THE ASSOCIATION BETWEEN AMINOGLYCOSIDE EXPOSURE AND OTOTOXICITY IN CHILDREN WITH CYSTIC FIBROSIS.

INTRODUCTION: Pulmonary exacerbations increase the requirement of aminoglycoside (AG) antibiotics in people with cystic fibrosis (pwCF). Several studies have shown that AGs have a cumulative effect on ototoxicity. We aimed to investigate the relationship between AG exposure and ototoxicity by using three different methods in patients with CF. MATERIALS-METHODS: The multicenter study included 121 pwCF aged between 5-18 years with a history of parenteral AG exposure. Standard pure tone audiometry (sPTA), extended high frequency audiometry (EHF-PTA), and distortion-product otoacoustic emissions (DPOAE) tests were performed. Mitochondrial mutation analysis for m1555G>A was performed in 61 patients. RESULTS: Median age was 12.85 years and 52.1% (n=63) were male. 18.2% (n=22) of the patients had received parenteral AGs more than 5 courses/lifetime. Ototoxicity was detected in at least one of the tests in 56.2% (n= 68) of the patients. Only 10.7 % (n=13) of the patients had reported a symptom indicating ototoxicity. 30.3% (n=30) of the patients had ototoxicity in the low-exposure group while it was 45.5% (n=10) in the high-exposure group according to EHF-PTA (p>0.05). Median number of parenteral amikacin courses was significantly higher in the ototoxic group [2(1.25-5.75) vs 2(1-3); p=0.045]. No m1555A>G mutation was detected in 61 patients who screened for mitochondrial mutation analysis. CONCLUSION: As AG ototoxicity occurs primarily at high frequencies, EHF-PTA is important in early detecting otoxicity. EHF-PTA and DPOAE detected ototoxicity in some patients with normal PTA results. All pwCF with a history of AG exposure should be evaluated for hearing loss since symptoms may only be noticed in the late period.

Evaluating the association between developmental language disorder and depressive symptoms in preschool children.

This study aims to investigate the association between developmental language disorder (DLD) and depressive symptoms in preschool-aged children, building upon previous research that has demonstrated emotional difficulties in children with DLD. Forty-one children with DLD or children at risk for DLD (DLD group) and 41 children with typical language development (TLD) were included in this study. Language development was evaluated using the TEDIL test which is a Turkish adaptation of the Test of Early Language Development-3. Auto acoustic Emissions Testing and Immittance-Metric Assessment were used to exclude children with hearing impairment. Developmental delays were excluded by Denver Developmental Screening Test II. Mothers filled out the Sociodemographic Data Form and the Child Depressive Symptoms Assessment Scale. The results demonstrate that children in DLD group scored significantly higher on the Child Depressive Symptoms Assessment Scale, manifesting increased levels of aggression, separation anxiety, impulsivity, hyperactivity, and encountering greater social adaptation difficulties and deterioration in cognitive processes than TLD. Multivariate regression analysis suggests that increased impulsivity and hyperactivity, alongside social and cognitive challenges, are predictors of DLD. The study concludes that depressive symptoms are more prevalent in children in DLD group than in their typically developing counterparts. These findings underscore the necessity for targeted psychiatric and pedagogical interventions, as well as individualized educational programs that cater to the socio-emotional and cognitive needs of children with DLD.

The effect of strabismus surgery on the dynamic balance in children with strabismus.

