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Objective: To study the electrophysiological characteristics of the Auditory Brainstem Response to Speech Sounds (s-ABR) in healthy adults, and then analyze its relationship between noise speech recognition ability and sex., Method: We accessed the auditory brainstem response to a synthesized stop-consonant speech syllable / da/in 40 native-Chinese speech adults. Timing components of the response were compared between males and females to determine which aspects of the response are affected by sex. The relationship of the slope between the onset peak (V) and though (A) (V/A slope) and the noise speech recognition ability was analyzed., Result: A dissimilarity between males and females was observed in the response to the component that change rapidly over time(P< 0.05). The other peaks latency except (P < 0.01) was different between gender, the remaining peaks did not have statisticals differences (P > 0.05). Noise speech recognition and the V/A slope was negatively correlated (r = 0.478, P < 0.05), which indicated that the greater slope of V/A, the lower of the speech recognition threshold under noise., Conclusion: The verbal components change rapidly over time, and high-frequency consonants evoked neural response obviously affected by gender. In the slower changing, lower frequency information in the stimulus was minimally affected by sex. The subjects with better abilities of processing transient and rapid information can show lower noise speech recognition threshold.

Objective: To investigate the development of early vocabulary capability in the prelingual deaf children after cochlear implantation (CI) , and to study the feasibility of current Chinese assessment procedures about language development for hearing-impaired children., Method: A total of 56 cases with severe-to-profound prelingual deaf children were participated in this study. The vocabulary development of CI children were evaluated by trained audiologists using the vocabulary assessment tools: Chinese communicative development inventory (CCDI) and mandarin expressive and receptive vocabulary test (MERVT). The questionnaire assessed by parents or guardians answered the questionnaire; vocabulary tests were evaluated by children accompanied with audiologists. Patients were assessed before operation and in 2 years after switch-on., Result: With the rehabilitation, early post-operative vocabulary development gradually improved. The vocabulary increased with an increase in the duration of CI use, and the receptive vocabulary developed earlier than the expressive ones., Conclusion: After 2 years of CI use, the child partly developed the vocabulary capability. Children's vocabulary test, CCDI and MERVT test, is an important index to evaluate the development of children's language ability after cochlear implantation. Vocabulary test, together with auditory and speech perception assessment procedures, constitute a more complete auditory-speech-language evaluation system for Chinese children after cochlear implants.

Objective: To investigate the development of early auditory capability and speech perception in the prelingual deaf children after cochlear implantation, and to study the feasibility of currently available Chinese assessment instruments for the evaluation of early auditory skill and speech perception in hearing-impaired children., Methods: A total of 83 children with severe-to-profound prelingual hearing impairment participated in this study. Participants were divided into four groups according to the age for surgery: A (1-2 years), B (2-3 years), C (3-4 years) and D (4-5 years). The auditory skill and speech perception ability of CI children were evaluated by trained audiologists using the infant-toddler/meaningful auditory integration scale (IT-MAIS/MAIS) questionnaire, the Mandarin Early Speech Perception (MESP) test and the Mandarin Pediatric Speech Intelligibility (MPSI) test. The questionnaires were used in face to face interviews with the parents or guardians. Each child was assessed before the operation and 3 months, 6 months, 12 months after switch-on., Results: After cochlear implantation, early postoperative auditory development and speech perception gradually improved. All MAIS/IT-MAIS scores showed a similar increasing trend with the rehabilitation duration (F=5.743, P=0.007). Preoperative and post operative MAIS/IT-MAIS scores of children in age group C (3-4 years) was higher than that of other groups. Children who had longer hearing aid experience before operation demonstrated higher MAIS/IT-MAIS scores than those with little or no hearing aid experience (F=4.947, P=0.000). The MESP test showed that, children were not able to perceive speech as well as detecting speech signals. However as the duration of CI use increased, speech perception ability also improved substantially. However, only about 40% of the subjects could be evaluated using the most difficult subtest on the MPSI in quiet at 12 months after switch-on. As MCR decreased, the proportion of children who could be tested using the MPSI reduced., Conclusions: Within one year after CI, children develop early auditory and speech perception capabilities with time. Chinese versions of the IT-MAIS/MAIS, MESP and MPSI are useful instruments to document early auditory and speech perception skills in children after CI implantation.

