Displaying publications 1 - 20 of 52 in total

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  1. Ahmad SA, Abdul Wahat NH, Zakaria MN, Wiener-Vacher SR, Abdullah NA
    Int J Pediatr Otorhinolaryngol, 2020 Aug;135:110132.
    PMID: 32502914 DOI: 10.1016/j.ijporl.2020.110132
    OBJECTIVE: Vestibular assessments in children are essential for the early identification of vestibular and balance dysfunctions. Vestibular evoked myogenic potentials, cervical (cVEMPs) and ocular (oVEMPs) have been reported to be feasible and effective when assessing otolith function in children. The main aim of the study was to obtain normative data for cVEMPs and oVEMPs from preschool and primary school-aged Malaysian children.

    METHODS: A group of 33 healthy children, aged from 5 years 9 months-12 years 4 months (mean ± SD = 8.83 ± 1.92 years), was recruited. Their otolith saccular function was assessed using 750 Hz tone burst for cVEMPs (with ER3A insert phone), while their utricular function was assessed using Brüel & Kjaer Mini-shaker Type 4810 (Naerum, Denmark) for oVEMPs.

    RESULTS: For cVEMPs, the mean value of P13 latency, N23 latency, P13-N23 interamplitude and asymmetry ratio were 12.62 ± 1.38 ms, 19.85 ± 1.95 ms, 92.47 ± 50.35 μV and 14.03 ± 9.75%, respectively. For oVEMPs, the mean value of N10 latency, P15 latency, N10-P15 interamplitude and asymmetry ratio were 9.23 ± 1.07 ms, 14.41 ± 1.04 ms, 10.32 ± 5.65 μV and 15.84 ± 11.49%, respectively. Two-way ANOVA analysis found that ear laterality and gender had no significant effect on all cVEMPs and oVEMPs parameters. No significant correlation was found between age and all VEMPs parameters.

    CONCLUSIONS: The normative data for cVEMPs and oVEMPs obtained in this study can be used as a guide by health professionals to assess saccular and utricular functions among children age from 5 to 12 years of age.

  2. Abdul Wahid SN, Md Daud MK, Sidek D, Abd Rahman N, Mansor S, Zakaria MN
    Int J Pediatr Otorhinolaryngol, 2012 Sep;76(9):1366-9.
    PMID: 22770594 DOI: 10.1016/j.ijporl.2012.06.008
    OBJECTIVE: To identify the outcomes of hearing screening using different protocols of both Distortion Product Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Response (AABR) tests in the same ear of the babies in a neonatal unit population.
    METHODS: A cross-sectional study was carried out on babies who were admitted into a neonatal unit. By using a formula of single proportion and considering 20% drop out, the number of sample required was 114. The subjects were chosen by using a systematic random sampling. The infants selected were subjected to DPOAE followed by AABR tests screening at the same setting before discharge.
    RESULTS: There were 73 newborns (61.6% male and 38.4% female) participated in this study with a total of 146 ears screened. Ototoxic medication was the most common risk factor followed by hyperbilirubinaemia and low birth weight. AABR had higher passing rate (82.9%) as compared to DPOAE (77.4%). The highest passing rate was achieved if the protocol of either passed DPOAE or AABR was used (90.4%). The rate was lower when auditory neuropathy spectrum disorder (ANSD) has been considered (82.9%). Hyperbilirubinaemia, prematurity, craniofacial malformation and ototoxic drugs seem to be the high risk factors for auditory neuropathy.
    CONCLUSION: AABR has a higher passing rate as compared to DPOAE. However, the use of both instruments in the screening process especially in NICU will be useful to determine the infants with ANSD who may need different approach to management. Therefore, a protocol in which newborns are tested with AABR first and then followed by DPOAE on those who fail the AABR is recommended.
  3. Awang MA, Zamri NN, Wan Mohamad WN, Zakaria MN
    Int J Adolesc Med Health, 2019 Mar 16;33(4).
    PMID: 30875322 DOI: 10.1515/ijamh-2018-0148
    INTRODUCTION: Acoustic reflex (AR) is a valuable clinical test for hearing diagnosis. Parameters of AR such as its amplitude and threshold have been commonly reported in research. Acoustic reflex latency (ARL) has not been widely studied and more research is warranted to determine its basic properties and clinical usefulness. The present study aimed to determine the influences of stimulation mode and stimulus frequency on ARL.

