Background and Aim: Hormones have various effects on different parts of the body, and their role in the auditory system has also been confirmed. The aim of this study was to provide a comprehensive review of various studies that have been conducted on 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  play different roles in the body, including influencing the auditory system. The protective effect of estrogen, aldosterone, norepinephrine, melatonin, and oxytocin against noise, the positive effect of growth hormone on the development of hair cells, sensorineural hearing loss caused by high or low levels of thyroid hormones, low levels of parathyroid hormone, low levels of insulin, low levels of melatonin, and low levels of dopamine, tinnitus and hyperacusis in high levels of cortisol, and early-onset presbycusis in women due to the presence of prolactin.
Conclusion: This study showed that 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: 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: 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 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: 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: Tinnitus, the perception of sound without an external source, significantly affects the quality of life for millions worldwide. Although many studies have explored its pathophysiology and neural underpinnings using various methods during resting states, the influence of eye state on neural activity remains poorly understood. This study examined brain activity differences between eyes-closed and eyes-open resting states in individuals with chronic tinnitus.
Methods: In this cross-sectional study, twenty patients with chronic tinnitus underwent Electroencephalography (EEG) during both eyes-closed and eyes-open resting states. EEG power spectra, source localization, and functional connectivity were analyzed across eight frequency bands. Paired-sample t-test and Statistical Non-Parametric Mapping (SnPM) test compared activity between these conditions.
Results: Eyes-closed recordings showed decreased delta, theta, and gamma power, increased alpha 1 and alpha 2 power, and a complex beta pattern (increased beta 1, decreased beta 2 and beta 3) compared to eyes-open. Source localization analysis revealed greater activity in regions associated with memory, attention, and emotional processing during eyes-closed compared to eyes-open. Functional connectivity analysis indicated stronger connections between auditory and memory-related regions in eyes-closed compared to eyes-open.
Conclusions: This preliminary study demonstrated distinct EEG power spectra, source localization, and functional connectivity between eyes-closed and eyes-open states in chronic tinnitus patients, suggesting state-specific neural patterns. Findings highlight interactions of sensory, cognitive, and affective processes, potentially relevant to tinnitus. Further research with control groups and larger samples is needed to confirm tinnitus-specific effects and optimize EEG conditions for elucidating neural mechanisms and guiding targeted interventions.

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 Speech recognition threshold in noise (SNR50) were 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.
Conclusions: 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: 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 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: Motion sickness, characterized by conflicting sensory signals, negatively impacts attention and cognitive functions. This study investigated the effects of motion sickness on auditory spatial perception and working memory in adults with normal hearing.
Methods: A Standard group comparison was conducted on  100 adults with motion sickness, classified into three groups—normal-minimal, mild-moderate, and severe—based on Motion Sickness Susceptibility Questionnaire (MSSQ)-short scores. Standardized assessments were used to evaluate auditory spatial perception, including interaural time difference (ITD), interaural level difference (ILD), and the Virtual Acoustic Space Identification (VASI) test, along with working memory assessed through the forward digit span and 2-back test. ITD and ILD tests involved a discrimination task using psychoacoustic staircase procedure, VASI required identification of virtual locations within head, and memory tasks involved repetition digits and 2^nd last digit in sequence, in forward task, and 2-back tasks, respectively.
Results: Participants with motion sickness (mild-moderate and severe groups) performed significantly poorer (p < 0.05) than those without on the VASI test, forward digit span, and 2-back. A moderate negative correlation was observed between MSSQ-short and VASI scores. Discriminant function analysis (DFA) revealed that participants with severe motion sickness could be categorized from the other two less severity groups (normal-minimal, mild-moderate), with VASI and forward digit span emerging as the most sensitive indicators of motion sickness induced changes in spatial and working memory.  
Conclusion: Findings underscores the importance of monitoring motion sickness, as it can impair spatial processing and working memory tasks in auditory domain.

