Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 03 19 1499 1499 Pushpavathi Mariswamy Professor, Prashanth Prabhu Assistant professor, Audiology Nisha Venkateswaran Scientist B Yashaswini Channabasavegowda - Aishwarya Shankar - 2025 10 29 2026 03 08 Background and Aim: Children with repaired cleft lip and palate (RCLP) are at increased risk for auditory processing difficulties, particularly in speech perception in noise and temporal auditory processing. Although emerging evidence suggests deficits in central auditory processing in this population, a systematic synthesis of temporal processing abilities remains limited. This review aimed to critically evaluate and synthesize existing evidence on temporal auditory processing abilities in children with RCLP. Recent Findings: A systematic literature search was conducted independently by two reviewers across PubMed, Scopus, CINAHL, ScienceDirect, and ProQuest for studies published between January 2000 and March 2025. Study selection was performed through title, abstract, and full-text screening. Eligibility criteria were defined using the PICOS framework, and risk of bias was assessed for all included studies. Of 1,132 identified records, 12 studies met the inclusion criteria. The reviewed evidence consistently demonstrated auditory processing deficits in children with RCLP, with temporal processing identified as the most frequently and severely affected domain. Across studies, children with RCLP showed significantly poorer temporal processing performance compared to craniofacially typical peers. Conclusion: This review underscores the clinical relevance of temporal auditory processing deficits in children with repaired cleft lip and palate. Unrecognized temporal processing impairments may adversely affect academic performance, reading skills, and speech–language development. Incorporating temporal auditory processing assessment into routine audiological evaluations is therefore recommended for early identification and targeted intervention. Future research should further investigate other subtypes of auditory processing disorders in this population to enhance clinical management strategies. https://avr.tums.ac.ir/index.php/avr/article/view/1499

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 08 30 1462 1462 Sahand Nazeri Department of Audiology, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Pich-e-Shemiran, Enghelab Ave., Tehran 1148965141, Iran. Farzaneh Fatahi Department of Audiology, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Pich-e-Shemiran, Enghelab Ave., Tehran 1148965141, Iran. Saeed Talebian Department of Physiotherapy, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Pich-e-Shemiran, Enghelab Ave., Tehran 1148965141, Iran. Nasrin Yazdani Otorhinolaryngology Research Center, Department of Otorhinolaryngology-Head and Neck Surgery, Amir Alam Hospital, Tehran University of Medical Sciences, North Saadi Ave., Tehran 1145765111, Iran. 2025 06 21 2025 08 27 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. https://avr.tums.ac.ir/index.php/avr/article/view/1462

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 09 13 1452 1452 Kavassery Nisha Scientist B Rohit Bhattacharyya Audiologist, Guwahati Medical College and Hospital, Assam, India Sushmitha Upadhya M.Sc Audiology, AIISH, Mysore Ritwik Jargar Audiologist , AIIMS, Rajkot, Gujarat, India 2025 05 21 2025 09 13 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 2nd 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. https://avr.tums.ac.ir/index.php/avr/article/view/1452

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 09 17 1478 1478 Azadeh Imani Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran Mohammad Nasehi - Hamid Jalilvand - Mohammad-Reza Zarrindast - Solmaz Khalife - 2025 07 21 2025 09 09 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. https://avr.tums.ac.ir/index.php/avr/article/view/1478

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 09 23 1429 1429 Sushmitha Upadhya Audiologist Grade 1, AIISH, Mysore Rohit Bhattacharyya Audiologist, Guwahati Medical College and Hospital, Assam, India Ritwik Jargar Audiologist , AIIMS, Rajkot, Gujarat, India Kavassery Nisha Scientist B 2025 03 21 2025 09 21 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. https://avr.tums.ac.ir/index.php/avr/article/view/1429

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 09 28 1467 1467 Saeidreza Babaei Ashkezari - Nematollah Rouhbakhsh 00 98 93 6349 2507 Vida Rahimi - Shohreh Jalaie - 2025 07 09 2025 09 21 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. https://avr.tums.ac.ir/index.php/avr/article/view/1467

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 10 11 1474 1474 Arun Kumar M Assistant professor Department of BASLP, SRBS, Vinayaka mission medical college and hospital, Karaikal, Puducherry India. Arun Banik Dean & Director, Professor (Speech and Hearing) School of Rehabilitation and Behavioural Sciences Vinayaka Mission Research Foundation (Deemed to be University) Aarupadai Veedu Medical College, Puducherry, India 2025 07 18 2025 10 08 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. https://avr.tums.ac.ir/index.php/avr/article/view/1474

