Prevalence and Risk Factors for Hearing Loss in Neonates Admitted to the Neonatal Intensive Care Unit: A Hospital Study.

INTRODUCTION: Hearing loss is one of the most common congenital disabilities in neonates. The aims of this study were to investigate the prevalence of hearing loss and identify the most significant risk factor in neonates hospitalized at the Neonatal Intensive Care Unit (NICU). METHODS: This cross-sectional study involved 530 neonates admitted to NICU Abuzar Hospital with risk factors for hearing loss based on Joint Committee of Infant Hearing (JCIH). The hearing screening tests include transient evoked otoacoustic emissions (TEOAES) and the automated auditory brain stem response (AABR). For infants with abnormal AABR and TEOAE results, the Auditory Brainstem Response (ABR) and Auditory Steady-State Responses (ASSR) tests were performed. RESULT: Of 530 infants, 27 (5.09%) were diagnosed with different types of hearing loss. Ototoxic drugs, hyperbilirubinemia requiring exchange transfusion, asphyxia, low weight birth, Apgar score < 5, and a kinship marriage of parents were significant risk factors for hearing loss in our study population. CONCLUSION: Due to the high prevalence of hearing loss in the NICU, it is recommended that a hearing screening program be performed for all infants admitted to the NICU. Implement a comprehensive plan for neonatal hearing screening for early detection and intervention of hearing loss is essential.

Risk Factors for Otitis Media in Children Referred to Abuzar Hospital in Ahvaz: A Case-Control Study.

Introduction Otitis media is one of the most common causes of infection in preschool children. The most damaging complication of otitis media is temporary or permanent hearing loss. This study aimed to determine the important risk factors for otitis media. Methods In this case-control study, 625 children aged six months to seven years were examined from winter to spring 2020, and 53 children with otitis media were allocated to the case group and the same number to the control group. The chi-square test was used to identify the risk factors affecting otitis media, and the risk factors were compared between the case and control groups. Logistic regression was used to investigate the relationship between the incidence of otitis media and risk factors. Results Bivariate analysis revealed the following primary risk factors for otitis media: using pacifiers or bottle feeding, working mother, seasonal rhinitis, allergic rhinitis, tonsillopharyngitis, rhinorrhea, and adenoid hypertrophy (P<0.05). In logistic regression analysis, using pacifiers or bottle feeding (odds ratio [OR]=0.156, P=0.000), working mother (OR=0.226, P=0.000), seasonal rhinitis (OR=0.175, P=0.000), allergic rhinitis (OR=5.20, P=0.000) and adenoid hypertrophy (OR=1.57, P=0.000) were identified as the most important risk factors. Conclusion Adenoid hypertrophy and allergic rhinitis increased the risk of otitis media more than the other risk factors. Therefore, pediatricians should increase their awareness of the existence of these risk factors in a patient, and take the appropriate diagnostic steps and implement therapeutic care to prevent language and speech complications.

The Correlation Analysis Between the Spatial Hearing Questionnaire (SHQ) and the Psychophysical Measurement of Spatial Hearing.

The aim of the present study was examining the relationship between a psychophysical spatial hearing test (spatial word in noise test) and Spatial Hearing Questionnaire. Sixty-six adults (18-40 years old) were divided in three groups: normal subjects, subjects with mild and moderate hearing loss. Spatial word in noise test and Persian version of the spatial hearing questionnaire were evaluated and compared among these groups. According to Pearson's test, there was a significant positive correlation between the scores of spatial word in noise test and Persian version of the Spatial Hearing Questionnaire in three groups (r = 0.64-0.89). Hearing loss can deteriorate spatial hearing ability. Both objective and subjective spatial hearing tests are shown to be effective in detecting spatial hearing disorder.

Dichotic training in children with auditory processing disorder.

OBJECTIVES: Several test batteries have been suggested for auditory processing disorder (APD) diagnosis. One of the important tests is dichotic listening tests. Significant ear asymmetry (usually right ear advantage) can be indicative of (APD). Two main trainings have been suggested for dichotic listening disorders: Differential Interaural Intensity Difference (DIID) and Dichotic Offset Training (DOT). The aim of the present study was comparing the efficacy of these two trainings in resolving dichotic listening disorders. METHODS: 12 children in the age range of 8 to 9 years old with APD were included (mean age 8.41 years old±0.51). They all had abnormal right ear advantage based on established age-appropriate norms for Farsi dichotic digit test. Then subjects were randomly divided into two groups (each contained 6 subjects): group 1 received DIID training (8.33 years old ±0.51) and group 2 received DOT training (8.50 years old±0.54). RESULTS: Both trainings were effective in improvement of dichotic listening. There was a significant difference between two trainings with respect to the length of treatment (P-value≤0.001). DOT needed more training sessions (12.83±0.98 sessions) than DIID (21.16±0.75 sessions) to achieve the same amount of performance improvement. CONCLUSION: Based on the present study it can be assumed that DOT might be a good replacement for DIID training in cases that DIID is not applicable and DIID candidacy conditions are not met. To generalize the results, studies with larger sample sizes are recommended.

Reliability of Interaural Time Difference-Based Localization Training in Elderly Individuals with Speech-in-Noise Perception Disorder.

