Background and Aim: Hearing sensitivity is so vital for musicians as loud music can cause hearing loss. The aim of this study was to assess hearing sensitivity of musicians in order to determine the effects of music exposure on hearing organ.
Materials and Methods: This case-control study  was conducted on 15 string musicians with musicianship history of more than 10 years and 15 normal hearing subjects. They all were male and 20-30 years old. TEOAEs and DPOAEs performed after otoscopy , immittance and pure tone audiometry in octave frequencies between 250 to 16000 Hz.
Results: There is not significant difference between pure tone thresholds of two groups for all frequencies.A significant difference of TEOAE is found between two groups for total response and amplituds of TEOAEs . DPOAEs amplituds are not significantly different between two groups .
Conclusion: Musicianship may  affect TEOAEs amplitudes , but cannot affect results of PTA and DPOAEs. Therefore this can be useful to detect cochlear lesions secondary to music exposure and also as a tool in hearing protection program.

Background and Aim: Risk factors including asphyxia , meningitis , form of delivery, etc. may cause hearing loss in neonates results in speech and language deprivation , emotional and educational problems. The aim of this study was to determine the prevalence of hearing loss and its relationship with risk factors among neonates hospitalized in neonate intensive care unit (NICU).
Materials and Methods: It was a cross-sectional study on 234 NICU hospitalized neonates in Ghaem and Imam-Reza hospitals of Mashhad. Epidemiologic and pathologic information were obtained. Otoacoustic emissions were done in all of neonates. Patients referred to the second otoacoustic emissions (OAEs) and patients failed in the second test controlled by auditory brainstem response (ABR).
Results: Hearing abnormality was found in 11 neonates (4.7%) including 2 girls and 9 boys.   (1 neonate with mild, 2 with mild to moderate, 2 with moderate to severe, 1 with sever to profound hearing loss and 4 with auditory neuropathy). Hearing abnormality has a significant greater incidence in group with apgar £5 and in patients with icterus (in need with transfusion).
Conclusion: Incidence of hearing loss in NICU hospitalized neonates are greater in comparison with general population. It has a greater incidence in group with icterus (in need with transfusion) and apgar £5,so,a comprehensive hearing screening program must be applied for early identification and intervention.

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: 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: 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.

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.

Background and Aim: Most of the studies indicates that the parents of the hearing impaired children show many mental health problems after the diagnosis of their children&aposs hearing impairment. Counselling with the parents of the hearing impaired children is one of the most important goals of any early intervention program. This paper describes a study to determine the effectiveness of a group counselling programme for parents of hearing impaired children.

Materials and Method: It was a semi-experimental study with a single group pretest-post test design. The participants were all the parents of hearing impaired children attending in an early intervention center. First the parents&apos mental health were assessed.Then the group counselling program was implemented. Program has involved six weekly 1.5 hour sessions. The format of each session included both lecture presentation and group discussion using cognitive behavioral procedure. Subjects were assessed before and immediately after group therapy by means of General Health Questionnaire(GHQ) and Symptom Check List 90 (SCL-90) questionnaires.

Resuts: The first part of the project had shown that over the half of the parents had considerable psychosocial morbidity. Comparisons showed a significant reduction from pretreatment to posttreatment in depression, anxiety and most of other psychological problems.

Conclusion: The study supports the effectiveness of group therapy programs in the treatment of parents of hearing impaired children. Concerning the progress of early detection programs for the children&aposs hearing impairment more studies should be done in the field of counseling with their parents.

Background and Aim: Self-reported and questionaire method for hearing impairment assessment allow us to study and to detect the invisible related issues, while They can not be done by traditional audiometry procedures. The purpose of this study is to compare measurement of hearing handicap using self-reported and staff version of NHHI and hearing thresholds in nursing home residents.

Materials and Method: The study participants were 43 individuals, 23 males and 20 females, aged 45-95 years. Pure tone average were calculated after conventional Pure tone audiometry . the self- and staff- reported questionnaire were also fulfilled.

Results: Nine (20.9%) individuals have normal hearing, 6 (14%) have slight, 10 (23.3%) mild, 7 (16.3%) moderate, 6 (16.3%) moderate to severe, 4 (9.3%) severe, and 1 (2.3%) profound hearing loss. Mean score of self and of staff reported versions were 32.22 % +29.31 and 32.67% +30.98, respectively. According to Kruskal-wallis test, there were significant correlation between self-reported and hearing level and between staff-reported and hearing level. The Pierson coefficient variation test between self and staff-reported, and self-reported and hearing level, staff-reported and hearing level showed significant correlation.