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 10 11 1486 1486 Sanaz Solotanparast PhD student of Iran university of medical science Reyhane Toufan Rehabilitation Research Center, Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Saeed Talebian Motor Control Laboratory, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Akram Pourbakht Rehabilitation Research Center, Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran 2025 08 04 2025 10 08 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. https://avr.tums.ac.ir/index.php/avr/article/view/1486

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 10 11 1480 1480 Prajeesh Thomas All India Institute of Speech & Hearing (AIISH) Animesh Barman All India Institute of Speech & Hearing, Mysuru, India 2025 07 23 2025 10 08 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. https://avr.tums.ac.ir/index.php/avr/article/view/1480

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 10 12 1490 1490 Noor Abdulazeez Abdulhameed Alrawi Mustansiriyah University/ M.B.Ch.B Haider Alsarhan Ibn Sina University for Medical and Pharmaceutical Sciences/M.B.Ch. B, F.I.B.M.S, Consultant Otolaryngologist Mohamed Altamimi College of Medicine / Mustansiriyah University/ M.B.Ch. B, F.I.C.M.S in Neurosurgery 2025 08 25 2025 10 12 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. https://avr.tums.ac.ir/index.php/avr/article/view/1490

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 10 12 1463 1463 Alireza Ranjbar Department of audiology, Tehran university of medical science, Tehran, Iran Vida Rahimi Elham Tavanai Department of audiology, Tehran university of medical science, Tehran, Iran Richard Tyler Department of Communication Sciences and Disorders, Department of Otolaryngology—Head and Neck Surgery, Iowa City, IA, USA Maryame Abadeh - 2025 06 29 2025 10 12 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. https://avr.tums.ac.ir/index.php/avr/article/view/1463

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 10 25 1468 1468 Parthasarathy Sindhu Assistant Professor Asha Yathiraj - 2025 07 11 2025 10 21 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. https://avr.tums.ac.ir/index.php/avr/article/view/1468

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 11 10 1495 1495 Zahra Moeinfard Shahid Beheshti University of Medical Sciences Mohammad Ebrahim Mahdavi Department of Audiology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences. Hamid Jalilvand Department of Audiology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences. 2025 10 10 2025 11 01 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. https://avr.tums.ac.ir/index.php/avr/article/view/1495

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 11 26 1491 1491 Milad Abbasi Assistant professor of Occupational Health Engineering, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran. Mahdi Sharifpour Bsc of Occupational Health Engineering, student research committee, Saveh University of Medical Sciences, Saveh, Iran. Yasin Manoochehri M.A student in business and administration, Islamic Azad university Sanandaj branch, Sanandaj, Iran. Jalil Derakhshan MSc in Occupational Health Engineering, School of Public Health, Hamedan University of Medical Sciences, Hamedan, Iran. 2025 08 25 2025 11 26 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. https://avr.tums.ac.ir/index.php/avr/article/view/1491

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 12 08 1470 1470 Majid Bershan School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. or Hamid Jalilvand - Sara Sardari - Maryam Yazdi - 2025 07 14 2025 11 01 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. https://avr.tums.ac.ir/index.php/avr/article/view/1470

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 01 13 1509 1509 EN Shokoufeh Zare Iran University of Medical Sciences Ali Ghorbani Iran University of Medical Sciences Nahid Jalilevand Mohamad Kamali Iran University of Medical Sciences 2025 11 16 2025 12 27 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 knowledge of deaf children who had received cochlear implant (CI) compared to their normal-hearing (NH) peers. Methods: This is a descriptive-analytical study with a cross-sectional design that  was conducted on  90 Persian-speaking children (30 with CIs and 60 with normal hearing). The hearing age (HA) of children with CIs ranged from 2 to 57 months, and their chronological age (CA) was in the range of 32-71 months. The Persian version of the Peabody picture vocabulary test (RPVT-P) was used to evaluate the children’s vocabulary knowledge. The t-test and Pearson’s correlation test were used to analyze and compare the data.  Results: There was a significant relationship between the total RPVT-P score and CA in both NH children (r= 0.842, p<0.001), and CI children (r = 0.824, p<0.001). There was a significant relationship between the total RPVT-P score and HA in children with CI (r = 0.658, p<0.001). There was a significant difference between the two groups of children in the scores of each RPVT-P item (p<0.001). Conclusion: Persian-speaking children with CI gradually develop their receptive vocabulary knowledge, but they do not reach the same level of skills as their NH peers. Children with CI can learn various vocabularies. Key words: Cochlear implants, deaf, hearing impairment, receptive language, vocabulary https://avr.tums.ac.ir/index.php/avr/article/view/1509

