[Correlation between acoustically evoked short latency negative response and vestibular evoked myogenic potentials in children with profound sensorineural hearing-loss]

Vestibular evoked myogenic potentials and acoustically evoked short latency negative response are two non-cochlear responses with probably saccular origin. The present study was conducted to determine the percentage of presence and the relation between these two responses in children with hearing loss. Thirty children with profound congenital sensorineural hearing loss were studied. Vestibular evoked myogenic potentials elicited by tone burst stimuli and acoustically evoked short latency negative response elicited by click stimuli were recorded. Both responses were recorded at air conduction threshold level monaurally via an internal receiver. Vestibular evoked myogenic potentials in 53.3% of children and acoustically evoked short latency negative response in 40.0% of cases were recorded. There was a significant correlation between the percentage of recording these two responses [p=0.005]. Gender and the stimulated ear had no effect on the results. In almost half of these disabled children, both vestibular evoked myogenic potentials and acoustically evoked short latency negative response were recorded. This finding may both indicate that hearing loss has no effect on the function of otolith organs in some children and vestibular deficits probably exist along with hearing impairment in others. This finding reiterates the importance of evaluation of vestibular system as part of standard auditory evaluations

[Static and dynamic balance in congenital severe to profound hearing-impaired children]

Research conducted since the early 1900s has consistently identified differences between deaf and hearing children on performance of a wide variety of motor tasks, most notably balance. Our study was performed to test static and dynamic balance skills in congenital severe to profound hearing impaired children in comparison with normal age-matched children. This cross-sectional study was conducted on 30 severe to profound hearing impaired and 40 normal children with age 6 to 10 years old. Bruininks-Oseretsky test of motor proficiency 2, balance subset with 9 parts was used for evaluation of balance skills. Hearing-impaired children showed 16.7 to 100% fail results in 7 parts of the balance subset. In normal children fail result was revealed just in 3 parts of the balance subset from 2.5 to 57.5%, and differences between two groups were significant [p<0.0001]. There was a significant difference between two groups in two static balance skills of standing on one leg on a line and standing on one leg on a balance beam with eyes closed [p<0.0001]. It seems that development of static balance skills are longer than dynamic ones. Because severe to profound hearing-impaired children showed more weakness than normal children in both static and dynamic balance abilities, functional tests of balance proficiency can help to identify balance disorders in these children

Translation, reliability and validity of the Newsha hearing, language and speech development scale among children in Iran

To translate and to test reliability and validity of the Newsha Hearing, Language and Speech Development Scale in Iran. The first version of Newsha scale was prepared in four developmental milestones of "hearing", "receptive language", "expressive language" and "speech" in 13 age groups from birth to 72 months via much survey on different related resources. After a pilot study on 75 children and performing necessary corrections, the test was conducted on 593 normal children of both sexes in nurseries and health centers of Tehran province from July 2006 to August 2007. The teat-retest reliability, inter-rater reliability, content validity and construct validity of the test were determined. More than 95% correlation was shown in both test-retest and inter-rater reliabilities [P < 0.001]. The content validity revealed "perfect" and "too much" options of seven choices Likert scale in more than 90%, and construct validity exhibited the effect of age on the test results. Accepting minimum or higher score was considered as the criteria of Newsha findings interpretation in all age groups of each developmental milestone. For the cases who can not accept this criterion, completion of scale in lower age[s] group to define any probable developmental delay is necessary. The sex difference was shown just in 3 items among all the 373 items of the scale [P < 0.02]. The "Newsha Developmental Scale" is an integrated and a comprehensive scale to evaluate development process and identify any delay in developmental abilities of children with Persian language from birth to 6 years of age that has good reliability and validity

effect of neonatal hyperbilirubinemia on the auditory system

Hyperbilirubinemia during the neonatal period is known to be an important risk factor for neonatal auditory impairment, and may reveal as a permanent brain damage, if no proper therapeutic intervention is considered. In the present study some electroacoustic and electrophysiologic tests were used to evaluate function of auditory system in a group of children with severe neonatal Jaundice. Forty five children with mean age of 16.1 +/- 14.81 months and 17 mg/dl and higher bilirubin level were studied, and the transient evoked otoacoustic emission, acoustic reflex, auditory brainstem response and auditory steady-state response tests were performed for them. The mean score of bilirubin was 29.37 ' 8.95 mg/dl. It was lower than 20 mg/dl in 22.2%, between 20-30 mg/dl in 24.4% and more than 30 mg/dl in 48.0% of children. No therapeutic intervention in 26.7%, phototherapy in 44.4%, and blood exchange in 28.9% of children were reported. 48.9% hypoxia and 26.6% preterm birth history was shown too. TEOAEs was recordable in 71.1% of cases. The normal result in acoustic reflex, ABR and ASSR tests was shown just in 11.1% of cases. The clinical symptoms of auditory neuropathy were revealed in 57.7% of children. Conducting auditory tests sensitive to hyperbilirubinemia place of injury is necessary to inform from functional effect and severity of disorder. Because the auditory neuropathy/ dys-synchrony is common in neonates with hyperbilirubinemic, the OAEs and ABR are the minimum essential tests to identify this disorder

[Identifying cochlear dead regions in hearing impaired children with the threshold equalizing noise test]

Regions in the cochlea with no [or very few] functioning inner hair cells and/or neurons are called dead regions. The aim of this study was to identify the cochlear dead regions in moderate to profound sensory neural hearing impaired children through the Threshold equalizing noise [TEN[HL]] test. In this cross-sectional study, the TEN[HL] was performed for the all frequencies available on test CD, on 30 children with ages ranging from five to forteen years [mean age, 8.5 +/- 2.8 years old]. In this study, 58.3% of ears were found to have a dead region for at least one frequency. Classifying by test frequencies, 20% were found to have a dead region, 24% to be inconclusive and 56% to have no dead regions. The difference between mean SNR[T] in ears with and without dead regions was statistically significant. The difference between mean absolute thresholds in two groups was statistically significant at 1000 Hz and below [p <0.05]. The results indicated a relatively high prevalence of dead regions in children with sensory neural hearing impairment, especially for frequencies at which the hearing loss exceeds 70 dB HL