Conclusion: The NHHI self assessment associated with other equipments significantly improved the identification and assessment of adults and elderly hearing handicap in nursing home residents. According to the study condition, it may be concluded that the self and staff version of NHHI questionnaire are significantly identical and can be used instead.

Background and Aim: Although for a child to maximize his or her mastery of language, hearing aids (HAs) must consistently be worn, and they must be functioning correctly many studies indicates some hearing- impaired children`s hearing aid do not work perfectly.The purpose of this study was to determine types of defects in students&apos hearing aid (HA) in Tehran Exceptional Schools.

Materials and method: In this cross-sectional analytic study defects in sixty –two HAs of 41 children were determined. All were the students of Exceptional Schools referred to Audiology Clinic, Faculty of Rehabilitation Medical Sciences University of Tehran. Functions of the HAs were first checked by a sthetoclips. Then the electroacoustic measurements performed to determine the values of maximum gain and maximum power output. The data were separately recorded in a questionnaire for each kind of the HAs.

Results: Fifty-six percent of HAs functioned perfectly and forty-four percent were not. The most Frequet defects were 24% and 20% pertained to the battery and manual controls respectively. External components had more difficulties than internal components. Seventy percent of ear molds were damaged. There were significant differences between peak of FOG and MPO curves in the catalogue and electroacoustic measurements in 2cc coupler.

Conclusion: Most damaged parts of HAs in Tehran Exceptional students is related to the battery and controls which are external components of HAs. Because of high rate of dysfunctioning HAs and ear molds in this population in this survey, it is necessary to promote orientation and counseling level after fitting and to develop the quality of HAs and ear molds for Exceptional School students.

Background and Aim: Learning disability(LD) is one of the most prevalent problems among elementary school children. Approximately 10 percent of all elementary school children suffer from this problem. It has been determined that learning disability is predominantly accompanied with subtle impairment in central auditory nervous system. The main idea of this study was to evaluate middle latency auditory evoked potential (MLAEPs) in learning disabled children.

Materials and Method: This cross-sectional study investigated middle latency auditory evoked potential in children with learning disability (n = 31) compared to normal children (n = 31). Latencies and amplitudes of MLAEPs results with different stimulus intensity and binaural stimulation were compared between two groups.

Results: Compared to control group, learning disabled children exhibited smaller amplitudes for all the components except the right ear Na and Pa. There is no significant difference between two groups for latencies of the components.

Conclusion: It seems that middle latency auditory evoked potential may be useful in diagnosis and evaluation of learning disabled children although more investigation is required.

Background and Aim: Hearing assessment in infants and children younger than two years is an important issue, because the golden time of the language learning and speaking is under the age of two. Steady state auditory evoked potentials (SSAEPs) is one of the best ways of the objective hearing assessment for infants and young children. The need for long time of stimulation and recording restricted the clinical uses of this method. Therefore, the reduction of the recording time is a common problem. SSAEP signals are contaminated with background EEG signals of the brain and nervous system. To discriminate these signals the approach is using averaging method.
Materials and Methods: In this work two adaptive methods were programmed and tried on (SSAEP) signals. The first method was the work of the Ziarani et al. and the second was the enhanced Kalman filter. To assess suggested methods and to compare them with traditional averaging one, two sets of clinical signals prepared with Rotmen research group in university of Toronto were applied.
Results: The speed of the extraction of the SSAEP signals with the Ziarani method is 1.6 times faster than the averaging method. The extraction time of the enhanced adaptive Kalman filter is 13.1 times faster than currently used averaging methods.
Conclusion: The Kalman filter method seems to be more reliable than the other two methods. In addition, this new application of the Kalman filter in hearing assessment could be more beneficial and faster than other methods as an objective method.

Background and Aim: Hearing loss is one of the most prevalent chronic conditions affecting the elderly. The impacts of hearing loss are depression, social isolation, and functional disability, particularly for those who have not yet been evaluated or treated for hearing loss. The aim of this study was audiologic screening and assessing candidacy  for hearing aid in the elderly people.
Materials and Methods: This analytic-cross sectional study was performed on 52 older adults aged from 51 to 97. Subjects were evaluated according to ASHA guidelines for audiologic screening in adults (1997). Using HHIE-S as hearing disability screening instrument, the need for hearing aid use was evaluated.
Results: About 86 percent of subjects had some degree of hearing loss. There were significant correlation between PTA(0.5, 1, 2) KHz>26 and HHIE-S>10. According to these two factors 21.2 percent of subjects needed to use hearing aid while 18 percent of this group had hearing aids.
Conclusion: There is high prevalence of hearing loss among older adults, thus it&aposs necessary to evaluate the need for hearing aid in this rapidly growing population. Among different factors affecting hearing aid candidacy the most correlated were PTA(0.5, 1, 2)KHz>26 and HHIE-S>10. Therefore according to this study by combination of these two evaluation of hearing aid candidacy would be more appropriate.