Background and Aim: Tinnitus has been associated with increased listening effort and reduced working memory (WM) capacity during speech comprehension. A practical approach to enhance cognitive processes is transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique applying constant low current. Anodal tDCS increases the expression of N-methyl-D-aspartate receptor 1(NR1 and NR2) proteins in blood, which are associated with WM improvement. This study aimed to evaluate the effect of tDCS on listening effort, WM, and N-methyl-D-aspartate (NMDA) receptor subunit protein expression in blood of individuals with tinnitus.
Methods: Thirty-two adults (30–60 years) were randomly assigned to experimental and control groups. The experimental group received anodal tDCS with electrodes on F3 and F4 for 20 minutes at 1.5 mA over 10 sessions, while the control group underwent electrode placement without stimulation. Pre- and post-intervention assessments included audiometry, tympanometry, tinnitus matching, listening effort evaluation (cognitive-behavioral tasks, dual-task, visual analogue scale, and tinnitus functional index), and WM assessment (N-BACK test). Blood samples were analyzed using Western blot to measure NR1 and NR2 protein expression in blood.
Results: Compared to the control group, tDCS significantly reduced listening effort (p<0.001) and improved WM (p<0.001). After intervention, the experimental group showed a 27% increase in NR1 and a 50% increase in NR2 expression.
Conclusion: tDCS effectively reduced listening effort and enhanced WM in individuals with chronic tinnitus. The upregulation of NR1/NR2 protein expression in blood may contribute to improved auditory-cognitive performance, highlighting the potential role of this technique in tinnitus rehabilitation.

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 audiometric configuration remains unclear. This study compared binaural TFS sensitivity between adults with sloping and rising/flat sensorineural hearing loss (SNHL).
Methods: This cross-sectional study included 47 adults (32 sloping, 15 rising/flat) aged 18–50 with bilateral mild to moderate SNHL (26–55 dB HL). All participants had normal outer and middle ear status, were right-handed, and had no cognitive impairment. TFS sensitivity was measured using the TFS- Low 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 poorer in the sloping group at all frequencies, but differences were insignificant (p > 0.05). For the TFS-AF test, thresholds at IPD 135° were significantly higher than at IPD 45° (p < 0.001), with no significant group effect. Significant correlations were observed between the thresholds of the TFS-LF and the TFS-AF test.
Conclusion: Based on the results of the TFS-LF and TFS-AF tests, there is no significant difference in TFS sensitivity between the two groups. Furthermore, TFS sensitivity is not determined solely by absolute hearing thresholds across different frequencies, and factors like age, cochlear health, neural timing, and individual variability may also affect outcomes.

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 hospitals 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: 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 < .001) and sequencing tasks (t= 27.25, p < .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: Musicians can detect changes in minute aspects including pitch, timing, and loudness, all of which assist in auditory spatial perception. This study hypothesized that non-musicians with musical aptitude might display spatial skills comparable to trained musicians, and superior to non-musicians without musical aptitude.
Methods: To test this hypothesis, we considered 101 participants in three groups: musicians (n=33, trained in classical music), non-musicians with good musical aptitude (NM-GA, n = 33) and non-musicians with poor musical aptitude (NM-PA, n = 35), selected based on convenience sampling. Music aptitude was assessed using Mini Profile of Music Perception Skills. A spatial test battery consisting of tests of binaural interaction - ITD (interaural time difference) and ILD (interaural level difference), and Virtual space identification test (VASI) were administered.
Results: Musicians and NM-GA demonstrated significantly lower ITD and ILD thresholds than NM-PA, suggesting the role of musical aptitude in sound lateralization. In VASI test, musicians scored highest, followed by NM-GA, who in turn had significantly higher scores than NM-PA, suggestive of further refinement of innate musical advantage due to training in musicians. Location specific analysis revealed NM-PA made significantly greater errors in R45, L45, R135, and L135 (p<0.001), often confusing them with extreme right (R90) or left (L90) locations.

Conclusion: Both innate musical aptitude and formal musical training contribute to enhanced spatial hearing abilities. While musicians and NM-GA exhibit superior ITD and ILD thresholds, musicians outperform NM-GA in VASI scores,  indicating training refines complex spatial perception beyond natural aptitude.

Background and aims: Auditory integration deficit is one of the subcategories and the most complex form of Auditory Processing Disorder (APD). This is due to its association with specific brain regions such as the corpus callosum and angular gyrus, which are key areas for multisensory integration. This study introduced the first Persian development of the dichotic offset training program. It presents preliminary findings on its efficacy when delivered in-person versus on-line.
Methods: In this single-subject study, two children, aged 13 years, diagnosed with auditory integration deficit, participated  The main intervention consisted of 8-14 sessions of Persian-Dichotic Offset Training (DOT), followed by post-treatment follow-up assessments utilizing two methods of treatment delivery: in-person and on-line. Data collected via Persian Buffalo Model Questionnaire-Revised (PBMQ-R), Randomized Dichotic Digits Test (P-RDDT), Persian-Dichotic Offset Test (P-DOM), and Persian-Staggered Spondee Word (SSW) and analyzed employing a single-subject statistical formula.
Results: The results suggest that the treatment effectively reduced integration problems in both in-person and on-line methods, as indicated by competitive left ear stimulus, Type A pattern, and qualitative error IX, the left ear performance, and the questionnaire scores. Both delivery methods proved effective, but online administration showed slightly superior outcomes.
Conclusion: The P-DOT Program, especially in its on-line method, appears to be a promising intervention for children with APD (integration subcategory). By enhancing binaural hearing skills, this approach may considerably improve the brain regions responsible for dichotic processing.  These preliminary single-subject findings, pending confirmation through larger-scale studies, particularly Randomized Controlled Trial(RCT) studies, may inform evidence-based clinical protocols for audiologists.

