Evaluation of the efferent system with contralateral suppression in auditory neuropathy spectrum disorder

Amaç: İşitsel nöropati spektrum bozukluğunun (ANSD) medial olivokoklear efferent sistem aktivitesi üzerine olan etkilerini anlık uyarılmış otoakustik emisyon (TEOAE) ve kontralateral supresyon (KLS) kullanarak değerlendirmek amaçlandı. Gereç ve Yöntemler: TEOAE yanıtları 2 gruba ayrılmış 48 kulakta kaydedildi. İşitsel nöropati grubundan 24 kulağı (ortalama 51,2 ay), kontrol grubu ise 24 kulağı (ortalama 55,9 ay) araştırmaya dahil edildi. Her iki grubun TEOAE ölçümleri karşı kulakta gürültülü (geniş band gürültü, 60 dB SPL şiddetinde) ve gürültüsüz olarak kaydedildi. Bulgular: ANSD ve kontrol grupları arasında kontralateral supresyon değerleri karşılaştırıldığında, istatistiksel olarak anlamlı fark gözlendi. KLS sonrası kontrol grubunun değerleri, öncekinden istatistiksel olarak anlamlı derecede düşüktü. ANSD grubunun KLS öncesi ve sonrası TEOAE sinyal-gürültü oranları (SNR) karşılaştırıldığında, ölçülen frekanslarda istatistiksel olarak anlamlı bir fark gözlenmedi. Sonuç: ANSD olgularında KLS uygulandığında anlamlı bir supresyon gözlenmemektedir. Kontrol grubunda KLS uygulandığında ise istatistiksel olarak da anlamlı supresyon görülmektedir. İşitsel nöropatili olgularda supresyon gözlenmemesi, efferent sistemin işlevsel olmamasından kaynaklanabileceği gibi hem afferent hem de efferent sistemin işlevselliğini yitirmesine bağlı olabilir. KLS, işitsel nöropatinin tanısında kullanılabilecek bir test bataryası olarak değerlendirilebilir. Ancak, işitsel nöropati tanısında kullanımına ilişkin daha fazla araştırmaya ihtiyaç vardır.Objective: It was aimed to examine the effects of Auditory Neurophaty Spectrum Disorder (ANSD) on medial olivocochlear efferent system activity by using Transient Evoked Otoacoustic Emission (TEOAE) and Contralateral Suppression (CLS). Material and Methods: TEOAEs were recorded in a total of 48 ears, divided into two groups. Twenty-four ears of the ANSD group (mean 51.2 months) and 24 ears of the control group (mean 55.9 months) were included in the study. TEOAE measuremens of both groups were recorded with (broadband noise, 60 dB SPL) and without noise in the contralateral ear. Results: When the contraateral supression values were compared between the ANSD and control groups, statistically significant difference was observed. The values of the control group after CLS were statistically significantly lower than before. When the TEOAE signal-to-noise ratios (SNR) of the ANSD group before and after KLS were compared, no statistically significant difference was observed in the measured frequencies. Conclusion: No significant suppression effect was found when CLS is performed to patients with ANSD. The absence of suppression in the ANSD grup may be due to the non-functionality of the efferent system as well as the loss of functionality of both afferent and efferent system. CLS can be considered as a test battery that may be used in the diagnosis of auditory neuropathy. However, there is need further research on its use in the diagnosis for auditory neuropathy

The Effect of Tympanic Membrane Perforation Site, Size and Middle Ear Volume on Hearing Loss

