Background and Aim: According to the guidelines approved by international scientific associations, the assessment of the vestibular system and its rehabilitation is carried out by audiologists. The subjective visual vertical (SVV) test, while simply done, is an appropriate test for assessment of otolithic system. This review study has tried to introduce the application of SVV test in different disorder of the vestibular system based on the clinical research in various resources.
Recent Findings: We searched the subject of SVV in various databases from 1900 up to 2017. We used keywords of subjective visual vertical and SVV. 110 papers were found and 78 of them were selected. The application of SVV in balance system diseases was reviewed based on these original articles and three related text books.
Conclusion: The SVV test in the Pusher syndrome, migraine and the chronic phase of Meniere's disease did not statistically differentiate between two groups of normal and abnormal people. However, the SVV deviation in individuals with pusher syndrome was higher than normal subjects. In Parkinson's disease, vestibular neuritis, vestibular schwannoma, Pisa syndrome, benign paroxysmal positional vertigo, aging, hydrocephalus, chronic neck pains, acute phase of Meniere's disease and multiple sclerosis, the SVV test was able to separate normal subjects from abnormal subjects. The method and procedure for performing the SVV test will have a significant impact on the test result. Therefore, it is necessary to standardize the method of performing the SVV test for each particular disease.

Background and Aim: Benign paroxysmal positional vertigo (BPPV) is most common type of vertigo in general population. Epley maneuver is the most effective treatment technique. However, there is no clinically valid test to verify effectiveness of maneuver quickly after treatment in the same session. Modified clinical test of sensory interaction on balance (mCTSIB) is considered as a quick and simple test. This study aimed to use mCTSIB for assessing effectiveness of Epley maneuver in BPPV patients.
Methods: The study was carried out on 44 patients (36 female and 8 male, mean age of 53.11 (SD=7.09) diagnosed with posterior semicircular canals BPPV in Dix-Hallpike test and no other vestibular disorders. mCTSIB in four conditions was assessed, before and after Epley maneuver. Balance time, lateral and anterior-posterior sway were recorded. mCTSIB repeated after three weeks to assess reliability.
Results: The time for balance control in mCTSIB after maneuver did not change significantly relative to before maneuver (p>0.05). Lateral sway changes in conditions 2, 3 and 4 in mCTSIB significantly reduced after maneuver (p=0.04). Anterior-posterior sway changes in conditions 1 and 2 showed no significant difference after maneuver, however, differences in conditions 3 and 4 were statistically significant (p<0.05). Test-retest showed reliable results.
Conclusion: mCTSIB is seems be a valid test with simple and quick apply for verifying the effectiveness of Epley maneuver in BPPV patients.

Background and Aim: Because children learn to communicate by hearing sounds, a hearing loss (HL) will deteriorate their cognitive and speaking abilities and language learning. Early detection and intervention are important factors in the successful treatment of HL in children. HL is divided into two main groups: conductive hearing loss (CHL) and sensorineural hearing loss (SNHL); the former is more prevalent in children and many of its causes are easy to detect and treat.
Methods: In this descriptive cross-sectional study, 1,446 children, aged 11-13 years, entering first-degree high school in the school year 2016, were randomly selected from two schools in Hamadan, western Iran, and their audiograms were studied. The collected data were analyzed by descriptive statistics using SPSS 16.
Results: Out of the 1,446 high school children examined in this study, 18 children (1.2%) suffered from HL (44.5% female and 55.5% male), 33% from CHL, and 67% from SNHL. Besides, 89% suffered from bilateral HL and 11% from unilateral HL.
Conclusion: Considering the prevalence of HL, especially SNHL, in this study in first-degree high school students of Hamadan, it seems vital to raise public awareness and early screening of ear diseases, which can lead to the detection and treatment in most cases.

Background and Aim: The vestibular impairment causes a reduction in daily life functions. Since it is difficult to detect the inter relationship between impairment of vestibular system and its effect on the personal activities, an assessment tool is required to evaluate the effect of the vestibular impairment on the daily living tasks. Thus the aim of this study was to survey the validity and reliability of the Persian version of the vestibular disorders activities of daily living (VDAL) inventory and preliminary results of the pre and post treatment of patients with vestibulopathy.
Methods: The validity and reliability of Persian version of vestibular impairment questionnaire were assessed. The questionnaire was given to 34 patients with vestibular impairment aged between 40-70 years. The participants were in the two groups, rehabilitation and control groups. The rehabilitation group received appropriate programs but the control group did not receive any treatments. Data were collected again after 4-6 weeks. The results of two the groups were compared.
Results: The content validity index was calculated for the tools to 1. The internal consistency was excellent for total score (α=0.95). Test-retest reliability showed good results for global score (ICC=0.95). The results of the study showed that vestibular rehabilitation could improve the score of the Persian version of VADL questionnaire.
Conclusions: The results demonstrated that the Persian version of this questionnaire is a reliable and valid tool for assessing the patients with vestibular impairment and can be applied for the follow-up of the rehabilitation programs.

