BACKGROUND:Acromegaly is a rare disorder in which growth hormone is secreted uncontrollably by the pituitary gland. Considering the risk of pathological effects of acromegaly on middle ear (ME) transfer function and hearing, we aimed to investigate the ME transfer functions of acromegaly patients who underwent transsphenoidal surgery using wide-band tympanometry (WBT) in this study. METHODS:Pure tone audiometry (PTA), 226 Hz probe-tone acoustic immitancemetry, and WBT were performed on all participants. Twenty-eight patients with acromegaly and 29 healthy subjects were included in the current study. RESULTS:The mean age of the acromegaly group (11 males, 17 females) was 49.25 ± 9.57 years, and that of the healthy controls (13 males, 16 females) was 45 ± 10.02 years. The PTA means of the acromegaly and healthy groups were between normal limits, but the mean of the acromegaly group (20.73 ± 10.95) was significantly worse than that of the healthy group (12.02 ± 6.67, P=.000). The WBT non-pressurized and pressurized absorbance values of the acromegaly and healthy groups did not show statistically significant differences. The equivalent ear canal volumes at 1000 Hz (P=.041) and the equivalent ear canal volume measured by averaging the WBT (P=.023) of the acromegaly group were larger than those of the healthy controls. CONCLUSION:The investigation revealed that the equivalent ear canal volumes were statistically significantly higher in patients with acromegaly. However, this did not impact the ME transfer function.

Background: There is a need for more laboratory tests in the diagnosis of Ménière’s disease (MD). Purpose: The adequacy of the findings of the video ocular counter-roll reflex (OCR) test to support the diagnosis of patients with unilateral MD in the nonattack period was investigated. Research Design: Hearing tests, ocular and cervical vestibular evoked myogenic potential (VEMP), Dizziness Handicap Inventory, and video OCR tests were performed on 31 patients with unilateral MD and 30 healthy controls, and the findings were compared. Study Sample: There were 10 males and 21 females (51.22 ± 12.76 years) in the MD group and 12 males and 18 females (46.43 ± 9.98) in the control group. Data Collection and Analysis: The significance of the difference between groups was analyzed using the Mann‐Whitney U test for continuous data and the chi-squared test for categorical data. OCR degrees in the MD group were analyzed using the Wilcoxon test. A correlation matrix and intraclass correlation coefficients were also calculated to analyze the test‐retest reliability of OCR degrees with the participant’s head tilted at 15, 30, and 40°. Results: In the ocular VEMP test, the N1‐P1 amplitudes of both ipsilesional (p < 0.001) and contralesional ears (p = 0.015) were significantly lower in the MD group than in the control group. In the cervical VEMP test, the P1‐N1 amplitudes of the ipsilesional (p < 0.001) and the contralesional sides (p = 0.006) were significantly lower in the MD group than in the control group. The OCR degrees did not show a significant difference between the MD and control groups, except for the 30th-second OCR degree of the right eye when the head was tilted 30° to the ipsilesional side (p = 0.031) and the 20th-second OCR degree of the right eye when the head was tilted 40° to the ipsilesional side (p = 0.036). Conclusions: The video OCR (vOCR) test did not discriminate between the pathological and nonpathological ears in patients with unilateral MD during a nonattack period. Furthermore, the vOCR results did not discriminate between the patients with unilateral MD and the healthy controls. To obtain consistent vOCR degrees a head tilt of at least 30° and a recording time of at least 40 seconds may be required.

Objectives: The aim of this study was to evaluate vestibulo-ocular reflex (VOR) of individuals over 60 years of age who have not been diagnosed with a specific vestibular pathology. Methods: Bilateral six-semicircular canal video head impulse test (vHIT), Dizziness Handicap Inventory and European Evaluation of Vertigo scales were applied to participants. Results: In total, 103 participants were included in the study (75 male, 28 female), and the mean age was 69.35 +/- 7.41 years. The mean age of 7th decade group was 64.32 +/- 3.12 (59 participants; 38 male, 21 female), and the mean age of 8th decade and older group was 76.11 +/- 5.93 (44 participants; 37 male, 7 female). No significant differences were found between the VOR gains of the lateral or vertical semicircular canals between the 7th decade and 8th decade and older groups (p>0.05). In the 8th decade and older group, the presence of right lateral semicircular canal corrective saccade and left posterior semicircular canal corrective saccade showed a positively moderate correlation with VOR gains of the same semicircular canals (r=0.455, p=0.002, and r=0.518, p=0.001, respectively). No significant correlation was found between age and VOR gain in the 7th decade group, however, there was a negatively weak correlation between age and left lateral semicircular canal VOR gain (r=-0.366, p=0.017) in the 8th decade and older group. Conclusion: While assessing the age-related changes in VOR using vHIT, it must be considered that the changes related to aging of the vestibular system begin to emerge in the population over 70 years of age, and corrective saccade findings may be more informative than VOR gains in revealing these changes.