    METHODS: In this study, 52 healthy young adults were enrolled (mean age = 23.2 ± 0.8 years, 61.8% were males). They underwent the standard AR testing and ARL values were computed. Both ipsilateral and contralateral recordings were made at 500, 1000, 2000 and 4000 Hz frequencies.

    RESULTS: The ARL values obtained are consistent with the findings from the previous studies. Two-way analysis of variance (ANOVA) revealed that the ARL values were not statistically influenced by either stimulation mode (p = 0.061) or stimulus frequency (p = 0.598).

    CONCLUSION: Among young adults, ARL does not appear to be influenced by stimulation mode and stimulus frequency. Further large scale research is warranted to support the present study's findings. The preliminary normative data for ARL obtained in this study can serve as the reference for future research involving this particular population.

  4. Zakaria MN, Salim R, Tahir A, Zainun Z, Mohd Sakeri NS
    Clin Otolaryngol, 2019 03;44(2):166-171.
    PMID: 30411501 DOI: 10.1111/coa.13255
    OBJECTIVES: Subjective visual vertical (SVV) is a simple, quick and reliable test for measuring utricular function. The literature on the effects of fundamental demographic variables such as age and gender on SVV is inconclusive and should be supported by research with larger samples. The aim of the present study was to determine the influences of age, gender and geometric pattern of visual image on SVV among healthy adults.

    STUDY DESIGN: This study employed a repeated measures design.

    SETTINGS: Otorhinolaryngology Clinic, Hospital Universiti Sains Malaysia, Malaysia.

    PARTICIPANTS: Eligible Malaysian adults (N = 187, aged 21-75 years) were recruited and categorised into young (N = 60), middle-aged (N = 66) and older (N = 61) groups. Most of them were Malay, and 51.3% were men.

    MAIN OUTCOME MEASURES: Subjective visual vertical angles (in degrees) were determined from each participant in a static upright condition using a computerised SVV device. They were asked to indicate their verticality perception for three types of visual images (solid line, dotted line and arrow pattern).

    RESULTS: Three-way mixed ANOVA revealed insignificant influences of age and gender on SVV results (P > 0.05). In contrast, mean SVV angles were significantly higher for the arrow pattern than for other visual images (P = 0.004).

    CONCLUSION: While the insignificant influences of age and gender on static SVV are further ascertained with larger samples, the perception of verticality is less accurate when aligning a more geometrically complex visual image (ie, arrow pattern). Further SVV research on vestibular-disordered patients is beneficial, particularly to verify the normative data obtained with this complex visual image.

  5. Zakaria MN, Tahir A, Zainun Z, Salim R, Mohd Sakeri NS, Abdul Wahat NH
    Acta Otolaryngol, 2021 Jan;141(1):62-65.
    PMID: 32957810 DOI: 10.1080/00016489.2020.1817552
    BACKGROUND: The graviceptive otolith function can be measured using subjective visual horizontal (SVH) testing. Nevertheless, more research efforts are required to understand the essential variables affecting SVH.

    OBJECTIVE: The aim of the present study was to determine the effects of type of visual image and gender on subjective visual horizontal (SVH) perception among healthy adults.

    MATERIALS AND METHODS: In this comparative study, 50 healthy young adults were enrolled. While in an upright body position, they were required to report their perception of horizontality for two types of visual images (solid line and arrow pattern) using a computerized SVH device.

    RESULTS: The arrow pattern produced significantly bigger SVH angles than the solid line (p < .001). In contrast, no significant influence of gender was found on SVH results (p = .743), Based on the statistical outcomes, the preliminary normative data for SVH were established.

    CONCLUSIONS AND SIGNIFICANCE: The arrow pattern (a more complex visual image) produced bigger SVH deviations than the simple solid line image. In contrast, the horizontality perception does not appear to be affected by gender. The preliminary normative SVH data gathered from the present study can be beneficial for clinical and future research applications.

  6. Abd Ghani A, Muslim NH, Zakaria MN
    Int J Pediatr Otorhinolaryngol, 2020 May;132:109907.
    PMID: 32018165 DOI: 10.1016/j.ijporl.2020.109907
    OBJECTIVE: Language disorders can affect reading skills contributing to poor academic achievements. As such, it is vital for speech language pathologists to identify the potential language-based reading problems among children. To achieve this, specific reading assessments should be developed and studied. Thus, the present study aimed to determine the effects of gender and academic achievement on oral reading fluency (ORF) and silent reading fluency (SRF) among Year 2 Malaysian children.