Purpose: To evaluate the effect of strabismus surgery on dynamic balance by using computerized dynamic posturography in children with strabismus. Methods: This study was designed as a prospective observational study. Hearing tests and complete ophthalmological examinations were performed for all subjects. Patients with moderate and severe amblyopia, hearing loss at any level, and/or any suspicion of balance impairment were excluded from the study. Postural stability evaluation was performed by computerized dynamic posturography including sensory organization test, adaptation test, and rhythmic weight shift test. All tests were applied preoperatively and in the postoperative 1st and 3rd months, respectively. Results: Fifteen female and twelve male pre-adolescents aged between 7 and 12 (9.67 ± 1.62 years) were included in the current study. In the sensory organization test, the preoperative visual ratio percentages (73.19 ± 14.95%) improved statistically significantly at the postoperative 1st and 3rd months (78.59 ± 16.21% and 81.44 ± 14.18; p = .026, p = .021, respectively). The preoperative toes up (110.66 ± 33,48) and toes down (81.46 ± 28.36) adaptation tests improved statistically significantly in the postoperative 3rd month (88.74 ± 20.94 and 63.36 ± 16.03; p < .001, p = .001, respectively). In the Rhythmic Weight Shift test, the postoperative 3rd-month directional control (forward-backward) value (74.25 ± 11.51%) was statistically significantly higher compared to the preoperative directional control (forward-backward) value (67.76 ± 11.38%) (p = .011). The postoperative 3rd-month directional control (forward-backward) value (74.25 ± 11.51%) was statistically significantly higher compared to the postoperative 1st-month directional control (forward-backward) value (68.43 ± 14.00%) (p = .028). Conclusion: Surgical treatment resulted in an improvement in the maintenance of dynamic balance in children with strabismus.

Effect of External Ear Deformity on Hearing in Wrestlers.

PURPOSE: Cauliflower ear in wrestlers can lead to hearing impairment. This study primarily aims to assess the hearing of wrestlers with bilateral cauliflower ears and determine their external ear canal (EEC) resonance frequencies. Our second aim is to evaluate their hearing quality, speech, and spatial perception. METHOD: This study included 28 male wrestlers aged 18-35 years with bilateral cauliflower ears, as well as 27 male participants in the control group with no wrestling history. The participants' hearing thresholds were determined across the frequency range of 125-16000 Hz for air-conduction and 500-4000 Hz for bone conduction. EEC resonance frequencies were measured. Additionally, all participants completed the Turkish version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire. RESULTS: Wrestlers with cauliflower ears exhibited significantly higher hearing thresholds, particularly at frequencies above 4000 Hz (p < .05). Analysis of EEC resonance showed a shift to higher frequencies in the second resonance peak of the right ear (p < .001) and the first resonance peak of the left ear (p = .045). SSQ scores revealed that wrestlers had higher spatial perception (p = .046), hearing quality (p = .004), and general scores (p = .042) in comparison to the control group. CONCLUSIONS: Blunt traumas in wrestlers, leading to cauliflower ear, can result in hearing loss. Moreover, deformities in the external ear affect the resonance frequencies of the EEC. Therefore, it is crucial to advocate for the use of ear protection equipment among wrestlers. When fitting hearing aids, attention should be given to changes in the EEC resonance frequency.

Investigation of the relationship between hyperacusis and auditory processing difficulties in individuals with normal hearing.

PURPOSE: This study aimed to investigate the prevalence of hyperacusis and auditory processing (listening) difficulties (APDiff) in normal-hearing young adults and to explore the relationship between these two conditions. METHODS: A total of 333 participants aged 18-24 underwent pure-tone audiometry tests and completed the Khalfa Hyperacusis Questionnaire (KHQ) and the University of Cincinnati Auditory Processing Inventory (UCAPI) online. RESULTS: Hyperacusis was identified in 26.43% of participants, and APDiff in 36.04%. A strong, positive correlation was found between KHQ and UCAPI scores (r = 0.603, p < 0.001). Logistic regression models indicated that hyperacusis significantly increased the likelihood of having APDiff (OR 7.688, p < 0.001). CONCLUSION: Despite the high prevalence of hyperacusis and APDiff in young adults, few seek help from audiology clinics. Our findings highlight a significant link between hyperacusis and APDiff, emphasizing the need for screening protocols for auditory processing skills in young adults due to these conditions' potential social and academic impacts.