Background and Aim: Speech-in-Noise (SIN) perception is one of the most important issues processed by human listeners. The purpose of speech tests is to determine the perceptual abilities of people in real life conditions; therefore, can speech tests in quiet be a valuable measure of this ability? Is the central representation of speech-in-quiet and SIN perception the same? This review study aimed to investigate the central representation of SIN perception in healthy individuals aged 14 to 60 years.
Recent Findings: Central representation of SIN perception is influenced by various peripheral factors and includes several neural processes. All auditory nerve fibers are stimulated by speech and noise. Low-frequency sounds play a much more important role than high-frequencies. The auditory nerve fibers that are stimulated by speech, respond only to fundamental frequencies (F0). The degree of neural synchronization that increases by noise and causes the simultaneous activity of these fibers, develops auditory processing. Large areas of the auditory cortex and its external parts (parietal, premotor, and mirror neurons) are stimulated. Larger groups of cortical nerve fibers are used for speech signals of the same family with significant ecological importance.
Conclusion: Central representation of SIN perception is not the same as in quiet. Speech perception tests in quiet cannot assess real-life perceptual abilities of people. SIN tests should be used routinely as a practical confirmatory test in audiology clinics. It is very necessary that the list of words and sentences required for SIN perception tests be prepared for different languages.

Background and Aim: Considering the critical input of the vestibular system to the hippocampus as an area involved in cognition, and vestibular disorders reported in patients with amnestic Mild Cognitive Impairment (aMCI), we aimed to investigate the effects of Vestibular Rehabilitation (VR) with and without noisy Galvanic Vestibular Stimulation (nGVS) on cognitive function in patients with aMCI.
Methods: In a randomized controlled trial, twenty-two patients with aMCI were randomly assigned to two groups receiving: 1) VR for four weeks (VR group); 2) VR for four weeks with nGVS for three sessions (GVS+VR group). Outcome measures were Rey's Auditory-Verbal Learning Test (RAVLT), Corsi blocks, Visual Search (VS), and match to sample tests.
Results: Mean immediate and delayed recalls of RAVLT, all of the outcomes of Corsi blocks and VS tests, and the error rate of the match to sample tests improved significantly after intervention in VR and GVS+VR groups. Between-group differences were observed for learning and delayed recalls of RAVLT (p=0.001, d=0.444 and p<0.001, d=0.512 respectively), reaction times 1 and 2 in VS (p=0.007, d=0.325 and p=0.001, d=0.446 respectively), the total correct trial of Corsi blocks (p=0.026, d=0.235), and error rate of the match to sample (p=0.017, d=0.266) tests.
Conclusion: The synergistic effect of VR and GVS suggested that simultaneous use of both stimulations improves verbal and visuospatial memory in aMCI patients. Study protocol location: https://irct.ir/trial/47249 Trial registration number: IRCT20160131026279N3

Background and Aim: The use of subliminal stimulation for unconscious effects on the target population is of great importance. while several studies have generated proper visual and auditory stimuli for subliminal stimulation, no study was found on the long-term effects of it. Therefore, this study aims to investigate the long-term effects of auditory subliminal presentation on the central nervous system structures using fMRI and Auditory Late Responses (ALRs).
Methods: Participants were 26 students with a mean age of 24.03±2.32 years. There was four group in study. First, fMRI was done and ALRs were recorded for all of them. Then, music files containing words embedded in them was presented subliminally to participants in groups A and B for 10 days, group C received music file without any subliminal stimuli and group D was control group. It was repeated after 10 days.
Results: The subliminal stimuli had significant effects on the amplitudes of P1, N1, P2, and P3 waves (F3=25.03, 25.41, 39.11, and 14.60; p<0.001). Between-group comparison showed significant changes in groups A and B compared to groups C and D (p<0.05). The difference in the recorded potential mean values showed the highest change for recording electrodes in the prefrontal, frontal, and central regions and the lowest change in parietal and occipital regions. There was no significant change for a latency component.
Conclusion: Subliminal stimuli, presented appropriately and continuously, can leave longterm effects on the central nervous system structure causing extensive changes in the people’sattitude to a certain subject.

