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Maximum Phonation Time Normative Values Among Malaysians and Its Relation to Body Mass Index

Al-Yahya SN, Mohamed Akram MHH, Vijaya Kumar K, Mat Amin SNA, Abdul Malik NA, Mohd Zawawi NA, et al.

J Voice, 2020 Aug 27.
PMID: 32861567 DOI: 10.1016/j.jvoice.2020.07.015

OBJECTIVE: Maximum phonation time (MPT) is a test to measure glottic efficiency for laryngeal pathology screening and treatment monitoring. The normative value of MPT for South East Asia population has yet to be reported. It is postulated that MPT may be affected by body mass index (BMI) despite the paucity of evidence. Therefore, this study was designed to establish the normative value of MPT for a South East Asia population and investigate its relation to BMI.
DESIGN & SETTING: This cross-sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center between May and September 2017.
PARTICIPANTS AND METHODS: Three hundred males and females with mean age of 30.23 (±11.04) years were recruited in equal number for each gender (n = 150) and divided into 3 groups of 50 according to their BMI (n = 50). The three groups are non-obese (BMI≤22.9kg/m2); obese (BMI between 23 and 34.9 kg/m2); and morbidly obese (BMI >35kg/m2). BMI and Voice Handicap Index-10 (VHI-10) were obtained. The average of three readings of MPT was measured using a stopwatch while the participants phonate /a/, /i/ and /u/. Unpaired t-test and ANOVA were used to compare means between and across groups. Spearman correlation assessed the correlation between MPT and BMI.
MAIN OUTCOME MEASURES: The normative values of MPT of both genders and correlation with BMI were analyzed.
RESULTS: The MPT normative values for males and females in the non-obese group were of 21.41 (±6.85) seconds and 18.05 (±5.06)seconds respectively for /a/. The MPT for all vowels were significantly higher in males across the BMI groups (P ≤ 0.05). There was low negative correlation between MPT and BMI in both genders.
CONCLUSIONS: This pioneering study documented the normative values of MPT among Malaysians showed that males had longer MPT than females across the BMI groups. Obesity affects the MPT in that as BMI increases, the MPT decreases.
Fulltext Concurrent Double Primary Tumours: Papillary Thyroid Carcinoma and Cervical Epithelioid Angiosarcoma

Lum SG, Mahmud N, Isa N, Mat Baki M

Medeni Med J, 2020;35(4):349-355.
PMID: 33717629 DOI: 10.5222/MMJ.2020.83479

Angiosarcoma is one of the rarest types of malignant vascular tumours that involved the head and neck region. It predominantly affects the scalp and superficial soft tissues. Angiosarcoma arising from the deep cervical soft tissue is extremely rare. There is a limited literature on neck angiosarcoma that occurred simultaneously with papillary thyroid carcinoma. We report a rare case of concurrent papillary thyroid carcinoma and cervical epithelioid angiosarcoma, and postoperative rapid progression of residual angiosarcoma that mimicked a neck haematoma. The diagnostic challenge and possible etiologies have been discussed here.
Fulltext Unusual Presentation of Myasthenia Crisis Following Thymectomy and Thyroidectomy

Mohamed Daud A, Mat Baki M, Azman M, Kamaruzaman E, Mohamed AS

Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):118-120.
PMID: 31741945 DOI: 10.1007/s12070-017-1146-x

Respiratory distress after thyroidectomy and thymectomy can be challenging. We encountered a 70-year-old lady with a long-standing goiter with concomitant thymoma. She underwent the surgery and developed respiratory distress upon extubation with loss of laryngeal sensation causing severe aspiration. She was diagnosed myasthenia gravis and symptoms resolved with MG treatments.
Fulltext A Rare Case of Basal Cell Adenocarcinoma of Parotid Gland with Intracranial Extension

Razali MN, Mat Baki M, Kew TY, Mohamad Yunus MR

Indian J Otolaryngol Head Neck Surg, 2019 Oct;71(Suppl 1):93-95.
PMID: 31741939 DOI: 10.1007/s12070-017-1116-3

Basal cell adenocarcinoma (BCAC) is a rare tumour entity. Despite its tendency to be infiltrative and destructive tumour with propensity to recur, it rarely metastasizes and long-term outcome following surgery is favourable. This paper presents a 42-year-old male with residual BCAC of parotid gland that had extended into infratemporal fossa and intracranial. The important aspect of this case is the rarity occurrence of BCAC of parotid with intracranial extension and its surgical approaches to achieve tumour clearance.
Validity and Reliability Study of Bahasa Malaysia Version of Voice Handicap Index-10

