Vol 31 No 4 (2022)

Research Article(s)

  • XML | PDF | views: 291 | pages: 243-248

    Background and Aim: Gallery walk is an active learning strategy in form of discussion that enables students to be more active in learning process. This study aimed to evaluate the effect of this strategy on the clinical performance of audiology students.
    Methods: In this quasi-experimental study, 30 fourth-year undergraduate students in audiology participated. They were assigned into two groups of traditional learning and gallery walk. The educational content of both groups was similar and was related to the adult care clinical practicum. The assessments included Eustachian tube function test, site-of-lesion tests, and clinical masking. The clinical knowledge, and satisfaction level of students were compared before and after intervention.
    Results: Before the intervention, the difference in clinical knowledge was not statistically significant between the two study groups (p>0.05). After the intervention, we observed a considerable improvement in knowledge scores in both groups, mostly in the gallery walk group. The mean scores of site-of-lesion tests, and total score of knowledge were also significantly higher in the gallery walk group (p<0.05). The satisfaction level of students was above the average level (mean score=3.9±0.74).
    Conclusion: The gallery walk strategy has more positive effects on clinical practice of audiology students compared to traditional learning strategy.

  • XML | PDF | views: 181 | pages: 249-263

    Background and Aim: Behcet’s disease (BD) is a multisystemic, chronic and progressive disorder with a relatively high prevalence in Iran. Therefore, this study aimed to compare the vestibular function between Iranian BD patients and normal subjects using cervical vestibular- evoked myogenic potentials (cVEMPs) and video head impulse test (vHIT).
    Methods: In this cross-sectional study, 44 patients with definitive BD in the inactive stage of disease and 30 age and sex matched normal subjects were evaluated via cVEMP and vHIT tests and dizziness handicap inventory (DHI). Then the parameters of the tests were compared between the two groups by statistical methods. Moreover, the effects of DHI scores and other contextual variables on the test results were examined.
    Results: In terms of the cVEMP test, the response rate and mean latency of p13 in the left ear were significantly lower, the amplitude of the cVEMP wave in the left ear and the amplitude asymmetry ratio were significantly higher in BD patients compared to normal subjects (p<0.05). Fifteen BD patients had abnormal amplitude and nine patients had abnormal latency of cVEMP responses. In terms of the vHIT test, the mean vestibule-ocular reflex gain of the left posterior semicircular canal and the mean gain asymmetry ratio of lateral canals were significantly higher in BD patients than in the controls (p<0.05).
    Conclusion: the vestibular system of some patients with BD is disturbed and the results of this study indicate the presence of unilateral vestibular weakness in BD. So vestibular assessment can be helpful for these patients.

  • XML | PDF | views: 215 | pages: 264-274

    Background and Aim: This study aimed to construct and validate the test material of speech recognition test for children. Such a material helps in conducting the speech tests for native Arab children with Syrian accent. This work is a part of a complete project on preparing and validating the necessary materials for speech and central auditory processing tests for the Arabic Syrian community.
    Methods: In this cross-sectional comparative study, two sets of phonetically balanced monosyllabic word lists were constructed. The two selected 25-monosyllabic word lists were presented to 50 normal hearing participants with the age range of 5 to 10 years. Tests of validity and reliability were conducted to assure the suitability of this material for the word recognition test. The test was repeated for the same children after three weeks.
    Results: The two word lists have shown high face and content validity, Cronbach`s alpha coefficient was 0.79, 0.85 for the two lists respectively. Factor validity has shown that the test materials are one-dimensional, the first factor achieved 57.25 and 53.13 of the variance. Test-retest reliability (p<0.001) and Intraclass Correlation Coefficients reliability (p<0.001) were also significant.
    Conclusion: The data analysis shows that the Syrian version of the word recognition test has high degree of validity and reliability. Therefore, developing the Syrian version of the scale has good psychometric properties, which makes it appropriate for the local use.