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 02 08 1503 1503 Selva Samaei University of Social Welfare and Rehabilitation Sciences Yones Lotfi University of Social Welfare and Rehabilitation Sciences Nasrin Yazdani Tehran University of Medical Sciences Mohsen Vahedi University of Social Welfare and Rehabilitation Sciences Moslem Shabani University of Social Welfare and Rehabilitation Sciences 2025 11 08 2025 12 24 Background and aim: Tinnitus is a persistent perception of sound without an external source and is often accompanied by emotional distress. Tailor-Made Notched Music Therapy (TMNMT) and Binaural Beat Stimulation (BBS) are non-invasive auditory approaches proposed to alleviate tinnitus symptoms. This study compared the effects of TMNMT alone and TMNMT combined with BBS in adults with chronic subjective tinnitus. Methods: In this randomized controlled trial, 24 adults with chronic tinnitus were allocated to either the TMNMT group or the TMNMT + BBS group. Individualized music files were created by removing the tinnitus frequency band; in the combined group, an 8-Hz alpha-range binaural beat was embedded at -20 dB. Participants listened to the audio stimuli twice daily for four weeks. Outcomes included the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and Visual Analog Scales for tinnitus Loudness (VAS-L) and Annoyance (VAS-A). Results: Both groups showed significant improvement across all outcome measures (p < 0.01). Greater mean reductions were observed in the TMNMT + BBS group for THI (Δ = 17.33 ± 13.11 vs. 9.00 ± 8.16) and BDI (Δ = 4.08 ± 1.79 vs. 1.83 ± 1.26), though between-group differences were not statistically significant. Effect sizes (Cohen’s d = 0.76-1.46) favored the combined intervention. Conclusion: TMNMT and TMNMT + BBS effectively reduced tinnitus-related distress and depressive symptoms. The addition of binaural beats produced stronger clinical gains; however, these differences were not statistically significant and therefore should be interpreted cautiously. Larger trials with extended follow-up are recommended. Trial Registration Number: IRCT20250215064735N1 https://avr.tums.ac.ir/index.php/avr/article/view/1503

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 02 17 1511 1511 EN Narges rostami Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Mohanna Javanbakht 1-Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran- 2. Pediatric Neurorehabilitation research center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Enayatollah Bakhshi 3. Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Amir-‌Abbas Ebrahimi 4. Department of Rehabilitation, Consultation and Early Intervention services. Exceptional Education Organization, Tehran, Iran Ahmad Rasouli Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran 2025 11 18 2026 01 18 Background and Aim: Auditory Processing Disorder (APD) impairs auditory information processing specially affecting speech understanding in noise. Early screening is essential to address learning and social challenges. The Teacher’s Evaluation of Auditory Performance (TEAP) is a validated teacher-based APD screening tool. This study translated TEAP into Persian (P-TEAP), evaluated its psychometric properties, and assessed correlations with the Scale of Auditory Behaviors (SAB) and Bamford-Kowal-Bench (BKB) sentence test. Methods: The TEAP was translated trough the International Quality of Life Assessment method. Face and content validity were assessed. Teachers completed both the P-TEAP and the SAB, while parents completed the parent version of SAB, for 243 children aged 7–13 years including 93 males, who underwent hearing screening and BKB testing. Results: All items were clear and relevant (CVR=0.92, CVI=1). Cronbach’s α was 0.905 for the total scale. Test-retest reliability was excellent (ICC=0.99). Convergent validity was supported by correlations with SAB-T (r=0.901), SAB-P (r=0.716), BKB right ear (r=-0.614), and BKB left ear (r=-0.590). ROC analysis identified a cut-off score of 6 with 95.0% sensitivity and 68.3% specificity using BKB as reference, and a cut-off of 6 with 98.5% sensitivity and 92.1% specificity using SAB-T as reference. Conclusion: The P-TEAP is a valid and reliable tool for screening APD in Persian-speaking children. Its robust psychometric properties and correlations with SAB and BKB support its use in research and clinical settings. https://avr.tums.ac.ir/index.php/avr/article/view/1511

