Acoustic reflexes are contractions of the stapedius muscle in the middle ear. This reflex occurs when a loud sound is presented to the ear causing the tympanic membrane to stiffen and cause a change in immittance (Martin & Clark, 2012). When measuring the acoustic reflex threshold, we are measuring the softest sound that can cause a reflex of the stapedius muscle as well as the duration of time needed for the reflex to decay. The reflex is presented as a deflection, or a curve/dip, on the immitance monitor of the device used (Campbell, 2014).
Acoustic Reflex measurements are a part of the immittance battery tests and use the same device as that of tympanometry testing. The reflex occurs by stimulating the stapedius muscle with a loud sound …show more content…
First, introduce the stimulus at 70 dB HL, if there is no response increase intensity by 10 dB until a response is seen. When is response is seen, lower the intensity level by 10 dB and if there is no response increase by 5 dB until a threshold can be determined. The tonal duration should be one second and a response is recorded when a deflection is observed to be a minimum of 0.01 to 0.02 mmho.(Martin & Clark, 2012). It has been observed that when the stimulus is louder, the reflex deflection will be larger(Katz, Medwetsky, Burkard, & Hood, 2002). Normative data has shown that normal ART ranges from 85-100 dB SPL or 80-90 dB HL in pure tone stimuli and is usually approximately 20 dB less in BBN(Katz, Medwetsky, Burkard, & Hood, …show more content…
Sensitivity is defined as the tests ability to identify all the true positives, and specificity is defined as the tests ability to identify all the true negatives(Lalkhen & McCluskey, 2008). Research on the sensitivity and specificity of acoustic reflexes in detecting acoustic neuroma has been proven to be poor at the frequency of 1000 Hz and would need an acoustic reflex decay testing to be at 115 dB, which risks losing any residual hearing the patient has. The same study found that using asymmetric audiometric testing was better at detecting acoustic neuromas than acoustic reflex testing(Hunter, Ries, Schlauch, Levine, & Ward, 1999). Another study found that administering the acoustic decay test at 20 dB SL id more sensitive and specific that at 10 dB SL, the study also revealed that decay and latency tests are more sensitive at detecting neuromas than ART (Mangham, Lindeman, & Dawson, 1980). However, a multiple studies have shown that AR measures are very sensitive and specific in detecting auditory neuropathy, one study showed 97% specificity and 83% sensitivity in detecting cerebellopontine angle tumors in 30 subjects; another study showed that AR was 84% sensitive in detecting VIII auditory nerve tumors in 89 patients (Noel & Aiken, 2014). Also, another study that tested the sensitivity and specificity of different immittance devices to detect
Acoustic Reflex measurements are a part of the immittance battery tests and use the same device as that of tympanometry testing. The reflex occurs by stimulating the stapedius muscle with a loud sound …show more content…
First, introduce the stimulus at 70 dB HL, if there is no response increase intensity by 10 dB until a response is seen. When is response is seen, lower the intensity level by 10 dB and if there is no response increase by 5 dB until a threshold can be determined. The tonal duration should be one second and a response is recorded when a deflection is observed to be a minimum of 0.01 to 0.02 mmho.(Martin & Clark, 2012). It has been observed that when the stimulus is louder, the reflex deflection will be larger(Katz, Medwetsky, Burkard, & Hood, 2002). Normative data has shown that normal ART ranges from 85-100 dB SPL or 80-90 dB HL in pure tone stimuli and is usually approximately 20 dB less in BBN(Katz, Medwetsky, Burkard, & Hood, …show more content…
Sensitivity is defined as the tests ability to identify all the true positives, and specificity is defined as the tests ability to identify all the true negatives(Lalkhen & McCluskey, 2008). Research on the sensitivity and specificity of acoustic reflexes in detecting acoustic neuroma has been proven to be poor at the frequency of 1000 Hz and would need an acoustic reflex decay testing to be at 115 dB, which risks losing any residual hearing the patient has. The same study found that using asymmetric audiometric testing was better at detecting acoustic neuromas than acoustic reflex testing(Hunter, Ries, Schlauch, Levine, & Ward, 1999). Another study found that administering the acoustic decay test at 20 dB SL id more sensitive and specific that at 10 dB SL, the study also revealed that decay and latency tests are more sensitive at detecting neuromas than ART (Mangham, Lindeman, & Dawson, 1980). However, a multiple studies have shown that AR measures are very sensitive and specific in detecting auditory neuropathy, one study showed 97% specificity and 83% sensitivity in detecting cerebellopontine angle tumors in 30 subjects; another study showed that AR was 84% sensitive in detecting VIII auditory nerve tumors in 89 patients (Noel & Aiken, 2014). Also, another study that tested the sensitivity and specificity of different immittance devices to detect