Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2025 08 30 192 196 EN Mohaddese Vahabi Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Mohanna Javanbakht Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran AND Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Enayatollah Bakhshi Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran 2025 06 15 2025 08 26 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. https://avr.tums.ac.ir/index.php/avr/article/view/1461

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2026 03 08 103 104 Masoud Motasaddi Zarandy - 2026 02 25 2026 03 03 Editorial https://avr.tums.ac.ir/index.php/avr/article/view/1552

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2025 10 14 105 115 EN Nasrin Gohari Hearing Disorders Research Center, Avicenna Institute of Clinical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran AND Department of Audiology, School of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran Sepideh Ghasemi Ranjbar Department of Audiology, School of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran Mahdi Khoshfetrat Department of Audiology, School of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran 2025 07 19 2025 09 09 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. https://avr.tums.ac.ir/index.php/avr/article/view/1476

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2025 09 23 116 124 EN Somaraj Odeyar Nitte (Deemed to be University), Nitte Institute of Speech and Hearing, Mangalore, India Jim Saroj Winston Nitte (Deemed to be University), Nitte Institute of Speech and Hearing, Mangalore, India 2025 05 28 2025 07 29 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. https://avr.tums.ac.ir/index.php/avr/article/view/1456

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2025 08 06 125 131 Sasan Etezadi Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran AND Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Nariman Rahbar Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran AND Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Seyyed Jalal Sameni Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran AND Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Farhad Torabinezhad Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran AND Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Behrooz Mahmoodi-Bakhtiari Department of Performing Arts, University of Tehran, Tehran, Iran 2025 06 05 2025 08 06 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. https://avr.tums.ac.ir/index.php/avr/article/view/1459

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2025 09 21 132 139 Navid Nourizadeh Department of Otorhinolaryngology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran AND Sinus and Surgical Endoscopic Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mojtaba Fallah Department of Otorhinolaryngology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Hadi Behzad Echo Hearing and Balance Clinic, Mashhad, Iran Setare Kafashan Echo Hearing and Balance Clinic, Mashhad, Iran Hassan Mehrad-Majd Clinical Research Development Unit, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2025 06 09 2025 08 07 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. https://avr.tums.ac.ir/index.php/avr/article/view/1460

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2025 08 12 140 149 Nikita Nanavati School of Audiology and Speech Language Pathology, Bharati Vidyapeeth (Deemed to be University), Pune, India Chitnahalli Shankarnarayan Vanaja School of Audiology and Speech Language Pathology, Bharati Vidyapeeth (Deemed to be University), Pune, India 2025 05 13 2025 08 12 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. https://avr.tums.ac.ir/index.php/avr/article/view/1444

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 35 2 2025 09 06 150 158 Mohammad-Reza Mahmoudian-Sani Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranSeyed Hassan Saneii Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran AND Department of Basic Sciences of Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran 2023 08 13 2023 09 25 Background and Aim: Evidence-Based Practice (EBP) is recommended by specialists for curing the patients more than other conventional treatments. In tinnitus management, Cognitive-Behavioral Therapy (CBT) is the only EBP-based method. Different factors, such as training, can affect the therapists’ attitudes towards the use of these treatments. This study aimed to investigate the effect of a training program in CBT on Iranian audiologists’attitudes towards using CBT for tinnitus management. Methods: This descriptive-analytical study was conducted on 88 audiologists (including 65 females) with a mean age of 33±9.54 years, who were randomly divided into two groups of intervention (receiving CBT training) and control (no training). The data were collected by a researcher-made demographic/clinical questionnaire and the Persian version of the Evidence-Based Practice Attitude Scale-35 (EBPAS-P35), which was completed before and after training. Results: Comparison of the total score of EBPAS-P35 showed a significant difference in the intervention groups before and after training (p<0.001). In addition, all EBPAS-P35 subscales scores were significantly different before and after training in the intervention group (p<0.001). A positive significant correlation was observed between the total score of the EBPAS-P35 and two factors of age (r=0.38, p=0.009) and clinical experience (r=0.34, p=0.009). Conclusion: Training in CBT can improve the attitude of audiologists in Iran towards using CBT for tinnitus management in patients. The age and clinical experience can affect the attitude of audiologists toward using CBT. https://avr.tums.ac.ir/index.php/avr/article/view/1199 https://avr.tums.ac.ir/index.php/avr/article/download/1199/558

