01.
Results: 20.94% was hearing-impaired of whom 13.75% had bilateral and 7.19% had unilateral hearing loss. 15.16% of students suffered from sensory-neural hearing loss (SNHL), 1.56% from conductive hearing loss (CHL) and 0.62% from mixed hearing loss (MHL), that is, SNHL occurred 10 times more than CHL. Hearing loss was often mild and moderate, and audiogram configuration was primarily high tone loss (HTL). On the whole, 8.13% of students needed medical treatment, 15.13% needed audiological rehabilitation and 3.44% of them were in need of both medical and rehabilitation Intervention. General information about hearing problem was very low among students, their parents and teachers, which was 26.87%, 20.9% and 22.39%, respectively. There is significant relation between SNHL and parents&apos relationship.
Conclusion: The prevalence of hearing loss in blinds is higher than in normal-visions. It is often sensorineural. So, it is important to identify these children through hearing screening (Using more high frequencies) and to conduct medical as well as rehabilitative intervention.

Objective: To determine SOAE,TEOAE, and DPOAE, characteristics in normal -hearing school boys.
Method and Material: This cross-sectional study was conducted on 7-11 year-old normal -hearing boys (n = 100) living in 12th zone of Tehran. OAEs also performed and investigated if otoscopy, pure tone and immittance audiometry were normal. Both handedness and ear effects was also considered.
Results : 31% had SOAEs. No significant differrence between the right and lefe ear SOAEs frequency and amplitude means. 1,3 kHz and total response TEOAEs amplitude was significantly different between two ears. There was no significant difference between both ear DPOAEs amplitudes, whereas the letf-handed boys&apos DPOAE amplitude is greater than the right -handed ones&apos amplitudes.
Conclusion : As some results including equal SOAEs of both ears , no difference between both ears SPOAEs amplitude , and handedness effect on the amplitude do not agree with other studies , these finding should be considered in testing OAEs of school boys.

Objective : To assess neonates and children suffering from meningitis , during the critical and recovery periods , using ABR , EOAE and Behavioral Audiometry.
Method and Material: 40 neonates to 12-year-old children were assessed. Using ABR test, the hearing of these cases was evaluated during the critical period-that is , 24-72 hours following the diagnosis. This test was repeated when patients recovered from meningitis-that is 24 hours before discharge (recovery period) Hearing function , again , was assessed 7-14 days following discharge through Immittance Audiometry, Behavioral Audiometry (PTA , SF and BOA). And EOAE (TEOAE and DPOAE) tests procedures.Findings: During the critical period , ABR test revealed normal hearing in 35 patients (87.5%) and severe to profound sensorineural hearing loss (unilateral and bilateral) in 5 patients (12.5%-girl=4, boy=1). The same result were obtained in re-evaluation in the recovery period. On the other hand , 7-14 days after of discharge , Immittance Audiometry and Behavioral Audiometry (including PTA , S.F and BOA tests), confirmed the mentioned results (cross - gcheck). EOAE test (DPOAE and TEOAE) in 35 normal hearing patients (according to ABR test) , showed normal cochlear function. 2 out of 5 cases suffering from severe to profound sensorineural hearing loss revealed normal cochlear function. According to EOAE results , abnormal cochlear function was evident in 3 patients.
Conclusion: ABR , EOAE tests , and Behavioral Audiometry in children meningitis during the critical period and recovery period can be used to diagnose any degree of hearing loss with a high level accuracy. The results of persent study is confirmed by previous investigations.

Background and Aim: High frequency audiometry (HFA) provides a valuable tool and optimal index for distinguishing and monitoring many pathologies of the ear. The purpose of this study was to measure the reliability of HFA threshold in children.
Materials and Methods : In this cross-sectional study , 100 normal-hearing children, of 7 to 13 years old, including 50 boys and 50 girls were examined with a Belton 2000 audiometer and Sennheiser HD 250 earphones in Pediatric Clinic  of Audiology Department, Faculty of Rehabilitation of Tehran University of Medical Sciences.
Results: The threshold differences between right and left ears in two test sessions, were not significantly different except for 14 KHz. HFA threshold in two test sessions showed no significant difference in all frequencies between girls and boys but 16 and 20 KHz in right ear and 10 KHz in left ear.
Conclusion : The test-retest thresholds for iudividual ears showed ±0-10 dB SPL for difference at least  in 99.74 % of ears at all frequencies that is clinically reliable and acceptable.

Background and Aim: Auditory neuropathy is an hearing disorder in which peripheral hearing is normal, but the eighth nerve and brainstem are abnormal. By clinical definition, patient with this disorder have normal OAE, but exhibit an absent or severely abnormal ABR. Auditory neuropathy was first reported in the late 1970s as different methods could identify discrepancy between absent ABR and present hearing threshold. Speech understanding difficulties are worse than can be predicted from other tests of hearing function. Auditory neuropathy may also affect vestibular function.

Case Report: This article presents electrophysiological and behavioral data from a case of auditory neuropathy in a child with normal hearing after bilirubinemia in a 5 years follow-up. Audiological findings demonstrate remarkable changes after multidisciplinary rehabilitation.

