We designed this study to measure the Percussion caused by pneumatic drill( 32gram) which is used commonly in different in city services. this study have been performed in the summer of 1375 in Hamedan. The results demonstrated that the average background noise level (including environment and compressor) was 92.4 with standard deviation of 5.4 dBC, the average background noise level of the drills while working was 109.6 dBC with the standard deviation of about 2.2dBC and the average peaking factor was 18.6 with a standard deviation of 3.7dBC. the average background noise level of the drills while working in a distance of 5m, 10m and 20m from the source respectively were 98.6 dBA(with a standard deviation of 2.8dBA), 91.5dBA(with a standard deviation of2.6dBA) and 86.8dBA with a standard deviation of 2.8dBA).Based on the obtained results and the potential effects of exposure to noise which mainly can be summarized to damage to auditory system, interference with the communication skills, neural excitation, Hypertension and tachycardia the side effects of noise should be taken in to account seriously.Based on the mounting evidences regarding the adverse impact of working in the noisy environment and the damaging consequences of living in such atmospheres and the findings of the current study which confirms that the noise exposure level is more than allowed limit, the health of the workers and citizens is threaded by the noise pollution factors mentioned in the current study and serious considerations should be taken in to account.

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.

Nowadays, sound is a critical part of our daily life and its unwanted and undesirable disturbances in the environment and in the workplace has induced much psychological and physical annoyance to human being and had also lessened the efficacy of the daily activities. Since the mechanical vibrations of molecules in the air had led in producing sound and considering profound damaging vibrations produced by the harsh sounds in the objects and instruments, we have studied the noise and the vibrations caused by it, together.With this introduction and Considering the potential devastating impact of noise and the need to keep staff which are working in the control room secure from this effects the power house of "Shahjid Madhaj"  have proposed a project to control and limiting the noise in the control room by examining the diverse ways of transmitting sound into it. The project will be discussed here in details.

The most common contributing factors in inducing hearing loss in adults are aging, exposure to noise and the interaction among these factors with other parameters. Individual parameters are also effective in the extent of hearing loss which is produced. Being aware of Vulnerability factors such as physical parameters, Auditory and non-auditory factors can be useful in considering a good hearing conservation program for noise induced hearing losses.In the current article we are aimed at introducing three important parameters and their sub-divisions pertaining to this issue.

NIHL occurs when too much sound intensity is transmitted into and through the auditory system and can be occur following a shot gun or the exposure to a moderately intense sound for a long period of time. NIHL caused by acoustic trauma refers to permanent cochlear damage from a one-time exposure to excessive sound pressure. This form of NIHL commonly results from exposure to high-intensity sounds such as explosions, gunfire, a large drum hit loudly and firecrackers.Meanwhile the sound intensity, duration of exposure and personal hearing thresholds as the effective factors in the amount of noise induced hearing loss should not be overlooked.  Since numerous investigations have been performed about intense sudden sound we will discuss it in detail in the current article.

Many researchers have reported that after the sound trauma, RNA and DNA in the outer hair cells and ganglion cells will decrease. Some scientists have also mentioned the mitochondrial enzyme deficits in cochlear cells. Sound stimulation will induce the decrease of enzyme activities which are effective in the process of energy production. This process happens because of the reduced ATP synthesis and in turn the damage to receptors due to energy disruption.  The moderate oxygen deficiency can also be considered as a potential factor in the amplitude changes of the potential of cochlear microphonic due to irrita6ing sounds. On the other hand, since the organ of corti is far from blood tissue, logically, Anaerobic Glycogen should be considered as the main factor in the metabolism of the organ of corti.In addition to that, there are evidences which demonstrate intense acoustical stimulation can increase Na+ and decrease K+ in endolymphatic fluid and a contrary effect in perylimphatic fluid in scala vestibule.

Sounds situated in a certain domain of intensity can evoke auditory system physiologically. Permanent and continuous stimulation which is produced by such sounds would not be harmful to hearing organ.  This safe intensity is estimated 61 dB SPL. However one should pay attention that in case the intensity of mechanical sound wave increases (more than 75 dB SPL), the exposure time should be decreased unless the serious harm to auditory system is expected.  Auditory system can be affected due to sound harms in two major types: Permanent threshold shift and temporary threshold shift which can be described as the changes in hearing status of human caused by the exposure to sententorian sounds. Numerous physiological factors can exacerbate the devastating effects of sounds that we are aimed at an overall description on this issue in the present review article.

The human immunodeficiency virus (HIV) is the virus that causes AIDS (acquired immune-deficiency syndrome). Head and neck are the most common sites in contamination with this virus. HIV can affect outer, middle and inner parts of the ear. Changing in the color of the skin, effusion, infection and sudden hearing loss are some types of the audiological and ontological findings in such patients.

Method and Materials :this cross sectional descriptive and analytic survey was done at Golestan navy hospital in Tehran, between June 1998 and March 1999 on total of 69 male subject (104 ears, ) 50 acoustic trauma & 54 noise induced H.L) between 20 to 40 ears old.
Results:1- The mean acoustic reflex threshold at 1 kHz showed there is no significant difference between two groups.
2- The intensity elicited maximum reflex amplitude at 1 kHz didn&apost produce at a significant linear correlation with subject&aposs age and ear canal volume in both groups.
3- The intensity elicited maximum reflex amplitude in NIHL group wasn&apost shown a significant correlation with ear compliance and gradient.
4- The mean Intensity (SPL) elicited maximum reflex amplitude in NIHL group was more than mean intensity (SPL) in acoustic trauma group.
5- The mean intensity (SL) elicited maximum reflex amplitude in NIHL group was More than mean intensity (SL) in acoustic trauma group.
Conclusion: Acoustic reflex amplitude is reduced for subjects with NIHL compared with acoustic trauma subjects.