Background and Aim:  Among all auditory assessment tools, auditory steady state response (ASSR) is a modern test. Modulation frequency for this test is usually 80 Hz. The purpose of this study, was to examined adult subjects with 40 Hz and 80 Hz ASSR and compare the results.
Materials and Methods: Thirty adult (60 ears) were evaluated by ASSR and PTA test, Results were divided into three groups: normal hearing, mild and moderate sensorineural hearing loss.
Results: In all groups, forty hertz ASSR thresholds were relatively closer to behavioral threshold than those of 80 Hz ASSR(p<0.05). Besides, the more severe hearing loss, the lower the difference between those two thresholds. Correlation coefficients were also higher in 40 Hz ASSR(p<0.05).
Conclusion: Frequency modulation thresholds with 40 Hz are more likely to be closer to the behavioral thresholds. Moreover, it has better results than the thresholds with 80 Hz.

Background and Aim: Regions in the cochlea with no (or very few) functioning inner hair cells and/or neurons are called dead regions. The aim of this study was to identify the cochlear dead regions in moderate to profound sensory neural hearing impaired children through the Threshold equalizing noise (TEN_HL) test.
Materials and Methods: In this cross-sectional study, the TEN(HL) was performed for the all frequencies available on test CD, on 30 children with ages ranging from five to forteen years (mean age, 8.5 ±2.8 years old).
Results: In this study, 58.3% of ears were found to have a dead region for at least one frequency. Classifying by test frequencies, 20% were found to have a dead region, 24% to be inconclusive and 56% to have no dead regions. The difference between mean SNR(T) in ears with and without dead regions was statistically significant. The difference between mean absolute thresholds in two groups was statistically significant at 1000 Hz and below (p <0.05).
Conclusion: The results indicated a relatively high prevalence of dead regions in children with sensory neural hearing impairment, especially for frequencies at which the hearing loss exceeds 70 dB HL.

Background and Aim: Hearing protectors (HP)  are widely employed as the only measure against noise exposure.  However, it is well known that unless do workers wear HP continuously, its efficacy will be very low. The purpose of this study was to determine the influence of risk perception, knowledge and safety attitude on hearing protection use in petrochemical industry&aposs workers.
Materials and Methods: In this cross-sectional study a structural questionnaire was administrated to 236 randomly selected workers in Iranian petrochemical industry who had been to 85 dBA noise and some influencing factors including risk perception, knowledge and general attitude to safety on using of HP had been investigated.
Results: This study showed that only 20.3% of employees claimed to wear hearing protection all the time when they exposed to noise. There was a significant relationship between use of hearing protector and worker&aposs risk perception (p=0.048) and also their knowledge about hearing protection(p=0.009). Also, the relationship between general attitude of workers to safety and risk perception was statistically significant (p=0.046).  
Conclusion: The results of the study  showed that for promoting the use of  hearing  protectors,  two main strategy should be followed. First, removing the barriers to make hearing protectors compliant, and  second enhancing the  workers&apos risk perception about hearing loss and  proper use of ear protectors.

Background: Fanconi anemia (FA) is an autosomal recessive genetic disorder wich characterized by progressive pancytopenia, multiple congenital anomalies,  increased susceptibility to acute myelogenous leukemia and epithelial cancers specially in head and neck and GUT. Characteristic feature of FA include short stature, café-au-laitspots, small eyes, mental retardation, skeletal and ear anomalies.
Case: A 23-year-old man who was a known case of FA since he was ten reffered to audiology clinic because of severe hearing loss. His initial diagnosis was pneumonia. Audilogic evaluation revealed  bilateral profound hearing loss.
Conclusion: One of the anomalies in FA are  ear anomalies. These included conductive haering loss, external auditory canal stenosis and auricular malformation and progressive sensoryneural hearing loss. In this report external auditory canal and tympanic membrane were normal. The result of tympanometry were type An and audiometry were bilateral profound hearing loss that is a rare finding  in FA patient.

