Editorial

Background and Aim: Hormones have various effects on different parts of the body, including the auditory system. This study aimed to review the effects of various hormones on the auditory system.
Recent Findings: Various hormones, including estrogen, progesterone, prolactin, oxytocin, aldosterone, growth hormone, dopamine, Thyroxine (T4), Triiodothyronine (T3), parathyroid hormone, cortisol, norepinephrine, insulin, and melatonin, affect the auditory system. Estrogen, aldosterone, norepinephrine, melatonin, and oxytocin have a protective effect against noise. Growth hormone has a positive impact on the development of hair cells. High or low levels of thyroid hormones and low levels of parathyroid hormone, insulin, melatonin, and dopamine can cause sensorineural hearing loss. High levels of cortisol can cause tinnitus and hyperacusis. Also, the presence of prolactin is related to early-onset presbycusis in women.
Conclusion: Hormones play an important role in the function of the auditory system and can affect the development and maturation of auditory structures and their function. Any disruption in hormonal balance may lead to temporary or permanent changes in the auditory system.

Background and Aim: Auditory memory and sequencing are vital components of central auditory processing, crucial for functions including speech perception in background noise. This study compared performance in auditory memory and sequencing tasks using true and nonsense words and explored their relation to speech perception in noise abilities.
Methods: The study was conducted on 82 participants aged 18 to 24 with normal hearing. The participants completed auditory memory and sequencing tasks using true and nonsense consonant-vowel-consonant-vowel words. Stimuli were organised into three to eight-word sequences and delivered through headphones binaurally. Responses were scored separately for auditory memory and sequencing. Also, the participants were tested for speech perception in the presence of noise by computing the Signal to Noise Ratio required for 50% correct recognition (SNR50).
Results: The study findings revealed that the participants performed significantly better on true words than nonsense words in the auditory memory (t=24.93, p<0.001) and sequencing tasks (t=27.25, p<0.001). A moderate negative correlation was evident between auditory sequencing and SNR50 for both true (r=-0.34, p=0.001) and nonsense words (r=–0.29, p=0.006). A subsequent logistic regression revealed that true word auditory sequencing scores can accurately predict speech perception in noise performance.
Conclusion: The findings show that cognitive-linguistic scaffolding enhances auditory memory and sequencing, as seen in superior performance for true words. Auditory sequencing predicts speech perception in noise, while auditory memory does not, highlighting the complex link between scaffolding and speech perception in noise.

Background and Aim: Standardized speech passages are essential tools in audiological assessments, particularly for verifying hearing aid performance and evaluating speech perception. To ensure linguistic and cultural relevance, these passages must be adapted to reflect the phonetic characteristics of the target language. This study focused on the translation and phonological adaptation of the North Wind and the Sun (NWS) passage into Persian, aiming to provide a linguistically balanced and culturally appropriate stimulus for use in speech-based verification protocols.
Methods: The NWS passage was translated into Persian with targeted phonetic and syntactic adjustments to ensure phoneme balance and linguistic coherence. Phoneme frequencies were compared to reference Persian studies, and expert reviewers evaluated clarity, naturalness, and content validity using Content Validity Ratio (CVR) analysis. Revisions were made based on feedback to optimize semantic integrity and phonetic distribution.
Results: The translated NWS passage contained 558 phoneme occurrences, with /a/ as the most frequent (63 times), aligning with Persian speech studies. The phoneme distribution stayed within the ±1 SD range, confirming linguistic consistency. Expert evaluations yielded a CVR of 0.85, surpassing the 0.78 threshold, validating its relevance for speech research. The Face Validity Ration (FVR) of 4.7 affirmed clarity, phonetic balance, and natural fluency in Persian speech assessments.
Conclusion: The translated NWS passage maintains phonetic balance with Persian linguistic norms, ensuring accuracy in speech mapping and verification of hearing aids. Its adaptability for phonetic research and hearing aid validation highlights its relevance for Persian-speaking populations and cross-linguistic comparisons.

Background and Aim: Patients with Chronic Otitis Media (COM) who undergo mastoidectomy sometimes experience imbalance, dizziness, and vertigo after the surgery. This study aimed to investigate the effects of mastoidectomy on the balance of patients with COM using standard and advanced balance tests.
Methods: The study was conducted in 2024 in Imam Reza and Ghaem Hospital affiliated with Mashhad University of Medical Sciences, Mashhad, Iran. Forty patients scheduled for mastoidectomy were enrolled over a 12-month period using a census method. Patients underwent balance tests before and after surgery. These tests included the video Head Impulse Test (vHIT), Subjective Visual Vertical (SVV), and posturography.
Results: Statistical analysis of the performance parameter under linear or sinusoidal plate movement conditions showed no significant difference before and after the surgery (p>0.05). Statistical analysis of the gain in the six semicircular canals in the vHIT test also showed no significant difference before and after the surgery (p>0.05). Similarly, statistical analysis of the deviation from the norm in the neutral position, –30° head tilt to the right, and –30° head tilt to the left showed no significant difference before and after the surgery (p>0.05).
Conclusion: The results of this study showed that mastoidectomy does not have a significant effect on balance tests, so performing it may not lead to severe balance disorders in patients with chronic otitis media who are candidates for mastoidectomy surgery.

