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(1) Background: Cochlear implants (CIs) are widely applied to recover audition for patients with severe degrees of or total hearing loss. Electrical stimulation using the electrically evoked ABR (E-ABR) can be recorded in CI recipients through the device. This work was designed to study E-ABR recorded individually from different channels located at the apical, middle, and basal cochlear regions in comparison to their simultaneous separated or adjacent combined recordings. (2) Methods: This study included 17 children fitted with unilateral cochlear implants. All children were subjected to impedance measurement, electrical compound action potentials (ECAP), and E-ABR recording of three channels located at the apical, middle, and basal cochlear regions. This was followed by simultaneous E-ABR recording of the three "separated" channels in comparison to E-ABR recording from three adjacent channels located at the middle cochlear region. (3) Results: Similar E-ABR latencies and amplitudes were found using either individual or simultaneously separated or adjacent combined recording. However, the mean amplitude measures of E-ABR for combined adjacent channels showed a positive correlation with the applied current level. (4) Conclusions: Combined E-ABR recording from adjacent channels is a faster and more reliable technique that can be used effectively without compromising the results of the recorded E-ABR.

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Abstract Introduction: Children with developmental language disorder have been reported to have poor temporal auditory processing. This study aimed to examine the frequency following response. Objective: This work aimed to investigate speech processing in quiet and in noise. Methods: Two groups of children were included in this work: the control group (15 children with normal language development) and the study group (25 children diagnosed with developmental language disorder). All children were submitted to intelligence scale, language assessment, full audiological evaluation, and frequency following response in quiet and noise (+5QNR and +10QNR). Results: Results showed no statically significant difference between both groups as regards IQor PTA. In the study group, the advanced analysis of frequency following response showed reduced F0 and F2 amplitudes. Results also showed that noise has an impact on both the transient and sustained components of the frequency following response in the same group. Conclusion: Children with developmental language disorder have difficulty in speech processing especially in the presence of background noise. Frequency following response is an efficient procedure that can be used to address speech processing problems in children with developmental language disorder.

Resumo Introdução: Tem sido relatado que crianças com transtorno do desenvolvimento da linguagem têm processamento auditivo temporal deficiente. Objetivo: Examinar a resposta de seguimento de frequência eo processamento da fala no silêncio e no ruído. Método: Dois grupos de crianças foram incluídos neste trabalho: o grupo controle (15 crianças com desenvolvimento normal de linguagem) e o grupo de estudo (25 crianças com diagnóstico de transtorno do desenvolvimento da linguagem). Todas as crianças foram submetidas à escala de inteligência, avaliação da linguagem, avaliação audiológica completa e resposta de seguimento de frequência em silêncio (Q) e no ruído (N): +5QNR e +10QNR. Resultados: Os resultados não mostraram diferença estatisticamente significante entre os dois grupos no que diz respeito ao QI ou PTA. No grupo de estudo, a análise avançada da resposta de seguimento de frequência mostrou amplitudes reduzidas de F0 e F2. Os resultados também mostraram que o ruído tem um impacto nos componentes transitório e sustentado da resposta de seguimento de frequência no mesmo grupo. Conclusão: Crianças com transtorno do desenvolvimento da linguagem apresentam dificuldade no processamento da fala principalmente na presença de ruído de fundo. A resposta de seguimento de frequência é um procedimento eficiente que pode ser usado para avaliar problemas de processamento de fala em crianças com transtorno do desenvolvimento da linguagem.

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Cochlear implants (CIs) are a successful alternative in cases with severe-to-profound HL. In these individuals, visual cross-modal re-organization can occur because of hearing loss where the visual cortex will recruit auditory cortical areas for visual processing. OBJECTIVES: This work is designed to study visual evoked potentials (VEPs) in children fitted with CIs in comparison to normal hearing children. METHOD: This work included 2 groups of children: Group I included 20 normal hearing children and study group included 25 children fitted with unilateral CIs. All cases were subjected to Thorough otological history. Check up on CIs performance using physical check and Aided sound field examination, ophthalmic examination and Pattern Visual Evoked Potentials (pVEPs). RESULTS: Both groups showed no significant difference as regard age or sex. And both had normal ophthalmic examinations. Children of the study groups showed satisfactory aided response. As regard pVEPs, the study group showed significant higher P100 amplitude in comparison to the control group. CONCLUSION: This study showed that deafness could induced cortical organization in the visual cortex and not limited to the auditory cortex only.