  • XML | PDF | views: 197 | pages: 275-281

    Background and Aim: Hearing loss is a highly prevalent symptom in patients with chronic kidney diseases (CKD). Comorbidities such as Diabetes Mellitus is known as the most common cause of CKD and a significant risk factor for sensorineural hearing loss (SNHL). The aim of this study was to compare SNHL among diabetic with non-diabetic hemodialysis patients.
    Methods: In this study, 33 diabetic patients on hemodialysis were selected from Hami center, Arak, Iran. Non-diabetic subjects were 31 hemodialysis patients without diabetes were matched for age, duration of CKD and hemodialysis. Data were obtained via questionnaire, patients’ files, physical examination, otoscopy and tympanometry. Hearing was analyzed using pure-tone audiometry for both groups.
    Results: In the study, 66.2% of diabetic patients and 52.1% of non-diabetic subjects had SNHL. Results showed that diabetic patient has 1.3 times more likely to have hearing impairment. This difference was not statistically significant. Bilateral mild SNHL was the most prevalent in both groups. No significant difference was reported in SNHL prevalence, mean thresholds of hearing and ear laterality between the groups. Gender and age had a significant effect on hearing loss after adjusting covariables. No significant association was found between diabetes and hearing loss.
    Conclusion: SNHL was more common in hemodialysis patients with diabetes. Patients with diabetes had poorer hearing thresholds compared to non-diabetic group, with no significant difference between groups. The periodical assessment of hearing and extending audiological care in this high-risk population is recommended due to long-term irreversible symptoms of the disease.

  • XML | PDF | views: 179 | pages: 282-288

    Background and Aim: Although cochlear implantation (CI) is a safe surgical procedure for severe to profound sensorineural hearing loss (SNHL) but, due to the embryological and anatomical connection between the vestibular and cochlear structures, vestibular dysfunction may occur after CI. Video head impulse test (vHIT) is a reliable test for assessing the function of semicircular canals (SCCs). This study aimed to determine the early effect of CI on SCCs function, by comparing pre- and post-operative vHIT results.
    Methods: In this cross-sectional study, participants were 22 adults with SNHL scheduled for unilateral CI in the right ear and 22 age-matched healthy subjects as a control group. The vHIT was conducted before and two weeks after CI.
    Results: The mean vHIT gains in the SNHL group were significantly lower than in controls, with a large effect size. Furthermore, the mean vHIT gains in the right lateral SCCs (p<0.001) and right anterior SCCs (p=0.003) were significantly reduced after CI, compared to the gain values before CI, with a large pooled effect size. However, these differences were not statistically significant for the right posterior SCCs. The comparison of vHIT gains in the nonimplanted ear showed no statistically significant difference between pre- and post-operative phases.
    Conclusion: The vHIT is a useful clinical method to detect the early effects of CI on the function of SCCs. These effects are more obvious in the lateral and superior SCCs in the implanted ear.

  • XML | PDF | views: 164 | pages: 289-294

    Background and Aim: To evaluate the success rate of revision myringoplasty using temporalis fascia graft and to assess the effect of potential influencing factors on closure of tympanic membrane (TM) and hearing outcome such as size and site of perforation, whether the patient is smoking or not and condition of contralateral ear.
    Methods: Thirty patients were included in this prospective study, who underwent revision myringoplasty for chronic otitis media without cholesteatoma in the period between 2017-2019 in the Department of Ear, Nose, and Throat-Head and Neck Surgery in Almowasat University Hospital. Data of all patients: perforation size and site, middle ear status, surgical approach, graft material, pre and postoperative morphological and functional results were assessed. The temporal fascia was used for the reconstruction of TM. The interrelation between multiple preoperative parameters and postoperative morphological (closure of the perforation) and functional (hearing level) outcomes were assessed.
    Results: Successful closure rate of the TM perforation was 86.66% and failure rate was 13.34% in revision myringoplasty. The improvement of the air bone gap between 10-20 dB was 76.66% while the air bone gap between 20-30 dB was unchanged 23.33%.
    Conclusion: Revision myringoplasty can offer reasonably good chances for postoperative graft healing and hearing improvement with a high success rate. This gives the patient a good benefit in protecting the ear from developing complications that may have poor structural changes in the middle ear (ossicular necrosis and tympanosclerosis) which in turn leads to hearing loss.

