Papers by Nik Adilah Nik Othman
Visual Journal of Emergency Medicine
Indian Journal of Otolaryngology and Head & Neck Surgery
Facial nerve palsy is one of the complications of temporal bone fracture. Several approaches can ... more Facial nerve palsy is one of the complications of temporal bone fracture. Several approaches can be used for facial nerve decompression which include the middle cranial fossa approach, transmastoid approach and translabyrinthine approach. When the site of injury is identified at the tympanic segment and perigeniculate area, total transcanal endoscopic approach (TTEA) is an excellent surgical option. This approach is safe and less invasive avoiding external incision and mastoid drilling. Our patient showed recovery to House-Brackmann grade II facial function and reduction of the air–bone gap 6 months after the surgery.
Visual Journal of Emergency Medicine, 2022
An International Journal of Otorhinolaryngology Clinics, 2021
In clinical settings, air conduction (AC) thresholds of pure tone audiometry (PTA) represent the ... more In clinical settings, air conduction (AC) thresholds of pure tone audiometry (PTA) represent the severity of hearing loss. If the AC thresholds are within the normal limit (≤20 dB HL), bone conduction (BC) thresholds are not typically determined. In this case report, the importance of having BC thresholds is highlighted (even though AC thresholds are normal) to achieve an accurate diagnosis.
Malaysian Family Physician
Chronic suppurative otitis media is defined as a chronic inflammation of the mucoperiosteal linin... more Chronic suppurative otitis media is defined as a chronic inflammation of the mucoperiosteal lining of the middle ear cleft. It is described as a persistent disease that is insidious in onset, often capable of causing severe destruction with irreversible sequelae, and clinically present with hearing loss and discharge. It has been classified into tubotympanic (safe) and atticoantral (unsafe) perforation. Cholesteatoma always occur in the atticoantral type and in marginal perforation. We report a case of cholesteatoma that occurred as a tubotympanic type of perforation.
IIUM Medical Journal Malaysia, 2018
Laryngoscope Investigative Otolaryngology, 2022
Objectives: Weber test is typically conducted using tuning forks, but an audiometer can also be u... more Objectives: Weber test is typically conducted using tuning forks, but an audiometer can also be used for a similar purpose. Compared to the tuning fork Weber (TFW) test, performing the audiometric Weber (AW) test offers many advantages. Nevertheless, AW and TFW tests' performance compared to pure-tone audiometry (PTA) has yet to be studied. The present study aimed to determine the accuracy and agreement between the AW and TFW tests compared to PTA. Methods: In this observational cross-sectional study, 74 participants (aged 12-67 years) with unilateral conductive hearing loss (CHL) or bilateral asymmetrical CHL were enrolled. The TFW test was performed according to the established protocol at 256 and 512 Hz. For the AW test, the bone vibrator was placed in the middle of the forehead, where 250 and 500 Hz frequencies were tested. TF and AW test results were then compared with the expected lateralization from the respective PTA results. Results: At 256 Hz (or 250 Hz), the overall accuracy values of TFW and AW tests were 81.1% and 86.5%, respectively. At 512 Hz (or 500 Hz), the overall accuracy results of TFW and AW tests were 85.1% and 82.4%, respectively. In addition, the kappa statistics revealed substantial agreements between the two tests and PTA (k = .63-.72). Conclusion: Both AW and TFW tests are reasonably accurate in assessing patients with CHL. It is recommended for audiologists to perform the simple AW test to verify incomplete or questionable audiograms that are commonly encountered in clinical practice.
Introduction: Post-auricular muscle response (PAMR) is a promising electrophysiological test and ... more Introduction: Post-auricular muscle response (PAMR) is a promising electrophysiological test and more research efforts are required to unveil its basic properties. The purpose of this study was to investigate the influence of the stimulus level on tone-evoked post-auricular muscle response (PAMR) among normally hearing adults. Methods: In this repeated measures study, 20 healthy adults (40 ears) were enrolled. All of them had normal hearing bilaterally and reported no otological disease or neurological deficit. Using Biologic Navigator Pro Auditory Evoked potential (AEP) system, PAMR was recorded according to the recommended test protocols. Participants were instructed to gaze their eyes laterally towards the stimulated ear and PAMR was recorded with tone bursts (500, 1000, 2000 and 4000 Hz). For each frequency, PAMR was recorded at three supra-threshold levels (60, 40 and 20 dB SL) and at thresholds. Results: The first negative-going peak (Pi) of PAMR was sighted between 12.81 ms a...