Ong FM, Husna Nik Hassan NF, Azman M, Sani A, Mat Baki M

J Voice, 2019 Jul;33(4):581.e17-581.e23.
PMID: 29793874 DOI: 10.1016/j.jvoice.2018.01.015

OBJECTIVES: This study aimed to determine the validity and reliability of Bahasa Malaysia version of Voice Handicap Index-10 (mVHI-10).
MATERIALS AND METHODS: This cross-sectional study was carried out in the Otorhinolaryngology, Head and Neck Surgery Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from June 2015 to May 2016. The mVHI-10 was produced following a rigorous forward and backward translation. One hundred participants, including 50 healthy volunteers (17 male, 33 female) and 50 patients with voice disorders (26 male, 24 female), were recruited to complete the mVHI-10 before flexible laryngoscopic examinations and acoustic analysis. The mVHI-10 was repeated in 2 weeks via telephone interview or clinic visit. Its reliability and validity were assessed using interclass correlation.
RESULTS: The test-retest reliability for total mVHI-10 and each item score was high, with the Cronbach alpha of >0.90. The total mVHI-10 score and domain scores were significantly higher (P
Immediate selective laryngeal reinnervation in vagal paraganglioma patients

Mat Baki M, Clarke P, Birchall MA

J Laryngol Otol, 2018 Sep;132(9):846-851.
PMID: 30180919 DOI: 10.1017/S0022215118000476

OBJECTIVE: This prospective case series aimed to present the outcomes of immediate selective laryngeal reinnervation.
METHODS: Two middle-aged women with vagal paraganglioma undergoing an excision operation underwent immediate selective laryngeal reinnervation using the phrenic nerve and ansa cervicalis as the donor nerve. Multidimensional outcome measures were employed pre-operatively, and at 1, 6 and 12 months post-operatively.
RESULTS: The voice handicap index-10 score improved from 23 (patient 1) and 18 (patient 2) at 1 month post-operation, to 5 (patient 1) and 1 (patient 2) at 12 months. The Eating Assessment Tool 10 score improved from 20 (patient 1) and 24 (patient 2) at 1 month post-operation, to 3 (patient 1) and 1 (patient 2) at 12 months. There was slight vocal fold abduction observed in patient one and no obvious abduction in patient two.
CONCLUSION: Selective reinnervation is safe to perform following vagal paraganglioma excision conducted on the same side. Voice and swallowing improvements were demonstrated, but no significant vocal fold abduction was achieved.
Effect of prolonged supine position on the intraocular pressure in patients with obstructive sleep apnea syndrome

Fang SY, Wan Abdul Halim WH, Mat Baki M, Din NM

Graefes Arch Clin Exp Ophthalmol, 2018 Apr;256(4):783-790.
PMID: 29492688 DOI: 10.1007/s00417-018-3919-7

PURPOSE: Obstructive sleep apnea syndrome (OSAS) patients are at risk of glaucoma but the risk increases if they have higher intraocular pressure (IOP) while sleeping. We aim to evaluate the postural effect of upright and prolong supine positions on IOP in these patients.
METHODS: This is a cross-sectional study involving 27 patients with symptoms of OSAS seen at a tertiary institutional center and 25 normal controls performed between June 2015 and June 2016. All patients and controls underwent a polysomnography (PSG) test and were diagnosed with OSAS based on the apnea-hypopnea index (AHI). Patients are those with OSAS symptoms and had AHI > 5, whereas controls are staffs from the ophthalmology clinic without clinical criteria for OSAS and had PSG result of AHI
Fulltext Does laryngeal reinnervation or type I thyroplasty give better voice results for patients with unilateral vocal fold paralysis (VOCALIST): study protocol for a feasibility randomised controlled trial

Blackshaw H, Carding P, Jepson M, Mat Baki M, Ambler G, Schilder A, et al.

