Wideband acoustic-reflex test in a test battery to predict middle-ear dysfunction

Douglas H. Keefe, Denis Fitzpatrick, Yi Wen Liu, Chris A. Sanford, Michael P. Gorga

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

A wideband (WB) aural acoustical test battery of middle-ear status, including acoustic-reflex thresholds (ARTs) and acoustic-transfer functions (ATFs, i.e., absorbance and admittance) was hypothesized to be more accurate than 1-kHz tympanometry in classifying ears that pass or refer on a newborn hearing screening (NHS) protocol based on otoacoustic emissions. Assessment of middle-ear status may improve NHS programs by identifying conductive dysfunction and cases in which auditory neuropathy exists. Ipsilateral ARTs were assessed with a stimulus including four broadband-noise or tonal activator pulses alternating with five clicks presented before, between and after the pulses. The reflex shift was defined as the difference between final and initial click responses. ARTs were measured using maximum likelihood both at low frequencies (0.8-2.8. kHz) and high (2.8-8. kHz). The median low-frequency ART was elevated by 24. dB in NHS refers compared to passes. An optimal combination of ATF and ART tests performed better than either test alone in predicting NHS outcomes, and WB tests performed better than 1-kHz tympanometry. Medial olivocochlear efferent shifts in cochlear function may influence ARs, but their presence would also be consistent with normal conductive function. Baseline clinical and WB ARTs were also compared in ipsilateral and contralateral measurements in adults.

Original languageEnglish (US)
Pages (from-to)52-65
Number of pages14
JournalHearing Research
Volume263
Issue number1-2
DOIs
StatePublished - May 2010

Keywords

  • Acoustic reflex
  • Medial olivocochlear efferent
  • Middle-ear muscle
  • Newborn hearing screening

ASJC Scopus subject areas

  • Sensory Systems

Fingerprint Dive into the research topics of 'Wideband acoustic-reflex test in a test battery to predict middle-ear dysfunction'. Together they form a unique fingerprint.

Cite this