Objective: To analyze and compare the clinical application of alternating click evoked electrocochleography (ECochG) and auditory brainstem response (ABR) in the diagnosis of auditory neuropathy (AN) subjects., Method: ECochGs and ABRs were recorded in 16 patients (32 ears) with AN/AD as AN group and 20 patients (26 ears) with sensorineural hearing loss(SNHL) as control group. Test stimuli were alternating polarity clicks. (1) To compare the occurrence rate of ECochGs and ABRs in AN patients. (2) To compare the peak latency of CAPs, absolute amplitude of CAPs, and amplitude ratios of -SP and CAP between AN group and control group., Result: ECochGs (--SPs or CAPs) presented in 78.1% (25 among 32 ears) of AN patients. CAPs latency of AN group was shorter than control group (P < 0.05), CAP absolute amplitude of AN group was lower than normal group (P < 0.05), while --SP/CAP was higher than control group (P < 0.01). Deformed ABRs presented in only 5 ears among 32 tested AN ears, while relative good ABR waveforms were evoked in control group. The occurrence rate of ABRs (15.6%) was significantly lower than that of ECochGs in AN patients (P < 0.01)., Conclusion: Both ECochGs and ABRs play important role in the diagnosis of AN. The capacity of temporal processing is significantly impaired while the intensity perception related capability is intact in AN patients.

Objective: To focus on the prevalence of rare Meniere's disease in the elderly(> or = 60 yrs) and to investigate its clinical characteristics., Method: To observe the elderly with Meniere's disease from 2004-01-2007-7 and to investigate its clinical manifestation, electrocochleography (ECoG), vestibular evoked myogenic potential (VEMP), caloric test and pure tone audiogram., Result: There were 13 cases of Meniere's disease in the elderly. And the prevalence of Meniere's disease was 2.22% (13/586). The initial symptoms were as following: 2 cases with cochlear and vestibular symptoms, 9 cases with mere cochlear symptoms, 1 cases with mere spinning vertigo and 1 case with mere drop attack. The audiogram in the elderly were varied: low and high frequency hearing loss, flat, and high-frequency hearing loss. And the high frequency hearing loss had no relation with the duration of Meniere's disease. The results of vestibular function were varied. The percentage of positive result of ECoG was 63.6% (7/11, 2 cases not determined)., Conclusion: The prevalence of Meniere's disease in children was 2.22%. The initial symptoms was cochlear and vestibular symptoms, mere cochlear symptoms, mere spinning vertigo and mere drop attack, respectively. The audiogram showed prominent high frequency hearing loss. The percentage of positive result of ECoG was high. And the results of vestibular function tests were varied.

Objective: To analyze two groups of patients with migrainous vertigo (MV )and vertigo resulting from posterior circulation ischemia (PCIV) and investigate the differential diagnosis between them., Method: There were 60 patients with MV and 64 patients with PCIV. Clinical tests include high risk factors of posterior circulation ischemia (PCI), cerebral MRI, ocular motion and high stimulating rate ABR., Result: Among 64 patients with PCIV, 29 had abnormal blood pressure and 14 had abnormal blood fat and/or pathoglycemia; 37 had abnormality in cervical vascular ultrasound; 14 suffered from amaurosis or dizziness upon fast getting up. Twenty two had abnormal high stimulating rate ABR and 4 had cerebral lacunar infarction in MRI. As for 60 patients with MV, 45 suffered from motion sickness; 20 were sensitive to motion; 32 had photophobia and (or) phonophobia; 45 had migraine; 16 had abnormal ocular motion function; 3 had abnormal cerebral MRI and 40 had abnormal results in high stimulating rate ABR. The percentage of abnormal high stimulating rate ABR in MV and PCIV were 53% (22/42) and 67% (40/60) respectively., Conclusion: The mean age of MV is younger than that of PCIV. Female is more prone to MV than male (2.75 : 1. 00); the sex difference in PCIV is lesser (1.46 : 1.00). Motion sickness, motion sensitivity, photophobia and (or) phonophobia are principal differential highlights to MV. The major characteristics of PCIV include abnormal blood pressure, abnormal blood fat, pathoglycemia and arteriosclerosis. Vestibular function tests could not serve as a differential point; Cerebral MRI might be helpful to differential diagnosis. The results of high stimulating rate ABR is not a differential point between PCIV and MV, but it might play a role in differentiating other kinds of vertigo.