Background and Aim: Sand Play Therapy (SPT) is a psychotherapy and nonverbal method used for people with trauma, disabilities, and distress. The present study aimed to investigate the effect of SPT on aggression and emotional adjustment of children with a hearing impairment aged 5–7 years.
Methods: In this quasi-experiment study with a pretest-posttest design and a control group, 30 children aged 5–7 years with hearing impairment participated. They were randomly assigned into two groups: control and experimental. The research instruments were Sinha and Singh adjustment questionnaire and the Shahim aggression questionnaire. The obtained data were analyzed using multivariate covariance analysis.
Results: There were statistically significant differences (score decrease) between the two study groups after the SPT in terms of aggression (p<0.05) and the emotional adjustment of children (p<0.05).
Conclusion: The results showed that SPT could decrease aggression and improve emotional adjustment in children with hearing loss. This method can be used to rehabilitate these children.

Background and Aim: Music can be a favorite, annoying, or even a distracting noise. It is known that the processing of brain hemispheres is affected by the pleasantness/unpleasantness of music, which could be utilized as a signal or noise in auditory neuroscience. By using the Acceptable Noise Level (ANL) test, which is the quantification of noise tolerance while listening to a running speech, we investigated whether the pleasantness/unpleasantness of music affects the ANL results under monotic-listening and dichotic-listening conditions.
Methods: Based on the subjective scale scores, pleasant and unpleasant music (10 songs) were selected as alternatives to babble noise or running speech for testing 50 subjects for seven monotic and dichotic listening conditions.
Results: While pleasant music changed the ANL significantly under monotic listening conditions, the higher level of babble noise was tolerated, and both characteristics of music pleasantness and unpleasantness changed ANL significantly for various dichotic conditions. The range of the ANL for dichotic conditions is wider than that for monotic conditions.
Conclusion: Music can affect the ANL in terms of pleasantness and unpleasantness for both monotic and dichotic listening conditions, with a greater effect on dichotic conditions, indicating the role of hemispheric specification in emotional music processing.

Background and Aim: Tinnitus is a common symptom and affects patients differently. The Iowa Tinnitus Primary Function (ITPF) questionnaire evaluates tinnitus in four areas: concentration, emotion, hearing, and sleep. This study aimed to translate and then assess the psychometrics of the ITPF questionnaire.
Methods: This is a cross-sectional and methodological (test construction) study. The questionnaire was translated by the Word Health Organization protocol. The validity and reliability of the questionnaire were assessed. The measured validities were the content, face, and discriminative. The reliability was estimated by internal consistency and test-retest stability. We also measured the effects of age and sex on the questionnaire’s score.
Results: The questionnaire was translated based on the protocol. Each item of the questionnaire was understandable for patients and healthy participants. The face and content validities were confirmed by the patients and specialists, respectively. The score of 10.97 was determined as the cutoff point between patients and healthy participants, with a sensitivity of 86.70% and a specificity of 96.10%. The Cronbach α was found to be 0.958, and the intraclass correlation coefficient was 0.975. No significant effect was observed for age (p=0.314) and gender (p=0.866).
Conclusion: The Persian version of the questionnaire showed high validity and reliability. It could be used in research and clinical settings.

Background and Aim: Satisfaction with hearing aids is very important for continued use of the device and improving hearing status and quality of lives of people with hearing loss. MarkeTrak survey has been used for many years to track factors influencing satisfaction with hearing aids. This study aimed to make a valid and reliable Persian version of the MarkeTrak survey to measure the effects of type of fitting, experience and technology on hearing aid satisfaction.
Methods: After confirmation of validity and reliability of the Persian MarkeTrak, 71 people participate in the study. The effects of bilateral versus unilateral hearing aids (type of fitting), experience and wireless versus non-wireless technology were tested.
Results: Bilateral hearing aid users has significantly higher satisfaction rate than unilateral users (65.6±7.2 versus 59.9±17.7). The effects of experience with using hearing aids and type of technology did not reach statistical significance.
Conclusion: Higher satisfaction with bilateral hearing aids might result from better sound quality in diverse listening conditions, spatial hearing and directionality with two ears rather than one ear.