Background and Aim: Mental health in children is a major key to success in their life. For children of any age, anxiety can strike without warning. This study was conducted to investigate the effects of cognitive-behavioral therapy (CBT) on reducing anxiety and depression of children with hearing impairment.
Methods: Thirty 7-11-year-old children with hearing impairment were randomly assigned to experimental (n=15) and control (n=15) groups. The intervention in the experimental group included identifying cognitions and incentives appraisal and correction of cognitions, assessing automated thoughts and cognitive distortions, teaching and tracking cognitive distortion, teaching and recognizing illogical beliefs, and assigning tasks. To collected data needed, interview and hospital anxiety and depression scale (HADS) were applied.
Results: There was a significant difference between control and experimental group after the intervention so that in the experimental group, a low score on depression and anxiety showed a significant reduction after the intervention (p<0.05). However, no significant change was observed in the score of the control group (p>0.05).
Conclusion: The results suggest that CBT is one of the effective methods in the field of treatment of depression and anxiety disorders of children with hearing loss. Overall, CBT can be applied to prevent negative effects of anxiety and depression on children with hearing loss.

Background and Aim: Cochlear Implants (CIs) bypass a non-functional inner ear by a direct electrical stimulation of the auditory nerve. Compared to normal acoustic hearing, sounds transmitted through the CI are degraded and this electrical signal may change the attention capacity of children with CI. According to Kahneman’s model, the presence of CI input might trigger the allocation of limited-capacity central resources for attentional processing of this degraded input and lead to attentional deficiencies. The aim of this study was to compare sustained auditory attention between children with CI and normal children.
Methods: Eighteen children with unilateral CI in right ear and profound hearing loss in left ear with age of implantation under two years, and 40 normal hearing children were selected for this study. The age range of all the children was between 8 and 11 years. Each child in the normal group was tested twice; once binaural and once with left ear plugged. In order to compare sustained auditory attention between the groups, we used sustained auditory attention capacity test (SAACT) and calculated inattention, impulsive, reduction index, and total errors for each child.
Results: In the normal group, all mentioned test variables in binaural versus monaural were not significantly different. In CI group, the values of inattention, impulsive, and total errors were more than these errors in the normal group whether bilateral or unilateral (p<0.05).
Conclusion: There is a statistically significant difference in all SAAC test variables (inattention, impulsive, reduction index, and total errors) between normal and implant groups.

Background and Aim: Frequency following response (FFR) is a neural response with multiple origins. The purpose of current study is to record FFR with alternative and single polarity 500 Hz tone burst stimuli in the setting of auditory brainstem response (ABR).
Methods: The population of this observational study consists of 21 adults (n=42 ears) with a mean age of 22.43 (SD=1.51), with 8 out 21 (38%) being female. The participant shows normal results in otoscopy, tympanometry, acoustic reflex, pure tone audiometry, speech recognition threshold, and speech discrimination score. They underwent ABR with a click and various polarities of 500 Hz tone burst stimuli.
Results: First, latencies of ABR waveform with the alternative polarity of click and tone burst were compared and then with changing the polarity to single polarity, FFR was recorded in 24 ears (about 57%) using the 500 Hz tone burst stimuli. The results showed that in some patients changing the polarity caused a better morphology.
Conclusion: In some cases, FFR can be recorded in ABR setting. In addition, because of large amplitude, they fade away ABR waveforms.

Background and Aim: Diabetes mellitus is a metabolic disease in which various organs of the body, including the ears, are involved. In this regard, less research has been conducted on the auditory system, especially in its central part. Regarding the high prevalence of diabetes and the lack of evaluation of dichotic hearing, this study aimed to assess the dichotic hearing system in people with type 2 diabetes (T2D) without neuropathy using the staggered spondaic word (SSW) test and dichotic digit test (DDT).
Methods: This study included 28 individuals with T2D without neuropathy who were diagnosed according to the protocol of American Diabetes Association (2014) and 24 healthy subjects aged 20 to 60 years old of both genders. Participants were evaluated using spondaic words test and normalized Persian version of the DDT.
Results: The mean and qualitative data in SSW and right ear score, left ear score, and ear advantage were compared between two groups in the DDT test. The results showed that the subjects with T2D, except for ear advantage in DDT test, have a significant difference with the normal group.
Conclusion: Dichotic hearing processing in patient with T2D without neuropathy has a poor function, and, in particular, affects the temporal lobe and brainstem regions.