Background and Aim: Auditory integration deficit is a complex typs of Auditory Processing Disorder (APD). This is due to its association with specific brain regions such as the corpus callosum and angular gyrus, which are key areas for multisensory integration. This study introduced the first Persian development of the dichotic offset training program. It presents preliminary findings on its efficacy when delivered in-person versus on-line. Methods: In this single-subject study, two children, aged 13 years, diagnosed with auditory integration deficit, participated. The main intervention consisted of 8–14 sessions of Persian- Dichotic Offset Training (P-DOT), followed by post-treatment follow-up assessments utilizing two methods of treatment delivery: in-person and on-line. Data collected via Persian-Buffalo Model Questionnaire-Revised (P-BMQ-R), Persian Randomized Dichotic Digits Test (P-RDDT), Persian-Dichotic Offset Test (P-DOT), and Persian-Staggered Spondee Word (P-SSW) and analyzed employing a single-subject statistical formula. Results: The results suggest that the treatment effectively reduced integration problems in both in-person and on-line methods, as indicated by competitive left ear stimulus, Type A pattern, and qualitative error IX, the left ear performance, and the questionnaire scores. Both delivery methods proved effective, but online administration showed slightly superior outcomes. Conclusion: The P-DOT Program, especially in its on-line method, appears to be a promising intervention for children with APD (integration subcategory). By enhancing binaural hearing skills, this approach may considerably improve the brain regions responsible for dichotic processing. These preliminary single-subject findings, pending confirmation through larger-scale studies, particularly Randomized Controlled Trial (RCT) studies, may inform evidence-based clinical protocols for audiologists.
Background and Aim: Tinnitus, the perception of sound without an external source, significantly affects the quality of life for millions worldwide. Although many studies have explored its pathophysiology and neural underpinnings using various methods during resting states, the influence of eye state on neural activity remains poorly understood. This study examined brain activity differences between eyes-closed and eyes-open resting states in individuals with chronic tinnitus. Methods: In this cross-sectional study, twenty patients with chronic tinnitus underwent Electroencephalography (EEG) during both eyes-closed and eyes-open resting states. EEG power spectra, source localization, and functional connectivity were analyzed across eight frequency bands. Paired-sample t-test and Statistical non-Parametric Mapping (SnPM) test compared neural activity between these conditions. Results: Eyes-closed recordings showed decreased delta, theta, and gamma power, increased alpha 1 and alpha 2 power, and a complex beta pattern (increased beta 1, decreased beta 2 and beta 3) compared to eyes-open. Source localization analysis revealed greater activity in regions associated with memory, attention, and emotional processing during eyes-closed compared to eyes-open. Functional connectivity analysis indicated stronger connections between auditory and memory-related regions in eyes-closed compared to eyes-open. Conclusion: This preliminary study demonstrated distinct EEG power spectra, source localization, and functional connectivity between eyes-closed and eyes-open states in chronic tinnitus patients, suggesting state-specific neural patterns. Findings highlight interactions of sensory, cognitive, and affective processes, potentially relevant to tinnitus. Further research with control groups and larger samples is needed to confirm tinnitus-specific effects and optimize EEG conditions for elucidating neural mechanisms and guiding targeted interventions
Background and Aim: Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder, typically affecting older adults, and is a recognized cause of vertigo and falls. The physically demanding conditions of Hajj may increase dizziness and fall risk, yet BPPV has not been studied in this mass-gathering context. This study aimed to estimate the self-reported prevalence of BPPV and falls among Hajj pilgrims, and to explore self- reported triggers of dizziness. Methods: A cross-sectional survey was conducted during Hajj 2022–2023 using a validated Arabic questionnaire adapted from published BPPV screeners. Diagnosis of probable BPPV was based solely on self-reported responses to two screening items (brief vertigo episodes <1 minute provoked by specific positional changes). The questionnaire also assessed demographics, comorbidities, falls, and self-reported triggers of dizziness during religious activities. Results: Of 183 respondents, 144 were eligible for analysis (mean age=36.8 years; range=16–72). Overall, 22.2% (95% CI: 15.7%–29.9%), reported dizziness, but only 1.4% (95% CI: 0.2%–4.9%) met the self-reported criteria for probable BPPV. The incidence of falls during Hajj was 2.1% (95% CI: 0.4%–6.0%), with no significant association with BPPV. Bowing during prayer was the only religious activity significantly associated with BPPV, although this was based on just two BPPV-positive cases Conclusion: The prevalence of BPPV was low in this predominantly young sample, limiting generalizability to the wider pilgrim population, which usually includes many older adults. Findings highlight the need for age-diverse, clinically confirmed studies to better understand vestibular health risks during Hajj.
