Investigation of central auditory processing performance in individuals with and without stuttering.

BACKGROUND: Differences in core auditory processing abilities, such as sound timing, frequency discrimination, auditory perception, and auditory memory, have been suggested in stutterers, despite the fact that the precise origin of stuttering is not entirely understood. It is suggested that these differences may play a role in the development of stuttering. The aim of our study is to assess the temporal central auditory processing performance in individuals with stuttering and compare it to individuals without stuttering to uncover potential differences stuttering and compare it to individuals without stuttering to reveal potential differences. METHOD: In current study, a total of 60 right-handed participants between the ages of 8 and 17 were included, divided into two balanced groups based on age, education, and gender: individuals with stuttering (n = 30) and individuals without stuttering (n = 30). All participants underwent the Frequency Pattern Test, Duration Pattern Test, and Gaps-In-Noise test. RESULTS: Individuals who stutter showed lower performance in the gap detection threshold and the percentage of total correct gap identification parameters of the Frequency Pattern Test, Duration Pattern Test, and Gaps-In-Noise test compared to fluent speakers. CONCLUSIONS: The findings indicate a potential relationship between stuttering and central auditory processing. In this context, incorporating central auditory processing measures into the assessment and therapy processes for stuttering may enhance the likelihood of obtaining more accurate results.

Multi-feature mismatch negativity: How can reliable data be recorded in a short time?

OBJECTIVE: The aim of the study was to conduct multi-feature mismatch negativity (MMN) implementations and identify via a test-retest study the reliability of MMN responses obtained through a 5-stimulus version of the MMN paradigm. It was also aimed to identify a reliable MMN recording number by comparing the MMN responses obtained under conditions of ten and four recordings conditions while making the recording time shorter. METHODS: Twenty-one healthy volunteers, aged between 18 and 36 years, were included in the study. A 5-stimulus version of the multi-feature MMN paradigm was presented to participants. Ten recordings were obtained for each participant under both test and retest conditions. The MATLAB program was utilized in the evaluation of MMN amplitude and latency. The Fz was chosen for the statistical analysis. Four of the ten recordings were chosen at random, and statistical analyses were performed again for those four recordings. RESULTS: There was no statistically significant difference in amplitudes obtained from test and retest conditions with ten recordings. With four recordings, for frequency, intensity, duration, and gap deviants, there were no statistically significant differences between amplitudes obtained under test and retest conditions. However, there was a statistically significant difference between amplitudes of the location deviant. No statistically significant difference was observed among latencies under test-retest conditions with both ten and four recordings. CONCLUSIONS: These findings demonstrate that MMN amplitudes could be used reliably as short-time evaluations with four recordings, but more recordings are required for MMN latencies. In terms of practicality, four recordings are more advantageous and comfortable for both clinicians and patients in MMN practice. SIGNIFICANCE: When behavioral tests are required, MMN is regarded as an objective test that can be used reliably for adults, children, and infants who cannot be evaluated using behavioral methods. It is concluded that conditions with four recordings aremore advantageous and comfortable for both clinicians and patients in MMN practice.

Is there any difference in hearing function between surgical and natural menopause?

This study was designed to examine cochlear function in surgical postmenopausal women and natural menopause. Three groups, each including 20 patients, were formed: surgical menopause (SM), natural menopause (NM), and healthy controls who had not yet gone through menopause. Conventional audiometry (0.125-8 kHz), ultra-high frequency audiometry (10-16 kHz), and otoacoustic emission (OAE) tests were used in the evaluation of the patients. Almost all the hearing thresholds were significantly poorer in the menopause groups than in the control group (p < .05). However, the amplitudes of the healthy controls were higher in transient evoked otoacoustic emissions (TEOAEs), especially in many frequencies of distortion product otoacoustic emissions (DPOAEs) (p < .05). In the SM group, all the frequencies between 0.125 and 10 kHz for the right ear, and 1, 2, 6 and 8 kHz air-conduction hearing thresholds for the left ear were significantly poorer compared to the NM group (p < .05). There was also a significant decrease in the 4, 6, and 8 kHz DPOAE amplitudes of the SM group compared to the NM group (p < .05). This study showed that postmenopausal women, in particular those with SM had significantly poorer hearing thresholds and lower OAE amplitudes. Menopause may be a potential risk factor for the development of hearing loss in women.