Background and Aim: Tinnitus often occurs in individuals with normal audiograms and may reflect hidden hearing loss (HHL). Conventional audiometry fails to detect these suprathreshold deficits. This study evaluated the clinical utility of a validated Tamil Speech-in-Noise (SIN) test, supported by otoacoustic emissions (OAEs) and auditory brainstem responses (ABRs), in detecting HHL in tinnitus patients.
Methods: Thirty native Tamil-speaking adults were recruited: 15 with chronic bilateral tinnitus and 15 matched controls. All had normal hearing thresholds. Participants underwent the Tamil SIN test, transient evoked OAEs, distortion product OAEs, and click-evoked ABRs. Group differences were analyzed using independent-sample t-tests.
Results: The tinnitus group showed significantly higher SNR-50 thresholds and SNR loss compared to controls, indicating impaired SIN perception. Both DPOAEs and TEOAEs were significantly reduced across frequencies, confirming cochlear dysfunction despite normal audiograms. ABR analysis revealed delayed Wave I and Wave III latencies, with marginal prolongation of Wave V, indicating early auditory nerve involvement.
Conclusion: Tinnitus patients with normal audiograms demonstrate measurable auditory deficits, reflecting HHL. The Tamil SIN test, complemented by OAE and ABR, provides a culturally appropriate and sensitive protocol for early detection. These findings highlight the limitations of pure-tone audiometry and support integrating multimodal assessments into tinnitus evaluations.

Background and aim:: The concept that recognizing sound regularities plays a major role in the segregation of auditory streams has lately gained significant interest. Thus, this study was designed to investigate how temporal and spectral regularities incorporated into the background auditory stream affect auditory stream segregation.
Methods: An indirect measure of auditory streaming task (i.e., detecting rare-level targets) was implemented in twenty-five healthy young adults. Participants were presented with two concurrent auditory streams involving foreground and background ones. Participants were instructed to detect rare-level targets in the foreground stream during three experimental conditions. These conditions vary based on the background auditory stream, which contained repeating temporal and spectral patterns alongside elements of randomness.
Results: Temporal and spectral regularities of the background auditory stream significantly increased the hit rate compared to random structure. Notably, this effect of regular cues on target detection and, possibly in turn, stream segregation was significantly greater for temporal compared to spectral regularities.
Conclusion: These findings showed that incorporating temporal or spectral regularities in the background auditory stream facilitated target detection and, possibly in turn, stream segregation. This perceptual regularity benefit was greater for temporal regularities than spectral regularities. These findings might present primary evidence for distinct facilitating effects of various theoretical frameworks of sound feature regularities on auditory streaming.

Background and Aim: Speech Sound Disorder (SSD) is a developmental communication disorder characterised by children's difficulties in producing speech sounds clearly. Auditory deficits, sensory integration issues and motor execution difficulties are reported in children with SSD. The vestibular system, being in proximity to the auditory system and important in sensory integration, requires exploration of its function in children with SSD. The study compared latency and amplitude parameters of Vestibular Evoked Myogenic Potentials (VEMPs) in children with SSD and typically developing children to assess otolithic function.
Methods: The study employed a standard group comparison, involving 10 children with SSD and 10 typically developing children matched for age and gender in the 6-11 years age range (7 boys). Participants underwent cervical VEMP and ocular VEMP testing in a sound-treated room, with appropriate strategies in place to ensure their cooperation with the test procedures.
Results: Statistically significantly higher peak-to-peak amplitude for cVEMP and oVEMP was observed in typically developing children, whereas the amplitude asymmetry ratio was statistically higher in children with SSD. Both findings suggest possible alterations in vestibular function among children with SSD, a finding reported for the first time in the literature.
Conclusions: Alterations in sacculo-collic and utriculo-ocular pathway function might be concomitant in children with SSD. This may influence sensory information related to relative position, movement of articulators, as well as the muscle tone of the neck and head, including articulators. The findings pave the way for exploring adjunct vestibular rehabilitation with speech-language intervention in children with SSD.