Background and Aim: Speech Sound Disorder (SSD) is a developmental communication disorder characterised by children’s difficulties in producing speech sounds clearly. Auditory deficits, sensory integration issues and motor execution difficulties are reported in children with SSD. The vestibular system, being in proximity to the auditory system and important in sensory integration, requires exploration of its function in children with SSD. The study compared latency and amplitude parameters of Vestibular Evoked Myogenic Potentials (VEMPs) in children with SSD and typically developing children to assess otolithic function. Methods: The study employed a standard group comparison, involving 10 children with SSD and 10 typically developing children matched for age and gender in the 6–11 years age range (7 boys). Participants underwent cervical VEMP and ocular VEMP testing in a sound-treated room, with appropriate strategies in place to ensure their cooperation with the test procedures. Results: Statistically significantly higher peak-to-peak amplitude for cVEMP and oVEMP was observed in typically developing children, whereas the amplitude asymmetry ratio was statistically higher in children with SSD. Both findings suggest possible alterations in vestibular function among children with SSD, a finding reported for the first time in the literature. Conclusion: Alterations in sacculo-collic and utriculo-ocular pathway function might be concomitant in children with SSD. This may influence sensory information related to relative position, movement of articulators, as well as the muscle tone of the neck and head, including articulators. The findings pave the way for exploring adjunct vestibular rehabilitation with speech-language intervention in children with SSD.
Background and Aim: Children with Repaired Cleft Lip and Palate (RCLP) are at increased risk for auditory processing difficulties, particularly in speech perception in noise and temporal auditory processing. Although emerging evidence suggests deficits in central auditory processing in this population, a systematic synthesis of temporal processing abilities remains limited. This review aimed to critically evaluate and synthesize existing evidence on temporal auditory processing abilities in children with RCLP. Recent Findings: A systematic literature search was conducted independently by two reviewers across PubMed, Scopus, CINAHL, ScienceDirect, and ProQuest for studies published between January 2000 and March 2025. Study selection was performed through title, abstract, and full-text screening. Eligibility criteria were defined using the PICOS framework, and risk of bias was assessed for all included studies. Of 1,132 identified records, 12 studies met the inclusion criteria. The reviewed evidence consistently demonstrated auditory processing deficits in children with RCLP, with temporal processing identified as the most frequently and severely affected domain. Across studies, children with RCLP showed significantly poorer temporal processing performance compared to craniofacially typical peers. Conclusion: This review underscores the clinical relevance of temporal auditory processing deficits in children with repaired cleft lip and palate. Unrecognized temporal processing impairments may adversely affect academic performance, reading skills, and speech–language development. Incorporating temporal auditory processing assessment into routine audiological evaluations is therefore recommended for early identification and targeted intervention. Future research should further investigate other subtypes of auditory processing disorders in this population to enhance clinical management strategies.