    METHODS: In this study that employed a comparative design, fifty-nine typically developing Malaysian children (24 boys, aged from 8 years, 0 months to 8 years, 11 months) were enrolled. They were chosen from three different classrooms (consisting of high achieving, medium achieving and low achieving students, respectively) in a primary school. Their ORF and SRF skills were assessed according to the established methods.

    RESULTS: As revealed by two-way ANOVA results, both ORF and SRF scores were found to be comparable between boys and girls (p > 0.05). In contrast, ORF and SRF results between the three classrooms were significantly different from each other (p 

  7. Zakaria MN, Wahat NHA, Zainun Z, Sakeri NSM, Salim R
    J Audiol Otol, 2020 Apr;24(2):107-111.
    PMID: 31995977 DOI: 10.7874/jao.2019.00297
    The present study aimed to determine the test-retest reliability of subjective visual horizontal (SVH) testing when tested with solid and dotted line images. In this repeated measures study, 36 healthy young Malaysian adults (mean age=23.3±2.3 years, 17 males and 19 females) were enrolled. All of them were healthy and had no hearing, vestibular, balance, or vision problems. The SVH angles were recorded from each participant in an upright body position using a computerized device. They were asked to report their horizontality perception for solid and dotted line images (in the presence of a static black background). After 1 week, the SVH procedure was repeated. The test-retest reliability of SVH was found to be good for both solid line [intraclass correlation (ICC)=0.80] and dotted line (ICC=0.78). As revealed by Bland-Altman plots, for each visual image, the agreements of SVH between the two sessions were within the clinically accepted criteria (±2°). The SVH testing was found to be temporally reliable, which can be clinically beneficial. Both solid and dotted lines in the SVH testing are reliable to be used among young adults.
  8. Zakaria MN, Salim R, Anual MSI, Patuzzi R
    Ear Hear, 2024 Feb 22.
    PMID: 38383959 DOI: 10.1097/AUD.0000000000001497
    OBJECTIVE: Various studies have been conducted to search for the most optimal stimulus for eliciting cervical vestibular evoked myogenic potential (cVEMP). More recently, there is a growing interest to study the usefulness of chirp stimuli in cVEMP recording. Nevertheless, contradictory outcomes have been reported across the studies, and further research with larger samples would be beneficial to provide better insight into this matter. As such, the present study was carried out to compare cVEMP results between narrowband (NB) CE-Chirp (centered at 500 Hz) and 500 Hz tone burst stimuli.

    DESIGN: In this study that employed a comparative study design, 98 normally hearing adults aged between 19 and 24 years were enrolled. All of them underwent the cVEMP testing based on the recommended test protocol. The stimuli were a 500 Hz tone burst and a NB CE-Chirp (360-720 Hz) presented through insert earphones at an intensity level of 120.5 dB peSPL.

    RESULTS: For each stimulus, cVEMP results did not differ significantly between the ears (p > 0.05). Relative to the 500 Hz tone burst, the NB CE-Chirp stimulus produced statistically shorter P1 and N1 latencies (p < 0.001). On the other hand, P1-N1 amplitude was found to be comparable between the two stimuli (p > 0.05).

    CONCLUSIONS: The present study did not find any supporting evidence that the NB CE-Chirp stimulus (centered at 500 Hz) outperformed the conventional 500 Hz tone burst in the cVEMP testing. Both stimuli are considered equally appropriate to record cVEMP responses in clinical settings.

  9. Zakaria MN, Abdullah R, Nik Othman NA
    Ear Hear, 2018 11 22;40(4):1039-1042.
    PMID: 30461445 DOI: 10.1097/AUD.0000000000000676
    OBJECTIVES: Post-auricular muscle response (PAMR) is a large myogenic potential that can be useful in estimating behavioral hearing thresholds when the recording protocol is optimal. The main aim of the present study was to determine the influence of stimulus repetition rate on PAMR threshold.

    DESIGN: In this repeated-measures study, 20 normally hearing adults aged between 18 and 30 years were recruited. Tone bursts (500, 1000, 2000, and 4000 Hz) were used to record PAMR thresholds at 3 different stimulus repetition rates (6.1/s, 11.1/s, and 17.1/s).

    RESULTS: Statistically higher PAMR thresholds were found for the faster stimulus rate (17.1/s) compared with the slower stimulus rate (6.1/s) (p < 0.05). For all stimulus rates and frequencies, significant correlations were found between PAMR and pure-tone audiometry thresholds (r = 0.62 to 0.82).