Electrophysiologic evaluation of facial nerve functions after oxaliplatin treatment.

PURPOSE: This study analyzes the effect of oxaliplatin treatment on the facial nerve. The facial nerve is the most commonly paralyzed cranial motor nerve because it advances through a long, curved bone canal. Electroneurography and blink reflex are the electrophysiological measurements used for evaluating facial nerve function. Oxaliplatin is a cytotoxic agent used in adjuvant or palliative systemic therapy for colorectal cancer treatment. METHODS: This study was performed on 20 individuals who were at least 18 years old at Hacettepe University Ear Nose Throat Department, Audiology and Speech Disorders Unit, and Neurology Division EMG Laboratory as they received oxaliplatin treatment from Hacettepe University Oncology Hospital. Electroneurography and blink-reflex values were recorded and examined. The parameters taken during the second and fourth months were compared for this purpose. RESULTS: This study shows that the prolongation of distal latencies of compound muscle action potential is statistically significant, the amplitudes showed no difference. The ENoG results were analyzed, the prolongation of latency measurements between pre-treatment and the fourth month after treatment were statistically significant. The blink-reflex results showed that comparison with the baseline values, the prolongation of latencies in R1 measurements between pre-treatment, the second month, and the fourth month were significant. CONCLUSIONS: The facial nerve is affected asymptomatically by oxaliplatin treatment. During oxaliplatin treatment, the evaluation of facial nerve function could be beneficial for patients by improving their quality of life. Electroneurography and blink-reflex tests can be used in the early evaluations of different medicines to determine their neurotoxicity.

Comparison of anxiety and child-care education characteristics of mothers who have children with or without speech delays / Comparação da ansiedade e características da educação infantil em mães com filhos com ou sem atrasos na fala

Abstract Introduction: Speech delay in a child could be the cause and/or result of the emotional disorder. The child rearing attitude that the parents have accepted could have both positive and negative effects on the personality of the child. Objective: The current study aimed to investigate the sociodemographic features and the mothers' anxiety of children with speech delay. Methods: One hundred five mothers with children aged between 3 and 6 years with speech delays were included in the patient group, and 105 mothers who have children aged between 3 and 6 years with normal speech and language development were included in the control group. An information form questionnaire including demographic characteristics, the Family Life and Childrearing Attitude Scale (PARI - Parental Attitude Research Instrument) and Beck anxiety scale were requested from all mothers in the patient and the control groups. Results: In the current study, there was a significant difference between the groups in terms of gender (p = 0.001). According to Parental Attitude Research Instrument, the mean of mothers of the children with speech delays was higher than the mean of mothers of normal children in terms of the answers to overprotective mother aspect (p < 0.01). The mothers of children with speech delays had more overprotective motherhood attitudes; however, the difference in terms of the answers to the aspects of democratic attitude and provision of equality, refusal to be a housewife, husband-wife conflict, and suppression and discipline were not statistically significant. The Beck anxiety scale, a significant difference was detected between the two groups (p < 0.01). It was found that the mothers of children with speech delays had more severe levels of anxiety. Conclusion: The social structure of the family, the attitudes and the behaviors of the mother, and the anxiety levels of the mothers have important effects on child development. Thus, it is necessary to perform further studies related to speech delays, in which many factors play a role in the etiology.

Resumo Introdução: O atraso da fala em uma criança pode ser a causa e/ou o resultado de distúrbio emocional. As atitudes tomadas pelos pais na educação da criança podem ter efeitos positivos e negativos sobre a personalidade infantil. Objetivo: Investigar as características sociodemográficas e a ansiedade das mães de crianças com atraso na fala. Método: Foram incluídas no grupo de pacientes 105 mães com crianças entre 3 e 6 anos de idade e atrasos na fala e no grupo controle 105 mães com crianças na mesma faixa etária e desenvolvimento normal da fala e da linguagem. Foi solicitado às mães de ambos os grupos o preenchimento de informações em um formulário, incluindo características demográficas, o instrumento Family Life and Child Rearing Attitude Scale (PARI - Parental Attitude Research Instrument) e o inventário de ansiedade Beck. Resultados: No estudo atual, houve diferença significativa entre os grupos em relação ao gênero (p = 0,001). De acordo com o instrumento Parental Attitude Research Instrument, a média das mães das crianças com atrasos na fala foi maior do que a média das mães de crianças normais em relação às respostas sobre superproteção materna (p < 0,01). As mães de crianças com atrasos na fala apresentaram mais atitudes de proteção materna excessiva; no entanto, a diferença das respostas sobre atitudes democráticas e igualitarismo, recusa do papel de dona de casa, conflito marital e disciplina rígida não foram estatisticamente significantes. No inventário de ansiedade de Beck foi encontrada uma diferença significativa entre os dois grupos (p < 0,01). Verificou-se que as mães de crianças com atrasos na fala apresentavam níveis mais graves de ansiedade. Conclusão: A estrutura social da família, as atitudes, o comportamento e os níveis de ansiedade das mães têm efeitos importantes no desenvolvimento da criança. Conclui-se, portanto, a necessidade de realizar estudos adicionais relacionados aos atrasos na fala, nos quais diversos fatores desempenham um papel etiológico.