Background and aim: Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder, typically affecting older adults, and is a recognized cause of vertigo and falls. The physically demanding conditions of Hajj may increase dizziness and fall risk, yet BPPV has not been studied in this mass-gathering context. This study aimed to estimate the self-reported prevalence of BPPV and falls among Hajj pilgrims, and to explore self-reported triggers of dizziness.
Methods: A cross-sectional survey was conducted during Hajj 2022–2023 using a validated Arabic questionnaire adapted from published BPPV screeners. Diagnosis of probable BPPV was based solely on self-reported responses to two screening items (brief vertigo episodes <1 minute provoked by specific positional changes). The questionnaire also assessed demographics, comorbidities, falls, and self-reported triggers of dizziness during religious activities.
Results: Of 183 respondents, 144 were eligible for analysis (mean age = 36.8 years; range = 16–72). Overall, 22.2% (95% CI: 15.7%–29.9%), reported dizziness, but only 1.4% (95% CI: 0.2%–4.9%) met the self-reported criteria for probable BPPV. The incidence of falls during Hajj was 2.1% (95% CI: 0.4%–6.0%), with no significant association with BPPV. Bowing during prayer was the only religious activity significantly associated with BPPV, although this was based on just two BPPV-positive cases.
Conclusion: The prevalence of BPPV was low in this predominantly young sample, limiting generalizability to the wider pilgrim population, which usually includes many older adults. Findings highlight the need for age-diverse, clinically confirmed studies to better understand vestibular health risks during Hajj.

Background and Aim: Posterior fossa lesions often present with slowly progressive hearing loss, making diagnosis challenging. Pure-tone audiometry (PTA) and the Auditory Brainstem Response (ABR) are essential tools for assessing retro-cochlear involvement and establishing hearing thresholds. This study aimed to assess the audiometric profiles of patients with posterior fossa lesions and ascertain whether they could distinguish between different types of lesions.
Methods: A cross-sectional study was conducted on 36 patients aged 10-65 years. Each participant underwent otoscopic examination, tympanometry, PTA, and ABR testing.  The data were analyzed using the chi-square and Kruskal-Wallis tests in SPSS version 25, with Cohen's f and Cramer's V for effect size. A p-value of less than 0.05 was considered significant.
Results: Lesion types showed a strong correlation with clinical presentation. Vascular loops were associated with tinnitus, vestibular schwannomas with facial numbness and hearing loss, and meningiomas with vertigo and headache. Schwannoma cases exhibited significantly higher ipsilateral hearing thresholds, especially at high frequencies (p < 0.05). ABR results varied by lesion type: vascular loops mostly caused delayed wave III, meningiomas produced prolonged wave V and I–V intervals, while schwannomas showed the most severe abnormalities, including missing or delayed waves and interpeak intervals. Contralaterally, only schwannomas displayed ABR delays in wave V and I–V interval.
Conclusion: Lesion differentiation was aided by the clinical and audiological characteristics of posterior fossa lesions. ABR offers objective data on retro-cochlear involvement, while PTA identifies changes in hearing threshold. When used together, they improved diagnostic precision and patient care.

Background and Aim: Tinnitus, the perception of sound without an external source, creates social, psychological, and economic challenges. Questionnaires are widely used to assess its impact on daily life. This study aimed to translate and validate the Persian version of the 12-item Tinnitus Primary Function Questionnaire (P-TPFQ-12) to provide a culturally appropriate tool for evaluating tinnitus-related disability in Persian speakers.
Methods: A cross-sectional study was conducted with 56 adults experiencing chronic tinnitus. The P-TPFQ-12 was translated using the International Quality of Life Assessment protocol. Content validity was evaluated using the Content Validity Ratio (CVR) and Content Validity Index (CVI) based on ratings from 10 audiologists. The Face Validity Index (FVI) was calculated with input from 10 experts and 10 patients. Internal consistency was determined using Cronbach’s  alphaand item–total correlations. Convergent validity was tested by correlating P-TPFQ-12 scores with the Tinnitus Handicap Inventory (THI), Beck Depression Inventory-II (BDI-II), and Pittsburgh Sleep Quality Index (PSQI). Test–retest reliability was assessed with intraclass correlation coefficients (ICC) in 21 participants after two weeks. Confirmatory factor analysis (CFA) examined two structural models.
Results: Content and face validity were excellent (CVR=1.0, CVI=1.0, FVI=1.0). Internal consistency was high (Cronbach’s α=0.956 overall; subscales=0.922–0.969). Strong correlations were found with THI (r=0.845), moderate with BDI-II (r=0.600) and PSQI (r=0.416). Test–retest reliability was strong (ICC=0.956). CFA supported a four-factor structure with high loadings (0.85–0.97).
Conclusion: The P-TPFQ-12 showed excellent reliability and validity, confirming its suitability as a concise, multidimensional tool for assessing tinnitus-related disability among Persian speakers.