  • XML | PDF | views: 212 | pages: 295-300

    Background and Aim: Difficulty in perception of speech in noise is one of the main complaints of hearing-impaired people. Due to profound hearing loss in cochlear implant (CI) users, they need higher signal-to-noise ratio for a better perception. Bimodal fitting is a preferred way for CI users because it prevents auditory nerve degeneration, is a complement of frequency range at the opposite ear, an is less invasive to provide binaural hearing. Acceptable noise level (ANL), as a reliable test to assess noise tolerance, has not yet been used in comparing children with bimodal hearing and CI. This study aimed to determine whether bimodal fitting can help CI children tolerate more noise.
    Methods: This descriptive-analytical study was conducted on 13 children with unilateral CI and bimodal hearing. Audiometry test was performed at aided and non-aided conditions. Then, their noise tolerance was assessed by the Persian version of ANL test.
    Results: Bimodal hearing resulted in statistically significant increase in ANL. The mean of ANL at unilateral CI and bimodal hearing conditions were 6.15±2.90 and 4.77±1.70, respectively.
    Conclusion: Bimodal fitting lead to more noise tolerance in unilateral CI children due to the combination of binaural summation and binaural release from masking.

  • XML | PDF | views: 189 | pages: 301-310

    Background and Aim: Generally, in noisy environments more informational masking occurs. Older adults benefit less than younger adults from spatial hearing and they have more problems of understanding speech in the presence of distracting speeches. This study was conducted to examine the effect of auditory spatial training on informational masking release in the elderly.
    Methods: Thirty-two 60-75-year-olds with normal hearing, who complain about difficulty in speech perception in noise, participated in control and intervention groups (16 people in each group). The intervention included fifteen sessions of auditory spatial training. The informational masking measurement test scores were compared before the intervention, one session after the intervention, and one month after between the two groups.
    Results: There was a significant improvement in informational masking measurement scores in the intervention group compared to the control (p<0.02). The results showed no significant differences between the informational masking measurement scores before and after the intervention in the control group (p>0.05) and a significant difference in most signal to noise ratio i.e. 0, -5 and -10, in the intervention group (p≤0.006). No significant difference was found between the results of the two assessments one session and one month after the intervention in any of the positions (p>0.05), which suggests that both groups’ scores remained highly stable one month after the intervention
    Conclusion: This study introduced a spatial training program to improve speech perception in noise in normal-hearing elderly listeners. It was recommended that this kind of training be included in geriatric population auditory rehabilitation programs.

  • XML | PDF | views: 149 | pages: 311-318

    Background and Aim: The masking level difference (MLD) test is a behavioral test that assesses binaural interactions and central auditory processing. This study aims to design a binaural MLD (BMLD) test application using tonal and Speech Stimuli in Persian.
    Methods: In the first stage, the BMLD test application was designed in MATLAB software. Then, the spondaic words were recorded and added to the sound processing panel of the application. In the next stage, the MLD of tonal and speech stimuli was measured on 20 subjects aged 18–25 years. To examine the test-retest reliability of the application, all steps were repeated after one week.
    Results: The MLD values for tonal and speech stimuli under the SoNo-SπNo condition were significantly different from those under the SoNo-SoNπ condition (p<0.05). These values for tonal and speech stimuli were 10.50 and 6.12 dB under the SoNo- SπNo condition, and 6.85 and 4.43 under the SoNo- SoNπ condition. There was no significant difference in the MLD values between males and females. The intraclass correlation coefficient value for different phase conditions was more than 0.8, indicating the high reliability of the BMLD test application for tonal and speech stimuli in Persian (p<0.05).
    Conclusion: The designed BMLD test application using tonal and speech stimuli in Persian has similar results compared to the conventional methods of MLD test for other languages, therefore, this application can be used in audiology clinics in Iran to perform the MLD test.

  • XML | PDF | views: 165 | pages: 319-326

    Background and Aim: Each year, millions of older people experience falling which can cause serious injuries such as broken bones, head injuries, or even death. Since Diabetes Mellitus can disrupt the balance system and increase falling, and given that fear of falling and balance confidence are critical fall-related psychological concerns that can be the risk factors of falls in the diabetic elderly, this study aimed to compare fear of falling and balance confidence of diabetic and non-diabetic older adults in Iran.
    Methods: Participants were 63 diabetic older patients and 59 non-diabetic peers aged 60 years and over. Data were collected using the Persian versions of falling efficacy scale-international and activities-specific balance confidence-short form questionnaires. In addition, modified Romberg and timed up and go tests were performed to assess subjective balance performance.
    Results: The scores of falling efficacy scale-international questionnaire and timed up and go test were significantly higher in diabetic group while the scores of activities-specific balance confidence-short form questionnaire were lower (p<0.001). No significant differences were observed in the modified Romberg test scores between two groups.
    Conclusion: Fear of falling and low balance confidence are more common in diabetic older adults compared to non-diabetic peers. They have poor performance in timed up and go test and have more falls during the last 12 months.