Comparison of anxiety and child-care education characteristics of mothers who have children with or without speech delays.

INTRODUCTION: Speech delay in a child could be the cause and/or result of the emotional disorder. The child rearing attitude that the parents have accepted could have both positive and negative effects on the personality of the child. OBJECTIVE: The current study aimed to investigate the sociodemographic features and the mothers' anxiety of children with speech delay. METHODS: One hundred five mothers with children aged between 3 and 6 years with speech delays were included in the patient group, and 105 mothers who have children aged between 3 and 6 years with normal speech and language development were included in the control group. An information form questionnaire including demographic characteristics, the Family Life and Childrearing Attitude Scale (PARI - Parental Attitude Research Instrument) and Beck anxiety scale were requested from all mothers in the patient and the control groups. RESULTS: In the current study, there was a significant difference between the groups in terms of gender (p=0.001). According to Parental Attitude Research Instrument, the mean of mothers of the children with speech delays was higher than the mean of mothers of normal children in terms of the answers to overprotective mother aspect (p<0.01). The mothers of children with speech delays had more overprotective motherhood attitudes; however, the difference in terms of the answers to the aspects of democratic attitude and provision of equality, refusal to be a housewife, husband-wife conflict, and suppression and discipline were not statistically significant. The Beck anxiety scale, a significant difference was detected between the two groups (p<0.01). It was found that the mothers of children with speech delays had more severe levels of anxiety. CONCLUSION: The social structure of the family, the attitudes and the behaviors of the mother, and the anxiety levels of the mothers have important effects on child development. Thus, it is necessary to perform further studies related to speech delays, in which many factors play a role in the etiology.

Adaptation, validity, and reliability of the Preschool Language Scale-Fifth Edition (PLS-5) in the Turkish context: The Turkish Preschool Language Scale-5 (TPLS-5).

INTRODUCTION: Speech and language assessment is very important in early diagnosis of children with hearing and speech disorders. Aim of this study is to determine the validity and reliability of Preschool Language Scale (5th edition) test with its Turkish translation and adaptation. METHODS AND MATERIALS: Our study is conducted on 1320 children aged between 0-7 years 11 months. While 1044 of these children have normal hearing, language and speech development, 276 of them have receptive and/or expressive language disorder. After the English-Turkish and Turkish-English translations of PLS-5 made by two experts command of both languages, some of the test items are reorganized because of the grammatical features of Turkish and the cultural structure of the country. The pilot study was conducted with 378 children. The test which is reorganized in the light of data obtained in pilot application, is applied to children chosen randomly with layering technique from different regions of Turkey, then 15 days later the first test applied again to 120 children. RESULTS: While 1044 of 1320 children aged between 0 and 7 years 11 months are normal, 276 of them have receptive and/or expressive language disorder. While 98 of 103 healthy children of 120 taken under the second evaluation have normal language development, 8 of 9 who used to have language development disorder in the past still remaining (Kappa coefficient:0,468, p<0,001). Pearson correaltion coefficient for TPLS-5 standard gauge are; IA raw score:0,937, IED raw score: 0,908 and TDP: 0,887 respectively. Correlation coefficient for age equivalance is found as IA:0,871, IED: 0,896, TDP: 0,887. CONCLUSIONS: TPLS-5 is the first and only language test in our country that can evaluate receptive and/or expressive language skills of children aged between 0-7 years 11 months. Results of the study show that TPLS-5 is a valid and reliable language test for the Turkish children.