Conclusion: auditory neuropathy may involve damage to the inner hair cells-specialized sensory cells in the inner ear that transmit information about sound through the nervous system to the brain. Other causes may include faulty connections between the inner hair cells and the nerve leading from the inner ear to the brain or damage to the nerve itself. People with auditory neuropathy have OAEs response but absent ABR and hearing loss threshold that can be permanent, get worse or get better.

Background and Aim: Laryngeal muscles contribute in sound production play a key role in specific language. Needle electromyography is the specific complementary method for muscle activity evaluation which is awfully painful and needs serenity of patient. The purpose of this study was to use Surface electromyography as a probable new approach for evaluation of laryngeal muscles activity.
Methods: 34 healthy women and 34 healthy men aged 20-30 years old were enrolled in this study. Each individual was seated in an armchair. Recording electrodes were placed bilaterally (right and left) in the low anterior neck at approximately one centimeter from midline on thyroarytenoid and cricothyroid muscles. Silent activity and fricative voice (/z/ , /ž/) and voiceless (/s/ , /š/) activities were recorded for ten seconds followed by 10 seconds of rest, for 5 repetition. All data were processed and frequency and non linear measurements were assessed. And were compared in time and frequency domain.
Results: Muscle activity in fricative voice in both groups was greater than rest condition (p<0.05). Moreover, muscle activity median frequency was significantly more in men than women (p<0.001).
Conclusion: Activity evaluation of thyroarytenoid and cricothyroid muscles using surface electromyography is difficult in women. That may be due to anatomical features such as length and width of neck in women.

Background and Aim: Noise-induced hearing loss is the most common problem in industrial areas. This study aimed to determine effects of excessive noise exposure on measurable characteristics of distortion product otoacoustic emissions (DPOAEs) in rabbits.
Methods: The study was carried out on 12 adult male New Zealand White rabbits including case group - exposed to 500-8000 Hz broadband white noise with 100 dBA SPL for 8 hours per day in 5 consecutive days - and control group. After three days period of acclimatization to the experimental condition, rabbits&apos hearing status in each group were measured by distortion product otoacoustic emissions on days zero means before the study was initiated as a baseline, eight, one hour after the latest exposure to noise, and ten. The recorded results were analyzed using SPSS software.
Results: Highest mean distortion product otoacoustic emissions amplitudes in case group were allocated to frequencies of 5888.50 Hz, 8166.50 Hz, 9855.00 Hz, 3956.00 Hz, and 3098.50 Hz, respectively. However, the lowest mean distortion product otoacoustic emissions amplitude was related to frequency of 588.00 Hz (p=0.001).
Conclusion: This study revealed that distortion product otoacoustic emissions amplitude shifts due to noise occur first in high and then in middle frequencies. Additionally, exposure to noise can decrease distortion product otoacoustic emissions amplitudes. We conclude that distortion product otoacoustic emissions can be a reliable test for estimating personal susceptibility to noise-induced hearing loss.

Background and Aim: Oral stereognosis is the ability to recognize the objects placed in the mouth this plays a significant role in speech sounds production. Since the children with hearing loss have articulation disorders, this study aimed to clear the relation of hearing loss degrees and oral stereognosis in 5-year-old children.
Methods: In this cross-sectional non-invasive study, 40 children of 5-year-old (30 children with different degrees of hearing loss and 10 normal children) were involved. Oral steriognostic test was done for all of them and the Mann-Whitney U was used for statistical analysis.
Results: There were significant differences between the mean of oral stereognostic ability between the normal children and the children with severe (p<0.01) or profound hearing loss (p=0.05). There was no significant difference between the mean of oral stereognostic ability among the children with moderate, severe and profound hearing loss compared with together. Besides, there was no significant difference between the mean of the time of diagnosis among all of hearing loss and normal children.
Conclusion: The study shows that the children with moderate, severe and profound hearing loss have inefficient oral stereognosis in comparison with the normal children.

Background and Aim: Several studies have demonstrated deficits in rapid naming in dyslexic readers however the extent of deficit is different in various orthographies. This study was intended to survey the naming speed in Persian children with dyslexia.

Methods: Rapid automatized naming (RAN) task of 19 children with dyslexia were compared with 31 nondyslexic children. Participants were selected from the students of the second grade of primary schools in Tehran city, Iran, with normal intelligence [intelligence quotient]. Nondyslexic children were at the age of 7.7 to 8.7 years (mean=7.6) and dyslexics were 7.8 to 9.4 years old (mean=8.1). Reading accuracy and speed were assessed by text reading (Diagnostic Reading Test), and high frequency word, low frequency word and nonword reading (Reading and Dyslexia Test).

Results: Dyslexic readers needed more time than non-dyslexics when naming objects (p<0.001), numbers (p=0.001) and letters (p<0.001). The mean of dyslexics z-scores were -1.98 on objects, -1.96 on numbers and -3.35 on letters. 42% of dyslexics did not show any deficit on rapid automatized naming task. All of the subtests were correlated to reading speed (p<0.050), but among subtests of rapid automatized naming task, only letter naming was correlated to reading accuracy (p<0.050).