Background and Aim: The fact that recognizing sound regularities plays a crucial role in segregating auditory streams has recently garnered significant interest. This study aimed to investigate how temporal and spectral regularities incorporated into the background auditory stream affect auditory stream segregation. Methods: Twenty-five healthy young adults performed an indirect measure of the auditory streaming task (i.e. detecting rare-level targets). They were presented with two concurrent auditory streams involving foreground and background streams, and were asked to detect rare-level targets in the foreground stream during three experimental conditions (spectral, temporal, or random regularities). Results: Temporal and spectral regularities of the background auditory stream significantly increased the hit rate compared to random regularities. This effect of regular cues on target detection and possibly stream segregation was significantly greater under temporal regularity conditions than under spectral regularity conditions. Conclusion: The findings suggest that incorporating temporal or spectral regularities into the background auditory stream can facilitate target detection and possibly stream segregation. This perceptual regularity benefit is greater for temporal regularities than for spectral regularities. These findings may provide primary evidence for the distinct facilitating effects of various theoretical frameworks on sound feature regularities and auditory streaming
Background and Aim: Tinnitus creates socioeconomic challenges. Questionnaires are widely used to assess their impact on daily life. This study aimed to validate the Persian version of the 12-item Tinnitus Primary Function Questionnaire (P-TPFQ) to provide a culturally appropriate tool for evaluating tinnitus-related disability in Persian speakers. Methods: This study with a cross-sectional design was conducted on 56 adults experiencing tinnitus. The TPFQ was translated according to the international quality of life assessment protocol. Content validity and face validity was evaluated using the Content Validity Ratio (CVR), Content Validity Index (CVI) and the Face Validity Index (FVI). Internal consistency was determined using Cronbach’s alpha. Convergent validity was tested by assessing the correlation with the scores of the Tinnitus Handicap Inventory (THI), Beck Depression Inventory-II (BDI-II), and Pittsburgh Sleep Quality Index (PSQI). Test-retest reliability was assessed using the Intraclass Correlation Coefficients (ICC). Confirmatory Factor Analysis (CFA) examined the construct validity. Results: Content and face validity were excellent (CVR=1.0, CVI=1.0, FVI=1.0). The CFA confirmed a four-factor structure with high loadings (0.85–0.97). Internal consistency was high (Cronbach’s α=0.956 for the overall scale; 0.922–0.969 for the subscales). The total P-TPFQ score had a strong and significant correlation with the THI score (r=0.845), and a moderate and significant correlation with BDI-II (r=0.600) and PSQI (r=0.416) scores (p<0.001). Test–retest reliability was high (ICC=0.956). Conclusion: The P-TPFQ with 12 items and four subscales has excellent reliability and validity. As a multidimensional tool, it can be used for assessing tinnitus-related behavioural aspects.
Background and Aim: Tinnitus is associated with increased listening effort and reduced Working Memory (WM) during speech comprehension. A practical approach to enhance cognitive processes is transcranial Direct Current Stimulation (tDCS). This study aimed to evaluate the effect of tDCS on listening effort, mental fatigue, tinnitus annoyance, WM, and expression of N-Methyl-D-Aspartate (NMDA) receptor subunits (NR1 and NR2) in the blood of individuals with tinnitus. Methods: Thirty-two chronic tinnitus participants (aged 30–60 years) were randomly assigned to intervention and control groups. The intervention group received anodal tDCS over the left Dorsolateral Prefrontal Cortex (DLPFC) with electrode on F3 for 20 minutes at 1.5 mA over 10 sessions, while the control group underwent sham tDCS. Pre- and post- intervention assessments included audiometry, tympanometry, tinnitus matching, a dual- task paradigm for measuring listening effort, the visual analogue scale for measuring mental fatigue, the Tinnitus Functional Index (TFI) for measuring tinnitus annoyance, and the N-Back test for WM assessment. Western blot analysis of blood samples measured NR1 and NR2 protein expression. Results: Compared to the control group, active tDCS significantly reduced listening effort, mental fatigue, tinnitus annoyance (p<0.001) and improved WM (p<0.001). After intervention, the intervention group showed a 27% increase in NR1 and a 50% increase in NR2 expression. Conclusion: The tDCS over DLPFC can reduce listening effort, mental fatigue, and tinnitus annoyance, and enhance WM in adults with chronic tinnitus, which is associated with improved NR1/NR2 protein expression in blood. These findings highlight the potential role of tDCS in tinnitus rehabilitation.
