Over 5% of the world’s population – 360 million people – has disabling hearing loss (328 million adults and 32 million children). Early diagnosis of hearing loss in children and providing hearing devices, including cochlear implants helps to develop speech, language, and listening skills needed for oral communication. Because of this reason, identifying children early with accurate hearing assessment in children is crucial. The aim of this study was to determine advantage of auditory steady-state response testing in comparing ABR and ASSR thresholds in children with severe hearing loss. Totally 21 children, 8 female and 13 males, aged between 18 and 46 months were included to this study. Mean age was 26 months. All the children underwent otoscopy and ABR before the measurement of ASSR thresholds. ABR and ASSR threshold measurements were performed by different physicians. They were performed in a quiet room, where sound level is less than 50 dB. Each child was asleep by nature during the test. Pearson’s correlation test have been used to evaluate correlation of thehearing thresholds of ABR and ASSR. The hearing thresholds in ABR correlated well with the threshold obtained with ASSR (Pearson’s correlation coefficient (0.231) is significant at the 0.01 level). In addition; in patients, where the thresholds for ABR were not measurable, it could be found in ASSR tests. If there is not any residual hearing for subjects, both tests resulted with no response. Based on these findings, both ABR and ASSR techniques may be used to provide an estimate of hearing sensitivity in children, but ASSR is a more valuable test than ABR. Determining thresholds for 0.5, 1, 2, 4 kHz is very important. Identifying children early with accurate hearing assessment leads to earlier fitting of sensory devices, including cochlear implants, which minimizes delays in auditory, speech, and language development.

Brainstem Evoked Response Audiometry test is a method to diagnose and differentiate the type, degree and the location of cochlear and retroocochlear hearing loss for infants early. Test methods to determine cochlear and retroocochlear hearing loss was introduced relatively late in the clinical practice of our country. Even though, we started to conduct BERA tests since 2007, there hasn’t beenany research conducted for determining the normal results for children aged 0-5. Aim: The study aims to determine some average Results of BERA tests for Mongolian children aged 0-5 with normal hearing by age groups using Octavus-BERA apparatus.The research has been conducted using cross sectional method of analytic research from 2009-2013.For the study, 110 children from children aged 0-5 who were diagnosed to have normal hearing from audiological department of Otorhinolaryngological hospital and 16 children with sensorineural (cochlear) hearing loss have been selected randomly. When the latency of waves for children aged 0-5 with normal hearing were measured and the average results for 70 dB were obtained in the BERA test: wave I was identified to be 1.64±0.15 – 2.08±0.5msec. Wave III was 3.68±0.18 - 4.47±0.73 msec, Wave V was 5.37±0.23 - 6.76±0.65 sec. When the latency between waves were measured and the average results were obtained in the BERA test: Between waves I-III, it was 2.05±0.20 – 2.39±0.53 msec. Between waves III-V was 1.69±0.10 -2.34±0.70 msec and between waves I-V was 3.70±0.29 - 4.65±0.56 msec. The latency of wave I for children with sensorineural hearing loss was 2.32±0.76 msec, 4.62±0.59msec for wave III and 6.55±0.65 msec for wave V, which was elongated with a statistical probability (p=0.00-0.05). Latency between waves was 2.39±0.45 msec between wave I-III, 1.83±0.16 msec between waves III-V and 3.97±0.88 msec between waves I-V, which doesn’t have statistically significant difference from the normal results.As the children’s age increases, the latency of the waves will shorten and becomes relatively stable from 25-30 months which is similar to adults. While the latency between waves I-III had no difference with statistical probability for children with all ages, latencies for waves III-V and I-V shortens as children’s age increases.Latency for children with sensorineural hearing loss was elongated with statistical probability (p<0,005) from normal results. But in terms of latency between waves, there has been no statistically significant difference (p>0.05). This Result has critical importance in diagnosing cochlear deafness.