    CONCLUSIONS: Even though the stimulus rate effect was significant at most of the tested frequencies, the differences in PAMR thresholds between the rates were small (<5 dB). Nevertheless, based on the correlation results, we suggest the use of 11.1/s stimulus rate when recording PAMR thresholds.

  10. Abdul Wahab NA, Wahab S, Abdul Rahman AH, Sidek D, Zakaria MN
    Psychiatry Investig, 2016 Jan;13(1):82-8.
    PMID: 26766950 DOI: 10.4306/pi.2016.13.1.82
    Electrophysiological studies, which are mostly focused on afferent pathway, have proven that auditory processing deficits exist in patients with schizophrenia. Nevertheless, reports on the suppressive effect of efferent auditory pathway on cochlear outer hair cells among schizophrenia patients are limited. The present, case-control, study examined the contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) in patients with schizophrenia.
  11. Zakaria MN, Jalaei B
    Int J Pediatr Otorhinolaryngol, 2017 Nov;102:28-31.
    PMID: 29106871 DOI: 10.1016/j.ijporl.2017.08.033
    OBJECTIVE: Auditory brainstem responses evoked by complex stimuli such as speech syllables have been studied in normal subjects and subjects with compromised auditory functions. The stability of speech-evoked auditory brainstem response (speech-ABR) when tested over time has been reported but the literature is limited. The present study was carried out to determine the test-retest reliability of speech-ABR in healthy children at a low sensation level.

    METHODS: Seventeen healthy children (6 boys, 11 girls) aged from 5 to 9 years (mean = 6.8 ± 3.3 years) were tested in two sessions separated by a 3-month period. The stimulus used was a 40-ms syllable /da/ presented at 30 dB sensation level.

    RESULTS: As revealed by pair t-test and intra-class correlation (ICC) analyses, peak latencies, peak amplitudes and composite onset measures of speech-ABR were found to be highly replicable. Compared to other parameters, higher ICC values were noted for peak latencies of speech-ABR.

    CONCLUSION: The present study was the first to report the test-retest reliability of speech-ABR recorded at low stimulation levels in healthy children. Due to its good stability, it can be used as an objective indicator for assessing the effectiveness of auditory rehabilitation in hearing-impaired children in future studies.

  12. Daud MK, Noh NF, Sidek DS, Abd Rahman N, Abd Rani N, Zakaria MN
    B-ENT, 2011;7(4):245-9.
    PMID: 22338236
    The effect of noise on employees of dental clinics is debatable. The purposes of this study were to determine the intensity and frequency components of dental instruments used by dental staff nurses and the prevalence of noise induced hearing loss.
  13. Al Rjoob M, Hassan NFHN, Aziz MAA, Zakaria MN, Mustafar MFBM
    Tunis Med, 2022 12 27;100(10):664-669.
    PMID: 36571750
    INTRODUCTION: Dysphagia is a common disorder among stroke patients. Dysphagia can lead to consequences that can negatively impact the quality of life (QoL) in stroke patients.

    AIM: To investigate the impact of dysphagia on the QoL in stroke patients.

    METHODS: Relevant types of literature were searched from PubMed, Scopus, ProQuest, and Google Scholar databases from inception to July 2022. Peerreviewed studies that aimed to determine the impact of dysphagia on the QoL in stroke patients were included regardless of the year of publication. The National Institutes of Health tool for observational cohort and cross-sectional studies was used to assess the methodological quality of the selected studies. In addition, data analysis was conducted using qualitative methodology with narrative synthesis.

    RESULTS: A total of 6 studies met the inclusion criteria with a total number of 381 participants. Only one study has good methodological quality while other studies have fair methodological quality. Dysphagia negatively impacts the QoL in stroke patients, especially those with severe dysphagia. However, after treatment, changes were evident through improved QoL and decreased severity of dysphagia. Moreover, the research found that patients with a higher educational level have a better QoL.

    CONCLUSION: Dysphagia has a negative impact on the QoL in stroke patients, so dysphagia in stroke patients should be diagnosed and treated as soon as possible to avoid poor QoL.

  14. Jalaei B, Shaabani M, Zakaria MN
    Braz J Otorhinolaryngol, 2017 Jan-Feb;83(1):10-15.
    PMID: 27102175 DOI: 10.1016/j.bjorl.2015.12.005
    INTRODUCTION: The performance of auditory steady state response (ASSR) in threshold testing when recorded ipsilaterally and contralaterally, as well as at low and high modulation frequencies (MFs), has not been systematically studied.

