• Journal of Audiology & Otology
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• v.23 no.1
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• pp.49-52
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• 2019

Background and Objectives: Considering important role of vitamin D in many physiological processes including vestibular system in the ear, aim of present study is to evaluate saccule function via cervical vestibular evoked myogenic potential (cVEMP), in patients with vitamin D deficiency. Subjects and Methods: After routine audiological tests, cVEMP were recorded in 15 patients with vitamin D deficiency and 16 normal subjects. The short tone burst (95 dB nHL, 500 Hz) was presented to ears. cVEMP was recorded with surface electromyography over the contracted ipsilateral sternocleidomastoid muscle. Results: Mean of p13, n13, interpeak latencies and amplitude ratios were measured in both groups. Statistical analysis did not show differences between two groups. Conclusions: Maybe serum 25-hydroxyvitamin D concentration was not low enough to have effect on saccule in the patients in present study or saccule have had low susceptibility to effects of vitamin D deficiency. For better judgment about effect of vitamin D deficiency on saccular function planning studies with high sample size is recommended.

• Korean Journal of Audiology
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• v.23 no.1
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• pp.49-52
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• 2019

Background and Objectives: Considering important role of vitamin D in many physiological processes including vestibular system in the ear, aim of present study is to evaluate saccule function via cervical vestibular evoked myogenic potential (cVEMP), in patients with vitamin D deficiency. Subjects and Methods: After routine audiological tests, cVEMP were recorded in 15 patients with vitamin D deficiency and 16 normal subjects. The short tone burst (95 dB nHL, 500 Hz) was presented to ears. cVEMP was recorded with surface electromyography over the contracted ipsilateral sternocleidomastoid muscle. Results: Mean of p13, n13, interpeak latencies and amplitude ratios were measured in both groups. Statistical analysis did not show differences between two groups. Conclusions: Maybe serum 25-hydroxyvitamin D concentration was not low enough to have effect on saccule in the patients in present study or saccule have had low susceptibility to effects of vitamin D deficiency. For better judgment about effect of vitamin D deficiency on saccular function planning studies with high sample size is recommended.

• Journal of Audiology & Otology
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• v.25 no.3
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• pp.152-158
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• 2021

Background and Objectives: Balance control is maintained in stationary and dynamic conditions, with coordinated muscle responses generated by somatosensory, vestibular, and visual inputs. This study aimed to investigate how the vestibular system is affected in the presence of an optical illusion to better understand the interconnected pathways of the visual and vestibular systems. Subjects and Methods: The study involved 54 young adults (27 males and 27 females) aged 18-25 years. The recruited participants were subjected to the cervical vestibular evoked myogenic potentials (cVEMP) test and video head impulse test (vHIT). The cVEMP and vHIT tests were performed once each in the absence and presence of an optical illusion. In addition, after each test, whether the individuals felt balanced was determined using a questionnaire. Results: cVEMP results in the presence of the optical illusion showed shortened latencies and increased amplitudes for the left side in comparison to the results in the absence of the optical illusion (p≤0.05). When vHIT results were compared, it was seen that the right lateral and bilateral anterior canal gains were increased, almost to 1.0 (p<0.05). Conclusions: It is thought that when the visual-vestibular inputs are incompatible with each other, the sensory reweighting mechanism is activated, and this mechanism strengthens the more reliable (vestibular) inputs, while suppressing the less reliable (visual) inputs. As long as the incompatible condition persists, the sensory reweighting mechanism will continue to operate, thanks to the feedback loop from the efferent vestibular system.

• Journal of Audiology & Otology
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• v.25 no.1
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• pp.14-21
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• 2021