Introduction:According to studies range by the World Health Organization in 2010, 278 million people are deaf or hearing impairment, out of which 24% use an hearing aid and one out of every 10 people has been treated with surgical method and 9 people’s hearing loss has been restored using acoustic treatment method.Purpose:Our purpose is to define noisy vowels of Mongolian word, which will be used for configuration of hearing aid, thereby improve hearing ability.The objectives1. Analyze spectrogram for noisy sound of Mongolian word and define frequency and level of noisy words.2. Define average difference of listening level of the noisy sounds of Mongolian language using “Listening field of Mongolian word”Materials and method:We did the spectrogram for noisy sounds of the Mongolian word using voices of 62 people including male and female children as well as adults. Also, we analyzed frequency energy of all vowels noted in the 60-65 dB computer, via the “PRAAT” software, which defines analysis of speech in phonetics and studied listening level of the strong vowels using listening sphere of word.Result:During our studies, we selected the vowels [a], [e], [u], [o] [a], [ʊ], [ɔ], [i] and defined spectrogram and energy concentration (formant) of each vowel to define the vowels with the highest energy, and further found out that distance difference of the spectrogram of each vowel and frequency between vowels as 300-780 Hz. On the other hand, difference between spectrogram of each strong sound such as [sh], [s], [v], [z], [dj], [kh] has been defines as 340-2800 dB.When we observed the words with strong sound in the listening field of Mongolian words, which were 3- 5 dB lower than the clearer words.Conclusion:1. According to spectrogram, noisy sound [sh], [s], [z], [dj] has frequency of 3300Hz-3500Hz, which is noisier and resulted in poor acoustic listening ability. Further, we found out that Distant difference of vowels of Mongolian language [a], [e], [o] and consonants [m], [n] is far, accordingly, acoustic listening ability has been good, on the other hand, distant difference of vowels of Mongolian word [ʊ], [ɔ], [u] is near or close, accordingly, acoustic listening ability has been not well.2. Level of distinquishment of the noisy sounds of Mongolian word has been lower by 3.6+ 0.8Db to 5.2+1.2Db at levels of clear sound to feedback.

Effects of industrial noise have been recognized by humanity since mid 19th century and works to study and prevent industrial noises had begun globally. Strong industrial noises damage human internal ear and hair cell of cort-organ rapidly and gradually, which causes deafness; and thousands of people are suffering from health problems. Many noisy industries, where thousands of people work, were built in our country by 1960’s anddeafness has increased due to exposure of industrial noise. Scientific studies to measure the level of industrial noise, to determine the hearing level of people who are working in it, to study the relationship between noise and hearing loss still haven’t been conducted completely. Aim: To measure distribution zone of industrial noise generator which generates noise with more than 85, to study hearing threshold of the people who are constantly affected by it, to prevent noise hearing loss.The plants of “Erdenet Industry” JSC, TPP-4 SOC, “Darkhan TU” SOC, TPP-3 SOC have been chosenwithin scope of the research. Noise level of 42 instruments of these plants which produces noise over85 “Noise distribution zone” where noise level decreases to 85, Chose 480 employees who have beenaffected by it for more than 5 years.Using modern audiometer at 250, 500, 1000, 2000, 4000, 8000 Hz to measure for each bone and air conduction in noise-proof rooms Average hearing thresholds are calculated at dense, medium, pitched noise levelEarplug and headphone were used at shop and assembly line with noise over 85 дБ for more than 24 hours by employees, their satisfaction was studied and it was watched that if they were using the protective equipment regularly.Hearing threshold of employees who constantly work at noisy environment found to be 28.5±3.8 dB atdense noise 31.8±4.4±0.3 at medium noise, 38.2±5.7 dB at pitched noise level for “Erdenet Industry” JSC, 30.9±3.1±0.3 дБ at dense noise, 34.6±3.5 dB at medium noise, 39.5±4.3 dB at pitched noise level for TPP-4 SOC, 31.9±3.6 dB at dense noise, 34.9±3.8 dB at medium noise, 40.9±4.1 dB at pitched noise level for “Darkhan TU” SOC, 28.9±2.6 dB at dense noise, 32.4±2.8 dB at medium noise, 36.4±4.4 dB at pitched noise level for TPP-3 SOC. 95.6% of employees of “Erdenet Industry” JSC, 95.7% of employees of TPP-4 SOC, 96.5 % of employees of “Darkhan TU” SOC, 95.8 % of employees of TPP-3 SOC were satisfied when noise protection tools Ear classic and Bilsom were used at environment with noise level over 85 dB. Average hearing threshold of employees who have worked for more than 5 years in weak industrial noise level (85 – 92.5 dB) found to be 28.4±3.0 dB at dense noise, 32.3±3.2 dB at medium noise, 37.1±4.5 dB at pitched noise level, for medium noise level environment 30.2±3.4±0.3 dB at dense noise, 33.5±4.0 dB at medium noise, 39.2±4.4 dB at pitched noise level, for strong noise environment 34.1±3.6 dB at dense noise, 34.5±3.8±0.4 at medium noise, 34.8±4.5 dB at pitched noise level, or it was reduced from healthy hearing threshold with true possibility when p=0.05.95.6% of employees of “Erdenet Industry” JSC, 95.7% of employees of TPP-4 SOC, 96.5 % of employees of “Darkhan TU” SOC, 95.8 % of employees of TPP-3 SOC were satisfied when noise protection tools Ear classic and Bilsom were used at environment with noise level over 85 dB, which makes these tools reliable protectors from hearing loss due to noise.