Background and Aim: Despite more affordable and advanced technologies for early detection of congenital hearing loss, unilateral hearing loss is the prevalent form of hearing loss affecting school-aged children. This study aimed to examine the impact of Words-in-Noise (WIN) training on speech perception of noise in children with unilateral hearing loss.
Methods: Thirteen children aged 8 to 12 years with unilateral hearing loss underwent a WIN training program in noise. The participants were tested before and after training on word identification in noise and cortical auditory evoked potentials.
Results: A comparison of the mean signal-to-noise ratio 50% between pre- and post-training indicated that signal-to-noise ratio 50% score decreased after training sessions. WIN training reduced the latency in N1 and P2 waves in the Fz electrode and the N1 wave in the Pz electrode and increased the amplitude of the waves in the Fz and Pz electrodes. The observed data suggest that all participants’ performance improved on word identification in noise and some electrophysiological parameters. Cortical auditory evoked potentials components changes did not correlate with the WIN scores.
Conclusion: The Persian version of the WIN training improved speech perception ability in the presence of competitive noise in children with unilateral hearing loss. Therefore, this software solution can partially solve speech comprehension problems with noise in these children.

Background and Aim: Hearing-impairment and hearing loss are humans’ most common neurological and sensory injuries. Having a child with hearing loss, in addition to affecting the amount of stress on the family and parents, can also affect the marital satisfaction of the couple. This study aimed to evaluate the effectiveness of Jung’s self-knowledge on the adaptability and marital satisfaction of mothers with hearing-impaired children.
Methods: This research was quasi-experimental with a pretest-post-test design with a control group. The study’s statistical population includes all mothers with hearing-impaired children living in Yazd City, Iran. A total of 30 women were selected using the purposive sampling method and were randomly divided into the control (15 people) and intervention groups (15 people). The intervention group received Jung’s self-knowledge training in eight 90-minute sessions once a week, while the control group received no training. Data were collected through a marital satisfaction questionnaire and a family adaptation questionnaire. The data were analyzed at the level of descriptive and inferential statistics.
Results: The results of the data analysis showed a significant difference between the variables of compatibility and marital satisfaction in the post-test of the experimental and control groups.
Conclusion: Jung’s self-knowledge affects the adaptability and marital satisfaction of mothers with hearing-impaired children. Therefore, self-knowledge with Jung’s method can be useful for improving the adaptability and marital satisfaction of mothers with hearing-impaired children.

Background and Aim: Word Recognition Test (WRT) is a widely used component of routine audiology battery. Several studies were conducted on the effect of words in word recognition lists and whether word difficulty level had an effect in word recalling process of patients. This study aims to compare the scores of patients to the designed Başkent WRT and commonly used Hacettepe WRT by focusing on the lexical neighbourhood.
Methods: Study carried out in an Ear Nose and Throat Department of a private university hospital between June and August 2021. 34 persons with sensorineural hearing loss and 34 persons without hearing loss was participated in the study. Designed WRT and widely used common WRT were presented to the participants.
Results: Results showed that common WRT included words with more lexical neighbours and sensorineural hearing loss group scores were significantly lower compared to designed WRT.
Conclusion: Persons with sensorineural hearing loss have a tendency to misunderstand presented words in WRT as they may trigger other words and misguide the patient.

Background and Aim: Real-Ear Unaided Gain (REUG) can reveal the outer-ear resonance which reflects the effects of body and ear factors. Deformity in the outer ear may change the real-ear unaided responses. Cauliflower ear is a common ear deformity in wrestlers. This study aimed to compare the REUG of normal and cauliflower ear in wrestlers to investigate the frequencies at which the gain may be inaccurate.
Methods: Ten male wrestlers with the age ranged from 21 to 31 years participated in this study. The study had within-subject design and only one group. The REUGs was recorded for both ears, normal and cauliflower ears, and the results analyzed.
Results: The mean of REUG values were significantly different between the deformed and normal ears. There were two distinct peaks in the REUG curve of the deformed ear, while there was a single peak in that of the normal ear.
Conclusion: The differences in the REUG at 2–6 kHz between the deformed and normal ears was seen.