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   2014| January-June  | Volume 1 | Issue 1  
    Online since July 28, 2014

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Fast psychophysical tuning curves of the cochlea in normal hearing individuals
Mohamed Shabana, Brian CJ Moore, Mostafa el-Khosht, Mona H Selim, Mona Dokla
January-June 2014, 1(1):12-17
Introduction Fast psychophysical tuning curve (fPTC) test is a fast computer-based method that aims to assess the frequency selectivity of the cochlea and to detect the dead regions. It can quickly identify tip frequency and Q10 of psychophysical tuning curves (PTCs) derived by using a band of noise that changes in center frequency and a Bιkιsy method to adjust the masker level required for threshold of the noise. We applied this method in normal hearing individuals in the presence of threshold equalizing noises at three signal levels. The sharpness of the PTCs (Q10) and the typical shift of tips of the PTCs for 16 normal hearing individuals, when the tip frequency is estimated for the average of a forward and reverse sweep, were obtained. The results were used to determine the mean, SD, and 95% confidence interval of the shifts in normal hearing individuals. Objective The purpose of this experiment was to estimate the typical shift of tips of the PTCs for normal hearing individuals. The results were used to determine the mean, SD, and 95% confidence interval of the shifts. The sharpness of the PTCs change with signal level under conditions where off-frequency listening is restricted, using a background noise, was also assessed. This was performed to allow a comparison with the results of hearing-impaired patients tested at the same level (but without background noise). Study design Sixteen adults of both sexes (eight male individuals and eight female individuals) were randomly selected to establish normative data for the fPTC test. They were selected with age ranging from 18 to 45 years. All individuals had normal middle ear function as indicated by tympanometry and acoustic reflex measurement and by hearing threshold equal to or better than 20 dB at octave frequencies in the frequency range (250-8000 Hz) (as defined by ANSI S3.6-2004).
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Videonystagmography findings in epileptic children
Mohamad El-Gohary, Madeha Elmously, Naema Esmail, Elhady A Abdel Gawwad, Soha Mekki, Ebtessam Nada
January-June 2014, 1(1):26-31
This study included 60 epileptic children (6-18 years) and 20 neurologically free age-matched children. It was conducted to identify vestibular system abnormalities associated with or caused by epilepsy in patients either complaining of dizziness or not. Otoneurological testing was performed including videonystagmographic testing. More than one type of epilepsy was encountered. Dizziness was reported as a complaint in most patients diagnosed with partial epilepsy. Variable videonystagmographic findings were found. Among patients with dizziness, the most prominent abnormality was abnormal oculomotor test results (23 of the 37 patients). Only two patients showed abnormal Dix-Hallpike testing. Positive vestibular findings were found among patients without dizziness, in only three of the 23 patients who had unilateral caloric weakness during caloric testing.
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Textbook on vertigo: Diagnosis and management

January-June 2014, 1(1):50-51
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Bilateral sudden sensorineural hearing loss in Kawasaki disease
Hossam Sanyelbhaa Talaat, Abdullah M Jamos, Ahmed Thabet Kamal Eldin, Mohamed Samer S Abdelaal
January-June 2014, 1(1):47-49
Kawasaki disease is an acute self-limited vasculitis and is commonly seen in children. This case report is a rare complication of Kawasaki disease. A 5-year-old boy had persistent fever, associated with bilateral nonexudative conjunctivitis, cervical lymphadenopathy, and maculopapular erythema on his trunk. The patient was diagnosed as Kawasaki disease and was treated by intravenous immunoglobulins and aspirin. However, 3 days after recovery of the symptoms, he developed bilateral severe sensorineural hearing loss. Corticosteroid therapy of 40 mg/day was immediately administrated for 15 days; no improvement was noticed in the child's hearing as evidenced by serial audiometry follow-up.
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Message from the Editor-in-Chief
Mohamed Shabana
January-June 2014, 1(1):2-2
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Effect of strabismus on vestibular functions: value of its correction
Mohamed A Abd Al-Rahman, Badawy S Badawy
January-June 2014, 1(1):18-25
Objective Studies that evaluate the relationship between strabismus and vestibular functions are very scarce with no consensus between their results. Hence, this study was designed to evaluate vestibular functions in patients with strabismus and to find out the effect of surgical correction of strabismus on vestibular functions. Materials and methods Thirty patients with strabismus aged between 10 and 33 years constituted the study group. The following procedures were carried out: otological examinations, detailed vertigo history, neurological and ophthalmological examinations, basic audiological evaluation, office tests for vestibular evaluation, videonystagmography, and computerized dynamic posturography. These vestibular tests either office tests or laboratory tests were performed three times, before eye surgery and 1 month and 2 months after eye surgery. Results Before surgery, in office tests for vestibular function, 36.6% of patients had abnormal results in dynamic visual acuity, whereas 26.7 and 16.7% had abnormalities in head thrust and head shake tests. In addition, 43.3% had abnormal sharpened Fukuda stepping test, whereas 33.3 and 13.3% had abnormal CTSIB and Fukuda stepping test. Reduction in equilibrium scores as well as condition 3, 5, and 6 of sensory organization test in all patients showed abnormal videonystagmography test results. Improvement occured postoperatively in office as well as laboratory tests. Conclusion Vestibular functions in strabismus patients are globally better in postoperative than in preoperative conditions, and this improvement appeared to be stable.