Among world population, 23.4% have different kinds of hearing disorders and 56% are middle ear disorders, 30% are inner ear disorder, 10% are congenital deaf and 4% are congenital mixed outer and middle ear disorder (WHO info, 2006).In 1995, by the German research, 2% of newborn babies were deaf therefore, among children from 1-18, 16% had middle ear disorder and 0.8% had inner ear disorder. In most cases (54%) cause of hear loss and deaf as sound transmitting apparatus. Later in 2010, sound transmitting apparatus related disorder was decreased by 22.4% J.Helms1995 , K.Schwager 2010 . Doctors proved that 62% of sound transmitting apparatus related disorders are middle ear diseases, 16,2% out of the diseases have the defect of malleus, 44,1 % have the defect of incus and discontinuity of incus and stapedius, and 39,7% is totally absent of ossicular chain 120 tympanoplasty III type surgeries were operated in 2011-2013 in Mongolia. Clinical and operative features of the tympanoplasty III type surgeries were prospectively recorded. Aim: To recover sound transmitting related hear loss with titan prosthesis implant. 120 tympanoplasty III type surgeries were operated in 2011-2013 in Mongolia. Clinical and operative features of the tympanoplasty III type surgeries were prospectively recorded. Out of the surgeries, 51 cases (42.5%) were cholesteatoma, 53 cases (44.2%) were granuloma middle ear and 16 cases (13.3%) were adhesive otitis media. The air and bone gap of all patients were above 15-35 dB. HEINZKURZ firm’s TTP-Variac system’s titan prosthesis was used. Titan prosthesis PORP was carried out in 86 cases (71.6%). For 40 (45.5%) out of the 86 cases, size of titan prosthesis PORP 2.25 mm was chosen. Hearing level increased for 72% out of patients by 10-25 dB after the operation. However, for 46 (54.5%) out of the 86 cases, size of titan prosthesis PORP 2.5 mm was chosen. Hearing level increased for 82% out of patients by 10-30 dB after the operation. Titan prosthesis TORP size 4-4.25 mm waschosen for 34 (28.4%) out of 120 cases. Hearing level increased by 10-30 dB for 80% out of patients involved after the operation Out of the surgeries, 51 cases (42.5%) were cholesteatoma, 53 cases (44.2%) were granuloma middleear and 16 cases (13.3%) were adhesive otitis media.Titan prosthesis PORP was carried out in 86 cases (71.6%). For 40 (45.5%) out of the 86 cases, size oftitan prosthesis PORP 2.25 mm was chosen. Hearing level increased for 72% out of patients by 10-25 dB after the operation. However, for 46 (54.5%) out of the 86 cases, size of titan prosthesis PORP 2.5 mm was chosen. Hearing level increased for 82% out of patients by 10-30 dB after the operation. Titan prosthesis TORP size 4-4.25 mm was chosen for 34 (28.4%) out of 120 cases. Hearing level increased by 10-30 dB for 80% out of patients involved after the operation. Implantation of Titanium prosthesis increased hearing capability by 80% dB. We drum cover the cartilage and cartilage film is used to by Canal wall down, Canal wall updone. Hearing level decrease d by patients involved after the operation. Implantation of Titanium prosthesis increased hearing capability by 80% dB. The air transfer of more than35 dB air-bonegapofmorethan15dB we observed defect of hearing bone