Background and Objectives: There is growing interest in the use of the Level-specific (LS) CE-Chirp^® stimulus in auditory brainstem response (ABR) due to its ability to produce prominent ABR waves with robust amplitudes. There are no known studies that investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus. The present study aims to investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus and compare its reliability with the ABR to standard click stimulus at multiple intensity levels in normal-hearing adults. Subjects and Methods: Eleven normal-hearing adults participated. The ABR test was repeated twice in the same clinical session and conducted again in another session. The ABR was acquired using both the click and LS CE-Chirp^® stimuli at 4 presentation levels (80, 60, 40, and 20 dBnHL). Only the right ear was tested using the ipsilateral electrode montage. The reliability of the ABR findings (amplitudes and latencies) to the click and LS CE-Chirp^® stimuli within the same clinical session and between the two clinical sessions was calculated using an intra-class correlation coefficient analysis (ICC). Results: The results showed a significant correlation of the ABR findings (amplitude and latencies) to both stimuli within the same session and between the clinical sessions. The ICC values ranged from moderate to excellent. Conclusions: The ABR results from both the LS CE-Chirp^® and click stimuli were consistent and reliable over the two clinical sessions suggesting that both stimuli can be used for neurological diagnoses with the same reliability.

• Korean Journal of Audiology
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• v.25 no.2
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• pp.72-79
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• 2021

Background and Objectives: The speech-in-noise test is typically performed using an audiometer. The results of the digit-in-noise recognition (DIN) test may be influenced by the flat frequency response of free-field audiometry and frequency of the hearing aid fit based on fitting rationale. This study aims to investigate the DIN test in unaided and aided conditions. Subjects and Methods: Thirty four adults with moderate and severe sensorineural hearing loss (SNHL) participated in the study. The signal-to-noise ratio (SNR) for 50% of the DIN test was obtained in the following two conditions: 1) the unaided condition, performed using an audiometer in a free field; and 2) aided condition, performed using a hearing aid with an unvented individual earmold that was fitted based on NAL-NL2. Results: There was a statistically significant elevation in the mean SNR for the severe SNHL group in both test conditions when compared with that of the moderate SNHL group. In both groups, the SNR for the aided condition was significantly lower than that of the unaided condition. Conclusions: Speech recognition in hearing-impaired patients can be realized by fitting hearing aids based on evidence-based fitting rationale rather than by measuring it using free-field audiometry measurement that is utilized in a routine clinic setup.

• Korean Journal of Audiology
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• v.25 no.3
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• pp.152-158
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• 2021

Background and Objectives: Balance control is maintained in stationary and dynamic conditions, with coordinated muscle responses generated by somatosensory, vestibular, and visual inputs. This study aimed to investigate how the vestibular system is affected in the presence of an optical illusion to better understand the interconnected pathways of the visual and vestibular systems. Subjects and Methods: The study involved 54 young adults (27 males and 27 females) aged 18-25 years. The recruited participants were subjected to the cervical vestibular evoked myogenic potentials (cVEMP) test and video head impulse test (vHIT). The cVEMP and vHIT tests were performed once each in the absence and presence of an optical illusion. In addition, after each test, whether the individuals felt balanced was determined using a questionnaire. Results: cVEMP results in the presence of the optical illusion showed shortened latencies and increased amplitudes for the left side in comparison to the results in the absence of the optical illusion (p≤0.05). When vHIT results were compared, it was seen that the right lateral and bilateral anterior canal gains were increased, almost to 1.0 (p<0.05). Conclusions: It is thought that when the visual-vestibular inputs are incompatible with each other, the sensory reweighting mechanism is activated, and this mechanism strengthens the more reliable (vestibular) inputs, while suppressing the less reliable (visual) inputs. As long as the incompatible condition persists, the sensory reweighting mechanism will continue to operate, thanks to the feedback loop from the efferent vestibular system.

• Korean Journal of Audiology
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• v.24 no.2
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• pp.71-78
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• 2020

Background and Objectives: Currently limited information is available on speech stimuli processing at the subcortical level in the recipients of cochlear implant (CI). Speech processing in the brainstem level is measured using speech-auditory brainstem response (S-ABR). The purpose of the present study was to measure the S-ABR components in the sound-field presentation in CI recipients, and compare with normal hearing (NH) children. Subjects and Methods: In this descriptive-analytical study, participants were divided in two groups: patients with CIs; and NH group. The CI group consisted of 20 prelingual hearing impairment children (mean age=8.90±0.79 years), with ipsilateral CIs (right side). The control group consisted of 20 healthy NH children, with comparable age and sex distribution. The S-ABR was evoked by the 40-ms synthesized /da/ syllable stimulus that was indicated in the sound-field presentation. Results: Sound-field S-ABR measured in the CI recipients indicated statistically significant delayed latencies, than in the NH group. In addition, these results demonstrated that the frequency following response peak amplitude was significantly higher in CI recipients, than in the NH counterparts (p<0.05). Finally, the neural phase locking were significantly lower in CI recipients (p<0.05). Conclusions: The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech process in CI recipients.

