Background and Aim: Tinnitus functional index (TFI) has been introduced as a standard self-assessment questionnaire for the evaluation of tinnitus severity and its negative consequences with enough sensitivity to detect the outcomes of treatment. The purpose of this study was to translate the original tinnitus functional index into Persian and to evaluate its reliability in a military population. Methods: The translation was performed in accordance with the Principles of Good Practice for the Translation and Cultural Adaptation Pro­cess for Patient-Reported Outcomes Measures. 32 military and veteran men with tinnitus aged 22−74 years participated in the current study. The participants completed the Persian version of the TFI and the second re-evaluation session was conducted over the telephone 10−14 days later. Both relative and absolute reliability indices were computed. Results: Intraclass correlation coefficient(2,1) with consistency definition for the TFI subscales varied from good to excellent. The agreement between the TFI total scores in the evaluation and re-evaluation using Bland-Altman analysis was acceptable and only one case was not located within the limits of agreement. Conclusion: Initial evaluation of the Persian version of TFI shows acceptable results in terms of reliability. The evaluation of the Persian TFI in different populations of patients with tinnitus and its validity would facilitate its clinical appli­cation. Keywords: Tinnitus; questionnaire; Persian

Background: Studies indicate that balance disorder, motor development problems, and weak postural control are likely to occur in children with severe to profound hearing deficits. Children with hearing deficits also indicate behavioral problems related to impulse control, distraction, and disability to maintain attention in the visual modality. Objectives: The present study, therefore, aimed to investigate the effect of balance exercises on balance performance, motor coordination, and attention in children with hearing deficits. Methods: In this experimental study, 36 children aged 7 to 12 years with severe to profound hearing deficits were randomly divided into two control and experimental groups using permuted block randomization. The experimental group performed a 12-session balance and vestibular sensory, motor exercise program. Assessments were performed as pretest and posttest by four subtests of the Bruininks-Oseretsky test of Motor Proficiency and Continuous Performance test. Then, the mean scores were compared between the pretest and posttest phases and between control and experimental groups by the paired t-test, Wilcoxon signed-rank test, twosample t-test, and Mann-Whitney U test. Results: The results indicated a significant difference between the control and experimental groups in the pretest and posttest scores of balance (P = 0.000), upper limb coordination (P = 0.000), bilateral coordination (P = 0.004), and visual-motor control (P = 0.023) subtests of Bruininks-Oseretsky test and Continuous Performance test (P = 0.017) in children with hearing deficits. Conclusions: Balance training including vestibular sensory and motor exercise program can simultaneously affect balance performance, motor coordination, and attention in children with hearing deficits.

Background and Aim: It is well known that hearing aid fitting is an effective approach to improve the communication ability of hearingimpaired people. In the past, most of the hearing aids were fitted unilaterally rather than bilaterally. Whereas the unilateral hearing aid fitting improves verbal communication partially, it causes late-onset auditory deprivation. The main aim of this study is to investigate the ANL for each ear among the users with unilateral hearing aid experience. Methods: A total of 23 participants were recruited (14 females, 9 males). The mean age was 74.65 years (ranged from 41 to 83). All subjects had bilateral symmetric sensorineural hearing loss. The most comfortable level (MCL), Background Noise Level (BNL), and acceptable noise level (ANL) were measured for ear with amplification experience and ear without experience. Results: MCL, BNL and ANL in the aided ear was 82.22, 73.48 and 8.74 respectively, in addition in the unaided ear the results for MCL, BNL and ANL was 81.78, 72.13 and 9.65 respectively. Comparing the mean values of MCL, BNL and ANL between two ears showed no significant difference. Conclusion: There was not any difference for BNL and ANL measures Keywords: Bilateral hearing loss; acceptable noise level; late onset auditory deprivation; Hearing aid