BMJ Open, 2017 Sep 29;7(9):e016871.
PMID: 28965097 DOI: 10.1136/bmjopen-2017-016871

INTRODUCTION: A functioning voice is essential for normal human communication. A good voice requires two moving vocal folds; if one fold is paralysed (unilateral vocal fold paralysis (UVFP)) people suffer from a breathy, weak voice that tires easily and is unable to function normally. UVFP can also result in choking and breathlessness. Current treatment for adults with UVFP is speech therapy to stimulate recovery of vocal fold (VF) motion or function and/or injection of the paralysed VF with a material to move it into a more favourable position for the functioning VF to close against. When these therapies are unsuccessful, or only provide temporary relief, surgery is offered. Two available surgical techniques are: (1) surgical medialisation; placing an implant near the paralysed VF to move it to the middle (thyroplasty) and/or repositioning the cartilage (arytenoid adduction) or (2) restoring the nerve supply to the VF (laryngeal reinnervation). Currently there is limited evidence to determine which surgery should be offered to adults with UVFP.
METHODS AND ANALYSIS: A feasibility study to test the practicality of running a multicentre, randomised clinical trial of surgery for UVFP, including: (1) a qualitative study to understand the recruitment process and how it operates in clinical centres and (2) a small randomised trial of 30 participants recruited at 3 UK sites comparing non-selective laryngeal reinnervation to type I thyroplasty. Participants will be followed up for 12 months. The primary outcome focuses on recruitment and retention, with secondary outcomes covering voice, swallowing and quality of life.
ETHICS AND DISSEMINATION: Ethical approval was received from National Research Ethics Service-Committee Bromley (reference 11/LO/0583). In addition to dissemination of results through presentation and publication of peer-reviewed articles, results will be shared with key clinician and patient groups required to develop the future large-scale randomised controlled trial.
TRIAL REGISTRATION NUMBER: ISRCTN90201732; 16 December 2015.
Fulltext Myeloid sarcoma: An unusual and rare laryngeal presentation

Tan SN, Gendeh HS, Sani A, Mat-Baki M

Int J Surg Case Rep, 2016;21:99-103.
PMID: 26957189 DOI: 10.1016/j.ijscr.2016.02.012

Myeloid Sarcoma (MS) or Granulocytic Sarcoma is an uncommon laryngeal malignancy. It may arise from myelodysplastic syndromes, malignancy or de novo. Presentation in the larynx is rare and some may present with Acute Myeloid Leukaemia (AML) whereby the later may be asymptomatic.
Reliability of OperaVOX against Multidimensional Voice Program (MDVP)

Mat Baki M, Wood G, Alston M, Ratcliffe P, Sandhu G, Rubin JS, et al.

Clin Otolaryngol, 2015 Feb;40(1):22-8.
PMID: 25263076 DOI: 10.1111/coa.12313

OBJECTIVE: To evaluate the agreement between OperaVOX and MDVP.
DESIGN: Cross sectional reliability study.
SETTING: University teaching hospital.
METHODS: Fifty healthy volunteers and 50 voice disorder patients had supervised recordings in a quiet room using OperaVOX by the iPod's internal microphone with sampling rate of 45 kHz. A five-seconds recording of vowel/a/was used to measure fundamental frequency (F0), jitter, shimmer and noise-to-harmonic ratio (NHR). All healthy volunteers and 21 patients had a second recording. The recorded voices were also analysed using the MDVP. The inter- and intrasoftware reliability was analysed using intraclass correlation (ICC) test and Bland-Altman (BA) method. Mann-Whitney test was used to compare the acoustic parameters between healthy volunteers and patients.
RESULTS: Nine of 50 patients had severe aperiodic voice. The ICC was high with a confidence interval of >0.75 for the inter- and intrasoftware reliability except for the NHR. For the intersoftware BA analysis, excluding the severe aperiodic voice data sets, the bias (95% LOA) of F0, jitter, shimmer and NHR was 0.81 (11.32, -9.71); -0.13 (1.26, -1.52); -0.52 (1.68, -2.72); and 0.08 (0.27, -0.10). For the intrasoftware reliability, it was -1.48 (18.43, -21.39); 0.05 (1.31, -1.21); -0.01 (2.87, -2.89); and 0.005 (0.20, -0.18), respectively. Normative data from the healthy volunteers were obtained. There was a significant difference in all acoustic parameters between volunteers and patients measured by the Opera-VOX (P
Fulltext Facial nerve paralysis: a rare complication of parotid abscess

Sabir Husin Athar PP, Yahya Z, Mat Baki M, Abdullah A

Malays J Med Sci, 2009 Apr;16(2):38-9.
PMID: 22589657

Benign parotid neoplasm and inflammatory processes of the parotid resulting in facial paralysis are extremely rare. We report a 72-year-old Malay female with poorly-controlled diabetes mellitus who presented with a painful right parotid swelling associated with right facial nerve palsy. The paralysis (Grade VI, House and Brackmann classification) remained after six months.