Amaç: Bu çalışma, çevrim içi eğitimin öğrenmeyi, motivasyonu ve başarıyı nasıl etkilediğine dair algılarına odaklanarak, odyoloji lisans öğrencilerinin koronavirüs hastalığı-2019 salgını sırasında çevrim içi eğitim deneyimlerini değerlendirmeyi amaçlamıştır. Gereç ve Yöntemler: Çalışmaya, odyoloji lisans programlarında en az bir dönem çevrim içi eğitim ve bir dönem geleneksel yüz yüze eğitim alan 331 katılımcı dâhil edilmiştir. Verilerin toplanmasında yazarlar tarafından geliştirilen demografik bilgi formu ve çevrim içi eğitim değerlendirme formu kullanılmıştır. Bulgular: Çevrim içi eğitimin avantajlarını değerlendiren anketin ilk aşamasında katılımcıların %63,13'ü ders kayıtlarına çevrim dışı erişebilmenin öğrenmelerini geliştirdiğini belirtmişlerdir. Dezavantajların değerlendirildiği ikinci aşamada, katılımcıların %67,36'sı çevrim içi eğitimde elverişli bir öğrenme ortamının olmamasının başarılarını engellediğini, %63,16'sı aktif katılım eksikliği hissettiğini, %60,71'i ise donanım sorunları (ses, görüntü ve bağlantı sorunları) nedeniyle derslere odaklanmakta zorluk yaşadığını belirtmiştir. Teorik ve uygulamalı derslerde çevrim içi eğitimin yeterliliği ile ilgili olarak, katılımcıların %36,54'ü teorik derslerde çevrim içi eğitimin öğrenme ihtiyaçlarını karşıladığını belirtirken, %80,65'i uygulamalı derslerde çevrim içi eğitimin etkinliği konusunda sınırlılık ifade etmiştir. Sonuç: Çalışmadan elde edilen bulgular odyoloji lisans öğrencilerinin çevrim içi eğitimi ders kayıtlarını tekrar izleyebilme, kendi hızında öğrenme ve bilgiye hızlı erişim imkânı sağlaması açısından avantajlı bulsa da uygulamalı ders içeriklerinin sunulmasında yetersiz kalması, derse aktif katılımı sınırlaması ve teknik aksaklıklar nedeni ile dezavantajlı bulduklarını göstermiştir.

Introduction The bone-anchored hearing implant system (BAHS) is an effective amplification system that transmits the sounds received by an external operating system to the inner ear by bypassing the middle ear placed in the temporal bone. Objective This study compares the results of patients who underwent bone-anchored hearing implant system (BAHS) surgery using two different surgical methods in terms of preoperative and postoperative complications, surgical time, audiological findings, and patient satisfaction. Methods The results of 22 patients who underwent BAHS were evaluated retrospectively from video records and audiological results, The Turkish Version of the Glasgow Benefit Inventory (GBI) questionnaire were evaluated. Two different surgical approaches were used for implantation: the linear incision technique (n = 9) and the punch technique (n = 13). Results Mean surgical durations were 9.67 ± 2.85 and 47.65 ± 6.13 minutes for Groups A and B, respectively, and these were significantly different (p < 0.001). There were no significant differences between the groups' speech recognition scores for a signal-to-noise ratio (SNR) of +5 (p = 0.173), SNR of 0 (p = 0.315), or SNR of -5 (p = 0.360) and results of the GBI scores. Conclusion The punch technique has a significant advantage due to a shorter surgery duration without increased surgical complications. Additionally, the punch technique showed no significant difference in hearing performance or satisfaction compared with linear incision.