The effects of tinnitus and/or hearing loss on the Symptom Checklist-90-Revised test.

OBJECTIVE: This study aims to evaluate the psychological attitudes of patients with tinnitus by using The Symptom Checklist-90-Revised and to investigate the relationship between hearing loss and attributed psychological attitudes. MATERIALS AND METHODS: 142 subjects (73 female, 69 male) divided into 4 groups: Group 1 (32 patients with tinnitus and hearing loss-), Group 2 (38 patients with tinnitus), Group 3 (36 patients with hearing loss), Group 4 (36 healthy subjects without tinnitus and hearing loss-control group). The Symptom Checklist-90-Revised (SCL-90-R) test was used to detect the subjects' tendency for psychological problems due to tinnitus and/or hearing loss. RESULTS: Mean values of Somatization (SOM), Obsessive-Compulsive (O-C) and Additional Scale (AS) were higher than cut-off points of 1.00 for Groups 1 and 2 (tinnitus and/or hearing loss). In patients with tinnitus and/or hearing loss, SOM, O-C, Depression (DEP), AS and Global Severity Index (GSI) were significantly higher than patients with hearing loss and control group. By multiple linear regression analysis, tinnitus was the significantly detected confounding factor for increase of SOM, O-C, Interpersonal Sensitivity (I-S), DEP, Hostility (HOS), Paranoid Ideation (PAR), AS and GSI parameters. CONCLUSION: It was concluded that tinnitus could induce some psychological symptoms such as depression; and this is independent of hearing loss. Tinnitus with or without hearing loss is the essential factor for causing psychological problems in patients. Tinnitus duration is not important in the scene of psychological status of the patients. This result shows that, age, gender (male, female), chronic or acute tinnitus experience, and having hearing loss did not cause too much problems in patients. But tinnitus experience in every form (for the present study, intermediate level subjective tinnitus) is significantly important confounding factor for affecting psychological status of the patients.

Features of unilateral hearing loss detected by newborn hearing screening programme in different regions of Turkey.

OBJECTIVE: Newborn hearing screening (NHS) works well for babies with bilateral hearing loss. However, for those with unilateral loss, it has yet to be established some standard rules like age of diagnose, risk factors, hearing loss degree. The aim of this study is to identify the demographic characteristics of newborns with unilateral hearing loss to obtain evidence based data in order to see what to be done for children with unilateral hearing loss (UHL). METHOD: Newborn hearing screening data of 123 babies with unilateral hearing loss, 71 (57.7%) male and 52 (42.3%) female, were investigated retrospectively. Data provided from the archives of six referral tertiary audiology centers from four regions in Turkey. Data, including type of hearing loss; age of diagnosis; prenatal, natal and postnatal risk factors; familial HL and parental consanguinity was analyzed in all regions and each of the Regions 1-4 separately. RESULT: The difference between data obtained in terms of gender and type of hearing loss was detected as statistically significant (p<0.05). While UHL was significantly higher in females at Region 1, and in males at other Regions of 2-4; SNHL was the most detected type of UHL in all regions with the rate of 82.9-100.0%. There were not significant differences between regions in terms of the degree of hearing loss, presence of risk factors, family history of hearing loss, age at diagnosis and parental consanguinity (p>0.05). Diagnosis procedure was completed mostly at 3-6 months in Region 4; whereas, in other regions (Regions 1-3), completion of procedure was delayed until 6 months-1 year. CONCLUSION: This study indicates that the effect of postnatal risk factors, i.e. curable hyperbilirubinemia, congenital infection and intensive care is relatively high on unilateral hearing loss, precautions should be taken regarding their prevention, as well as physicians and other health personnel should be trained in terms of these risks. For early and timely diagnosis, families will be informed about hearing loss and NHS programme; will be supported, including financial support of diagnosis process. By dissemination of the NHS programme to the total of country by high participation rate, risk factors can be determined better and measures can be increased. Additionally, further studies are needed with more comprehensive standard broad data for more evidence based consensus.

Multicentre investigation on electrically evoked compound action potential and stapedius reflex: how do these objective measures relate to implant programming parameters?

