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.
Vestibulocochlear Nerve Diseases

Introduction: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. Method: Forty normal and 65 PVD subjects participated in this cross-sectional study. Normal subjects were recruited amongst Universiti Sains Malaysia (USM) staff and students who had no history of ear and vestibular disorders. Results: Mean total score of MVVSS in normal and PVD subjects were 13.9 ± 11.1 and 30.1 ± 20.9, respectively. When the total scores of normal and PVD group were compared, the Mann-Whitney U test showed that there was a significant difference between the two groups (p<0.05). This is consistent with previous studies. It was also of interest to see if subtypes of PVD [benign paroxymal positional vertigo (BPPV), Meniere’s disease, labyrinthitis and unknown] have different MVVSS results. However, analysis of variance (ANOVA) found no significant difference in term of outcomes of MVVSS among the different PVD pathologies. Using receiver operating characteristic curve (ROC) method, the sensitivity and specificity of MVVSS were 71% and 60%, respectively. Conclusion: MVVSS is able to discriminate clinically among the normal and PVD subjects. However, it is not a good indicator for differential diagnosis of PVD subtypes, at least in this study. Its sensitivity and specificity in clinical diagnosis are reasonably high. Perhaps a bigger sample size would be useful to further study the clinical usefulness of MVVSS.

SUMMARY Introduction: The aim of this article was to review the types of psychological interventions for patients with tinnitus, professionals involved in giving the intervention, the effectiveness of each method of interventions and comparisons with non-psychological approaches in treating tinnitus. Materials and Methods: PubMed database searched. Results: Twenty one articles that employed randomized controlled trials design were included. Cognitive behavioural therapy (CBT) was the most common intervention conducted by the researchers. Clinical psychologists and trainee psychologists were the most professionals involved in the therapy. The length of therapy ranged from six weeks to three months. Discussion: Psychological interventions were more effective in reducing psychological impacts of tinnitus than non-psychological interventions such as the use of tinnitus maskers. Nevertheless, the combination of the treatments yielded more superior outcomes. Conclusion: A simplified version of psychological intervention that can be implemented by other clinical professionals should be developed to treat tinnitus holistically to overcome the shortage number of clinical psychologists.
Tinnitus ; Clinical Trial

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 acomputerized device. They were asked to report their horizontality perception for solid and dottedline images (in the presence of a static black background). After 1 week, the SVH procedurewas 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-Altmanplots, for each visual image, the agreements of SVH between the two sessions were within theclinically accepted criteria (±2°). The SVH testing was found to be temporally reliable, which canbe clinically beneficial. Both solid and dotted lines in the SVH testing are reliable to be usedamong young adults. J Audiol Otol 2020;24(2):107-111

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.
Auditory Pathways ; Case-Control Studies ; Ear ; Hearing* ; Humans ; Masks ; Noise* ; Schizophrenia*

OBJECTIVE: 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. METHODS: Participants were twenty-three healthy controls and sixteen schizophrenia patients with normal hearing, middle ear and cochlear outer hair cells function. Absolute non-linear and linear TEOAEs were measured in both ears by delivering clicks stimuli at 80 dB SPL and 60 dB SPL respectively. Subsequently, contralateral suppression was determined by subtracting the absolute TEOAEs response obtained at 60 dBpe SPL during the absence and presence of contralateral white noise delivered at 65 dB HL. No attention tasks were conducted during measurements. RESULTS: We found no significant difference in absolute TEOAEs responses at 80 dB SPL, in either diagnosis or ear groups (p>0.05). However, the overall contralateral suppression was significantly larger in schizophrenia patients (p<0.05). Specifically, patients with schizophrenia demonstrated significantly increased right ear contralateral suppression compared to healthy control (p<0.05). CONCLUSION: The present findings suggest increased inhibitory effect of efferent auditory pathway especially on the right cochlear outer hair cells. Further studies to investigate increased suppressive effects are crucial to expand the current understanding of auditory hallucination mechanisms in schizophrenia patients.
Afferent Pathways ; Auditory Pathways ; Case-Control Studies ; Diagnosis ; Ear ; Ear, Middle ; Efferent Pathways ; Hair ; Hallucinations ; Hearing ; Humans ; Noise ; Schizophrenia*

No abstract available.

No abstract available.
Tinnitus*

Introduction: Tinnitus is a common complaint amongpatients with ear diseases and can be serious if not treated.Recently, a Malay tinnitus questionnaire, known as the“Borang Evaluasi Soal selidik Tinnitus” (BEST) had beendeveloped and preliminarily validated among Malayspeakingpopulation. The aims of the present study were todetermine the test-retest reliability and responsiveness ofthe BEST questionnaire.Method: Forty-six Malay adults (aged 23-74 years) withtinnitus were enrolled. They were instructed to fill in theBEST questionnaire accordingly. After one week, 21 of themwere asked to fill in the questionnaire again. The other 25subjects underwent tinnitus intervention for three monthsand following this; the BEST was administered to themagain.Results: In the test-retest reliability task, the intraclasscorrelation values obtained were acceptably high (0.70-0.90).After the intervention, significant differences in the BESTresult were found in the mind domain, main domain andcomposite score (p<0.05) with moderate effect sizes (0.61-0.70).Conclusion: The test-retest reliability of the BEST was foundto be good. It also showed good responsiveness tointervention. The clinical usefulness of the BEST inassessing patients with tinnitus was further supported bythe present study.nnaire; reliability; responsiveness; effect size

No abstract available.
Hearing Loss, Conductive ; Sound Localization