Displaying publications 1 - 20 of 44 in total

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  1. 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.

  2. Zuraida Zainun, Mohd Normani Zakaria, Din Suhaimi Sidek, Zalina Ismail
    MyJurnal
    Peripheral vestibular disorder (PVD) is serious and common. Clinically, giving an accurate diagnosis of PVD can be challenging. Vestibular evoked myogenic potential (VEMP) is an objective test to evaluate the integrity of vestibular organs, particularly saccule and/or inferior vestibular nerve. This study was performed to determine the sensitivity and specificity of VEMP using different stimuli. Fourty normal and 65 PVD subjects who fulfilled the inclusion criteria were recruited. While sitting comfortably, VEMP waveforms were recorded with active electrode on sternocleidomastoid muscle and negative electrode on upper forehead. Tone bursts (500, 750 and 1000 Hz) were delivered via headphones at 90 dBnHL and 5/s presentation rate. VEMP parameters for each stimulus (amplitude and latency of P1 and N1 peak) were analyzed accordingly. Receiver operating characteristic (ROC) was performed to determine the sensitivity and specificity of VEMP at different test frequencies. N1 amplitude of 750 Hz stimulus produced the most ideal sensitivity (65% on right and 63% on left) and specificity (83% on right and 78% on left). The importance of using a few tone bursts in VEMP test in order to minimize the false negative in cases might be encountered in clinics as the certain tone burst had inadequate sensitivity in detecting PVD cases. The 750 Hz stimulus produced the most ideal VEMP with adequate values of sensitivity and specificity, at least in this study.
  3. Zakaria MN, Jalaei B, Wahab NA
    Eur Arch Otorhinolaryngol, 2016 Feb;273(2):349-54.
    PMID: 25682179 DOI: 10.1007/s00405-015-3555-3
    For estimating behavioral hearing thresholds, auditory steady state response (ASSR) can be reliably evoked by stimuli at low and high modulation frequencies (MFs). In this regard, little is known regarding ASSR thresholds evoked by stimuli at different MFs in female and male participants. In fact, recent data suggest that 40-Hz ASSR is influenced by estrogen level in females. Hence, the aim of the present study was to determine the effect of gender and MF on ASSR thresholds in young adults. Twenty-eight normally hearing participants (14 males and 14 females) were enrolled in this study. For each subject, ASSR thresholds were recorded with narrow-band chirps at 500, 1,000, 2,000, and 4,000 Hz carrier frequencies (CFs) and at 40 and 90 Hz MFs. Two-way mixed ANOVA (with gender and MF as the factors) revealed no significant interaction effect between factors at all CFs (p > 0.05). The gender effect was only significant at 500 Hz CF (p < 0.05). At 500 and 1,000 Hz CFs, mean ASSR thresholds were significantly lower at 40 Hz MF than at 90 Hz MF (p < 0.05). Interestingly, at 2,000 and 4,000 Hz CFs, mean ASSR thresholds were significantly lower at 90 Hz MF than at 40 Hz MF (p < 0.05). The lower ASSR thresholds in females might be due to hormonal influence. When recording ASSR thresholds at low MF, we suggest the use of gender-specific normative data so that more valid comparisons can be made, particularly at 500 Hz CF.
  4. 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.
  5. 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 

  6. Jalaei B, Zakaria MN, Sidek D
    Iran J Otorhinolaryngol, 2017 Jan;29(90):53-57.
    PMID: 28229064
    INTRODUCTION: Noonan syndrome (NS) is a heterogeneous genetic disease that affects many parts of the body. It was named after Dr. Jacqueline Anne Noonan, a paediatric cardiologist.

    CASE REPORT: We report audiological tests and auditory brainstem response (ABR) findings in a 5-year old Malay boy with NS. Despite showing the marked signs of NS, the child could only produce a few meaningful words. Audiological tests found him to have bilateral mild conductive hearing loss at low frequencies. In ABR testing, despite having good waveform morphology, the results were atypical. Absolute latency of wave V was normal but interpeak latencies of wave's I-V, I-II, II-III were prolonged. Interestingly, interpeak latency of waves III-V was abnormally shorter.

    CONCLUSION: Abnormal ABR results are possibly due to abnormal anatomical condition of brainstem and might contribute to speech delay.

  7. Zakaria MN, Nik Othman NA, Musa Z
    J Otol, 2017 Mar;12(1):29-33.
    PMID: 29937834 DOI: 10.1016/j.joto.2017.02.002
    Objective: Electrocochleography (ECochG) is valuable to diagnose Meniere's disease objectively. The aim of the present study was to provide preliminary normative data for ECochG among Asian adults. The influences of ethnicity (Malay versus Chinese) and gender on ECochG results were also studied.

    Methods: Twenty-two Malay adults (10 men and 12 women) and twenty Chinese participants (10 men and 10 women) aged between 20 and 49 years participated in this study. Extratympanic ECochG (ET-ECochG) was recorded according to standard non-invasive procedure. Summating potential (SP) amplitude, action potential (AP) amplitude and SP/AP ratio were analyzed accordingly.