    OBJECTIVE: To verify the influences of mode of recording (ipsilateral vs. contralateral) and modulation frequency (40Hz vs. 90Hz) on ASSR thresholds.

    METHODS: Fifteen female and 14 male subjects (aged 18-30 years) with normal hearing bilaterally were studied. Narrow-band CE-chirp(®) stimuli (centerd at 500, 1000, 2000, and 4000Hz) modulated at 40 and 90Hz MFs were presented to the participants' right ear. The ASSR thresholds were then recorded at each test frequency in both ipsilateral and contralateral channels.

    RESULTS: Due to pronounced interaction effects between mode of recording and MF (p<0.05 by two-way repeated measures ANOVA), mean ASSR thresholds were then compared among four conditions (ipsi-40Hz, ipsi-90Hz, contra-40Hz, and contra-90Hz) using one-way repeated measures ANOVA. At the 500 and 1000Hz test frequencies, contra-40Hz condition produced the lowest mean ASSR thresholds. In contrast, at high frequencies (2000 and 4000Hz), ipsi-90Hz condition revealed the lowest mean ASSR thresholds. At most test frequencies, contra-90Hz produced the highest mean ASSR thresholds.

    CONCLUSIONS: Based on the findings, the present study recommends two different protocols for an optimum threshold testing with ASSR, at least when testing young adults. This includes the use of contra-40Hz recording mode due to its promising performance in hearing threshold estimation.
  15. Nasution DLI, Furuta M, Li H, Zakaria MN, Takeshita T, Peres MA, et al.
    J Clin Periodontol, 2023 Aug;50(8):1042-1050.
    PMID: 36935202 DOI: 10.1111/jcpe.13809
    AIM: To investigate the existence of a bidirectional temporal relationship between periodontal condition and glycaemic status.

    MATERIALS AND METHODS: This longitudinal study included 2198 participants with mean age 43.4 ± 7.7 years, who underwent dental examinations in Yokohama, Japan, at two time points, 2003-2004 and 2008-2009, at an interval of 5 years. Periodontal condition was assessed by the mean value of probing pocket depth (PPD) and clinical attachment level (CAL). Glycaemic status was assessed by fasting glucose and glycated haemoglobin (HbA1c).

    RESULTS: The cross-lagged panel models showed the effect of HbA1c at baseline on mean PPD at follow-up (β = 0.044, p = .039). There was a marginal effect of fasting glucose on the mean PPD (β = 0.037, p = .059). It was similar to the effect of fasting glucose or HbAlc on mean CAL. However, in the opposite direction, no effect of mean PPD or CAL at baseline on fasting glucose or HbAlc at follow-up was identified.

    CONCLUSIONS: This study demonstrated a unidirectional relationship between glycaemic status and periodontal condition. The study population, however, had mostly mild periodontitis. Future studies are needed to investigate the effect of periodontal condition on glycaemic status in patients with severe periodontitis.

  16. Abdul Wahab NA, Zakaria MN, Abdul Rahman AH, Sidek D, Wahab S
    Psychiatry Investig, 2017 Nov;14(6):786-794.
    PMID: 29209382 DOI: 10.4306/pi.2017.14.6.786
    Objective: The present, case-control, study investigates binaural hearing performance in schizophrenia patients towards sentences presented in quiet and noise.

    Methods: Participants were twenty-one healthy controls and sixteen schizophrenia patients with normal peripheral auditory functions. The binaural hearing was examined in four listening conditions by using the Malay version of hearing in noise test. The syntactically and semantically correct sentences were presented via headphones to the randomly selected subjects. In each condition, the adaptively obtained reception thresholds for speech (RTS) were used to determine RTS noise composite and spatial release from masking.

    Results: Schizophrenia patients demonstrated significantly higher mean RTS value relative to healthy controls (p=0.018). The large effect size found in three listening conditions, i.e., in quiet (d=1.07), noise right (d=0.88) and noise composite (d=0.90) indicates statistically significant difference between the groups. However, noise front and noise left conditions show medium (d=0.61) and small (d=0.50) effect size respectively. No statistical difference between groups was noted in regards to spatial release from masking on right (p=0.305) and left (p=0.970) ear.

    Conclusion: The present findings suggest an abnormal unilateral auditory processing in central auditory pathway in schizophrenia patients. Future studies to explore the role of binaural and spatial auditory processing were recommended.

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