Background and Aim: Musicians can detect changes in minute aspects including pitch, timing, and loudness, all of which assist in auditory spatial perception. This study hypothesized that non-musicians with musical aptitude might display spatial skills comparable to trained musicians, and superior to non-musicians without musical aptitude. Methods: To test this hypothesis, we considered 101 participants in three groups: musicians (n=33, trained in classical music), 33 Non-Musicians with Good musical Aptitude (NM- GA) and 35 Non-Musicians with Poor musical Aptitude (NM-PA), selected based on convenience sampling. Music aptitude was assessed using the Mini profile of music perception skills. A spatial test battery consisting of tests of binaural interaction Interaural Time Difference (ITD) and Interaural Level Difference (ILD), and Virtual Acoustic Space Identification (VASI) test were administered. Results: Musicians and NM-GA demonstrated significantly lower ITD and ILD thresholds than NM-PA, suggesting the role of musical aptitude in sound lateralization. In VASI test, musicians scored highest, followed by NM-GA, who in turn had significantly higher scores than NM-PA, suggestive of further refinement of innate musical advantage due to training in musicians. Location specific analysis revealed NM-PA made significantly greater errors in right 45, left 45, right 135, and left 135 (p<0.001), often confusing them with extreme right (R 90) or left (L 90) locations. Conclusion: Both innate musical aptitude and formal musical training contribute to enhanced spatial hearing abilities. While musicians and NM-GA exhibit superior ITD and ILD thresholds, musicians outperform NM-GA in VASI scores, indicating training refines complex spatial perception beyond natural aptitude
Background and Aim: Tinnitus often occurs in individuals with normal audiograms and may reflect Hidden Hearing Loss (HHL). Conventional audiometry fails to detect these suprathreshold deficits. This study evaluated the clinical utility of a validated Tamil Speech- in-Noise (SIN) test, supported by Otoacoustic Emissions (OAEs) and Auditory Brainstem Responses (ABRs), in detecting HHL in tinnitus patients. Methods: Thirty native Tamil-speaking adults were recruited: 15 with chronic bilateral tinnitus and 15 matched controls. All had normal hearing thresholds. Participants underwent the Tamil Speech-in-Noise (SIN) test, Transient Evoked Otoacoustic Emissions (TEOAEs), Distortion Product Otoacoustic Emissions (DPOAEs), and click-evoked Auditory Brainstem Response (ABR). Group differences were analyzed using independent-sample t-tests. Results: The tinnitus group showed significantly higher Signal-to-Noise Retios at 50% correct (SNR-50) values and Signal-to-Noise Ratio (SNR) loss compared to controls, indicating impaired SIN perception. Both DPOAEs and TEOAEs were significantly reduced across frequencies, confirming cochlear dysfunction despite normal audiograms. ABR analysis revealed delayed wave I and wave III latencies, with marginal prolongation of wave V, indicating early auditory nerve involvement. Conclusion: Tinnitus patients with normal audiograms demonstrate measurable auditory deficits, reflecting HHL. The Tamil SIN test, complemented by both OAE and ABR, provides a culturally appropriate and sensitive protocol for early detection. These findings highlight the limitations of pure-tone audiometry and support integrating multimodal assessments into tinnitus evaluations.
Background and Aim: Hormones have various effects on different parts of the body,including the auditory system. This study aimed to review the effects of various hormoneson the auditory system. Recent Findings: Various hormones, including estrogen, progesterone, prolactin,oxytocin, aldosterone, growth hormone, dopamine, Thyroxine (T4), Triiodothyronine (T3),parathyroid hormone, cortisol, norepinephrine, insulin, and melatonin, affect the auditorysystem. Estrogen, aldosterone, norepinephrine, melatonin, and oxytocin have a protectiveeffect against noise. Growth hormone has a positive impact on the development of hair cells.High or low levels of thyroid hormones and low levels of parathyroid hormone, insulin,melatonin, and dopamine can cause sensorineural hearing loss. High levels of cortisol cancause tinnitus and hyperacusis. Also, the presence of prolactin is related to early-onsetpresbycusis in women. Conclusion: Hormones play an important role in the function of the auditory system andcan affect the development and maturation of auditory structures and their function. Anydisruption in hormonal balance may lead to temporary or permanent changes in the auditorysystem.
