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Acoustic Reflex Measurement

Schairer, Kim S.1; Feeney, M. Patrick2,3; Sanford, Chris A.4

doi: 10.1097/AUD.0b013e31829c70d9

Middle ear muscle reflex (MEMR) measurements have been a part of the standard clinical immittance test battery for decades as a cross-check with the behavioral audiogram and as a way to separate cochlear from retrocochlear pathologies. MEMR responses are measured in the ear canal by using a probe stimulus (e.g., single frequency or broadband noise) to monitor admittance changes elicited by a reflex-activating stimulus. In the clinical MEMR procedures, one test yields changes in a single measurement (i.e., admittance) at a single pure tone (e.g., 226 or 1000 Hz). In contrast, for the wideband acoustic immittance (WAI) procedure, one test yields information about multiple measurements (e.g., admittance, power reflectance, absorbance) across a wide frequency range (e.g., 250 to 8000 Hz analysis bandwidth of the probe). One benefit of the WAI method is that the MEMR can be identified in a single test regardless of the frequency at which the maximum shift in the immittance measurement occurs; this is beneficial because maximal shifts in immittance vary as a function of age and other factors. Another benefit is that the wideband response analysis yields lower MEMR thresholds than with the clinical procedures. Lower MEMR thresholds would allow for MEMR decay tests in ears in which the activator levels could not be safely presented. Finally, the WAI procedures can be automated with objective identification of the MEMR, which would allow for use in newborn and other screening programs in which the tests are completed by nonaudiological personnel.

1Audiology and Speech-Language Pathology Service, James H. Quillen Veteran Affairs Medical Center, Mountain Home, Tennessee, USA; 2National Center for Rehabilitative Auditory Research, Portland Veterans Affairs Medical Center, Portland, Oregon, USA; 3Department of Otolaryngology, Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA; and 4Department of Communication Sciences and Disorders, Idaho State University, Pocatello, Idaho, USA.

ACKNOWLEDGMENTS: This work was supported by Department of Veterans Affairs Rehabilitation Research and Development Service Research Enhancement Award Program.

The contents do not represent the views of the Department of Veterans Affairs or of the U.S. Government.

Address for correspondence: Kim S. Schairer, Audiology, James H. Quillen Veteran Affairs Medical Center, Box 4000, Mountain Home, TN 37684, USA. E-mail:

Received February 12, 2013

Accepted May 16, 2013

© 2013 by Lippincott Williams & Wilkins