Introduction  Vestibular pathologies cause physical and psychological symptoms, as well as cognitive problems. Objective  To evaluate the deterioration in sleep quality associated with vestibular pathologies. Methods  The Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), the Pittsburgh Sleep Quality Index (PSQI), and the Limits of Stability test (LOS) were applied to the participants. Results  We included 25 patients with Meniere's disease (MD), 22 patients with benign paroxysmal positional vertigo (BPPV), 21 patients with unilateral peripheral vestibular loss (UPVL), 23 patients with vestibular migraine (VM), and 43 controls. The total PSQI scores of the controls were better than those of the MD ( p  = 0.014), VM ( p < 0.001), BPPV ( p  = 0.003), and UPVL ( p  = 0.001) groups. The proportion of poor sleepers in the MD ( p  = 0.005), BPPV ( p  = 0.018), and UPVL ( p < 0.001) groups was significantly higher than that of the controls. The highest total DHI score (45.68 ± 25.76) was found among the MD group, and it was significantly higher than the scores of the BPPV ( p  = 0.007) and control ( p < 0.001) groups. The highest BDI score was obtained in the VM group, and it was significantly higher than the scores of the BPPV ( p  = 0.046) and control ( p < 0.001) groups. Moreover, the BDI scores of the MD ( p = 0.001) and UPVL groups were also significantly worse than the score of the controls ( p = 0.001). Conclusion  The present study showed thatpatients with vestibular symptoms have physical and functional complaints, as well as increased psychosocial stress and decreased sleep quality. Evaluating multiple parameters of quality of life may contribute to a better understanding of vestibular physiology and symptoms, and may help establish a more effective therapeutic approach.

Vertigo or dizziness is among the leading complaints of adults, and the underlying causes vary significantly.Accurate diagnosis is the main step for managing a dizzy patient and recording the detailed anamnesis is the key point.For this reason, many ques-tionnaires are designed to define the severity of complaints or disease, to detect the influence on the patient, planning the treatment or follow-up the treatment success.Various vertigo-specific scales have been developed for the assessment of vestibular symptoms and

Objective: This study aimed to evaluate clinical musical perception, analyze the relationship between speech recognition and music perception, and investigate the effects of a three-month musical perception activities on these parameters in adult cochlear implant (CI) users with post -lingual hearing loss. Methods: Free-field hearing and speech tests in a quiet environment, the Turkish matrix test, and the Turkish version of the clinical assessment of musical perception test were performed on 18 adult unilateral CI users before and after the three-month music training. Results were compared with those of 18 healthy controls. Results: Prior to the musical perception activities, word recognition scores, Turkish matrix test results, and 500, 1000, and 6000 Hz free-field hearing thresholds were significantly correlated with the clinical assessment of musical perception test scores in the CI group (p<0.047). Timbre recognition scores (p=0.019) had improved significantly in the CI group after the three-month musical perception activities. On the other hand, timbre recognition scores had significantly affected the Turkish matrix test results (R2adjusted=0.56). Conclusion: Our study showed that speech perception in noise and clinical musical perception measurements affected each other in CI users. The inclusion of musical perception activities to support an auditory rehabilitation program may contribute to increased speech recognition skills in noise.

Objective: In this study, we aimed to compare the hearing thresholds and outer hair cell functions of patients with psoriasis vulgaris (PV) with healthy individuals and to investigate the ototoxic effects of acitretin treatment (AT) in patients with PV. Materials and Methods: This study included 23 patients with PV who required treatment with acitretin as well as 23 healthy individuals. Conventional and extended high-frequency pure-tone audiometry and transient-evoked otoacoustic emission tests were performed at regular intervals during the 24 weeks of acitretin treatment. Results: During the acitretin treatment for the PV group, the hearing thresholds of 4,000 Hz (right ear, p=0.004) presented a significant difference that did not have a worsening effect. The signal-to-noise ratios of TEOAE did not show a significant difference. At 24 weeks of AT, the changes in the hearing thresholds (4,000 Hz) and TEOAE signal-to-noise ratios did not indicate any worsening owing to acitretin. According to the ASHA criteria, there was no significant evidence of ototoxicity related to acitretin. According to the TUNE ototoxicity grading system, it was seen that at 24 weeks of AT, all the patients with psoriasis were scored as grade 0 (no hearing loss). Conclusion: This study showed that acitretin does not have an ototoxic effect when it is used to treat PV in the recommended treatment doses.