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 33 2 2023 11 08 133 141 Rohollah Fallah Madvari Occupational Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AND Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Arghavan Abrchi Occupational Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AND Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Reyhane Sefidkar Center for Healthcare Data Modeling, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AND Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Fereydoon Laal Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran AND Department of Occupational Health Engineering, Birjand University of Medical Sciences, Birjand, Iran Hamideh Bidel Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mahdi Jafari Nodoushan Occupational Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran AND Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2023 08 10 2023 10 02 Background and Aim: There is evidence of associations between noise exposure and psychological outcomes from noise annoyance. This study aims to examine the mediating role of noise annoyance in the relationship of noise exposure with Emotional Intelligence (EI) and Cognitive Emotion Regulation (CER). Methods: This is a cross-sectional study that was conducted on 58 male workers of a lead mine in Yazd, Iran. Noise exposure was determined based on ISO 9612:2009. Noise annoyance was assessed using the ISO/TS 15666:2003’s numerical rating scale. The Schutte Self-Report Emotional Intelligence Test (modified version) and the Cognitive Emotion Regulation Questionnaire (CERQ) were used for data collection. Mann-Whitney U test, correlation test, and Generalized Structural Equation Modeling (GSEM) were used to analyze the data. Results: The mean age of workers was 35.78±7.10 years. A significant relationship was found between noise annoyance and noise exposure, such that a unit increase in noise exposure had a multiplicative effect on the odds of experiencing more annoyance (p<0.001). Also, for every one-unit increase in noise annoyance, mean scores for EI and CER decreased by 0.192 and 0.172, respectively. Conclusion: Noise exposure is directly related to noise annoyance and indirectly related to EI and CER. Further studies in this area are recommended to clarify the issue and the relationships between these variables. https://avr.tums.ac.ir/index.php/avr/article/view/1196 https://avr.tums.ac.ir/index.php/avr/article/download/1196/552

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 33 2 2023 11 01 142 151 EN Siti Aisyah Mohammad Tahir Audiology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Che Muhammad Amir Che Awang Audiology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Noor Alaudin Abdul Wahab Audiology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia AND Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia AND Centre for Ear, Hearing and Speech, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Mohd Normani Zakaria Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia Suzaily Wahab Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan, Kuala Lumpur, Malaysia Nor Haniza Abdul Wahat Audiology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia AND Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia AND Centre for Ear, Hearing and Speech, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Nashrah Maamor Audiology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia AND Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia AND Centre for Ear, Hearing and Speech, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia 2023 08 08 2023 10 09 Background and Aim: There is limited study on the role of rostral efferent auditory pathway on Outer Hair Cell (OHC) activity. We investigated the effect of integrating alternate auditory attention (ALAUDIN©) tasks with White Noise (WN) and its reliability using contralateral suppression of Transient Evoked Otoacoustic Emission (TEOAE). Methods: This study was conducted at the Audiology Clinic, Universiti Kebangsaan Malaysia, with fifty normal-hearing adults. All subjects underwent standard audiological testing to ensure normal hearing, middle ear, and cochlear function. Contralateral suppressors with and without attention tasks were delivered randomly to the non-test ear while simultaneously measuring TEOAE amplitude in the test ear to investigate the effect of auditory attention on OHC electromotility. Suppressors with and without attention refer to the combination of a 1000 Hz tone and speech stimulus embedded in WN and WN alone, respectively. Subsequently, the difference in TEOAE amplitude during the presence and absence of suppressors was calculated, and thus suppression magnitude was determined. Results: Intraclass correlation revealed that 4 suppressors produced high reliability. In paired sample t-tests, the tasks significantly reduced the amplitude of the TEOAE in the right ear compared to the left ear (p<0.05). However, the suppression magnitude did not differ significantly between ears (p>0.05). Descriptively, females showed greater TEOAE suppression. Conclusion: This study demonstrated that directing ALAUDIN© tasks to one ear can affect OHC electromotility, as evidenced by TEOAE amplitude changes, but it did not impact the overall suppression magnitude. Additionally, it hinted at potential gender differences in TEOAE suppression, warranting further investigation. https://avr.tums.ac.ir/index.php/avr/article/view/1195 https://avr.tums.ac.ir/index.php/avr/article/download/1195/549

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 33 2 2023 11 01 152 161 Oğuz Kadir Eğilmez Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey Mahmut Sinan Yılmaz Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey Sena Genç Elden Ear, Nose, and Throat Clinic, Pamukova State Hospital, Sakarya, Turkey Mehmet Koçoğlu Department of Audiology, Sakarya University Training and Research Hospital, Sakarya, Turkey Ahmet Kara Department of Otorhinolaryngology, Sakarya University Training and Research Hospital, Sakarya, Turkey Mehmet Güven Department of Otorhinolaryngology, Sakarya University Training a