Background and Aim: Hearing loss and vestibular dysfunction frequently co-occur in older adults, affecting balance and mobility. Changes in the vestibular system can alter cervical vestibular myogenic potentials. This study aimed to investigate the amplitude and frequency tuning characteristics of cervical Vestibular Evoked Myogenic Potentials (cVEMP) across different degrees of hearing loss in older adults.
Methods: A cross-sectional study was conducted with 30 young adults with normal hearing and 30 older adults (50–70 years) with bilateral sensorineural hearing loss, categorized into mild, moderate and moderately severe hearing loss groups (n=10 per group). cVEMPs were recorded for 500 Hz, 1000 Hz, and 2000 Hz tone bursts. Amplitude and frequency amplitude ratios were analyzed using ANOVA with post hoc tests.
Results: Older adults with hearing loss showed significantly reduced amplitudes compared to young adults across all frequencies. Amplitude progressively decreased with increasing hearing loss severity, though it was not statistically significant between the hearing loss subgroups. Frequency amplitude ratios of persons with moderate and moderately severe hearing loss were significantly different from those of normal hearing. Frequency tuning shift towards 1000Hz was observed in mild hearing loss group. Responses were absent in a significantly higher proportion of persons with higher degree of hearing loss.
Conclusion: This study highlights saccular function in older adults across various degrees of hearing loss. It reveals tuning shift in cases of mild hearing loss, and a progressive decline in frequency-specific responsiveness with increasing hearing impairment.

Background and Aim: Hearing loss in developing countries drives interest in stem cell therapies, though underlying molecular mechanisms remain partly unclear. One key pathway in this process is the Retinoic Acid (RA) signaling pathway. This study aimed to evaluate the effect of RA on the expression of neural markers, including nestin, Neurogenin 1 (NGN1), Guanine-Adenine-Thymine-Adenine Binding Protein 3 (GATA3), and Microtubule-Associated Protein 2 (MAP2), in human Adipose-Derived Stem Cells (hADSCs).
Methods: hADSCs were purchased and treated with RA (1 μM) under standard conditions for 7 and 14 days. RNA was extracted using the FavorPrep™ RNA kit and converted to complementary DNA (cDNA). Nestin, NGN1, GATA3, and MAP2 gene expression was assessed using real-time Polymerase Chain Reaction (PCR) with Glyceraldehyde-3-Phosphate Dehydrogenase (GAPDH) as an internal control. Data analysis was conducted using the 2–ΔΔCt method.
Results: RA significantly increased the expression levels of nestin, NGN1, and MAP2 after 14 days compared to the control group (day 0). RA also increased nestin and MAP2 expression after 7 days, although these changes were not statistically significant compared to the control; moreover, RA acid induced morphological changes in hADSCs.
Conclusion: This study demonstrated that RA enhances the neural differentiation of hADSCs by upregulating the neural markers nestin, NGN1, and MAP2. These findings highlight the potential role of RA in neural differentiation and its clinical applications. These findings suggest that RA’s effects may be dose- and time-dependent, with one μM for 14 days enhancing neural marker expression.

Background and Aim: Noise-Induced Hearing Loss (NIHL) is a prevalent occupational concern, affecting high-frequency hearing sensitivity, which may impair speech perception in noisy environments. This study investigates the relationship between high-frequency hearing thresholds (4000–12500 Hz) and speech perception in noise, using the Persian Quick Speech-in-Noise (Quick SIN) test. The aim was to determine how these thresholds and speech perception in quiet correlate with and predict speech perception difficulties in noise.
Methods: A cross-sectional study was conducted on 288 participants aged 18–60 at the Center for Research on Occupational Diseases, Tehran University of Medical Sciences, from March to August 2024. Participants underwent audiometric testing for conventional (250–8000 Hz) and extended high-frequency (12500 Hz) thresholds, Word Recognition Score (WRS), and the Persian Quick SIN test (basic and high-frequency lists). Pearson’s and Spearman’s correlations and multiple linear regression models evaluated relationships and predictive factors, with significance set at p<0.05.
Results: Strong positive correlations were observed between basic and high-frequency Signal-to-Noise Ratio (SNR) loss and hearing thresholds at 4000–12500 Hz (r/ρ=0.738–0.84, p<0.001), with strong negative correlations with WRS (ρ=–0.756 to –0.785, p<0.001). Regression models identified 8000 and 12500 Hz thresholds, WRS, and education level as significant predictors of SNR loss (R²=0.764–0.812). High-frequency list SNR loss was significantly lower than basic list SNR loss (p<0.001).
Conclusion: High-frequency hearing sensitivity, particularly at 8000 and 12500 Hz, significantly impacts speech perception in noise. Integrating high-frequency audiometry and speech-in-noise testing into occupational health assessments can improve early detection and management of NIHL.