One of the most important issue for selecting and fitting of hearing aids that should receive special attention is binaural amplification.According to several investigations, superiority of binaural amplification on monaural one is confirmed.Binaural Amplification may have considerable effects on fromation and developing of superior dimensions of hearing including: Localization, Binaural squelch (Better hearing in presence of noise).So, it is necessary to know the basic and scientific concepts and applicable principles of binaural hearing and binaural fitting.Present paper deals with this important subject.

OAEs are sound founds in the external aditory meatus that originate in the cochlea. OAEs are generated only when the organ of corti is in near normal condition and They can be detected only when the middle ear system is operating normally. The sound generated by the cochlea are small but  potentially audible, sometimes as much as 30 dBSPL. They can emerge spontaneously in the cochlea, but more commonly OAEs follow acoustic stimulation. No electrod are needed to  observe OAEs. In fact, microphone are used to detect them.

In addition to Stimulus frequuncy and level, emitting Inner ear structurs status, OAEs parameters depend on conductive sound pathways charactristics, so abnormal OAEs donot always represent cochlear abnormality. Middle ear transmites Vibrations in two directions: forward and backward. Middle ear pathologies affect both forward and backward transmission.In this paper, The purpose is investigation of immediate effects of tympanic over - and under - pressure on click evoked Otoacoustic Emissions (CEOAEs) in healthy individuals. Healthy subjects with normal hearing and middle ear were exposed to ambient pressure changes in a pressure champer. The pressure was progressively changed in 100 dapa steps to accomplish on increase and decrease  in tympanic pressure. Pressure equilibration of the middle ear was avoided. The relative tympanic over-and under - pressure (+/-320 dapa) was monitored by tympanometry and CEOAEs recorded at every step of tympanic pressure change. The CEOAEs recorded during progressive tympanic over-and under- pressure had reduced amplitude and shorter latencies that were most pronounced in the 750 to 3000 Hz frequency bands.

Arachnoid cysts are cerebrospinal fluid-filled sacs that are located between the brain or spinal cord and the arachnoid membrane, one of the three membranes that cover the brain and spinal cord. They are usually located within subarachnoid space with a membrane consisting of arachnoid cells and collagen fibers and are filled with CSF. It is naturally considered as a congenital cyst because of its common appearance in the infancy. Typical symptoms of an arachnoid cyst around the brain include headache, nausea and vomiting, seizures, hearing and visual disturbances, vertigo, and difficulties with balance and walking. MRI and CT can help in diagnosis. Arachnoid cysts are benign and the vast majority remains asymptomatic throughout life. If they are deemed to be causing symptoms then surgery can be contemplated. Here, we are aimed at describing a case of Arachnoid cysts involved cerebellopontine angle that has been reffered to audiology clinic in Tehran University of Medical Sciences. The experiments and results of radiographic techniques has been brought here.

Method & Material: This study was performed on 36 normal-hearing subjects aged 18-25 years for survey of temporary threshold shift (TTS) by transient evoked otoacoustic emissions. Finding: Noise can affect the pure-tone thresholds and (TEOAEs) amplitudes. When cochlea affected by noise, evaluating TEOAE is more suitable than pure-tone audiometry. Because of this test, is objective an unaffected by attention and alertness and can be evaluated in difficult to test subject and also have high carefulness and can be performed in a quiet, but not sound-proof room.

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: OAE an audiologic study for diagnosis of exteracochlear auditory neuropathy.
Method & Material: Immitance audiometry, OAE and ABR and rehabilitation Intervention was performed for 3 children suffered from kernictrus.
Conclusion: 1) OAE in the from of screening, distorted product and transient evoked-otoacoustic emission has to be added to our audiology test battery. 2) OAE studies have their own merit when we are clinically involved with the diagnosis of especial clinical entities like neonatal hypoxia, kernicterus, multiple sclerosis, meningitides and meningoencephalitis. 3) Case selection for cochlear implantation needs a knowledge of patients' OAE results. 4) In the case of intracerebral auditory neuropathy the need for other rehabilitative measures will be better understood.

Objective: As the cerebrovascular diseases (CVD) are among the most common anomalies that are directly or indirectly affecting the auditory cortex, studying in this area is important. We tried to evaluate the function of CANS in a group of 50-70 years old cerebrovascular accident (CVA) patients with no hearing complaint by competing sentences test (CST) as a dichotic speech test.
Method and Material: This cross-sectional analytical study was conducted at Loghman-e-Hakim hospital between 22, august 1999 and 20, July 2000 in a group of 30 normal 50-70 years old persons and a group of 40 patients with CVA including 30 patients with abnormal CT scan and 10 patients with normal CT scan.
Results: The results point out the mean scores of CST in the normal group were at normal range (80-100%) in both ears. And mean scores of CST decreased in the patients groups. There were significant difference between mean scores of CST in the patients with CVA and control groups. Conclusion: CST seems to be a valuable test in the CANS test batteries for the cerebrovascular diseases.

Exract

There is a general belief that speech perception training and specifically speechreading training for adults with acquired hearing impairment is very useful. Numerous researchers have mentioned that visual cues play an important role even in speech perception of people with normal hearing. In this review article publications and rasearch of different years on lipreading training have been have been reviewed.

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: 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.