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 02 22 1519 1519 Maryam Cheraghi Student Research Committee, School of Rehabilitation, Hamadan University of Medical Science, Hamadan, Iran Kowsar Baghban Hamadan University of Medical Sciences & Health Services Bahareh Rezaei Department of Speech Therapy, School of Rehabilitation, Hamadan University of Medical Science, Hamadan Maryam Farhadian Department of Biostatistics, School of Public Health, Hamadan University of Medical Science, Hamadan Sogand Zarei - 2025 11 30 2026 02 21 Background & Aim: Hearing impairment in childrn can affect language acquisition and consequently lead to delays in speech and language skills. The purpose of this study was to examine the relationship between phonological working memory (PWM) and mean length of utterance (MLU) in normal and hearing-impaired Persian-speaking children. Methods: The study included 27 children with profound hearing loss (mean age = 5.42 ± 0.31 years) and 27 typically developing children (mean age = 5.62 ± 0.36 years), matched for age range (5–6 years) and gender (12 boys, 15girls). A nonword repetition task was used to assess PWM, and 50 utterances were selected from the obtained discourse samples to evaluate MLU. Results: The relationship between these two variables was compared across the two groups. A strong and significant correlation was found between PWM and MLU in children with profound hearing loss (HL). Additionally, the correlation in typically developing children was moderate and significant. Conclusion: A strong correlation between PWM and MLU was found in children with HL, whereas a moderate correlation was observed in typically developing children. These findings indicate the relevance of PWM to MLU in both groups, with a stronger association in children with hearing loss, without implying causality. https://avr.tums.ac.ir/index.php/avr/article/view/1519

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 10 12 1484 1484 EN Hanin Rayes King Abdulaziz University Alaa Arafah - Alaa Sindi - Rawan Aldhabi - 2025 08 02 2025 10 12 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. https://avr.tums.ac.ir/index.php/avr/article/view/1484

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 02 23 1533 1533 Mohammad Akbar Fayaz - Mansoureh Adel Ghahraman Elham Tavanai - Kazem Malmir - Nasrin Yazdani - Akram Farahani - Mohammad Amin Safari - 2025 12 31 2026 02 18 Background and Aim: Inflammatory processes play a key role in vestibular neuritis (VN) pathogenesis, and recent research has associated vitamin D deficiency with various audio-vestibular conditions, including reduced serum 25-hydroxyvitamin D [25(OH)D] concentrations in individuals with acute VN. Given its notable immunomodulatory and anti-inflammatory actions, vitamin D may serve as an adjunct to enhance VRT outcomes. The present study examined the impact of combining 25(OH)D supplementation with VRT on vestibular function among patients with VN. Methods: In this randomized controlled trial, 41 patients with VN were allocated into two groups. The VRT group (n=20) received individualized vestibular rehabilitation for 30 minutes, three times daily for 12 weeks. The VRT+VitD group (n=21) received the same VRT protocol plus a weekly oral dose of 50,000 IU of 25(OH)D for 12 weeks. Outcomes were assessed pre- and post-intervention using the Dizziness Handicap Inventory (DHI), Vertigo Symptom Scale-short form (VSS-sf), and affected canal vestibulo-ocular reflex gains with video head impulse test, within- and between-groups. Results: Both groups improved significantly across all measurements. The VRT+VitD group showed a normal serum level of vitamin D post-intervention (39.36±3.06; p<0.001) and greater improvements in subjective symptom reduction (DHI; p=0.023; partial η²=0.126), and VOR gains (p<0.001 with partial η²=0.459, 0.576, and 0.197 for lateral, anterior, and posterior canals, respectively) compared to the VRT group. Conclusion: Correcting vitamin D deficiency supports and potentially enhances the effects of vestibular rehabilitation in patients with vestibular neuritis, although these outcomes should be interpreted with caution due to the study’s limitations. https://avr.tums.ac.ir/index.php/avr/article/view/1533

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 03 19 1496 1496 Ali Jahangard - Ali Mohammadzadeh - 2025 10 15 2026 02 21 Background and Aim: Speech perception is severely impaired by sensorineural hearing loss (SNHL) and background noise. This study compared two newly developed Persian speech-in-noise tests, the Persian dynamic spatial quick speech in noise (P-DSQSIN) test and the Persian hearing in noise test (P-HINT), to evaluate the clinical utility of both in adults with SNHL. Methods: Fifty subjects with moderate to moderately severe SNHL (aged 18–50) and twenty-five normal hearing (NH) subjects (aged 18–25) participated. They were assessed using both the P-DSQSIN and P-HINT. Additionally, the Persian spatial hearing questionnaire (P-SHQ) and the Persian speech, spatial and qualities of hearing scale (P-SSQ) were used to correlate objective test results with subjective perceptions of speech difficulties in noise. Results: Significant differences (p<0.05) were found between the two groups across tests and questionnaires. The P-DSQSIN test demonstrated several advantages over P-HINT concerning clinical use, including setup complexity, ease of administration, and scoring. The results of the two tests showed a moderate positive correlation (r=0.693, p<0.001). In the SNHL group, the results revealed moderate significant positive correlations between the P-DSQSIN SNR loss and P-HINT SNR with the P-SHQ (r = 0.538, p < 0.001 and r=0.427, p =0.007) and P-SSQ questionnaire scores (r = 0.647, p < 0.001 and r = 0.348, p = 0.015). Conclusion: Both tests assess the listener’s ability to hear in background noise. However, the P-DSQSIN test is a more sensitive measure of speech perception in noise than the P-HINT in subjects with SNHL. https://avr.tums.ac.ir/index.php/avr/article/view/1496