Objective:The aim of this study was to analyze the location and the size of perforation in cases with tympanic membrane perforation, its relation to the manubrium mallei and middle ear volume, and to investigate how these are correlated with the severity and frequencies of conductive hearing loss.Methods: This prospectively designed study included the patients who presented to the the Department of Otorhinolaryngology at the Dokuz Eylül University with hearing loss or tinnitus complaints in the period from June 2014 through June 2017 and were identified to have tympanic membrane perforation in their otoscopic examination. Patients who underwent myringoplasty and type 1 tympanoplasty and whose air-bone gap was found lower than 10 dB in the postoperative audiological examination were included in the study. Effects of the perforation size, the perforation site, and the relationship of the perforation with the manubrium, as well as the effects of the middle ear volume on the severity and frequency of conductive hearing loss were compared.Results: The study included 44 ears of 38 patients (13 male and 25 female) of whom six had tympanic membrane perforation in both ears. Air conduction threshold and air-bone gap were significantly found higher if the perforation area was wide (p<0.05), the perforation involved both the anterior and the posterior quadrants (p<0.05), had contact with the manubrium mallei (p<0.05), and the middle ear volume reduced (p<0.05).Conclusion: Solely tympanic membrane perforation affects hearing function; nevertheless, hearing function are better in cases, which have perforations small in size, no contact with manubrium mallei and well pneumatized middle ears

Effect of Korean Red Ginseng on Noise-Induced Hearing Loss

Objective:Noise-induced hearing loss (NIHL) is one of the most important problems affecting both social and professional life of patients. There is no treatment method considered to be successful on the hearing loss that has become a permanent nature. Aim of this study is to evaluate protective effect of Korean Red Ginseng (KRG) against NIHL in an animal model.Methods:Twenty-eight rats were separated into four groups [control saline (group I), control KRG (group II), saline + noise (group III), KRG + noise (group IV)]. Rats in the saline and KRG groups were fed via oral gavage with a dose of 200 mg/kg/day throughout for 10 days. Fourteen rats (group III and IV) were exposed to 4 kHz octave band noise at 120 dB SPL for 5 hours. Hearing levels of rats were evaluated by distortion product otoacoustic emissions (DPOAE) and auditory brainstem responses (ABR) at 4, 8, 12, 16 and 32 kHz frequencies prior to and on days 1, 7 and 10 after the noise exposure. Rats were sacrificed on 10th day, after the last audiological test. Cochlea and spiral ganglion tissues were evaluated by light microscopy.Results:Audiological and histological results demonstrated that after noise the group IV showed better results than group III. In the noise exposed groups, the most prominent damage was seen at the 8 kHz frequency region than other regions. After the noise exposure, DPOAE responses were lost in 1st, 7th and 10th measurements in both group III and IV. Thus, we were not able to perform any statistical analyses for DPOAE results.Conclusion:Our findings suggest that KRG seems to be an efficient agent against NIHL. There is need for additional research to find out about the mechanisms of KRG’s protective effect

Konuşma Materyallerindeki Ünlülerin Frekans İçerikleri Açısından Anlaşılırlığa Etkilerinin Karşılaştırılması