Background Temporal resolution is essential to speech acoustic perception. However, it may alter in individuals with auditory disorders, impairing the development of spoken and written language. The envelope of speech signals contains amplitude modulation (AM) that has critical information. Any problem reducing the listener's sensitivity to these amplitude variations (auditory temporal acuity) is likely to cause speech comprehension problems. The modulation detection threshold (MDT) test is a measure for evaluating temporal resolution. However, this test cannot be used for patients with poor cooperation; therefore, objective evaluation of MDT is essential. Purpose The main aim of this study is to find the association between the auditory steady-state response (ASSR) and psychoacoustic measurement of MDT at different intensity levels and to assess the amplitude and phase of ASSR as a function of modulation depth. Design This was a correlational research. Study Sample Eighteen individuals (nine males and nine females) with normal hearing sensitivity, aged between 18 and 23 years, participated in this study. Data Collection and Analysis ASSR was recorded at fixed AM rates and variable AM depths for carrier frequencies of 1,000 and 2,000 Hz with varying intensities. The least AM depth, efficient to evoke an ASSR response, was interpreted as the physiological detection threshold of AM. The ASSR amplitude and phase, as a function of AM depth, were also evaluated at an intensity level of 60 dB hearing level (HL) with modulation rates of 40 and 100 Hz. Moreover, the Natus instrument (Biologic Systems) was used for the electrophysiological measurements. An AC40 clinical audiometer (Intra-acoustic, Denmark) was also used for the psychoacoustic measurement of MDT in a similar setting to ASSR, using the two-alternative forced choice method. Pearson's correlation test and linear regression model and paired t-test were used for statistical analyses. Results A significant positive correlation was found between psychoacoustic and electrophysiological measurements at a carrier frequency of 1000 Hz, with a modulation rate of 40 Hz at intensity levels of 60 dB HL (r = 0.63, p = 0.004), 50 dB HL (r = 0.52, p = 0.02). A significant positive correlation was also found at a carrier frequency of 2000 Hz, with a modulation rate of 47 Hz at 60 dB HL (r = 0.55, p = 0.01) and 50 dB HL (r = 0.67, p = 0.002) and a modulation rate of 97 Hz at 60 dB HL (r = 0.65, p = 0.003). Moreover, a significant association was found between the modulation depth and ASSR amplitude and phase increment at carrier frequencies of 1,000 and 2000 Hz, with modulation rates of 40 and 100 Hz. Conclusion There was a significant correlation between ASSR and behavioral measurement of MDT, even at low intensities with low modulation rates of 40 and 47 Hz. The ASSR amplitude and phase increment was a function of modulation depth increase. The findings of this study can be used as a basis for evaluating the relationship between two approaches in the clinical population.

The speech-evoked auditory brainstem response (sABR) shows how complex sounds such as speech and music are processed in the auditory system. Speech-ABR could be used to evaluate particular impairments and improvements in auditory processing system. Many researchers used linear approaches for characterizing different components of sABR signal, whereas nonlinear techniques are not applied so commonly. The primary aim of the present study is to examine the underlying dynamics of normal sABR signals. The secondary goal is to evaluate whether some chaotic features exist in this signal. We have presented a methodology for determining various components of sABR signals, by performing Ensemble Empirical Mode Decomposition (EEMD) to get the intrinsic mode functions (IMFs). Then, composite multiscale entropy (CMSE), the largest Lyapunov exponent (LLE) and deterministic nonlinear prediction are computed for each extracted IMF. EEMD decomposes sABR signal into five modes and a residue. The CMSE results of sABR signals obtained from 40 healthy people showed that 1st, and 2nd IMFs were similar to the white noise, IMF-3 with synthetic chaotic time series and 4th, and 5th IMFs with sine waveform. LLE analysis showed positive values for 3rd IMFs. Moreover, 1st, and 2nd IMFs showed overlaps with surrogate data and 3rd, 4th and 5th IMFs showed no overlap with corresponding surrogate data. Results showed the presence of noisy, chaotic and deterministic components in the signal which respectively corresponded to 1st, and 2nd IMFs, IMF-3, and 4th and 5th IMFs. While these findings provide supportive evidence of the chaos conjecture for the 3rd IMF, they do not confirm any such claims. However, they provide a first step towards an understanding of nonlinear behavior of auditory system dynamics in brainstem level.