Objectives: This study aims to evaluate the effects of acquired esotropia on vestibulo-ocular reflex (VOR) gain in children using video (vHIT) and functional head impulse (fHIT) tests. Methods: A total of 62 children aged 6-18 years, with acquired esotropia and normal vision, were evaluated in the study. The patients were divided into two sub-groups: accommodative and non-accommodative. VOR gains were analyzed by performing lateral canal vHIT and fHIT with monocular and binocular recordings by a single examiner. Results: Seventeen (10 male, 7 female) children with accommodative esotropia, 24 (14 male, 10 female) children with non-accommodative esotropia, and 21 (8 male and 12 female) healthy controls were included in this study. The vHIT findings did not differ between the groups (p>.05). In the non-accommodative esotropia group, the location of the camera in both binocular and monocular vHIT recordings made a significant difference in the left VOR gain (p = .025, z = -2.243, p = .032, and z = -2.143, respectively), but no difference was observed in the right VOR gain. In the accommodative esotropia group, while the camera was on the left there was a significant difference in the right VOR gain between binocular and monocular recordings (p = .016, z = -2.413) but no difference was observed in the left VOR gain. No overt or covert saccade was detected in any group. Conclusions: The statistical differences found in vHIT and fHIT in acquired esotropia patients are thought to be sporadic and based on the results of this study no correction or change in recording technique is required for vHIT or fHIT in children with acquired esotropia.

Purpose To investigate the effect of different types of convergent strabismus on horizontal eye movements and compare data with healthy control subjects. Materials and methods This prospective, cross-sectional study included 38 patients with convergent strabismus (16 fully accommodative, 13 partially accommodative and 9 non-accommodative esotropia) and 19 age-matched control subjects. All of the participants had a detailed ophthalmological examination including visual acuity assessment, cover-uncover prism test, slit lamp, and indirect ophthalmoscopy examination. Videonystagmography (VNG) was used for the evaluation of horizontal eye movements such as saccadic accuracy, velocity, latency, and smooth pursuit velocity gain. Results The saccadic accuracy in the rightward direction was lower in the fully accommodative esotropia group compared to the partially accommodative esotropia group in the right eye ( p = 0.002 ). The saccadic latency in the rightward direction was longer in the fully accommodative esotropia group compared to the control group ( p = 0.008 ) and smooth pursuit velocity gain in the leftward direction was lower in the partially and non-accommodative esotropia group compared to the control group in binocular recording ( p = 0.004, p = 0.001, respectively). There was no difference in the saccadic velocity among the study groups ( p > 0.05 ). Finally, asymmetry of saccadic velocity and latency was observed between right- and leftward directions in the partially accommodative esotropia group in the right eye ( p = 0.003, p = 0.008 , respectively). Conclusion This study demonstrated that horizontal eye movements may vary in different types of convergent strabismus. VNG may be an auxiliary tool to the clinical examination in differentiating fully or non-accommodative esotropia.

The vestibular system is responsible for sensing the velocity and acceleration of angular and linear movements of the head and sensitivity to gravity in maintaining balance with its peripheral and central structures. It performs this function through vestibular reflexes. When peripheral vestibular diseases occur unilaterally or bilaterally, the functions of vestibular reflexes are affected, resulting in deterioration in eye movements compatible with head movements and anti-gravity muscle activity coordination, which ensures upright posture against gravity. Dizziness and/or imbalance persist in patients in whom the central compensation process cannot be completed, resulting in restrictions in the patient’s independent movements, daily activities, and quality of life. In the middle and long term, these restrictions cause sedentary life, fear of falling, loss of general condition, emotional problems, and social isolation. In patients diagnosed with unilateral peripheral vestibular disease, vestibular rehabilitation methods based on exercise and living environment arrangements are used as valid and reliable methods to support central compensation mechanisms and to eliminate movement restrictions. Along with conventional exercises, virtual reality-based vestibular rehabilitation systems on stable or unstable platforms are also used for this purpose. In this chapter, the essential principles of conventional and virtual reality-based vestibular rehabilitation methods take place.