Amaç: Bu çalışmada ünlülerinin frekans içerikleri açısından Türkçe tek heceli konuşma materyallerinin anlaşılırlıklarına etkilerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: Ünsüz-ünlü-ünsüz biçimindeki tek heceli anlamlı konuşma materyallerinin yüksek frekans enerjileri farklı düzeylerde süzülerek filtrelenmiş türevleri oluşturuldu. Bu materyaller ve türevleri normal işiten genç yetişkinlere dinletilerek her birinin anlaşılırlık oranı belirlendi. Farklı filtre düzeylerinden elde edilen anlaşılırlık oranları kullanılarak materyallerin spektrumlarındaki yüksek frekanslı bölgelerin anlaşılırlık açısından önem değerleri hesaplandı. Tüm materyaller içerdikleri ünlülere göre gruplandırılarak grupların yüksek frekans önem değerleri istatistiksel olarak birbirleriyle karşılaştırıldı. Bulgular: Tek yönlü varyans analizine göre ünlüler arasında yüksek frekans önem puanları açısından istatistiksel olarak anlamlı fark vardı. Grupların yüksek frekans önem puanlarına dayalı yapılan ikili karşılaştırmalarda /a/, /o/ ve /u/ grupları arasında anlamlı bir fark bulunmazken her birinin /e/, /i/ ve /ı/ gruplarından farklılaştığı, /e/, /i/ ve /ı/ grupları arasında anlamlı bir fark olmadığı ortaya çıktı. Diğer taraftan /ü/ ve /ö/ gruplarının yüksek frekans önem puanlarının hiçbir gruptan anlamlı olarak farklılaşmadığı görüldü. Sonuç: Bu çalışmanın sonucuna göre /a/, /o/ ve /u/ ünlülerinin alçak frekanslılar, /ü/ ve /ö/ ünlülerinin orta frekanslılar ve /ı/, /i/ ve /e/ ünlülerinin yüksek frekanslılar olarak kategorize edilmesi önerilebilir. Bu kategorizasyon özellikle konuşma listelerinin kısaltılmış versiyonlarında listeler arasında daha geçerli bir fonemik dengeleme yapabilmek için kullanılabilir.Objectives: In this study, it was aimed to compare the effects of vowels on the intelligibility of Turkish monosyllabic speech materials in terms of their frequency content. Materials and Methods: The high-frequency energies of the speech materials comprised of monosyllable meaningful words in consonant-vowel-consonant format were filtered so that their filtered derivatives were generated. These materials and their derivatives were presented to normal-hearing young adults, and the intelligibility rates of each material were determined. The significance values of the high-frequency regions in the spectra of the materials in terms of intelligibility were calculated using their intelligibility rates obtained from different filter levels. All materials were grouped according to their vowel content, and the high-frequency significance values of the groups were compared statistically. Results: According to a one-way analysis of variance, there was a statistically significant difference between the vowel groups in terms of high-frequency significance scores. In the pairwise comparisons based on high-frequency significance values of the groups, there was no significant difference between the /ɑ/, /Ɔ/ and /u/ groups, but each differed from the /ɛ/, /i/ and /ɯ/ groups. On the other hand, the high-frequency significance values of the /y/ and /œ/ groups did not differ significantly from any group (vowels are transcribed with the International Phonetic Alphabet). Conclusion: According to the results of this study, it can be suggested to categorize /a/, /o/ and /u/ vowels as low- frequency, /y/ and /ɯ/ vowels as mid-frequency and /ɯ/, /i/ and /e/ as high-frequency vowels. This categorization may be used to make a more proper phonemic balance between lists, particularly in shortened versions of speech lists