The New Zealand medical journal, Jan 28, 1997
To determine the effect of frequent vacuum cleaning of carpets on Der p 1, the major group one al... more To determine the effect of frequent vacuum cleaning of carpets on Der p 1, the major group one allergen of the house dust mite Dermatophagoides pteronyssinus. Nine rooms and three hallways in the resident medical officers quarters at Wellington Hospital were regularly vacuum cleaned (daily, except weekends) over a five week period. Dust samples were collected before and at weekly intervals for Der p 1 measurement by a double monoclonal antibody ELISA technique. Der p 1 concentrations progressively declined from an initial geometric mean level (95% CI) of 4.47 micrograms/g fine dust (0.11-21.73) to 1.83 micrograms/g (0.29-9.57) after five weeks, a mean reduction of 48.0% (31.7-65.5). Similarly when expressed per unit area Der p 1 levels declined from 6.35 micrograms/m2 (1.15-35.16) to 1.66 micrograms/m2 (0.33-9.04), a mean reduction of 68.5% (58.6-78.3). Frequent vacuum cleaning over a short time significantly reduces house dust mite allergen levels in carpets. Larger long term trial...
International journal of statistics in medical research, Dec 30, 2022
Introduction: Sensorineural acuity level (SAL) test is believed to be helpful in estimating bone ... more Introduction: Sensorineural acuity level (SAL) test is believed to be helpful in estimating bone conduction thresholds in masking dilemma cases. However, before the SAL normative data can be used in clinical settings, there is a need to study the fundamental variable related to SAL normative data such as head circumference. As such, the purpose of the current study was to compare SAL normative values between subjects with bigger and smaller head circumferences at different frequencies. Materials and Methods: In this study, 48 healthy Malaysian adult subjects (aged between 18 and 50 years) were enrolled. Pure tone audiometry (PTA) and SAL test were subsequently conducted based on the recommended protocols. The SAL normative values were then compared between subjects with bigger and smaller head circumferences. Data analysis methods included paired t-test, effect size, and Bayesian approach. Results: No significant differences were noted in the SAL results when the two groups were compared, implying that the SAL normative data were not influenced by the head circumference (p > 0.05, BF10 = 0.232-0.708). Conclusions: Based on the findings of this study it appears that the SAL test results are not affected by the head sizes of the subjects. Future SAL test studies may use the normative SAL values established in the current study as a guide.
Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2020
ABSTRACTIntroduction: Facial nerve schwannoma is a rare benign tumour involving any site of the f... more ABSTRACTIntroduction: Facial nerve schwannoma is a rare benign tumour involving any site of the facial nerve where schwann cells are present.Case report: A 29-year-old lady presented with right ear tinnitus for one year, associated with reduced hearing for the last six months. Otherwise, no other cranial nerves were involved. The patient did not complain of any facial twitching or vestibular symptom. Patient was then investigated using audiological assessment and imaging which concluded the diagnosis as facial nerve schwannoma. In view of normal facial never function, the patient received conservative management.Discussion: Symptoms may differ according to the location of the tumour and also compression on the adjacent structures, namely facial nerve palsy, hearing loss and tinnitus. Treatment option depends on the grade of facial nerve palsy and its prognosis post-surgery. Although the mainstay of treatment is surgical excision, every patient has to be individually assessed and tre...
