ACOUSTIC STAPEDIAL REFLEX THRESHOLD IN NORMAL HEARING PARTICIPANTS IN SULAIMANI CITY
Hiwa Asaad Abdulkareem a
a Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
Submitted: 15/12/2020; Accepted: 25/5/2021; Published: 21/12/2021
DOI Link: https://doi.org/10.17656/jsmc.10330
Acoustic stapedial reflex threshold (ASRT) is an objective, important test that can be included in a test battery along with behavioural pure tone audiometry and otoacoustic emissions to differentiate among middle ear, cochlear, and retro cochlear sites of the lesion. It can be used as a cross-check with a behavioural audiogram to increase confidence in the diagnosis. In most people with normal hearing thresholds and middle ear function, the acoustic stapedial reflex will be present at all frequencies and within an intensity range of 70-90 dB HL above the behavioural hearing threshold.
To measure ASRT in participants with normal hearing thresholds in Sulaymaniyah city and to observe the effect of different parameters on the threshold.
Patients and Methods
The study was conducted on 200 participants (400 ears) who met inclusion criteria (110 males and 90 females); data were collected through visiting five different places with different age groups within three months duration. Participants were divided into three age groups (6-12 years), (13-18 years), (19 years and above).Only participants with normal otoscopic examination, normal pure tone audiometry, normal tympanogram, undergone through stapedial reflex threshold measurement, and the reflexes were elicited and recorded bilaterally by using tympanometer (Impedance meter) MAICO MI34 brand, single frequency 226 Hz of German-made model 2011.
Mean ASRT measured in both ears was within the normal range of 70-90 dB HL above hearing threshold in both ipsilateral and contralateral pathways as Right ipsilateral (74.5 dB HL), right contralateral (76.9 dB HL), left ipsilateral (74.6 dB HL), and left contralateral (76.8 dB HL) above hearing thresholds. There was no significant difference between right and left ears according to ASRT (P-values > 0.05). There was no gender effect on ASRT (P-values > 0.05), while there was a significant effect of age on ASRT, especially in the adult population (P-values < 0.05).
A stapedial reflex threshold in normal hearing subjects was within normal range, different parameters as the side of ear and gender did not affect the threshold. In contrast, with advancing age amount of intensity needed to elicit the reflex increased.
Acoustic stapedial reflex threshold, Middle ear muscle reflex, and acoustic stapedial reflex, the effect of gender and age on ASRT.
Bess FH.,Humes L E. Audiology: the fundamentals. 4th ed. Walters Kluwer: Lippincott Williams & Wilkins; 2008.P.133-142
Wiley T, Fowler C. Acoustic immittance measures in clinical audiology.1st ed. San Diego: Singular Pub. Group; 1997.p.4.
Interacoustics.com. Full line supplier of hearing and balance - Interacoustics[updated 2015, Cited 2013 April. Available from: http://www.interacoustics.com
Katz J, Chasin M, English K, Hood L, Tillery K. Handbook of clinical audiology. Philadelphia: Wolters Kluwer Health; 2015.p.165-168.
Silman S. The acoustic reflex basic principles and clinical applications. Oxford: Elsevier Science; 1984.p.15.
Martin F, Clark J. Introduction to audiology.1st ed. Boston: Pearson; 2012.p.163-249.
Aage MR. Hearing: Anatomy, Physiology, and Disorders of the Auditory System.2nd ed. St. Louis: Mosby;2009.541p.
Roeser R, Valente M, Hosford-Dunn H. Audiology the diagnosis.2nd ed. New York: Thieme; 2007.p.390.
Gelfand S, Piper N. Acoustic Reflex Thresholds. Ear and Hearing J. 1984; 5(4):228-234.
Hughes G, Pensak M, Hughes G. Clinical Otology.3rd ed. New York: Thieme; 2017.p.114-260.
Clark J. Promoting Education for Developing World ENT. [Updated 2017 Cited 2013 July]. Available from:http://www.entdev.uct.ac.za
McGrath AP. Women and Infants Hospital's Organization. Pure Tone Audiometry. [Updated 2019, Cited 2016] Available from:http://www.womenandinfants.org
Absalon A, Pirasteh I, DashtiKG, AsemiRA, EsfahaniNA, Nilforoush M. A Prevalence Study of Hearing Loss among Primary School Children in the South East of Iran. International Journal of Otolaryngology. 2013;56(3):1-4.
Gelfand S, Schwander T, Silman S. Acoustic Reflex Thresholds in Normal and Cochlear-Impaired Ears. Journal of Speech and Hearing Disorders. 1990;55(2):198.
Wiley T, Oviatt D, Block M. Acoustic-Immittance Measures in Normal Ears. J Speech Hear Res. 1987; 30(2):161.
Osterhammel D, Osterhammel P. Age and Sex Variations for the Normal Stapedial Reflex Thresholds and Tympanometric Compliance Values. Scandinavian Audiology J. 1979;8(3):153-158.
Wilson, R. H., Margolis, R. H. Acoustic reflex measurements In Musiek,: Contemporary Perspectives in Hearing Assessment.1st ed Boston: Allyn & Bacon;1999.p.131-165.
World Health Organization. WHO Hearing impairment grades? [updated 2018, Cited 2015 June] available from:http://www.who.int/pbd/deafness/hearing_impairment_grades/en/
Middle Ear Analyzers. [updated 2020, Cited 2020 Feberuary] Maico diagnostic Middle ear analyzer available from: http://www.maico-diagnostic.com/products/middle-ear-analyzers/mi-34/
Hall J. Original Papers·Travauxoriginaux: Acoustic Reflex Amplitude. Effect of Age and Sex. International Journal of Audiology. 1982;21(4):294-309.
Silman S. The effects of ageing on the stapedius reflex thresholds. The Journal of the Acoustical Society of America. 1979;66(3):735.
Kliegman R, Nelson W. Nelson textbook of pediatrics.21st ed. Philadelphia, Pa.]: Elsevier Saunders; 2019.p.88.
Feeney MP, Fitzpatrick DF, Hunter LL, Keefe DH. Aural Acoustic Stapedius-Muscle Reflex Threshold Procedures to Test Human Infants and Adults. J Assoc Otolaryngol. 2017;18(1):65-88.
Da Costa EA, De Carvalho GM, Duarte AS, et al.High Levels of Sound Pressure:Acoustic Reflex Thresholds and Auditory Complaints of Workers with Noise Exposure.Braz.J of Otolaryngology. 2015; 81(4):10-16.
Digiovanni JA, Reis DT.Stapedial Reflex and Ears with High Static Acoustic Admittance. American J of Audiology. 2017;16(1):68-74.
Causon A, Munro KJ, Plack CJ. The Role of the Clinically Obtained Acoustic Reflex as a Research Tool for Subclinical Hearing Pathologies. Research Article. 2020: doi:10.1177/2331216520972860.
© The Authors, published by University of Sulaimani, College of Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.