Background and Aim: Assessing Speech Perception in Noise (SPIN) in multilingual contexts like India is challenging due to the lack of linguistically appropriate test materials. Recognizing the limitations of existing SPIN tests in multilingual and clinically diverse settings, this study addressed critical need by developing a language-neutral, nonsense SPIN test material tailored for Dravidian languages.
Methods: Nonsense word lists in the consonant vowel consonant vowel format were generated using a random combination of common phonemes in the Dravidian languages (Kannada, Malayalam, Telugu, Tulu, Tamil). These lists were recorded, and the Signalto-Noise Ratio required to achieve 50% Speech Recognition (SNR50) was used to select optimized lists based on a criterion of mean ±0.15 SD. The final lists were administered to 50 normal-hearing individuals at 0 dB SNR. Language independence was evaluated by comparing performance across speakers of the five languages. Further performance was also assessed across eight SNR levels to establish a psychometric slope function and goodness of fit was assessed. To evaluate test–retest reliability, 12 participants were retested within a one-week interval.
Results: The study resulted in 4 final optimized lists based on SNR50 selection criteria and further analysis. Lists showed sensitivity to varying SNR levels, as reflected by consistent psychometric function slopes. Comparable performance across language groups confirmed the language-independent nature of the test.
Conclusion: Developed test provides audiologists with a reliable and standardized tool to assess SPIN. By eliminating the influence of familiarity and ensuring language neutrality, the test is well-suited for clinical use across speakers of Dravidian languages.

Background and Aim: Temporal Fine Structure (TFS) cues are crucial for pitch perception, sound localization, and speech understanding in noise. Hearing loss can impair TFS sensitivity, but the role of audiogram configuration remains unclear. Therefore, this study aimed to compare binaural TFS sensitivity in adults with Sensorineural Hearing Loss (SNHL) having different audiogram configurations.
Methods: This comparative cross-sectional study included 47 adults (32 with sloping audiograms, 15 with rising/flat audiograms) aged 18–50 with bilateral mild to moderate SNHL (26–55 dB HL). All participants had normal outer and middle ear status, were righthanded, and had no cognitive impairment. TFS sensitivity was measured using the TFSLow Frequency (TFS-LF) test at 250, 500, and 750 Hz, and the TFS-Adaptive Frequency (TFS-AF) test at Interaural Phase Differences (IPDs) of 45° and 135°.
Results: For the TFS-LF test, average thresholds were lower in the sloping group at all frequencies, but the difference between the two groups was not significant (p>0.05). For the TFS-AF test, thresholds at IPD 135° were significantly higher than at IPD 45° (p<0.001), but the difference between the two groups was not significant. Significant correlations were observed between the TFS-LF and the TFS-AF thresholds (r=–0.783, p<0.001).
Conclusion: There is no significant difference in TFS sensitivity between adults with sloping and rising/flat audiograms. Absolute hearing thresholds at various frequencies do not solely influence TFS sensitivity; factors such as cochlear health, neural timing, and individual variability may also affect the outcome.

Background: Auditory Training (AT) is an effective intervention for Auditory Processing Disorder (APD), and its outcomes are usually assessed through behavioral and electrophysiological tests. Among objective tools, speech-evoked Auditory Brainstem Response (s-ABR) has been used to evaluate AT effects, and it has shown promise, but s-ABR recorded in contralateral noise —a method activating both afferent and efferent auditory pathways —has not been applied to monitor rehabilitation progress in APD.
The Case: Here we compare pre- and post-intervention different tests’ results of a 7-yearold boy with APD (with documented deficits in dichotic processing and speech-in-noise perception) to investigate which is the most appropriate tool for assessing rehabilitation efficacy. The case underwent behavioral and electrophysiological evaluations, including s-ABR with and without contralateral noise, before and after 15 sessions of targeted AT tailored to the child’s specific processing weaknesses. Post-training results revealed significant improvement in behavioral tests and questionnaire scores. S-ABR assessments also demonstrated improvements, including increased V/A slope as well as improvements in wave latencies and amplitudes, with more pronounced changes observed in recordings with contralateral noise.
Conclusion: This case highlights the novel use of s-ABR in contralateral noise as a promising objective tool for monitoring auditory rehabilitation in APD. While behavioral assessments remain the gold standard, this electrophysiological test may provide valuable complementary information, particularly for patients with limited behavioral test cooperation or when behavioral results are unreliable. As this case report involves a single child with APD, further studies are needed to validate these findings in broader APD populations.