OBJECTIVES: The aims of this study were to collect data on electrically evoked compound action potential (eCAP) and electrically evoked stapedius reflex thresholds (eSRT) in HiResolution(TM) cochlear implant (CI) users, and to explore the relationships between these objective measures and behavioural measures of comfort levels (M-levels). METHODS: A prospective study on newly implanted subjects was designed. The eCAP was measured intra-operatively and at first fitting through neural response imaging (NRI), using the SoundWave(TM) fitting software. The eSRT was measured intra-operatively by visual monitoring of the stapes, using both single-electrode stimulation and speech bursts (four electrodes stimulated at the same time). Measures of M-levels were performed according to standard clinical practice and collected at first fitting, 3 and 6 months of CI use. RESULTS: One hundred seventeen subjects from 14 centres, all implanted unilaterally with a HiResolution CII Bionic Ear(®) or HiRes 90K(®), were included in the study. Speech burst stimulation elicited a significantly higher eSRT success rate than single-electrode stimulation, 84 vs. 64% respectively. The NRI success rate was 81% intra-operatively, significantly increasing to 96% after 6 months. Fitting guidelines were defined on the basis of a single NRI measurement. Correlations, analysis of variance, and multiple regression analysis were applied to generate a predictive model for the M-levels. DISCUSSION: Useful insights were produced into the behaviour of objective measures according to time, electrode location, and fitting parameters. They may usefully assist in programming the CI when no reliable feedback is obtained through standard behavioural procedures.

Comparison of learning preferences of Turkish children who had been applied cochlear implantation in Turkey and Germany according to theory of multiple intelligence.

AIM: The aim of the study is to determinate the using dominant multiple intelligence types and compare the learning preferences of Turkish cochlear implanted children aged four to ten in Turkey and Germany according to Theory of multiple intelligence. MATERIAL AND METHOD: The study has been conducted on a total of 80 children and four groups in Freiburg/Germany and Ankara/Turkey. The applications have been done in University of Freiburg, Cochlear Implant Center in Germany, and University of Hacettepe, ENT Department, Audiology and Speech Pathology Section in Turkey. In this study, the data have been collected by means of General Information Form and Cochlear Implant Information Form applied to parents. To determine the dominant multiple intelligence types of children, the TIMI (Teele Inventory of Multiple Intelligences) which was developed by Sue Teele have been used. RESULTS: The study results exposed that there was not a statistically significant difference on dominant intelligence areas and averages of scores of multiple intelligence types in control groups (p>0.05). Although, the dominant intelligence areas were different (except for first dominant intelligence) in cochlear implanted children in Turkey and Germany, there was not a statistically significant difference on averages of scores of dominant multiple intelligence types. CONCLUSION: Every hearing impaired child who started training, should be evaluated in terms of multiple intelligence areas and identified strengths and weaknesses. Multiple intelligence activities should be used in their educational programs.

Depressive emotioning in adolescents with cochlear implant and normal hearing.

OBJECTIVE: The purpose of this study is to compare the levels of depressive emotioning of adolescents with cochlear implants and the ones who have normal hearing. METHODS: For this purpose, Rosenberg Self-Esteem Scale is applied upon the study group which consists of 30 adolescents with cochlear implant between the ages of 12-19 and upon the control group which consists of 60 adolescents having the similar characteristics. The scale is used to evaluate the level of depressive emotioning of adolescents with cochlear implant and with normal hearing. RESULTS: At the end of the application, the scores of these two groups which they got according to their answers were compared statistically. When the results were examined, there seemed to be no significant difference statistically between the depressive emotioning values of the cochlear implant group and the control group. Apart from this, in this study, we examined changes in the level of depressive emotioning according to different variables. As a result, it was found out that in both groups level of depressive emotioning was lower for adolescents who had had preschool education, had brothers/sisters, high level of income, whose father and mother had higher levels of education. On the other hand, the birth sequence and the child's father's profession did not seem to have any effect on the child's level of depressive emotioning. CONCLUSIONS: As a result of these findings, it was thought that cochlear implantation had a positive effect on life quality and it was suggested that the adolescents and their families should get assistance from experts about the characteristics and principles of approaching the child in this period. The adolescent should be directed towards social activities and courses, their positive sides should be supported and further studies should be carried out with different case groups on this matter. In addition to, examining the interactions of hearing loss effects can help professionals determine the individuals who are at a higher risk for developing mental distress.