Objective: To investigate the complementary relation between head shaking nystagmus (HSN) and bithermal caloric test., Method: All of the 60 patients with vertigo were tested with bithermal caloric test, HSN and audiological tests., Result: There were 19 patients with normal CP and HSN, in which 8 had shared the same direction (towards the uninjured side) and 11 indicated opposite direction(HSN towards the lesioned side). Ten patients had normal CP with no HSN. Eight patients had abnormal CP and no HSN. In 23 patients with abnormal CP and HSN, HSN in 19 patients had opposite direction against that of CP and HSN in 4 patients had the same direction with that of CP (towards the lesioned side)., Conclusion: HSN and bithermal caloric test had the complementary effects and it is helpful to interpret the vestibular function more accurately if they are applied together.

Objective: To investigate the significance of vestibular function battery and electrocochleogram on diagnosis of Meniere's disease., Method: Patients with Meniere's disease were given pure tone hearing threshold test, auditory brainstem responses (ABR), electrocochleogram (ECoG), vestibular bithermal caloric test and vestibular evoked myogenic potentials (VEMP) test., Result: (1) As for the bithermal caloric test, the percentage of the abnormal canal paresis (CP) at three durations, i.e. , 0 to approximately 5 years, 6 to approximately 10 years and over 11 years were 56.9%, 75.9% and 61.6% respectively. The total positive rate was 50.0%. CP and duration of Meniere's disease had low correlation (P < 0.05). (2) The percentage of the abnormal VEMP at three durations, i.e., 0-5 years,6-10 years and over 11 years were 57.4%, 60% and 57.1% respectively. The total positive rate was 58.0%. The duration of Meniere 's disease with normal and abnormal VEMP had no significant difference( P >0.05). (3) The percentage of the abnormal ECoG at three durations, i.e., 0-5 years, 6-10 years and over 11 years were 72.1%, 73.3% and 81.3% (49/68,22/30 and 13/16) respectively. The total positive rate was 76.9%. The duration of Meniere's disease with normal and abnormal ECoG had no significant difference (P >0.05)., Conclusion: Diagnosis of Meniere's disease is mainly based on the medical history. If it could combine with ECoG, bithermal caloric test and VEMP, the diagnosis would be earlier and more accurate.

Objective: To investigate the diagnostic methods and significance of several tests for delayed endolymphatic hydrops (DEH)., Method: Fifteen patients with delayed endolymphatic hydrops were tested with pure tone threshold, ECochG, bithermal caloric test and vestibular evoked myogenic potentials test to detect the lesioned side and the extent of hydrops., Result: All of the 15 patients had sensorineural hearing loss to the medium-severe extent at least. Ten were the ipsilateral type, four contralateral type and one bilateral type. Five cases had abnormal horizontal semicircular canal (HSCC) hydrops and saccular hydrops; six cases had abnormal HSCC function and normal saccular function; two cases had abnormal saccular function and normal HSCC function. The seven abnormal VEMP took the forms of loss of p13-n23, elongation of the latency of p13 or depressed amplitude cases with of p13-n23., Conclusion: ECochG, bithermal caloric test and VEMP may play a major role in the diagnosis of delayed endolymphatic hydrops and they should be utilized as the routine tests.