    Results: ET-ECochG results were found to be comparable between left and right ears (p > 0.05). No notable differences in ET-ECochG results were found between Malay and Chinese groups (p > 0.05). No significant influence of gender on ET-ECochG outcomes was also noted (p > 0.05). The derived normative data for Asian adults (84 ears) are consistent with previous reports.

    Conclusion: The present study provides preliminary normative data for ET-ECochG among Asian adults. The ECochG components do not appear to be influenced by either ethnicity or gender. The derived normative data can be used for clinical applications and as the reference for future studies involving Asian population.

  8. 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.

  9. Zakaria MN, Nik Othman NA, Musa Z
    Acta Otolaryngol, 2021 Nov;141(11):984-988.
    PMID: 34669557 DOI: 10.1080/00016489.2021.1990996
    BACKGROUND: The non-invasive tympanic electrocochleography (TM-ECochG) is useful for clinical diagnoses. Nevertheless, the influence of the electrode location on tympanic membrane (TM) on ECochG results needs to be studied.

    OBJECTIVE: The aim of the present study was to compare the TM-ECochG results obtained when the electrode was placed on the superior region versus the inferior region of TM.

    MATERIALS AND METHODS: Forty healthy adults (aged 29 to 50 years) participated in this comparative study. The TM-ECochG testing was conducted with the electrode placed on the superior and inferior regions of TM.

    RESULTS: SP and AP amplitudes were statistically higher for the inferior region of TM (p < .05). In contrast, SP/AP ratios were comparable between the two regions of TM (p = .417).

    CONCLUSIONS AND SIGNIFICANCE: In TM-ECochG recording, when the electrode was placed on the inferior region of TM, SP and AP amplitudes were greater than when the electrode was placed on the superior region of TM. On the other hand, SP/AP amplitude ratio was not affected by the location of electrode on TM. The findings from the present study could be useful to guide clinicians in optimizing TM-ECochG recording when testing their respective patients.

  10. Zuraida, Z., Mohd Normani, Din Suhaimi, S., Zalina, I., Geshina, M. S.
    MyJurnal
    Background: Vertigo Symptom Scale (VSS) by Yardley et al. (1992) is one of the disease specific
    questionnaires used widely in clinical settings. It is conducted in English and had been translated into six languages including Dutch, French, German, Spanish, Swedish, and Turkish. It has been acknowledged as a good subjective tool to determine the severity of balance disorders. Objective: To develop a valid Malay version of VSS (MVVSS) using appropriate translation methods and validation technique. Method: Forward and backward translation was performed by four professionals from different fields. The translated questionnaire was then assessed for its test reliability based on an experiment on 30 normal subjects. Further, to determine the cultural adaptation issues, the face validity of MVVSS was assessed from 32 normal subjects. They were asked to fill in the MVVSS questionnaire accordingly and give opinions regarding its language, understanding and overall format of questionnaire. Results: Final results of the translation process showed sufficient concurrence among the professionals involved. The reliability test among the normal subjects also showed a high Cronbach’s alpha value (0.90). The face validity method on 32 subjects (mean age of 29.9 ± 9.2 years) showed good feedbacks in terms of language, understanding and overall format of the MVVSS. Conclusion: The translation process was successful and the further validation showed an adequate face validity response. This suggests that our MVVSS has been culturally adapted and can be used in all Malay conversing patients.
  11. Zainun Z, Zakaria MN, Sidek D, Ismail Z
    Med J Malaysia, 2012 Aug;67(4):386-9.
    PMID: 23082446
    The Vertigo symptom scale (VSS) is a well established tool for the evaluation of vestibular disorders and the associated symptoms of autonomic arousal and somatosensation. By using a validated Malay version of vertigo symptom scale (MVVSS) questionnaire, the severity of the vertigo from patients' perspective can be determined and rated. Before MVVSS can be applied clinically among Malaysians, it was of interest to determine its clinical value in identifying vestibular disorders.
  12. Zakaria MN, Jalaei B, Aw CL, Sidek D
    Neurol Sci, 2016 Jun;37(6):943-8.
    PMID: 26921173 DOI: 10.1007/s10072-016-2522-0
    Due to its objective nature, auditory brainstem response (ABR) evoked by complex stimuli has been gaining attention lately. The present study aimed to compare the speech-evoked auditory brainstem response (speech-ABR) results between two ethnic groups: Malay and Chinese. In addition, it was also of interest to compare the speech-ABR outcomes obtained from the present study with the published Caucasian data. Thirty healthy male adults (15 Malay and 15 Chinese) were enrolled in this comparative study. Speech syllable/da/presented at 80 dBnHL was used to record speech-ABR waveforms from the right ear of each subject. Amplitudes and latencies of speech-ABR peaks (V, A, C, D, E, F and O), as well as composite onset measures (V/A duration, V/A amplitude and V/A slope) were computed and analyzed. When the two ethnic groups were compared, all speech-ABR results were not statistically different from each other (p > 0.05). When the data from the present study were compared with the published Caucasian data, most of the statistical analyses were significant (p 
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