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Abstract Introduction Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage. Objectives The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints. Methods The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions. Results Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases. Conclusion Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.

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Introduction Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage. Objectives The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints. Methods The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions. Results Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases. Conclusion Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.

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INTRODUCTION: Children with developmental language disorder have been reported to have poor temporal auditory processing. This study aimed to examine the frequency following response. OBJECTIVE: This work aimed to investigate speech processing in quiet and in noise. METHODS: Two groups of children were included in this work: the control group (15 children with normal language development) and the study group (25 children diagnosed with developmental language disorder). All children were submitted to intelligence scale, language assessment, full audiological evaluation, and frequency following response in quiet and noise (+5QNR and +10QNR). RESULTS: Results showed no statically significant difference between both groups as regards IQ or PTA. In the study group, the advanced analysis of frequency following response showed reduced F0 and F2 amplitudes. Results also showed that noise has an impact on both the transient and sustained components of the frequency following response in the same group. CONCLUSION: Children with developmental language disorder have difficulty in speech processing especially in the presence of background noise. Frequency following response is an efficient procedure that can be used to address speech processing problems in children with developmental language disorder.

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The auditory brainstem response (ABR) is a commonly used objective clinical measure for hearing evaluation. It can be also used to draw conclusions about the functioning of distinct stages of the auditory pathway including the binaural processing stages using the binaural interaction component (BIC) of the ABR. OBJECTIVE: To study binaural processing in normal hearing subjects complaining of tinnitus. METHODS: Sixty cases with bilateral normal peripheral hearing were included in this work, divided into 2 groups, i.e., group 1 (comprised of 30 healthy subjects representing the control group) and group 2 (comprised of 30 subjects with tinnitus representing the study group). All of the subjects were submitted to a basic audiological evaluation (including pure tone audiometry, speech audiometry, and immittancemetry) and ABR audiometry recorded in monaural and then binaural conditions. RESULTS: In monaural recording, the tinnitus group showed significantly delayed latencies of waves I, III, and V in addition to significantly reduced wave I and III amplitudes when compared with the controls. Similar significant findings were found when binaural ABR responses were compared between both groups. Comparing BIC between both groups showed significant earlier BIC for latencies of waves I and V in the control group, while the BIC for amplitudes showed similar results in both groups. CONCLUSIONS: These finding suggest the presence of binaural processing deficits in tinnitus patients at different levels along the ascending auditory pathway.

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Many studies showed that children with sensorineural hearing loss (SNHL) have possible vestibular affection which is related to the severity of cochlear pathology. OBJECTIVES: this work is designed to evaluate vestibular function in children with congenital severe to profound SNHL and correlate the degree of hearing loss with the results of vestibular tests. METHODS: this work included 52 children divided into two groups; control group consisted of 20 normal hearing children with no vestibular complaints, and study group consisted of 32 children with congenital severe to profound SNHL. All children were submitted to basic audiologic evaluation, combined vestibular evoked myogenic potentials, sinusoidal harmonic acceleration test (SHA) of rotatory chair test. RESULTS: all children in the control group had normal oVEMP and cVEMPs results while abnormal cVEMPs and oVEMPs results were found in 89% and 96.9% of the tested ears of the study group respectively. Sinusoidal harmonic acceleration test results were normal in control group with significant reduction in gain, phase lead and higher level of asymmetry in 50% of the children in study group. There was a significant relation between the degree of hearing loss and the cVEMPs, oVEMPs abnormalities, while SHA test results showed no such relationship. CONCLUSION: There is an evident vestibular abnormalities in children with severe to profound sensorineural hearing loss as revealed by the rotatory chair testing and VEMPs recordings. Vestibular assessment is very important in such group as it has an impact on their rehabilitation plan.