BACKGROUND: Previous studies have shown that interaural-time-difference (ITD) training can improve localization ability. Surprisingly little is, however, known about localization training vis-à-vis speech perception in noise based on interaural time difference in the envelope (ITD ENV). We sought to investigate the reliability of an ITD ENV-based training program in speech-in-noise perception among elderly individuals with normal hearing and speech-in-noise disorder. METHODS: The present interventional study was performed during 2016. Sixteen elderly men between 55 and 65 years of age with the clinical diagnosis of normal hearing up to 2000 Hz and speech-in-noise perception disorder participated in this study. The training localization program was based on changes in ITD ENV. In order to evaluate the reliability of the training program, we performed speech-in-noise tests before the training program, immediately afterward, and then at 2 months' follow-up. The reliability of the training program was analyzed using the Friedman test and the SPSS software. RESULTS: Significant statistical differences were shown in the mean scores of speech-in-noise perception between the 3 time points (P=0.001). The results also indicated no difference in the mean scores of speech-in-noise perception between the 2 time points of immediately after the training program and 2 months' follow-up (P=0.212). CONCLUSION: The present study showed the reliability of an ITD ENV-based localization training in elderly individuals with speech-in-noise perception disorder.

Envelope-based inter-aural time difference localization training to improve speech-in-noise perception in the elderly.

Background: Many elderly individuals complain of difficulty in understanding speech in noise despite having normal hearing thresholds. According to previous studies, auditory training leads to improvement in speech-in-noise perception, but these studies did not consider the etiology, so their results cannot be generalized. The present study aimed at investigating the effectiveness of envelopebased interaural time difference (ITD ENV) localization training on improving ITD threshold and speech-in-noise perception. Methods: Thirty-two elderly males aged 55 to 65 years with clinically diagnosed normal hearing at 250-2000 Hertz, who suffered from speech-in-noise perception difficulty participated in this study. These individuals were randomly divided into training and control groups: 16 elderlies in the experimental group received envelope-based interaural time difference localization training in 9 sessions, but 16 matched elderlies in the control group did not receive any training. The ITD ENV threshold and spatial word recognition score (WRS) in noise were analyzed before and after the localization training. Results: Findings demonstrated that following the training program, the interaural time difference envelope threshold and spatial word recognition score (WRS) in noise were improved significantly in the experimental group (p≤ 0.001). Moreover, a significant difference was detected in interaural time difference envelope threshold and spatial word recognition score (WRS) in noise (p≤ 0.001) before and after the training in the experimental group. Conclusion: The results of the present study revealed the effectiveness of envelope- based interaural time difference localization training in localization ability and speech in noise perception in the elderlies with normal hearing up to 2000 Hz who suffered from speech-in-noise perception difficulty.

Validity and reliability of the Persian version of spatial hearing questionnaire.

BACKGROUND: Our hearing ability in space is critical for hearing speech in noisy environment and localization. The Spatial Hearing Questionnaire (SHQ) has been devised to focus only on spatial haring tasks (e.g., lateralization, distance detection and binaural detection). The aim of the present study was to determine the reliability and validity of the Persian translation of the SHQ (Spatial Hearing Questionnaire). METHODS: Translation and back-translation, reliability, content and construct validity were investigated. Eighty patients with sensory neural hearing loss (SNHL) (52.50% female and 47.5 % male) with the mean±SD age of 49.02±13.60 years completed SHQ, and they were categorized into mild, moderate, moderate to severe and severe groups based on their hearing threshold. Inclusion criteria in this study were the MMSE questionnaire score of higher than 21, good general health, no history of psychiatric disorders, dizziness or vertigo, dementia or alcohol abuse. RESULTS: The reliability was assessed by Cronbach's alpha and found to be 0.99. Item-total correlation was between r= 0.84 and 0.92. There was a significant difference between the mean score of PSHQ in the four groups. Based on the factor analysis, two factors were extracted from the questions in P-SHQ: sound localization; and music and speech understanding in noise and quiet. These factors could explain 82.1% and 9.3% of the total variance, respectively. CONCLUSION: The present study proved the reliability and validity of the Persian version of SHQ (PSHQ). This provides a suitable tool for spatial hearing assessment in clinical/research environments.

Clinical assessment of dizzy patients: the necessity and role of diagnostic tests.

Over administration of diagnostic tests in health care settings is a critical issue, imposing a great deal of expenditure on health sector. Vertigo and dizziness are common complaints of many patients who seek medical advice, and the vast majority of them undergo several evaluations, including Brain Magnetic Resonance Imaging (MRI), Laboratory tests, Pure Tone Audiometry (PTA), and Electrocardiography (ECG). The aim of this study was to investigate the performing rate of these diagnostic tests, and to evaluate their necessity and medical indications. This study was conducted on 270 dizzy patients referred to Apadana Dizziness and Vertigo Clinic, Ahvaz, Iran, from July 2008 to February 2013. Of these, 71.9% were diagnosed with peripheral lesions while laboratory assessment (58.1%) and brain MRI (38.1%) were the most requested tests. Age was an important factor, affecting the frequency of performing the ECG and Brain MRI. Medications were still administered widely even to those who seemed to respond well enough to vestibular rehabilitation. These findings revealed that many unnecessary and time-consuming diagnostic tests were performed, which had minor contribution to the final diagnosis and treatment of the patients. Therefore, a modification in the assessment methods of the dizzy patients with emphasis on history and clinical presentation seems essential.