Background and aim: Contraversy exists regarding the link between the psychoacoustical measures and the perceptual rating of musical skills.  The study aimed to determine whether the perception of musical abilities, as rated by music teachers, is associated with specific psychoacoustical abilities.
Methods: Twenty-seven children who had undergone Carnatic music training for a duration of 2 months to 1 year were assessed using three psychoacoustical tests: Gap Detection Test (GDT), Duration Discrimination Test (DDT), and Difference Limen of Frequency (DLF) tests.  Two music teachers, with different teaching experiences, rated their pitch, rhythm, tempo, auditory memory, and overall musical abilities.
Results: The inter-rater reliability was found to be excellent, suggesting that the ratings given by both teachers were similar.  A Spearman’s rank correlation test showed a moderate significant correlation between rating scores awarded by the teachers and the thresholds obtained by the trainees on the psychoacoustical tasks.  These correlations were seen between temporal resolution (GDT) with the rating of the teachers for auditory memory (r=-.55, p=.003), and between frequency discrimination at mid-frequency stimuli (DLF at 1000 Hz) and the rating by the teachers for tempo (r=-.62, p=.000). A principal component analysis also grouped GDT and DLF at 1000 Hz with the ratings of the teachers, substantiating the findings of the correlation.
Conclusions: The findings indicated that music teachers are able to provide information only on a few acoustical aspects when rating music trainees.  Hence, to get more specific information about the musical abilities of trainees, they should be evaluated using psychoacoustical measures.

Background and Aim: Speech audiometry assesses functional hearing beyond pure-tone thresholds, reflecting real-world speech perception. The present study compared whole-word and phoneme scoring methods for the Persian SBMU-1 monosyllabic word lists presented in speech-spectrum noise to determine their psychometric equivalence and sensitivity to signal-to-noise ratio (SNR) changes.
Methods: Twenty-two young adults with normal hearing participated. SBMU-1 consonant–vowel–consonant (CVC) words were presented binaurally at six SNRs (−5, 0, +5, +10, +15, +20 dB) in speech-spectrum noise at 60 dB HL. Recognition performance was analyzed using whole-word and phoneme scoring. List equivalency and scoring effects were examined using Friedman and Wilcoxon signed-rank tests with Bonferroni correction.
Results: Speech recognition improved systematically with increasing SNR for both scoring methods. Phoneme scoring consistently yielded higher scores than whole-word scoring, especially under low SNRs, revealing a 10–20% performance advantage. At high SNRs, the two methods converged. Across lists, differences were minor and list-specific, confirming the general equivalency of SBMU -1 lists in noise.
Conclusion: Phoneme scoring provides a more sensitive measure of perceptual performance in noise by capturing partial recognition, whereas whole-word scoring better represents functional communication ability. The SBMU-1 word lists are psychometrically balanced and suitable for both clinical and research applications in Persian speech audiometry.

Background and Aim: Previous research has linked personality traits to noise perception, yet the role of temperament, a fundamental determinant of emotional and sensory processing, remains insufficiently explored. This study aimed to examine the impact of various temperament types on hyperacusis, noise sensitivity, and noise annoyance among industrial workers.
Method: A cross-sectional study was conducted among 320 participants aged 20–60, selected via strict criteria. Variables were assessed using validated questionnaires, including Mojahedi Temperament, Weinstein Noise Sensitivity, Noise Annoyance, and Khalfa Hyperacusis. Data were analyzed using SPSS, with descriptive statistics, correlation, ANOVA, and MANCOVA employed for relationships and group differences.
Results: The results indicated that Melancholic individuals exhibited the highest hyperacusis (Mean = 6.01), sensitivity (Mean = 7.37), and annoyance (Mean = 8.19), whereas phlegmatic individuals showed the lowest sensitivity (Mean = 2.82,) and annoyance (Mean = 3.16). The dryness-wetness temperament dimension correlated positively with hyperacusis (r = 0.275, p < 0.01) and annoyance (r = 0.184, p < 0.05), indicating greater noise reactivity in individuals with drier temperaments. The effect of temperament on hyperacusis (η² = 0.11) was stronger than its impact on sensitivity (η² = 0.03) and annoyance (η² = 0.07).
Conclusion: In conclusion, this study highlights the significant role of temperament in shaping individuals' responses to noise, with melancholic and choleric individuals exhibiting the highest levels of noise sensitivity and annoyance, and phlegmatic individuals reporting the lowest levels. These findings underscore the necessity of personalized noise mitigation strategies in occupational settings to protect worker health.

