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Fulltext Extended high frequency hearing loss in tinnitus-positive chronic suppurative otitis media patient

Mohd Salehuddin NS, Md Daud MK, Nik Othman NA, Abd Rahman N

Laryngoscope Investig Otolaryngol, 2021 Oct;6(5):1137-1141.
PMID: 34667858 DOI: 10.1002/lio2.651

Objectives: 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.
Design and methods: A cross-sectional study was conducted on 220 ears diagnosed as having CSOM with an equal number of tinnitus and without tinnitus groups. Only those with normal cochlear function based on conventional pure tone audiometry (250 Hz to 8 kHz) were included. They were further tested for hearing at extended high frequencies of up to 16 kHz. The severity of tinnitus was tested using a tinnitus questionnaire.
Results: The prevalence of extended high frequency hearing loss in the normal cochlear function CSOM patients with tinnitus was 81.8% (95% CI 74.5%, 89.1%), whereas the prevalence in the tinnitus negative group was 30.0% (95% CI 21.3%, 38.7%). There was a significant association between extended high frequency hearing loss and tinnitus in CSOM patients (P
Fulltext Evaluation of the current bacteriological profile and antibiotic sensitivity pattern in chronic suppurative otitis media

Wan Draman WNA, Md Daud MK, Mohamad H, Hassan SA, Abd Rahman N

Laryngoscope Investig Otolaryngol, 2021 Dec;6(6):1300-1306.
PMID: 34938866 DOI: 10.1002/lio2.682

OBJECTIVE: To determine the current microbiological profile of chronic suppurative otitis media (CSOM), their antimicrobial sensitivity, their resistance pattern to locally available antibiotics and the appropriate antibiotic against isolated microorganisms causing CSOM.
METHODS: This cross-sectional study involved 91 ear swab specimens obtained from patients clinically diagnosed with active CSOM. Swabs were cultured for microbial identification according to a standard protocol. We performed antibiotic susceptibility testing, using the modified Kirby-Bauer disc diffusion method, and the diameter of the inhibition zone was interpreted based Clinical Laboratory Standards Institute guidelines.
RESULTS: Microbial growth was seen in 85 (93.4%) samples, but 6 (6.6%) samples had no growth. Among the samples with growth, 63 (69.2%) were monomicrobial, 13 (14.3%) were polymicrobial, and 9 (9.9%) were of mixed growth with more than three microorganisms. The most common bacteria isolated was Pseudomonas aeruginosa (32.6%) followed by Staphylococcus aureus (16.9%) and Klebsiella spp. (5.6%). The most sensitive antibiotics against P aeruginosa were ceftazidime, meropenem, piperacillin-tazobactam, and cefepime. S aureus showed the highest sensitivity toward rifampin, cefoxitin, and fusidic acid.
CONCLUSIONS: The bacteriological profile of CSOM showed a high prevalence of P aeruginosa, followed by S aureus and Klebsiella spp. with different distributions in different age groups. We observed a declining pattern of their antibiotic sensitivity. It is important to be aware of the current trend of the bacteriological profiles and to revise the antibiotic regime according to both the sensitivity and age groups.Level of Evidence: NA.
Fulltext Cervical vestibular evoked myogenic potential (cVEMP) findings in adults with sensorineural hearing loss (SNHL): comparisons between 500 Hz tone burst and narrowband CE-Chirp stimuli

Zakaria MN, Salim R, Abdul Wahat NH, Md Daud MK, Wan Mohamad WN

Sci Rep, 2023 Dec 21;13(1):22842.
PMID: 38129442 DOI: 10.1038/s41598-023-48810-1

There has been a growing interest in studying the usefulness of chirp stimuli in recording cervical vestibular evoked myogenic potential (cVEMP) waveforms. Nevertheless, the study outcomes are debatable and require verification. In view of this, the aim of the present study was to compare cVEMP results when elicited by 500 Hz tone burst and narrowband (NB) CE-Chirp stimuli in adults with sensorineural hearing loss (SNHL). Fifty adults with bilateral SNHL (aged 20-65 years) underwent the cVEMP testing based on the established protocol. The 500 Hz tone burst and NB CE-Chirp (centred at 500 Hz) stimuli were presented to each ear at an intensity level of 120.5 dB peSPL. P1 latency, N1 latency, and P1-N1 amplitude values were analysed accordingly. The NB CE-Chirp stimulus produced significantly shorter P1 and N1 latencies (p 0.80). In contrast, both stimuli elicited cVEMP responses with P1-N1 amplitude values that were not statistically different from one another (p = 0.157, d = 0.15). Additionally, age and hearing level were found to be significantly correlated (r = 0.56, p
Skull Base Osteomyelitis and Parapharyngeal Abscess as Complications of Otitis Media in a Young Immunocompetent Man

Salim I, Mohd Saad MS, Ahmad Kailani AAA, Md Daud MK

Indian J Otolaryngol Head Neck Surg, 2024 Dec;76(6):6009-6012.
PMID: 39559024 DOI: 10.1007/s12070-024-05054-3

Skull base osteomyelitis (SBO) is a rare and lethal infection of temporal bone, uncommonly caused by purulent otitis media. Although uncommon, a young and immunocompetent person is not exceptional to develop SBO as in our case. We reported a case of SBO in a young, immunocompetent gentleman who presented with right otorrhea associated with fever, trismus, headache, and neck stiffness, which was unresponsive to oral and topical antibiotics. Examination revealed fullness at the right mastoid tip with no evidence of mastoid abscess, trismus, with restrictions of neck movements. Otoscopy of right ear showed mucopus with 10% anterosuperior tympanic membrane perforation without keratin or granulation tissue. Pus for culture and sensitivity grew Klebsiella pneumonia and computed tomography (CT) showed osteomyelitic changes with associated parapharyngeal collection. The patient was started on intravenous antimicrobial therapy and responded well to the treatment.