Background and Aim: Hearing loss and vestibular dysfunction frequently co-occur in older adults, affecting balance and mobility. Changes in the vestibular system can alter cervical vestibular myogenic potentials. This study aimed to investigate the amplitude and frequency tuning characteristics of cervical Vestibular Evoked Myogenic Potentials (cVEMP) across different degrees of hearing loss in older adults. Methods: A cross-sectional study was conducted with 30 young adults with normal hearing and 30 older adults (50-70 years) with bilateral sensorineural hearing loss, categorized into mild, moderate and moderately severe hearing loss groups (n=10 per group). cVEMPs were recorded for 500 Hz, 1000 Hz, and 2000 Hz tone bursts. Amplitude and frequency amplitude ratios were analyzed using ANOVA with post hoc tests. Results: Older adults with hearing loss showed significantly reduced amplitudes compared to young adults across all frequencies. Amplitude progressively decreased with increasing hearing loss severity, though it was not statistically significant between the hearing loss subgroups. Frequency amplitude ratios of persons with moderate and moderately severe hearing loss were significantly different from those of normal hearing. Frequency tuning shift towards 1000Hz was observed in mild hearing loss group. Responses were absent in a significantly higher proportion of persons with higher degree of hearing loss. Conclusion: This study highlights saccular function in older adults across various degrees of hearing loss. It reveals tuning shift in cases of mild hearing loss, and a progressive decline in frequency-specific responsiveness with increasing hearing impairment.
Background and Aim: Temporal Fine Structure (TFS) cues are crucial for pitchperception, sound localization, and speech understanding in noise. Hearing loss can impairTFS sensitivity, but the role of audiogram configuration remains unclear. Therefore, thisstudy aimed to compare binaural TFS sensitivity in adults with Sensorineural Hearing Loss(SNHL) having different audiogram configurations. Methods: This comparative cross-sectional study included 47 adults (32 with slopingaudiograms, 15 with rising/flat audiograms) aged 18-50 with bilateral mild to moderateSNHL (26-55 dB HL). All participants had normal outer and middle ear status, were right-handed, and had no cognitive impairment. TFS sensitivity was measured using the TFS-Low Frequency (TFS-LF) test at 250, 500, and 750 Hz, and the TFS-Adaptive Frequency(TFS-AF) test at Interaural Phase Differences (IPDs) of 45 degrees and 135 degrees. Results: For the TFS-LF test, average thresholds were lower in the sloping group at allfrequencies, but the difference between the two groups was not significant (p>0.05). For theTFS-AF test, thresholds at IPD 135 degrees were significantly higher than at IPD 45 degrees (p<0.001),but the difference between the two groups was not significant. Significant correlations wereobserved between the TFS-LF and the TFS-AF thresholds (r=-0.783, p<0.001). Conclusion: There is no significant difference in TFS sensitivity between adults withsloping and rising/flat audiograms. Absolute hearing thresholds at various frequencies donot solely influence TFS sensitivity; factors such as cochlear health, neural timing, andindividual variability may also affect the outcome
Background and Aim: Assessing Speech Perception in Noise (SPIN) in multilingual contexts like India is challenging due to the lack of linguistically appropriate test materials. Recognizing the limitations of existing SPIN tests in multilingual and clinically diverse settings, this study addressed critical need by developing a language-neutral, nonsense SPIN test material tailored for Dravidian languages. Methods: Nonsense word lists in the consonant vowel consonant vowel format were generated using a random combination of common phonemes in the Dravidian languages (Kannada, Malayalam, Telugu, Tulu, Tamil). These lists were recorded, and the Signal-to-Noise Ratio required to achieve 50% Speech Recognition (SNR50) was used to select optimized lists based on a criterion of mean +/- 0.15 SD. The final lists were administered to 50 normal-hearing individuals at 0 dB SNR. Language independence was evaluated by comparing performance across speakers of the five languages. Further performance was also assessed across eight SNR levels to establish a psychometric slope function and goodness of fit was assessed. To evaluate test-retest reliability, 12 participants were retested within a one-week interval. Results: The study resulted in 4 final optimized lists based on SNR50 selection criteria and further analysis. Lists showed sensitivity to varying SNR levels, as reflected by consistent psychometric function slopes. Comparable performance across language groups confirmed the language-independent nature of the test. Conclusion: Developed test provides audiologists with a reliable and standardized tool to assess SPIN. By eliminating the influence of familiarity and ensuring language neutrality, the test is well-suited for clinical use across speakers of Dravidian languages.