Background and Aim: Nowadays, auditory perception is not a complete method to assess vowels quality and we need to use more objective instruments.In this study we want to determine and compare the persian vowels formants in normal and hearing Impaired students in 7ـ9 year old children of Isfahan.
Materials and Methods: This cross sectional study was performed on 64 normal and hearing impaired students. Background information was by interview and then, vowel production test was performed. First three formants of each vowel were obtained and recorded by speech studio soft ware and Dr. Speech device Data were compared between groups.
Results: Mean F₁ and F₂, and F₂/F₁ and F₃/F₁ ratio of Persian vowels between these three studied groups were different significantly. Mean F₃ of /o/, /e/ and /a/ in all groups was different significantly. Although we could not find such a significant differences for /u/, /i/ and /æ/ between these groups(p<0.05).
Conclusion: The most important difference between normal and hearing impaired children is their vowel Space, and we found that, the more sever the hearing impairment is, the closer vowel space will be seen. The hearing impaired children rely mostly on their proprioceptive sense because of their hearing deficiency and it causes less movement of the tongue, so they usually substitute vowels which have similar F₁ and F₂.

Background and Aim: One of the most common complaints, particularly among patients with normal or near normal low-frequency hearing, is that their voice sounds "hollow". This is associated with "Occlusion effect". The aim of this study was to comparison of occlusion effect in normal hearing subjects via Real Ear Measurement and Audiometric Bing test.
Materials and Method: Twenty volunteers with normal hearing (10 male, 10 female), with ages ranging from 18 - 24 years were enrolled in this study. First, audiometric Bing test was performed in frequencies of 250, 500, 750 and 1000 Hz. Then in real ear measurement, subjects were instructed to vocalize /â/ and /i/ for 5 seconds. Probe microphone was recorded the sound pressure in the ear canals. The degrees of occlusion effect unit were obtained for further analysis.
Results: The means of occlusion effect were present in all subjects. There was no correlation between the results of audiometric Bing test and real-ear measurement. No significant difference was obtained between genders and monaural or binaural occlusion in real-ear measurement. But in audiometric Bing test, the difference between monaural or binaural occlusion was significant(p<0.05).
Conclusion: The peak of occlusion effect varies significantly among hearing aid users, so the hearing aid must be tuned. Probe- microphone measures will assist in determination how much gain is enough, and where frequency- specific adjustments are needed.

Background and Aim: Hearing impairment affects all aspect of individual life, specially language and communication skills. When hearing impairment is congenital or occurs early in life, the child's ability to learn optimally through audition, will be affected. The aim of this study was to evaluate linguistic skills of preschool hearing impaired children and compare these skills with normal peers.

Methods: This descriptive cross-sectional study was performed on 38 preschool hearing impaired children that the main handicap was severe to profound hearing loss with ability to communicate orally and 28 normal children with the same cultural and social context. Twenty four non linguistic variables including age, gender, the age of entrance of preschool center, number of hearing aids, etc. were obtained by filling a questionnaire and fifteen linguistics variables including number of utterance, morphemes, correct utterance, noun phrase, ambiguous utterance, correct sentences, compound sentences, etc. were collected by some part of TOLD-P-3 test and three complementary questions. Then we compared the data from two groups.

Results: There were significant differences between number of utterance, number of correct mean length utterance, number of well-formed sentences in normal and hearing impaired group (p<0.000). There were no significant difference between unintelligible utterances, repetitive utterances and bad-formed sentences between two groups(p>0.05).

Conclusion: This study showed a severe deficit in linguistic skills in preschool hearing impaired children.

Background and Aim: Balance disturbance is one of the non-auditory effects of noisy industrial environments that is usually neglected. The aim of the current study was to investigate the effect of occupational noise on vestibular system among workers with noise-induced hearing loss (NIHL), based on both vestibular evoked myogenic potentials (VEMP) and caloric tests.

Methods: Thirty male workers with noise-induced hearing loss and thirty male matched controls were examined by VEMP and caloric tests. Study parameters included unilateral weakness, p13 and n23 latencies, and p13-n23 amplitude. Caloric test was performed only for 20 patients.

Results: No significant difference was observed in unilateral weakness between the two groups. On the other hand, the difference in mean latencies of p13 in the right ear (p=0.003) and left ear (p=0.01) was significant between the two groups. However, the difference in n23 latency was significant only in the right ear (p=0.03). There was no significant difference between groups in p13-n23 amplitude.

Conclusion: It seems that pars inferior of vestibule is the susceptible part in individuals with NIHL. In general, abnormal findings in both VEMP and caloric tests were more common compared to functional symptoms such as vertigo, which may be due to central compensation and the symmetry of the disorder.