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  1. Akmaliza Ali, Ellin Fariza Selamat
    MyJurnal
    Kajian terdahulu mendapati Respons Auditori Keadaan Mantap (ASSR) mempunyai variasi yang besar dalam meramal ambang pendengaran, manakala kebolehulangan ASSR masih kurang dilaporkan. Kajian ini bertujuan untuk menentukan kebolehulangan ASSR dalam menilai ambang pendengaran golongan dewasa lanjut umur yang bermasalah pendengaran sensorineural. Seramai 15 orang subjek berumur antara 55 hingga 75 tahun terlibat dalam kajian ini. Ambang pendengaran ditentukan menggunakan audiometri nada tulen (PTA) dan ASSR pada frekuensi 0.5, 1, 2 dan 4 kHz, di mana ASSR diulang pada 0.5 dan 1 kHz. Secara keseluruhannya, nilai ambang ASSR adalah lebih tinggi daripada PTA. ANOVA satu hala menunjukkan perbezaan antara ambang PTA dan ASSR adalah tidak signifikan pada semua frekuensi. Terdapat korelasi yang signifikan antara ambang PTA dan ambang ASSR pada 0.5 kHz (r = 0.77, p < 0.05), 1 kHz (r = 0.45, p < 0.05), 2 kHz (r = 0.58, p < 0.05) dan 4 kHz (r = 0.73, p < 0.05). Ujian t berpasangan menunjukkan tiada perbezaan signifikan antara ujian ASSR pertama dan ASSR ulangan pada frekuensi 0.5 kHz (t = 2.09, p > 0.05) dan 1 kHz (t = 0.436, p > 0.05). Korelasi Pearson menunjukkan korelasi yang sederhana di antara dua pengukuran ASSR pada 0.5 kHz (r = 0.68, p < 0.001) dan 1 kHz (r = 0.60, p < 0.001). Hasil kajian ini mendapati bahawa ambang pendengaran ASSR tidak berubah secara signifikan jika diulang uji dan ujian ASSR boleh disarankan sebagai alternatif kepada PTA dalam menentukan ambang pendengaran golongan dewasa lanjut usia bermasalah pendengaran sensorineural.
    Matched MeSH terms: Audiometry, Evoked Response
  2. 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.

    Matched MeSH terms: Audiometry, Evoked Response/methods*
  3. Bester C, Collins A, Razmovski T, Weder S, Briggs RJ, Wei B, et al.
    Hear Res, 2022 Dec;426:108353.
    PMID: 34600798 DOI: 10.1016/j.heares.2021.108353
    BACKGROUND: Preservation of natural hearing during cochlear implantation is associated with improved speech outcomes, however more than half of implant recipients lose this hearing. Real-time electrophysiological monitoring of cochlear output during implantation, made possible by recording electrocochleography using the electrodes on the cochlear implant, has shown promise in predicting hearing preservation. Sudden drops in the amplitude of the cochlear microphonic (CM) have been shown to predict more severe hearing losses. Here, we report on a randomized clinical trial investigating whether immediate surgical intervention triggered by these drops can save residual hearing.

    METHODS: A single-blinded placebo-controlled trial of surgical intervention triggered when CM amplitude dropped by at least 30% of a prior maximum amplitude during cochlear implantation. Intraoperative electrocochleography was recorded in 60 adults implanted with Cochlear Ltd's Thin Straight Electrode, half randomly assigned to a control group and half to an interventional group. The surgical intervention was to withdraw the electrode in ½-mm steps to recover CM amplitude. The primary outcome was hearing preservation 3 months following implantation, with secondary outcomes of speech-in-noise reception thresholds by group or CM outcome, and depth of implantation.

    RESULTS: Sixty patients were recruited; neither pre-operative audiometry nor speech reception thresholds were significantly different between groups. Post-operatively, hearing preservation was significantly better in the interventional group. This was the case in absolute difference (median of 30 dB for control, 20 dB for interventional, χ² = 6.2, p = .013), as well as for relative difference (medians of 66% for the control, 31% for the interventional, χ² = 5.9, p = .015). Speech-in-noise reception thresholds were significantly better in patients with no CM drop at any point during insertion compared with patients with a CM drop; however, those with successfully recovered CMs after an initial drop were not significantly different (median gain required for speech reception score of 50% above noise of 6.9 dB for no drop, 8.6 for recovered CM, and 9.8 for CM drop, χ² = 6.8, p = .032). Angular insertion depth was not significantly different between control and interventional groups.

    CONCLUSIONS: This is the first demonstration that surgical intervention in response to intraoperative hearing monitoring can save residual hearing during cochlear implantation.

    Matched MeSH terms: Audiometry, Evoked Response/methods
  4. 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.
    Matched MeSH terms: Audiometry, Evoked Response/methods*
  5. Ngui LX, Tang IP, Prepageran N, Lai ZW
    Int J Pediatr Otorhinolaryngol, 2019 May;120:184-188.
    PMID: 30844634 DOI: 10.1016/j.ijporl.2019.02.045
    INTRODUCTION: Congenital hearing loss is one of the commonest congenital anomalies. Neonatal hearing screening aims to detect congenital hearing loss early and provide prompt intervention for better speech and language development. The two recommended methods for neonatal hearing screening are otoacoustic emission (OAE) and automated auditory brainstem response (AABR).

    OBJECTIVE: To study the effectiveness of distortion product otoacoustic emission (DPOAE) and automated auditory brainstem response (AABR) as first screening tool among non-risk newborns in a hospital with high delivery rate.

    METHOD: A total of 722 non-risk newborns (1444 ears) were screened with both DPOAE and AABR prior to discharge within one month. Babies who failed AABR were rescreened with AABR ± diagnostic auditory brainstem response tests within one month of age.

    RESULTS: The pass rate for AABR (67.9%) was higher than DPOAE (50.1%). Both DPOAE and AABR pass rates improved significantly with increasing age (p-value<0.001). The highest pass rate for both DPOAE and AABR were between the age of 36-48 h, 73.1% and 84.2% respectively. The mean testing time for AABR (13.54 min ± 7.47) was significantly longer than DPOAE (3.52 min ± 1.87), with a p-value of <0.001.

    CONCLUSIONS: OAE test is faster and easier than AABR, but with higher false positive rate. The most ideal hearing screening protocol should be tailored according to different centre.

    Matched MeSH terms: Audiometry, Evoked Response
  6. Abdullah A, Hazim MY, Almyzan A, Jamilah AG, Roslin S, Ann MT, et al.
    Singapore Med J, 2006 Jan;47(1):60-4.
    PMID: 16397723
    This study aims to determine the prevalence of hearing loss among newborns delivered at Hospital Universiti Kebangsaan Malaysia and to evaluate the usefulness of our hearing screening protocol.
    Matched MeSH terms: Audiometry, Evoked Response
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