Development of frequency specific word recognition test for Turkish

Konuşmayı anlama, toplumsal yaşamdaki bireyin en önemli iletişimsel becerilerinden birisidir. İşitme kaybının değerlendirilmesinde kullanılan konuşma testleri, bireylerin konuşmayı anlama performansı hakkında vazgeçilmez bilgi sağlaması açısından odyolojik test bataryasının temel bir öğesidir. Test uyaranı olarak insan sesinin kullanıldığı bu testler, işitsel sistemin işlemleme kapasitesi hakkında frekansa özgü bilgi sağlamaya pek elverişli değillerdir. Bu çalışmada, konuşmayı anlama becerisinin frekansa özgü olarak değerlendirilmesine yardımcı olacak Türkçe için frekansa özgü sözcük tanıma testini geliştirmek amaçlandı. Bunun için, Dokuz Eylül Sözcük Tanıma Testi'nin hazırlanma sürecinde oluşturulan sözcük havuzundan yararlanıldı. Yetişkin ve çocuk sesiyle kaydedilmiş tek heceli anlamlı sözcükler farklı genişliklere sahip bant geçirgen filtrelerden geçirildi. Bant geçirgen filtrelerin yüksek geçirgen kesme frekansları sabit 250 Hz iken, alçak geçirgen kesme frekansları yetişkin sesli kayıtlarda 4, 3, 2, 1.5 ve 1 kHz; çocuk sesli kayıtlarda 8, 6, 4, 3 ve 2 kHz idi. Böylelikle her bir sözcük kaydının, spektrumu yüksek frekanslarda yarı oktav aralıklarla darlaşan, 5'er adet türevi elde edildi. Tüm türevler normal işiten genç yetişkin katılımcılara dinletildi. Katılımcılardan elde edilen yanıtlara göre, filtre frekans bandının darlaşmasına bağlı olarak sözcüklerin anlaşılırlığında meydana gelen değişimlerin eğim oranları saptandı. Bu çalışmanın sonucuna göre, sözcüklerin anlaşılırlık oranları, filtre bant genişliğinin ve her bir sözcüğün spektral yapısının bir fonksiyonu olarak farklı eğim oranlarıyla azalıyordu. 0.25-1 kHz, 1-1,5 kHz, 1.5-2 kHz, 2-3 kHz, 3-4 kHz, 3-6 kHz ve 4-6 kHz frekans bantlarından birinde anlaşılırlıkları yüksek bir eğim oranıyla azalan sözcükler, frekansa özgü sözcük tanıma testinin konuşma materyalleri olmaya aday olarak belirlendi. Speech perception is one of the most important communicational abilities of human being in daily life. Because of the fact that speech tests that are used for evaluation of hearing impairment supply invaluable information about speech perception performance, they are considered as a basic component of audiological test battery. Utilizing human voice as a test signal, these tests are not convenient for supplying frequency specific information about the processing capacity of auditory system. The aim of this study was to develop a frequency specific word recognition test for Turkish which would aid to obtain frequency specific information in terms of speech perception ability. For this purpose, materials of word lists composed during development of Dokuz Eylul Word Recognition Test were utilized. Monosyllabic meaningful words which were recorded by an adult as well as a kid speaker were band-pass filtered at various widths of frequency bands. The high cut-off frequency of the filter band was set to 250 Hz constant, while the lower cut-off frequencies were set to 4, 3, 2, 1.5, 1 kHz for the adult speaker recordings and 8, 6, 4, 3, 2 kHz for the kid speaker recordings. In this way, for every word recordings, five different filtered derivations narrowing with half octave band intervals were obtained. All derivations were tested on young-adult listeners with normal hearing. According to the results which were obtained from the participants, the slopes of alterations in the rate of intelligibility of words that resulted by narrowing of filter frequency band were determined. As a result of this study, intelligibility rates of words were declining with different slope rates as a function of the filter bandwidth and spectral content of each word. The words which had declining intelligibility rates with high slope in one of the frequency ranges of 0.25-1 kHz, 1-1,5 kHz, 1.5-2 kHz, 2-3 kHz, 3-4 kHz, 3-6 kHz and 4-6 kHz were ascertained as candidate for speech materials of frequency specific word recognition test

The effect of sensorineural hearing loss on central auditory processing of signals in noise in older adults

Objectives The study aimed to explore the effect of sensorineural hearing loss on the central auditory processing of signals in noise using cortical auditory evoked potentials (CAEPs) in a cohort of older adults. Design Three groups of individuals participated in the study. Each group included 33 older adults with normal hearing, those with mild hearing loss and those with moderate hearing loss. N1-P2 peaks of CAEPs by speech stimuli in silent conditions and with varying sound pressure levels of background noise were recorded. CAEP latencies, amplitudes and relative changes in CAEP amplitudes as a function of decreasing signal-to-noise ratios (SNR) in three groups were analyzed using the mixed analysis of variance method. Results There was a significant main effect of SNR on all CAEP components, as well as significant main effects of hearing status on N1 latencies, amplitudes and relative changes in N1 amplitudes. A significant interaction was found between hearing status and SNR for relative changes in N1 amplitudes. The normal hearing group differed from both the mild and moderate hearing loss groups in terms of relative changes in N1 amplitudes at SNR 10 dB. Conclusion The results showed decreased amplitudes and increased latencies for N1-P2 response as the SNR of CAEP stimuli was lowered. The degree of reduction in the N1 amplitudes of the older people with normal hearing resulting from the increase in the background noise level was greater than those in their sensorineural hearing-impaired counterparts, providing evidence for decreased central inhibition for individuals with age-related hearing loss