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BACKGROUND: Tinnitus is an annoying problem and until now there is no consensus on its treatment. AIMS: In this prospective study, we evaluated the effectiveness of intratympanic lidocaine and dexamethasone (ITLD) injections for the management of subjective idiopathic tinnitus (SIT). METHODS: Forty patients with SIT attended the Department of Otorhinolaryngology, Tanta University Hospital, Egypt, between May 2013 and May 2014. The patients were categorized into two groups: group A included 20 patients treated with ITLD injection, and group B included 20 patients treated with intratympanic saline injection as a control. Intratympanic injections were performed four times within 4 weeks in a double-blind manner. At the end of the treatment program, we analyzed the improvement and worsening rates of tinnitus using the following parameters: tinnitus questionnaires, Tinnitus Handicap Index (THI), and loudness matching test. RESULTS: The effectiveness rates of the ITLD group reported in the tinnitus questionnaires, the THI and the loudness matching test were 74.3% in all tests, compared to 26.7, 40.0 and 26.7%, respectively, in the saline group. There was a statistically significant difference between the groups within 2 months after injection. To analyze the therapeutic effect of ITLD on tinnitus of 6 months duration, the improvement rates reported in the tinnitus questionnaires, the THI and the loudness matching test were 78.5% in all tests in the ITLD group, compared to 40.0, 40.0 and 30.0%, respectively, in the saline group. CONCLUSION: There were statistically significant differences between both groups. ITLD seems to be effective for idiopathic tinnitus.

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UNLABELLED: Cochlear implants (CIs) can be used effectively in the profoundly impaired children individuals. OBJECTIVES: This work was designed to assess speech processing at brainstem and cortical level in children fitted with CIs to investigate the possible influence of brainstem processing of speech on the cortical processing in those children. METHOD: Twenty children fitted with CIs underwent aided sound-field audiologic evaluation, speech evoked cortical auditory evoked potentials (S-CAEPs) and according to the results, children were classified into two groups: group I with good cortical response and group II with poor cortical response. This was followed by speech evoked ABR (S-ABR) recoding. RESULTS: P1 component of CAEPs was recorded in all children while other component showed variable results. S-ABR was recorded in all children even those with poor S-CAEPs response who showed delayed D, E, F and O latencies. However, S-ABR amplitudes did not show any significant difference between both groups. CONCLUSIONS: Children fitted with CI showed immediate cortical activation following device programming and this activity depends on the age of implantation as well as the child's age. S-ABR provides a new clinical tool that showed an important role of brainstem in complex sound processing that contribute to cortical processing.

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BACKGROUND: Despite that gentamicin is a very effective aminoglycoside, its potential ototoxicity which is of irreversible nature makes a challenge and limitation for its use. This study was designed to investigate possible neurotrophic and antioxidant effects of silymarin comparable to 4-methylcatechol in protection against gentamicin-induced ototoxicity. METHODS AND RESULTS: Twenty pigmented guinea pigs were divided into four equal groups, where group I served as normal control group. The other groups received gentamicin (120 mg/kg/day, ip) for 19 days where group II given vehicle of 1% CMC, group III and group IV were pre-treated 2h before gentamicin by 4-methylcatechol (10 µg/kg, ip) and silymarin (100mg/kg, oral gavage), respectively. The main findings indicated that silymarin exhibited restoration of nerve growth factor (NGF) levels and increased tropomyosin-related kinase receptors-A (Trk-A) m-RNA expression in cochlear tissue and preservation of hair cells of organ of Corti by scanning electron microscopy (SEM) with significant decrease in auditory brainstem response (ABR) threshold compared to 4-methylcatechol. Only silymarin caused significant amelioration in oxidative stress state by reducing malondialdehyde (MDA) levels and increasing catalase activity. CONCLUSIONS: Silymarin exerts superiority over 4-methylcatechol when recommended as protective agent against gentamicin ototoxicity based on its efficient neurotrophic and antioxidant activities.

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OBJECTIVES: Tinnitus can be accompanied by depression, anxiety, insomnia, problems with auditory perception and poor general and mental health. This work was designed to evaluate the cognitive and psychological status in tinnitus patients using different subjective and objective measures. METHODS: This work included 40 patients complaining of tinnitus without any vestibular complaints. Those patients were compared with 40 healthy age and sex matched controls. All subjects were evaluated through: basic audiologic evaluation, electrophysiological test (P300), oculomotor tests (smooth-pursuit, optokinetic, gaze and saccadic eye movements) and psychological evaluation (Hamilton depression and anxiety scales, Mini Mental Status Examination and Trail making tests). RESULTS: Patients with tinnitus showed abnormalities at both electrophysiological and psychological levels when compared with normal subjects. CONCLUSION: This study provides evidences that different pathological mechanisms are involved in tinnitus generation which are more extensive than we thought.

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