Background and Aims: Aging leads to noticeable functional changes in central auditory processing and dichotic function. The aim of this study was comparison of dichotic function between young and elderly people, as a factor of Stimulus Onset Asynchrony (SOA).
Methods: Persian syllables were presented dichotically to the participants. The onset time of the concurrent stimuli differed from 0 to 150 ms between the right and left ear. The effects of SOA changes (from 0 to 150 ms) were investigated in 20 normal- hearing young adults (aged 18 to 29 years) and 20 elderly individuals (aged 60 to 75 years) The Binaural (Both) Ear Correct (BEC%) score, as an indicative of dichotic performance, was measured.
Results: The BEC% scores decreased as SOA was reduced in both groups. However, this decline was more pronounced and significant in the elderly group. In contrast, young adults achieved higher BEC% scores across all SOA levels compared with the elderly individuals.
Conclusion: The reduction in BEC% scores in elderly individuals (particularly at lower SOA levels), indicates a decline in central auditory processing function in this group. This study highlights the impact of aging on central auditory processing and dichotic function, which could be implemented in designing and updating rehabilitative programs.

Background and Aim: Early intervention with cochlear implantation for deaf children helps them acquire receptive and expressive language. Word learning is one aspect of language acquisition. The current study aimed to evaluate receptive vocabulary in deaf children who received cochlear implants (CIs). 
Methods: A descriptive-analytical cross-sectional  survey  was conducted with  90 study  participants. The participants included thirty children with CIs  and sixty normal-hearing children. The hearing ages of the children with CIs ranged  from 2 to 57 months, with chronological  ages between  32 and 71 months. 
The Receptive Picture Vocabulary Test in Persian  (RPVT-P) was used to evaluate  children’s vocabulary. Parametric t-tests and Pearson correlation were used to analyze and compare the data. 
Results: There was a significant relationship between the total score of the RPVT-P and chronological ages of NH children ( r = 0.842, p < 0.0001), and children with CIs  (r = 0.824, p < 0.0001). There was a significant relationship between the total score of the RPVT-P and hearing age of children with CIs (r = 0.658, p < 0.0001). There was a  significant difference between children with CIs  and NH children in the total scores for  each item of the RPVT-P (p <0.0001).
Conclusion: Children with cochlear implants gradually develop their understanding of vocabulary, but they do not reach  the same level of skills as typically developing  children. Children with CIs can acquire various types of vocabularies.

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-year-old 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.

Background and Aim: Toxic encephalitis, a rare form of neuroinflammation induced by toxic agents, can lead to multifaceted neurological dysfunction, including auditory impairment. Sensorineural hearing loss (SNHL), a reduction in hearing sensitivity due to inner ear or auditory nerve damage, is an uncommon but clinically significant manifestation in such cases. This study aimed to present a comprehensive audiological and neurological evaluation of a patient with toxic encephalitis to highlight the auditory consequences and emphasize the importance of early detection and intervention.
Case presentation: We report a 44-year-old woman with progressive bilateral SNHL over one year and vertigo. Neurological examination showed cerebellar dysfunction, and Magnetic resonance imaging revealed multiple acute infarcts with basal meningeal enhancement and vasculitic changes suggestive of toxin-induced neuroinflammatory injury. Occupational history confirmed prolonged exposure to industrial solvents, a recognized neurotoxic factor. Audiological testing demonstrated bilateral moderate SNHL with absent otoacoustic emissions and abnormal auditory brainstem responses, supporting the diagnosis of toxic encephalopathy with encephalitic features.
Conclusion: This study highlights the significant impact of toxic encephalitis on auditory pathways, revealing vulnerabilities in cochlear and brainstem structures. By integrating behavioral, physiological, and electrophysiological evaluations, it provides insights into hearing loss associated with the condition. Early diagnosis and intervention are crucial to improving outcomes, and further research is needed to explore the mechanisms linking toxic encephalitis features and auditory dysfunction.