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Central auditory plasticity indexed by mismatch negativity
Abdel-Hamid Elshintinawy, Enaas Kolkaila, Takwa A Gabr
January-June 2014, 1(1):3-11
Introduction Unilateral hearing loss (UHL) represents a particular model for investigating the functional auditory plasticity in humans. Normally, monaural stimulation produces a normal pattern of a contralateral dominance. With UHL, this pattern changes. Objective The aim of the study was to investigate the effects of UHL side and age at onset on auditory processing. Design Mismatch negativity (MMN) was recorded in response to speech and tone stimuli. Study sample This study included two groups: the control (50 bilateral normal hearing) and study (206 UHL patients) groups. This group was further classified according to UHL side and age at UHL onset. Results In controls, higher speech-evoked MMN amplitude was recorded in the right ear. The study group showed impaired speech-evoked MMN in either left or right UHL patients, especially in early onset UHL patients. Tone-evoked MMN was not affected in controls or UHL patients. Conclusion Cortical reorganization induced by UHL occurs mainly in patients with left-side affection. Speech processing is affected in UHL irrespective of the affected side, especially in early onset patients.
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Evaluation of speech perception in patients with ski slope hearing loss using Arabic consonant speech discrimination lists
Mai M El Ghazaly, Mohamed A Talaat, Mona I Mourad
January-June 2014, 1(1):32-37
Introduction Cochlear dead regions are regions of the basilar membrane where the inner hair cells and/or associated neurons function so poorly, such that they may be considered dead. Diagnosing patients suffering from ski slope hearing loss should put in consideration the possibility of cochlear dead regions. These patients often miss out high-frequency components of speech, which are consonant sounds (especially fricatives). Objectives The current study was designed to evaluate speech perception of patients with ski slope high-frequency hearing loss on a modified Arabic consonant speech discrimination lists developed at the University of Alexandria and to evaluate the possible effect of high-frequency dead regions of the cochlear partition on such performance. Materials and methods Twenty patients with ski slope hearing loss were subjected to the Threshold Equalizing Noise (HL) test to bracket cochlear dead regions. The performance of each on the modified Arabic consonant speech discrimination lists was assessed and correlated with the presence or absence of cochlear dead regions and also with their extent if present across a number of spectral frequencies. Results The results of this study showed that the average correct score of ears with no dead regions on the modified Arabic consonant discrimination lists was 75.32%, whereas the score of ears with dead region(s) was 61.19%. According to the extent of dead regions, the average score of ears with dead region at 4000 Hz only was 62.5%, that of ears with dead regions at 2000-4000 Hz was 61.8%, and that of ears with dead regions at 1000-4000 Hz was 56.5%. The highest probability of error in all ears was for the fricatives. Conclusion Speech tests that emphasize high-frequency speech elements are crucial in determining cochlear functional reserves in a practical manner. Psychophysical tests that investigate dead regions of the cochlea are synergistic to the high-frequency emphasis speech tests.
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Auditory steady-state response audiometry in children with severe to profound sensorineural hearing loss
Dalia M Hassan, Nagwa Hazzaa, Elham El Saiid, Mohamed Moneer
January-June 2014, 1(1):38-46
Objective The aim of the study was to find out the predictive value of single monotic auditory steady-state response (ASSR) for hearing threshold estimation in children with severe to profound sensorineural hearing loss (SNHL). Methodology Forty-eight children (96 ears) with severe to profound SNHL were included in the present study, with age range 1-10 years. They were subjected to age-based audiological evaluation to estimate the behavioral thresholds. Single monotic ASSR was performed for all children using test signals of 250, 500, 1000, 2000, and 4000 Hz, modulated in both ears at high rates of 67, 74, 81, 88, and 95 Hz, respectively, using GSI Audera-evoked potential system. ASSR thresholds were obtained and analyzed according to the equipment default criteria. Results The number and percentage of ASSR detected were highest at 1000 Hz then 500 Hz followed by 2000 Hz and were the least at 4000 and 250 Hz in all children. The ASSR thresholds obtained were statistically correlated with the behavioral pure tone audiometry thresholds at 500, 100, and 2000 Hz. A considerable number of ears with no sound field thresholds or click auditory brainstem response responses showed ASSR. Conclusion Single monotic ASSR, with high modulation frequencies, has proven to be a reasonable method for estimating hearing sensitivity in the mid-conventional audiometric frequencies in children with severe to profound SNHL. Recommendations All children with no behavioral hearing threshold and/or absent click-evoked auditory brainstem response should be tested by ASSR at 500, 1000, and 2000 Hz to give information about the presence of useful residual hearing. ASSR can provide important information for use in the cochlear implant selection process
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Khaled Abdul-Hady
January-June 2014, 1(1):1-1
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