• Korean Journal of Audiology
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• v.25 no.1
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• pp.14-21
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• 2021

Background and Objectives: There is growing interest in the use of the Level-specific (LS) CE-Chirp^® stimulus in auditory brainstem response (ABR) due to its ability to produce prominent ABR waves with robust amplitudes. There are no known studies that investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus. The present study aims to investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus and compare its reliability with the ABR to standard click stimulus at multiple intensity levels in normal-hearing adults. Subjects and Methods: Eleven normal-hearing adults participated. The ABR test was repeated twice in the same clinical session and conducted again in another session. The ABR was acquired using both the click and LS CE-Chirp^® stimuli at 4 presentation levels (80, 60, 40, and 20 dBnHL). Only the right ear was tested using the ipsilateral electrode montage. The reliability of the ABR findings (amplitudes and latencies) to the click and LS CE-Chirp^® stimuli within the same clinical session and between the two clinical sessions was calculated using an intra-class correlation coefficient analysis (ICC). Results: The results showed a significant correlation of the ABR findings (amplitude and latencies) to both stimuli within the same session and between the clinical sessions. The ICC values ranged from moderate to excellent. Conclusions: The ABR results from both the LS CE-Chirp^® and click stimuli were consistent and reliable over the two clinical sessions suggesting that both stimuli can be used for neurological diagnoses with the same reliability.

• Journal of Audiology & Otology
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• v.24 no.2
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• pp.71-78
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• 2020

Background and Objectives: Currently limited information is available on speech stimuli processing at the subcortical level in the recipients of cochlear implant (CI). Speech processing in the brainstem level is measured using speech-auditory brainstem response (S-ABR). The purpose of the present study was to measure the S-ABR components in the sound-field presentation in CI recipients, and compare with normal hearing (NH) children. Subjects and Methods: In this descriptive-analytical study, participants were divided in two groups: patients with CIs; and NH group. The CI group consisted of 20 prelingual hearing impairment children (mean age=8.90±0.79 years), with ipsilateral CIs (right side). The control group consisted of 20 healthy NH children, with comparable age and sex distribution. The S-ABR was evoked by the 40-ms synthesized /da/ syllable stimulus that was indicated in the sound-field presentation. Results: Sound-field S-ABR measured in the CI recipients indicated statistically significant delayed latencies, than in the NH group. In addition, these results demonstrated that the frequency following response peak amplitude was significantly higher in CI recipients, than in the NH counterparts (p<0.05). Finally, the neural phase locking were significantly lower in CI recipients (p<0.05). Conclusions: The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech process in CI recipients.

• Journal of Audiology & Otology
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• v.23 no.3
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• pp.129-134
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• 2019

Background and Objectives: Sine a self-reported questionnaire for hearing-impaired listeners is not available by Malay language yet, it is important to develop or translate any available existing questionnaires. The aim of this study was to translate, adapt and validate the Hearing Handicap Inventory for Adult (HHIA) to be used by the audiologist among the hearing-impaired population in Malaysia. Subjects and Methods: The HHIAs was translated to Malay language using forward-backward translation techniques by four-panellists (two for each level). The translated HHIA was then reconciled and harmonized for cultural aspects and content of the questionnaire by the researchers and two expert panels before being pilot-tested among 10 hearing-impaired patients. Questionnaire validation was conducted among 80 adults with a hearing loss to calculate for Cronbach's α (internal reliability), Spearman's correlation (inter-item correlation) and factor analysis. Results: None of the translated items were removed from the scale. The overall Cronbach's α was 0.964; 0.927 and 0.934 for both social and emotional subscales, respectively. The factor analysis (force-concept inventory) demonstrated a two-structure with a strong correlation between all items in either component 1 or 2, that resembled the original scale. The Mann-Whitney test revealed significantly higher scores for those adults with a hearing loss than those adults with normal hearing. Conclusions: The Malay HHIA has been successfully translated and validated for the purpose of determining the psychosocial aspects of adults with hearing loss in the local population.