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 04 19 1501 1501 Hemanth Shetty University of Mysuru Srikar Vijayasarathy https://orcid.org/0000-0003-0064-3789 2025 11 03 2026 04 18 Background and Aim: To investigate if the effectiveness of digital noise reduction (DNR) in improving speech recognition scores and reducing listening effort in younger and older adults with moderate sensorineural hearing loss is associated with envelope distortion caused by the DNR algorithm used in hearing aids. Methods: Participants included 17 younger adults (18-45 years) and 20 older adults (51-70 years) with flat moderate sensorineural hearing loss (SNHL). The benefit of a modulation-based DNR algorithm was assessed using sentences (0° azimuth) presented in speech noise (180° azimuth) at +4 dB SNR. The Envelope Difference Index was calculated using the algorithm, and correlations between DNR benefits and envelope distortion were analysed. Results: DNR enhanced speech-in-noise recognition scores for younger adults, but it did not have the same effect for older adults. Listening effort, measured by final-word recall scores, improved significantly in both younger and older adults in the DNR group. However, there was no significant difference in EDI between the groups. No correlation was found between the magnitude of the envelope difference index and DNR benefits on speech recognition and listening effort in younger and older adults.  Conclusions: Digital noise reduction improved speech recognition in noise for younger adults but not older adults with moderate hearing loss, though both groups showed reduced listening effort, with benefits unrelated to signal envelope distortion. https://avr.tums.ac.ir/index.php/avr/article/view/1501

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2025 11 10 1475 1475 Arun Kumar M Assistant professor Department of BASLP, SRBS, Vinayaka mission medical college and hospital, Karaikal, Puducherry India. 2025 07 18 2025 11 01 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. https://avr.tums.ac.ir/index.php/avr/article/view/1475

Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 04 12 1520 1520 Kristi Kaveri Dutta Bharati Vidyapeeth (DU) School of Audiology and Speech Language Pathology Anuj Kumar Neupane - Dhriti Hasija - Aashka Kishore Gidwani - 2025 12 04 2026 04 07 Background: Persistent Postural-Perceptual Dizziness (PPPD) is a chronic functional vestibular disorder characterized by persistent non-spinning dizziness aggravated by motion, upright posture, and visually complex environments. Multimodal management including vestibular rehabilitation therapy (VRT) and cognitive behavioral therapy (CBT) is recommended; however, evidence supporting cognition-integrated tele-vestibular rehabilitation remains limited. This case aimed to examine the clinical utility of a CBT-informed tele-vestibular rehabilitation model in PPPD secondary to peripheral vestibular dysfunction. The Case: A 31-year-old female presented with a two-year history of persistent dizziness, episodic vertigo, motion sensitivity, and visual dependence, along with anxiety and depressive symptoms. Audiological findings were normal. Vestibular evaluation revealed spontaneous left-beating nystagmus, right-sided utricular involvement on oVEMP (prolonged latencies, reduced amplitudes), and corrective saccades in the right lateral canal on vHIT; MRI findings were unremarkable. Baseline scores indicated severe handicap (DHI: 76/100) and high functional limitation (VADL; Niigata PPPD Questionnaire: 83/114). The patient underwent a 10-month structured program comprising four months of tele-VRT followed by six months of cognition-integrated tele-rehabilitation incorporating psychoeducation, self-monitoring, cognitive restructuring, and graded exposure. Post-intervention outcomes demonstrated reduced symptom severity (NPQ: 45/114), improved VADL scores, decreased DHI (53/100), increased right oVEMP amplitudes, and resolution of corrective saccades on vHIT. Conclusion: Cognition-integrated tele-vestibular rehabilitation was associated with meaningful functional, psychological, and partial objective vestibular improvements. This case highlights the feasibility and potential benefit of remotely delivered, multidimensional rehabilitation in PPPD and underscores the need for larger controlled studies. https://avr.tums.ac.ir/index.php/avr/article/view/1520