Background and Aim: Patients with Chronic Otitis Media (COM) who undergo mastoidectomy sometimes experience imbalance, dizziness, and vertigo after the surgery. This study aimed to investigate the effects of mastoidectomy on the balance of patients with COM using standard and advanced balance tests. Methods: The study was conducted in 2024 in Imam Reza and Ghaem Hospital affiliated with Mashhad University of Medical Sciences, Mashhad, Iran. Forty patients scheduled for mastoidectomy were enrolled over a 12-month period using a census method. Patients underwent balance tests before and after surgery. These tests included the video Head Impulse Test (vHIT), Subjective Visual Vertical (SVV), and posturography. Results: Statistical analysis of the performance parameter under linear or sinusoidal plate movement conditions showed no significant difference before and after the surgery (p>0.05). Statistical analysis of the gain in the six semicircular canals in the vHIT test also showed no significant difference before and after the surgery (p>0.05). Similarly, statistical analysis of the deviation from the norm in the neutral position, -30 degrees head tilt to the right, and -30 degrees head tilt to the left showed no significant difference before and after the surgery (p>0.05). Conclusion: The results of this study showed that mastoidectomy does not have a significant effect on balance tests, so performing it may not lead to severe balance disorders in patients with chronic otitis media who are candidates for mastoidectomy surgery.
Background: Auditory Training (AT) is an effective intervention for Auditory Processing Disorder (APD), and its outcomes are usually assessed through behavioral and electrophysiological tests. Among objective tools, speech-evoked Auditory Brainstem Response (s-ABR) has been used to evaluate AT effects, and it has shown promise, but s-ABR recorded in contralateral noise -a method activating both afferent and efferent auditory pathways -has not been applied to monitor rehabilitation progress in APD. The Case: Here we compare pre-and post-intervention different tests' results of a 7-year-old boy with APD (with documented deficits in dichotic processing and speech-in-noise perception) to investigate which is the most appropriate tool for assessing rehabilitation efficacy. The case underwent behavioral and electrophysiological evaluations, including s-ABR with and without contralateral noise, before and after 15 sessions of targeted AT tailored to the child's specific processing weaknesses. Post-training results revealed significant improvement in behavioral tests and questionnaire scores. S-ABR assessments also demonstrated improvements, including increased V/A slope as well as improvements in wave latencies and amplitudes, with more pronounced changes observed in recordings with contralateral noise. Conclusion: This case highlights the novel use of s-ABR in contralateral noise as a promising objective tool for monitoring auditory rehabilitation in APD. While behavioral assessments remain the gold standard, this electrophysiological test may provide valuable complementary information, particularly for patients with limited behavioral test cooperation or when behavioral results are unreliable. As this case report involves a single child with APD, further studies are needed to validate these findings in broader APD populations.
Background and Aim: Hearing loss in developing countries drives interest in stem cell therapies, though underlying molecular mechanisms remain partly unclear. One key pathway in this process is the Retinoic Acid (RA) signaling pathway. This study aimed to evaluate the effect of RA on the expression of neural markers, including nestin, Neurogenin 1 (NGN1), Guanine-Adenine-Thymine-Adenine Binding Protein 3 (GATA3), and Microtubule-Associated Protein 2 (MAP2), in human Adipose-Derived Stem Cells (hADSCs). Methods: hADSCs were purchased and treated with RA (1 & micro;M) under standard conditions for 7 and 14 days. RNA was extracted using the FavorPrepTM RNA kit and converted to complementary DNA (cDNA). Nestin, NGN1, GATA3, and MAP2 gene expression was assessed using real-time Polymerase Chain Reaction (PCR) with Glyceraldehyde-3-Phosphate Dehydrogenase (GAPDH) as an internal control. Data analysis was conducted using the 2-Delta Delta Ct method. Results: RA significantly increased the expression levels of nestin, NGN1, and MAP2 after 14 days compared to the control group (day 0). RA also increased nestin and MAP2 expression after 7 days, although these changes were not statistically significant compared to the control; moreover, RA acid induced morphological changes in hADSCs. Conclusion: This study demonstrated that RA enhances the neural differentiation of hADSCs by upregulating the neural markers nestin, NGN1, and MAP2. These findings highlight the potential role of RA in neural differentiation and its clinical applications. These findings suggest that RA's effects may be dose-and time-dependent, with one & micro;M for 14 days enhancing neural marker expression.