There are a lot of influencing factors of facial nerve palsy; experts believe that is most likely caused by a Virus (54%) and Bacterial infections. Noninfectious causes of facial nerve palsy induce tumors (28%) and less commonly influences head trauma (18%). The retrospective analysis of WHO, in 2012. There are some cases of postoperative complication in middle ear surgery is facial nerve palsy and the total recovery outcome of function was not good. From 2013 to 2016 in EMJJ hospital, Mongolia, we enrolled 16 cases with facial nerve damaged in intratympanic canal but we could not recruit some patients with facial palsy over 6 months. Each subject was tested with pure tone test, ABR, Tympanometry. These were performed for the detection of hearing loss after Temporal bone injury. Then we also investigated location of facial nerve damages of patients by MRI and CT before reconstructive surgery. After that surgery, all patients were given corticosteroid treatment (20mg/day) and physical therapy performed such as acupuncture for a week. Study results revealed that 6 cases after 18 days, 2 cases after 30 days, 1 patient after 45 days of reconstructive surgery regained good symmetry. Therefore, we considered that, postoperative treatments like physical therapy with B12, steroid had good benefits for operation result and to shorten the recovery time. There was a patient who had damaged facial nerve in the tympanic segment during Mastoidectomy. In that case, we performed cable nerve grafting using the r.auricularismagnium but we could not recover facial nerve function. Traumatic facial nerve paralysis is the second most common type. We discussed that performing reconstruction surgery within first 3 months after intratemporal facial nerve injury is extremely desirable and more effective. In our opinion, nerve recovery might be not successfully cause of injured myelin sheet of facial nerve during middle ear surgery.

Otosclerosis is a disease that involves the cochlea and it is developed when the structure ofconnecting tissue in the area of stapedius and the oval window has changed and become unmovable.Consequently, conductive hearing loss and therefore severe sensorineural hearing loss are caused.The causes of otosclerosis have not been discovered yet but many factors impact on this disease. Anyresearch works has not been done on otosclerosis in Mongolia until now and we have conducted theresearch in 2008-2013. Therefore, we aimed to identify the hearing condition after surgery treatmentof otosclerosis.41 patients /47 ears/ who were diagnosed of having otosclerosis with conductive hearing loss, nomiddle ear infection through the comprehensive ear and hearing examinations were selected in thisstudy which was done at EMJJ Clinics between 2007 and 2013. The hearing improvement after thesurgery has been tested under bone and air conduction frequency 500, 1000, 2000, 4000, 8000 Hzand the results before and after the surgery were statistically processed on Excel 2010 and SPSS 17.0software programs. Stapedotomia and Stapedoectomia surgery approaches were applied and afteropening of attics, the hearing bones are palpated and the diagnosis of stapes otosclerosis is confirmedby the surgeon, who removes the stapes. Then a titanium K-piston (prosthese or implant) is thenplaced into this opening and connected to the malleus, or the incus.Out of 41 patients (85.4% female) involved in the study and 36 people had one ear side otosclerosisand 5 people had both ear otosclerosis. After the surgery 25 patients did not have dizziness andvomiting symptoms and 14 patients did not have dizziness with movement after 12 hours, andfor 4 patients all symptoms were disappeared after 24 hours. As for the result from the hearingexamination after 21, 60 days of the surgery, bone conduction was normal, air conduction, andhearing for 32 patients improved completely, and after 120 days of the surgery, the hearing of 33patients improved completely, bone conduction became 2000 Hz at 4000 Hz frequency 12-15 dB,average of air conduction 15,4±10,1 dB, bone-air gap 10,4±3,1 dB for 5 people, and bone conduction2000 Hz-4000 Hz, at 8000 Hz frequency 20-40dB, air conduction became 25-45dB 10,4±5,1db for 9patients and all patients had no hearing loss except for 4 people who still had tinnitus.After surgery stapedotomia and stapedoectomia for the otosclerosis, the hearing improvement was95.2% and it has been concluded that there is full possibility to perform surgeries of stapedotomia andstapedoectomia for the otosclerosis in Mongolian situation.

Introduction: Mostly fever change influences for heart and vital vessel and it is important for future treatment to compare difference of diagnosis and treatment feature of heart-disease in fever change. Goal: To compare difference of pain, feature, treatment and diagnosis when reduced fever change in heart Materials and Methods: The study was conducted using methods of ‘Comparing manuscript sources studies’, ’Analyses and syntheses’ for determining numbers and described with ‘Hermeneutics’ methodology. The study was based on approved methodology and ethical review in December 2018 Result: Fever could be directly matter of death because it should be needed to pay attention for method of treatment, to make research for general medicine of fever, to make research other organs & heart, to take medicine within ice sweet, to reduce fever and to treat through cautery, oily cream and ointment. Conclusion
1. Most diagnostic and pain of fever influence for heart and it depends on process of fever accordance with our research collection.
2. It is possible to consider similarly pain, diagnosis and treatment of heart pneumonia and heart fever based on classification of general heart disease of science of medicine.