Background and Aim: To evaluate the association between psychoacoustical characteristics of tinnitus and audiogram configurations and reveal which theoretical mechanism dominates tinnitus. Materials and Methods: The medical charts of 110 adult participants' 164 ears with tinnitus were retrospectively reviewed. Audiological results, edge frequency, and psychoacoustical characteristics of tinnitus were assessed. Participants were divided into two groups as follows: normal hearing (NH) and sensorineural hearing loss (SNHL). Results: No significant relationship was observed between age, gender, tinnitus pitch, and loudness between the two groups. In the SNHL group, there was a weak positive correlation between tinnitus pitch and frequency of maximum hearing loss (FMHL), and a strong positive correlation between the mean tinnitus loudness at the tinnitus pitch and FMHL. Besides, the edge frequency was positively and weakly correlated with the tinnitus pitch and FMHL. No statistically significant difference was observed between the groups regarding the tinnitus pitch. However, tinnitus loudness was statistically higher in the NH group. No relationship was observed between the audiogram shapes and tinnitus timbre, pitch, and FMHL. In addition, the most likened tinnitus timbre was found to be tonal/whistle in both groups. A moderate positive correlation was observed between the tinnitus pitch and edge frequency in the gradual slope audiograms. Conclusions: The findings obtained in this study supported homeostatic plasticity theories for the SNHL group, and hidden hearing loss for the NH group.

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.

BACKGROUND:Deteriorated speech understanding is a common complaint in elderly people, and behavioral tests are used for routine clinical assessment of this problem. Cortical auditory evoked potentials (CAEPs) are frequently used for assessing speech detection and discrimination abilities of the elderly, and give promise for differential diagnosis of speech understanding problems.PURPOSE:The aim of the study was to compare the P1, N1, and P2 CAEP latencies and amplitudes in presbycusis with low and high word recognition score (WRS).RESEARCH DESIGN:A cross-sectional study design was used for the study. Two groups were formed from the patients with presbycusis based on their scores on the speech recognition test.STUDY SAMPLE:Fifty-seven elderly volunteers participated in the study. The first group composed of 27 participants with high WRS, the other group composed of 30 participants with low WRS.DATA COLLECTION AND ANALYSIS:The CAEP waves were recorded from these participants using speech signals. Latencies and amplitudes of P1-N1-P2 waves of the two groups were compared with the t-test statistic.RESULTS:There were significant prolongation of P1 and N1 latencies in presbycusis with low WRS when compared with presbycusis with a relatively high word score (p < 0.05).CONCLUSION:According to the result of the research, P1 and N1 latencies of presbycusis with low WRS were longer than the participants with high WRS. Factors affecting peripheral auditory system, such as stimulus sensation level, might be responsible for P1 and N1 latency prolongation of the low WRS group.

Objective The video head impulse test (vHIT) is a diagnostic tool to assess the function of the semicircular canals and branches of the vestibular nerve. The aim of this study was to analyze the interexaminer variability of vHIT results in healthy subjects. Materials and Methods A total of 21 healthy participants were included in the study. vHIT responses were collected by four clinicians. Variability of the vHIT results between examiners was analyzed statistically. Results The vestibulo-ocular reflex (VOR) velocity regression values were from 0.99 to 1.09 degrees per second for the lateral canals. For the vertical canals, VOR velocity regression values were from 0.87 to 1.21 degrees per second. According to repeated measures analysis of variance, the normality assumptions for the velocity regression of the left lateral canal (p = 0.002) and the right anterior canal (p < 0.01) were met and the differences were statistically significant. The normality assumptions were not met for 40, 60, and 80 ms median gain of the right lateral canal (p = 0.016, p = 0.038, and p = 0.001, respectively); 40 and 60 ms median gain of the left lateral canal (p < 0.001 and p = 0.008, respectively); and the velocity regression of the left posterior canal (p < 0.00). These differences were found to be statistically significant by using the Friedman test. Conclusion The interexaminer differences of the VOR gain values for the vHIT were statistically significant. Serial vHIT testing should be performed by the same examiner to reduce the effects of interexaminer variability.