Preliminary results of auditory brainstem implantation in prelingually deaf children with inner ear malformations including severe stenosis of the cochlear aperture and aplasia of the cochlear nerve.

OBJECTIVE: The aim of our study is to present the results of 11 children where auditory brainstem implantation (ABI) was successfully performed to restore hearing. STUDY DESIGN: Case presentation. This study was conducted at the departments of Otolaryngology and Neurosurgery at Hacettepe University Ankara, Turkey. PATIENTS: Between July 2006 and April 2008, 11 prelingual (30-56 mo) deaf children with several cochlear malformations had ABI. INTERVENTION: All patients were programmed and were enrolled in auditory verbal therapy sessions and family counseling programs at Hacettepe Auditory Verbal Center. The evaluation was performed at preimplant and again 1, 3, 6, 9, and 12 months post-switch on. MAIN OUTCOME MEASURES: The main test components composing this test battery were Ling 6 Sound Detection-Identification Test, Word Identification Test in Turkish, Meaningful Auditory Integration Scale, and Meaningful Use of Speech Scale. RESULTS: Successful brainstem implantations were performed in all patients with retrosigmoid approach. Six children gained basic audiologic functions and were able to recognize and discriminate sounds, and many could identify environmental sounds such as a doorbell and telephone ring by the third month of ABI. Improvement in mean performance on Meaningful Auditory Integration Scale is apparent for all ABI children. Improvement in Meaningful Use of Speech Scale scores in 2 patients, demonstrating that the child using its own voice for speech performance, was observed between the baseline and 12th month. First, 5 children were able to identify Ling's 6 sound by the end of 2 to 6 months, and 2 of them also started to identify words due to their pattern differences and multisyllabic word identification by 6 to 9 months. Two children with Attention Deficit Hyperactivity Disorder have made slower progress than the other children with ABIs. CONCLUSION: Our preliminary results show that there is adequate contribution of brainstem implants in the development of auditory-verbal skills. Additional handicaps slow the progress of the prelingually deaf children.

The family oriented musical training for children with cochlear implants: speech and musical perception results of two year follow-up.

OBJECTIVE: The purpose of this study is to determine whether children can gain benefit from training on pitch and music perception. Our main goals were to prepare a tool for training pitch and rhythm perception and evaluate musical attitude in children, to determine whether pitch and rhythm perception improve more rapidly through training and to assess the impact of training on speech perception. METHOD: A family centred habilitation program based on musical training is developed. Nine newly implanted children who were switched on in HiRes and trained from the outset and 9 children using HiRes strategy who did not receive training both undergo assessments to determine pitch and rhythm perception skills and speech perception assessments. Music group was formed by the children who were implanted consecutively. As a control group, children who are being followed for another study which examines "the changes of sound quality perception, speech understanding, speech production, and communication mode" are included. The speech perception test battery contains a comprehensive range of age appropriate tasks covering detection, discrimination, identification, recognition and comprehension abilities. Also meaningful auditory integration scale (MAIS) or infant-toddler MAIS (if more appropriate) and the meaningful use of speech scale (MUSS) were administered in order to collect information about children's use of sound in everyday situations such as device bounding, alerting to sound and deriving meaning from auditory stimuli. Musical training program was based on a take-home electric keyboard which is used for listening to different pairs of notes. For this study, three octaves and one extra note at the high end of the keyboard were used. Children were expected to discriminate a pair of notes. Assessments of speech perception at pre-implant, 1-, 3-, 6-, 12-, 24-months post switch-on. By the end of the first and second years, parents were given the 'musical stages questionnaire' which covers some of the key areas of musical development to compare both groups' musical development. RESULTS: Children who were involved in music study demonstrated significant familiarity in both determining pitch differences. No significant difference was found between music group compared with the non-trained group in terms of speech perception (p>0.05). However, by the end of 3rd month, music group came into prominence particularly at the rate of being linguistically/developmentally ready to carry out formal modified open-set speech perception evaluation (p<0.05). Both groups seemed to be developed similarly in sound awareness and general reaction, differentiating melody, dynamic, rhythmical changes and emotional aspects of musical development (p>0.05) whereas music group had more exposure to music at the end of the first year (p<0.05). However, by the end of the second year music group developed more than the control group in all aspects of musical skills (p<0.05). CONCLUSION: Music training program helps appreciation of music and may enhance their progress in other auditory domains after cochlear implantation in children. While, effects of the musical training program on daily listening attitudes and social aspects such as closer parent-child relationship were significantly observed future training programs that should strive to improve satisfaction with music listening and its effect on auditory perception.