Conclusion: More than half of dyslexics cases showed an apparent deficit in naming speed (objects, numbers and letters), which was more evident at letters. Naming speed was related to reading accuracy and reading speed although the relationship was stronger with the second one.

Background and Aim: Children with auditory processing disorders and impaired phonological working memory have difficulty in storing an accurate phonological representation of speech.

Therefore, it is highly important to assess phonological working memory in this population. One of the methods in assessing phonological working memory is to use a non-sense syllable test. The aim of this study is to create a valid and reiable non-sense syllable test in order to evaluate phonological working memory in Persian speaking children with auditory processing disorders.

Methods: In this cross sectional comparative study, 40 non-sense syllable words were developed according to the criteria of non-syllable word construction and under supervision of a linguistic specialist. The non-sense syllable test was assessed in 53 boys and 47 girls from 7 to 10 years of age. The content validity of the non-sense syllable words was assessed by experts. To evaluate the validity of the test, correlation between the results of the test and forward digit recall and backward digit recall tests were measured. The non-sense syllable test was performed twice to evaluate its relaibility.

Results: The validity of the non-sense syllable test was 95.5 (SD=2). The correlation coefficient between non-sense syllable repetition, forward digit recall, and backward digit recal l tests were 0.76 and 0.75 respectively (p<0.001). The correlation coefficient between different performances of non-sense syllable tests was 0.8 (p<0.001).

Conclusion: These findings show that the non-sense syllable repetition test can be used to evaluate phonological working memory in Persian speaking children from 7-10 years of age.

Background and Aim: Auditory lateralization is a binaural phenomenon that is the result of processing of interaural time and intensity cues in the central auditory system. The main advantage of this phenomenon in human is understanding speech in noisy environments due to the auditory sciene analysis and cocktail party effects . The aim of the present study was to assess the auditory lateralization ability in normal children.

Methods: Participants were 80 normal school age children (8-11 years) of both genders, 42 girls and 38 boys. Lateralization functions were determined by interaural time difference (ITD) ranging from -880 to +880 µs and interaural intensity difference (IID) ranging from -10 to +10 dB for high-pass and low-pass noise.

Results: Interaural intensity difference lateralization functions were linear , while the interaural time difference lateralization functions were S-shaped with a clear linear component from -220 to +220 µs and with an asymptote from -440 to -880 µs and +440 to +880 µs. Generally, interaural intensity difference errors were significantly less than interaural time difference tasks (p<0.0001). Age effect was only present in interaural time difference tasks (p=0.001).

Conclusion: According to these results, children with the age of 11 years performed better in lateralization using interaural time difference cues compared to other children whereas there was no difference in performance in all ages when using interaural intensity difference cues.

Background and Aim: The cochlea and vestibule are related developmentally. Therefore individuals with severe to profound sensourineural hearing loss have additional risk for vestibular dysfunction. The aim of this study was to assess saccular function using vestibular evoked myogenic potentials (VEMP) in children with severe to profound sensorineural hearing loss (SNHL) who are candidates for cochlear implant.

Methods: Thirty children (17 males and 13 females) with bilateral severe to profound sensorineural hearing loss in the age range of 3-15 years participated in this study. 17 children (9 males and 8 females) with normal hearing in the age range of 3-13 years participated as the control group. All children in each group were evaluated for saccular function by performing vestibular-evoked myogenic potentials in both ears.

Results: Comparison of mean threshold values between the two groups revealed statistically significant difference (p<0.05). In addition, comparison of mean amplitude values between the two groups revealed statistically significant difference (p<0.05). However, comparison of p1 3 and n23 latency values between the two groups revealed no significant difference (p>0.05). Out of the 30 children with bilateral severe to profound sensorineural hearing loss eight children (26.66%) had absent VEMP responses in both ears.

Conclusion: Children with severe to profound sensorineural hearing loss who are candidates for cochlear implant ha d more potential for saccular abnormalities compared to normal-hearing children. Therefore, assessment of vestibular function is very important in this population.

Background and Aim: Conversational repair skills are essential for establishing mutually successful verbal communication. Cognitive and linguistic disorders can have negative effects on these skills. Children with hearing loss have special cognitive and linguistic issues. This study was performed to contribute to the paucity of data on conversational repair strategies used by hearing impaired children.

Methods: The participants included 58 children with moderate hearing loss (38 boys and 20 girls) aged 6 to 7 from Ahvaz city. A cross-sectional study design was used. Frequency of using different types of repair strategies in ten repair situations was calculated. Scores of intelligence, memory, word finding, lexical richness, and mean length of sentences was obtained through cognitive-linguistic tests. Data was analyzed employing an independent t-test, Pearson correlation coefficient, and logistic regression.

Results: A direct correlation was observed between clarification strategy and communicative social intelligence (p=0.045). A direct correlation was observed between applying different types of conversational repair strategies and linguistic abilities in children with moderate hearing loss (p<0.05).

Conclusion: Children with moderate hearing loss (age: 6-7 years) use repetition more than any other strategy to repair conversation. One unit increase in word finding ability or in mean length of sentence predicts one unit increase in the degree of using repetition strategy.