Background: Hypersensitivity to loud sounds is commonly noticed in children with autism spectrum disorders. Objective and methods: This was a cross-sectional study that included 50 children, ages ranging from 1.5 to 3.33 years, divided into a study group of 25 autistic children with normal hearing and a control group of 25 normal hearing healthy children. The aim of this research was to the assess any abnormality in the loudness growth function objectively using auditory brainstem response (ABR), as well as to detect any ABR abnormalities in normal hearing autistic children with delayed language development. Results: Forty-four percent of normal hearing autistic children showed a lower threshold compared to healthy controls. They also showed signifi cantly delayed wave III, but within-normal wave V, and consequently a longer inter-peak interval (IPI): I Ϫ III and shorter IPI: III Ϫ V, refl ecting retro-cochlear dysfunction that may be related to their diffi culty in communication. The mean slope of wave V latency intensity curve did not differ between autism and their controls, refl ecting normal loudness growth. Male autistic children showed statistically signifi cant longer latencies of wave V than females except at high intensities, but there was no statistically signifi cant difference between them with regard to the mean slope of wave V latency intensity curve . Conclusion: Autistic children with normal hearing showed a within-normal loudness growth indicating that their abnormal reactions to sounds may either be phonophobia, an efferent system affection or a more central pathology that needs further evaluation. They also showed a retro-cochlear dysfunction that may be related to their diffi culty in communication.

Objective: It is agreed that the cochlear microphonic (CM) arises mainly from the normal outer hair cells (OHCs) in cochlea. The aim of this research is to study the CM characteristics in different hearing profiles and reflect the usefulness of recording CM simultaneously during Auditory Brainstem Response (ABR) threshold testing in children. Methods: This is a retrospective study that included 33 cases comprised of children with autism spectral disorders (ASD), children with cochlear sensorineural hearing loss (SNHL), children with auditory neuropathy spectrum disorder (ANSD) and 41 normal hearing healthy children as controls. The children’s ages ranged from 0.5 to 96 months. Both the CM and ABR waves were simultaneously recorded using alternating split polarity ABR. Results: CM amplitudes and thresholds in normal hearing children with ASD did not significantly differ from normal hearing healthy children. CM were preserved in children with ANSD despite the absence of distortion product OAE responses, but in a significantly lower amplitude than those with DPOAE. There was no statistically significant correlation between the children’s ages and CM amplitude at any intensity level and in any of the different child groups, except in the controls where there was a statistically significant negative correlation between the children’s ages and CM amplitude at 70dBnHL, while there was a statistically significant positive correlation between the children’s ages and CM threshold. There were no differences in the CM amplitude between the two ears at any intensity level in all of the different groups of children. Conclusion: Children with ASD showed comparable outer hair cell function to normal hearing healthy children, reflecting absence of any peripheral hyperacusis due to loudness recruitment. CM should always be searched for when testing young children when there is absence of ABR response with absence or presence of otoacoustic emissions, to avoid any false negative results for ANSD. CM can be preserved in children with SNHL with loudness recruitment. This finding could be confused with ANSD, so CM should be traced down to its threshold for an appropriate diagnosis.

Background: Counselling, stress reduction and sound stimulation have been effective in the management of tinnitus. Aim of the work: It was to investigate the effectiveness of counselling and amplification and sound stimulation (Zen tones of fractal music) technology for hearing impaired patients suffering from tinnitus. Methods: This study included 40 hearing impaired subjects with tinnitus, divided into two groups: Both received counselling for 2 months then amplification for 4 months. The study group had their hearing aids with Zen program activated. Results: Post-counselling, none of the cases or controls showed improvement >20 points in the total tinnitus handicap inventory (THI) score. Only 20% of the study group and 15% of the controls showed improved tinnitus severity. Only one of the study group showed improvement in the tinnitus functional index (TFI) > 13 points. After hearing aids, 80% of the study group showed improvement in the tinnitus severity degree compared to 60% of the controls. And 20% improved ≥20 points in the total THI score, compared to none of the controls. Half of the study group improved in the TFI >13 points, compared to only 10% of the controls, and this was statistically significant. After 6 months, both groups showed comparable improvement in THI tinnitus severity degree: But 60% of the study group and only 15% of the controls improved ≥20 points in total THI score and this difference was statistically significant. And (85%) of the study group improved >13 points in total TFI score following both counselling and hearing aid fitting, compared to 50% of the controls, and this was statistically significant. Conclusion: Counselling alone had no significant effect on tinnitus improvement in the hearing-impaired patients. The combined approach of counselling and amplification resulted in remarkable improvement. And added music resulted in greater improvements, but was more effective when the loudness of the perceived tinnitus was weaker.

Background: The subjective visual vertical (SVV) is a measure of otolith-mediated verticality perception. The aim of this study was to test otolith function using the SVV in patients with posterior canal (PC) benign paroxysmal positional vertigo (BPPV) before and after Epley’s Canalith repositioning maneuver (CRM). Methodology: This study included 20 PC BPPV patients and 20 healthy control subjects. SVV was tested using special equipment, at the time of BPPV diagnosis, then after CRM, and then 1 week after the resolution of vertigo and nystagmus. SVV was determined from clockwise (CW) and counter-clockwise (CCW) directions. The absolute average and the conventional numerical average was calculated. Results: Using the conventional method, there was no statistically significant difference between BPPV and their controls regarding either the CW or the CCW-SVV or the average slope. There was no statistically significant difference between CW and CCW-SVV in the patients. There was no statistically significant difference in the mean SVV values or the distribution of normal and abnormal results or the distribution of the SVV tilt between both-sided BPPV. Using the absolute average, SVV tilt was significantly higher in the patients than the controls. The preset angle affected the result. The mean SVV was significantly lower after resolution of BPPV than before treatment. Conclusion: Absolute SVV average was more accurate than numerical SVV average. There was a reduction of the SVV tilt after the CRM in BPPV patients. So, the SVV test can be used as a prognostic test for BPPV improvement after treatment.

No abstract