Background and Aim: Noise-Induced Hearing Loss (NIHL) is a prevalent occupational concern, affecting high-frequency hearing sensitivity, which may impair speech perception in noisy environments. This study investigates the relationship between high-frequency hearing thresholds (4000-12500 Hz) and speech perception in noise, using the Persian Quick Speech-in-Noise (Quick SIN) test. The aim was to determine how these thresholds and speech perception in quiet correlate with and predict speech perception difficulties in noise. Methods: A cross-sectional study was conducted on 288 participants aged 18-60 at the Center for Research on Occupational Diseases, Tehran University of Medical Sciences, from March to August 2024. Participants underwent audiometric testing for conventional (250-8000 Hz) and extended high-frequency (12500 Hz) thresholds, Word Recognition Score (WRS), and the Persian Quick SIN test (basic and high-frequency lists). Pearson's and Spearman's correlations and multiple linear regression models evaluated relationships and predictive factors, with significance set at p<0.05. Results: Strong positive correlations were observed between basic and high-frequency Signal-to-Noise Ratio (SNR) loss and hearing thresholds at 4000-12500 Hz (r/rho=0.738- 0.84, p<0.001), with strong negative correlations with WRS (rho=-0.756 to -0.785, p<0.001). Regression models identified 8000 and 12500 Hz thresholds, WRS, and education level as significant predictors of SNR loss (R & sup2;=0.764-0.812). High-frequency list SNR loss was significantly lower than basic list SNR loss (p<0.001). Conclusion: High-frequency hearing sensitivity, particularly at 8000 and 12500 Hz, significantly impacts speech perception in noise. Integrating high-frequency audiometry and speech-in-noise testing into occupational health assessments can improve early detection and management of NIHL
Background and Aim: Standardized speech passages are essential tools in audiological assessments, particularly for verifying hearing aid performance and evaluating speech perception. To ensure linguistic and cultural relevance, these passages must be adapted to reflect the phonetic characteristics of the target language. This study focused on the translation and phonological adaptation of the North Wind and the Sun (NWS) passage into Persian, aiming to provide a linguistically balanced and culturally appropriate stimulus for use in speech-based verification protocols. Methods: The NWS passage was translated into Persian with targeted phonetic and syntactic adjustments to ensure phoneme balance and linguistic coherence. Phoneme frequencies were compared to reference Persian studies, and expert reviewers evaluated clarity, naturalness, and content validity using Content Validity Ratio (CVR) analysis. Revisions were made based on feedback to optimize semantic integrity and phonetic distribution. Results: The translated NWS passage contained 558 phoneme occurrences, with /a/ as the most frequent (63 times), aligning with Persian speech studies. The phoneme distribution stayed within the +/- 1 SD range, confirming linguistic consistency. Expert evaluations yielded a CVR of 0.85, surpassing the 0.78 threshold, validating its relevance for speech research. The Face Validity Ration (FVR) of 4.7 affirmed clarity, phonetic balance, and natural fluency in Persian speech assessments. Conclusion: The translated NWS passage maintains phonetic balance with Persian linguistic norms, ensuring accuracy in speech mapping and verification of hearing aids. Its adaptability for phonetic research and hearing aid validation highlights its relevance for Persian-speaking populations and cross-linguistic comparisons.
