Introduction: Friedreich’s ataxia (FRDA) is an inherited ataxia with a range of progressive features including axonal degeneration of sensory nerves. The aim of this study was to investigate auditory perception in affected individuals. Methods: Fourteen subjects with genetically defined FRDA participated. Two control groups, one consisting of healthy, normally hearing individuals and another comprised of subjects with sensorineural hearing loss, were also assessed. Auditory processing was evaluated using structured tasks designed to reveal the listeners’ ability to perceive temporal and spectral cues. Findings were then correlated with open-set speech understanding. Results: Nine of 14 individuals with FRDA showed evidence of auditory processing disorder. Gap and amplitude modulation detection levels in these subjects were significantly elevated, indicating impaired encoding of rapid signal changes. Electrophysiologic findings (auditory brainstem response, ABR) also reflected disrupted neural activity. Speech understanding was significantly affected in these listeners and the degree of disruption was related to temporal processing ability. Speech analyses indicated that timing cues (notably consonant voice onset time and vowel duration) were most affected. Conclusion: The results suggest that auditory pathway abnormality is a relatively common consequence of FRDA. Regular auditory evaluation should therefore be part of the management regime for all affected individuals. This assessment should include both ABR testing, which can provide insights into the degree to which auditory neural activity is disrupted, and some functional measure of hearing capacity such as speech perception assessment, which can quantify the disorder and provide a basis for intervention.

Introduction: This discussion paper aims to synthesise available literature on hearing sciences from Islamic perspective and to relate this to the current hearing care practices. The paper focuses on several main scopes: i) the importance of sense of hearing from Islamic and scientific perspectives ii) impacts of hearing impairment iii) limitations in understanding and practicing Islamic teaching due to hearing impairment, iv) Islamic responsibility towards people with hearing impairment, v) current available methods to facilitate Islamic practices among hearing impaired people, and vi) incorporating Islamization in hearing care practice. Design: Narrative review and synthesis Method: Related publications and references were identified through several ways: i) by structured searches in PubMed, Google scholar, Web of Knowledge and Science Direct using the combinations of ‘Islam’, ‘hearing impairment’, ‘hearing loss’, ‘hearing’, ‘social’, learning’, ‘memory’, ‘disability’, ‘Islamic responsibility’, and ‘learning for deaf’ as key words, ii) by inspecting the reference lists of relevant articles, and iii) by identification of relevant references from Quran and Hadith by authors who have background in Quranic studies. Results: The number of publications within the audiology field, which address the aforementioned scopes, is rather limited. Additionally, a review and synthesis of literature from other related fields such as medical, health, and education, with references from Quran and Hadith, were also carried out to facilitate the discussion of the above mentioned scopes. Conclusion: This paper concludes that there is an emerging trend for the studies of hearing and Islam in the literature. Facilitating hearing impaired people in understanding and practicing Islam becomes a shared obligation for parents, society, and the patients themselves. This discussion also identifies that there is a need for more contributions from Muslim scholars in integrating and implementing the Islamic principles in current hearing care practices.

Introduction: This study aimed to develop a self-administered hearing screening test using digit triplets in Malay (MDTT) to be used as a national hearing screening tool via internet and telephone landlines in Malaysia. Methods: Recordings of disyllabic Malay digits by a female Malay native speaker were used together with a speech shaped stationary noise (TSN). The test stimuli were normalized using responses from twenty normal hearing native Malay speakers. The data were used to produce eight equivalent test lists. An additional twenty normal hearing native Malay speakers were recruited to test the lists equivalency. Forty six listeners with varying levels of hearing were recruited to validate the tests. ROC analysis was done to identify the pass and refer cut-off limits. Results: No statistical differences were found between lists for both test conditions. The evaluation in fixed SNRs resulted in a mean speech reception threshold (SRT) of -11.3 ± 0.34 dB SNR for headphone and -10.24 ± 0.1 dB SNR for telephone applications. A significant main effect of type of transducer was observed in both normal and hearing impaired groups. The cut off for refer, sensitivity and specificity for the tests using telephones are (-5.8dB, 80.8%, 95%) and headphones (-9.8dB, 80.8%, 100%). Conclusions: The MDTT was successfully developed and the normative values are comparable to other versions of the digit triplet tests. The MDTT showed high sensitivity and specificity and can be made available to any Malay speaking public via telephone and internet.

Introduction: With recent advancements in vestibular assessments, new ancillary tests can assist clinicians to better understand underlying cause of a balance problem. The recently established specialized vestibular clinic in Sultan Ahmad Shah Medical Centre @IIUM is equipped with these tests. This study aimed to determine the prevalence of the different diagnoses of balance disorders in a specialized vestibular clinic in Kuantan, Malaysia. Materials and Methods: This is a retrospective review of 121 walk-in patients over an 18-month period at a specialized Vestibular Clinic in Sultan Ahmad Shah Medical Centre @IIUM. The variables analysed in this review include the age, gender, ethnicity, diagnoses, and total number of visits before diagnoses were achieved. Results: Meticulous history taking, focused otorhinolaryngological examination and detailed vestibular assessment through the specialized vestibular clinic helped us in reaching a conclusive diagnosis. The most common cause of balance disorders in our review was Benign Paroxysmal Positional Vertigo (BPPV), constituting 41.3% of the cases. Among the canals, the posterior canal is the most affected  (70%) and is usually treated with Epley manoeuvre. Other common diagnoses   include Vestibular Migraine, Meniere’s Disease and Vestibular Neuritis. Conclusion: Vestibular clinics play a vital role in helping to pinpoint the accurate diagnosis of patients with balance disorders.

IntroductionVertigo, or the perception of a spinning sensation, is a common symptom experienced by patients who are referred to Otorhinolaryngology clinics. Betahistine is a medication that has been widely used to treat vertigo and its accompanying symptoms. However, the effects of this medication on the vestibulo-ocular reflex (VOR) are still unknown. Initially, it was assumed that betahistine should be discontinued prior to any vestibular tests, particularly the video head impulse test (vHIT). MethodThirty young healthy adults were randomly divided into two equal groups for this randomized double-blind clinical study (betahistine 24 mg and placebo). Baseline pure-tone audiometry (PTA), tympanometry, and VOR measurements were taken, followed by experimental measurements at one hour, four hours, eight hours, and 24 hours after consumption. The video head impulse test (vHIT) was used to determine the VOR. ResultBetahistine had no statistically significant effect on vestibulo-ocular reflex gain (F(4,140) = 0.601, p = 0.662). The gain variability across repetitive head impulses remained constant over time. ConclusionsBetahistine has no effect on the vestibulo-ocular reflex. As a result, this medication can be taken prior to the vHIT procedure.