Background and Aim : Self-administered questionnaires are clinically important to document how ti... more Background and Aim : Self-administered questionnaires are clinically important to document how tinnitus affects the daily life of patients. In this regard, there is a need to have an alternative questionnaire that covers relevant aspects of tinnitus and related symptoms. The present study aimed to develop and validate a new tinnitus questionnaire known as Tinnitus Handicap Questionnaire or Borang Evaluasi Soal selidik Tinitus (BEST) in Malay version. Methods : The present study had two consecutive phases. In phase 1 of study, BEST questionnaire was initially developed in English and underwent forward and backward translation processes. Following relevant amendments, the final version of BEST (Malay version) was ready for subsequent tasks. It consists of 25 items categorized under 3M domain (mind, main and mental). In phase 2, 65 patients with tinnitus were recruited for determining the validity and reliability of BEST. Results : Content validity index (CVI) of BEST ranged from 0....
Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomy... more Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.
IIUM Medical Journal Malaysia
Duplication of the internal auditory canal is a rare entity. It can be unilateral or bilateral in... more Duplication of the internal auditory canal is a rare entity. It can be unilateral or bilateral involvement and usually found during an investigation of sensorineural hearing loss or facial nerve palsy. We report this image finding in a child with Down syndrome with bilateral profound sensorineural hearing loss. There was no facial nerve palsy. We highlight the rarity of this image finding and the importance of imaging for detection of middle and inner ear abnormality in a case of congenital sensorineural hearing loss as it helps in decision making for the suitable treatment. Keywords: Duplicate IAC; Bilateral Duplicate IAC; sensorineural hearing loss; Down syndrome
Laryngoscope Investigative Otolaryngology
To determine the association between extended high frequency hearing loss and tinnitus in normal ... more To determine the association between extended high frequency hearing loss and tinnitus in normal cochlear function based on a conventional audiometry chronic suppurative otitis media (CSOM) patient.
Acta Medica (Hradec Kralove, Czech Republic)
Skull base osteomyelitis (SBO) also commonly known as malignant otitis externa was first describe... more Skull base osteomyelitis (SBO) also commonly known as malignant otitis externa was first described by Meltzer and Kelemen in 1959. Prior to the advent of the antibiotic era, this disease carried a poor prognosis with significant morbidity. It often proved fatal with mortality rates as high as 50%. Commonly seen in the immunocompromised patients, diabetes mellitus is an important associated comorbidity in the pathophysiologic development of this disease. Treatment is instituted by medical therapy with surgery having a limited role. Surgical intervention has a limited role, for example, in fungal SBO. Such cases may require local debridement and intraoperative tissue biopsies for histopathologic confirmation. This is to demonstrate fungal invasion into the skull base, as well as to exclude other sinister differential diagnoses like squamous cell carcinoma of temporal bone. In this case report, we present a rare case of candida SBO and the literature review.
Otology & Neurotology
Background: Presbycusis is an age-related sensorineural hearing loss and it may reduce quality of... more Background: Presbycusis is an age-related sensorineural hearing loss and it may reduce quality of life. We conducted a study to establish the prevalence of high-frequency presbycusis in normal hearing individuals and to validate the role of extended high-frequency distortion product otoacoustic emission (DPOAE) in the screening. Method: A cross-sectional study was conducted among 205 normal hearing adult participants with an age range between 25 and 54 years old. Hearing analysis with extended high-frequency pure-tone audiometry (PTA) and high-frequency DPOAE was carried out for all eligible participants. High-frequency presbycusis was considered to be present when the impairment of more than 25 dB occurs at higher than 8 kHz frequencies on both ears. Results: : Prevalence of high-frequency presbycusis using extended PTA was 31.7 (95% CI: 25.3, 38.1) and using high-frequency DPOAE was 57.4 (95% CI: 50.7, 64.4). The sensitivity and specificity of high-frequency DPOAE in detecting high-frequency presbycusis were 72.3 and 49.3% respectively with positive predictive value of 39.8% and negative predictive value of 79.3%. The association between age and high-frequency presbycusis was significant based on high-frequency DPOAE (p = 0.029). Conclusions: : The prevalence of high-frequency hearing loss is higher with increasing in age. High-frequency DPOAE may be used as a screening tool followed by confirmation using extended PTA. The early detection of presbycusis is important so that measures can be taken to prevent more severe problems developing.
Oman Medical Journal, Jan 15, 2016
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Papers by Nik Adilah Nik Othman