[Evaluation of high frequency hearing thresholds in smokers]. / Sigara kullananlarda yüksek frekans isitme esiklerinin degerlendirilmesi.

OBJECTIVES: We investigated whether high frequency hearing thresholds differed between smokers and nonsmokers. SUBJECTS AND METHODS: The study was carried out in 50 individuals including 20 nonsmokers (mean age 29 years; range 25 to 37 years) and 30 smokers (mean age 34 years; range 25 to 50 years). The smokers group was comprised of individuals who had been smoking at least a pack a day for more than 10 years. High frequency hearing thresholds (8-18 kHz) were compared between the two groups. RESULTS: The mean hearing thresholds of smokers at 16 kHz were 50.66 dB HL and 49.50 dB HL in the left and right ears, respectively; the corresponding figures for nonsmokers were 31.00 dB HL and 33.25 dB HL, respectively (p=0.005). The mean hearing thresholds of smokers and nonsmokers at 18 kHz were 57.33 dB HL and 41.25 dB HL for the left ears, and 59.33 dB HL and 42.52 dB HL for the right ears, respectively (p=0.005). Analyses between the two groups after exclusion of subjects over 40 years of age showed significant differences at 16 kHz and at 18 kHz for the left ears, and at 18 kHz for the right ears (p=0.005). CONCLUSION: Our results suggest that smoking can be considered one of the factors that plays a role in high frequency hearing loss.

Long-term effects of dexamethasone on hearing ability in children with pneumococcal meningitis.

Controlled trials concerning adjuvant dexamethasone therapy in bacterial meningitis do not point unequivocally to a beneficial effect on hearing ability. We investigated the remote adverse outcomes of pneumococcal meningitis and, if any, beneficial effects of adjuvant dexamethasone therapy on hearing ability. Fifty-five subjects who experienced pneumococcal meningitis between 1987-97 were divided into two groups as 25 subjects who did not receive dexamethasone (Group 1) and the remaining 30 subjects who did (Group 2). All subjects underwent pure tone thresholds estimation. There were a total of 11 subjects (20%) with sensorineural hearing impairment (SNHI): 6 in the first group (24%) and 5 in the second group (16%). Although there was no statistically significant difference in the SNHI ratio between the groups, all the subjects who used adjuvant dexamethasone therapy suffered only minimal-borderline SNHI, whereas 2 patients in Group 1 had moderate-serious SNHI. Even though adjuvant dexamethasone therapy had no statistically significant impact on hearing ability after long-term follow-up, its use may be a good choice in terms of preventing serious SNHI.

Hearing loss in biotinidase deficiency: genotype-phenotype correlation.

Children with symptoms of profound biotinidase deficiency with null mutations are more likely to have hearing loss develop than those with missense mutations, even if not treated for a period of time. Hearing loss appears to be preventable in children with null mutations if treatment is initiated soon after birth.

The extent and levels of tinnitus in children of central Ankara.

OBJECTIVE: The objective of this study is to determine the presence and prevalence of tinnitus among primary school and junior high school students in central Ankara. METHODS: In the first stage of the study, all students were tested for the presence of tinnitus by answering a comprehensive questionnaire. The students who had previous ear operations were excluded from the rest of the study. The initial survey/tests yielded presence of tinnitus, frequency of occurrence, characteristics, associated symptoms and the age groups. RESULTS: 15.1% of the children reported to have tinnitus. No significant difference was found between gender (female 45.5%, male 54.4%) and ears (right 25.3%, left 25.5%). The age group that suffered most from tinnitus is 14 years old (20.8%), 25 children had positive family history (16.2%), 44 children had headaches as the most common accompanying symptom (28.6%), 64 of them had tiredness as the predisposing factor (41.6%) and 52 of them have defined worsening of tinnitus during mornings (33.8%). The characteristics of tinnitus were identified as high pitch (n=125, 81.2%), soft loudness (n=124, 80.5%) and ringing (n=61, 39.6%). CONCLUSIONS: The study produced much needed data to shed light onto understanding levels and characteristics of tinnitus in school children in Turkey. The data obtained was carefully analyzed and found to be comparative to international studies.