Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement

2018 ◽  
Vol 29 (04) ◽  
pp. 337-347 ◽  
Author(s):  
Jace Wolfe ◽  
Rene Gifford ◽  
Erin Schafer
Keyword(s):  
Cochlear Implant ◽  
Reflex Response ◽  
Acoustic Reflex ◽  
Probe Tone ◽  
Reflectance Measurement ◽  
Repeated Measures Design ◽  
Electrode Contact ◽  
Stapedial Reflex ◽  
Reflex Threshold ◽  
Wideband Reflectance

AbstractThe electrically evoked stapedial reflex threshold (ESRT) has been shown to be a good predictor of upper stimulation level for cochlear implant recipients. Previous research has shown that the ESRT may be recorded at lower stimulation levels and with a higher incidence of success with the use of higher frequency probe tones (e.g., 678 and 1000 Hz) relative to the use of the conventional 226-Hz probe tone. Research has also shown that the acoustic reflex may be recorded at lower stimulus levels with the use of wideband reflectance when compared to the acoustic reflex threshold recorded with a conventional acoustic immittance measurement.The objective of this study was to compare the ESRT recorded with acoustic immittance and wideband reflectance measurements.A repeated measures design was used to evaluate potential differences in ESRTs with stimulation at an apical, middle, and basal electrode contact with the use of two different techniques, acoustic immittance measurement and wideband reflectance.Twelve users of Cochlear Nucleus cochlear implants were included in the study.Participants’ ESRTs were evaluated in response to simulation at three different electrode contact sites (i.e., an apical, middle, and basal electrode contact) with the use of two different middle ear measurement techniques, acoustic immittance with the use of a 226-Hz probe tone and wideband reflectance with the use of a chirp stimulus.The mean ESRT recorded with wideband reflectance measurement was significantly lower when compared to the ESRT recorded with acoustic immittance. For one participant, the ESRT was not recorded with acoustic immittance before reaching the participant’s loudness discomfort threshold, but it was successfully recorded with the use of wideband reflectanceThe ESRT may potentially be recorded at lower presentation levels with the use of wideband reflectance measures relative to the use of acoustic immittance with a 226-Hz probe tone. This may allow for the ESRT to be obtained at levels that are more comfortable for the cochlear implant recipient, which may also allow for a higher incidence in the successful recording of the ESRT.

Optimizations for the Electrically-Evoked Stapedial Reflex Threshold Measurement in Cochlear Implant Recipients

2017 ◽  
Vol 38 (2) ◽  
pp. 255-261 ◽  
Author(s):  
Jace Wolfe ◽  
Melanie Gilbert ◽  
Erin Schafer ◽  
Leonid M. Litvak ◽  
Anthony J. Spahr ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Stapedial Reflex ◽  
Reflex Threshold ◽  
Threshold Measurement

Stapedius Reflex in Patients with an Inner Ear Prosthesis

1992 ◽  
Vol 15 (7) ◽  
pp. 436-439 ◽  
Author(s):  
K. Stephan ◽  
K. Welzl-Muller
Keyword(s):  
Electrical Stimulation ◽  
Cochlear Implant ◽  
Inner Ear ◽  
Time Course ◽  
Temporal Integration ◽  
Fast Response ◽  
Acoustic Stimulation ◽  
Acoustic Reflex ◽  
Stapedius Reflex ◽  
Reflex Threshold

The stapedius reflex elicited by electrical stimulation was investigated in 21 deaf individuals supplied with an inner ear prosthesis. All patients were implanted with the Vienna cochlear implant using intra or extracochlear electrodes. Analog stimulation with sinus bursts of various durations (25, 50, 100, 300, 500 ms) and frequencies (125, 500, 1000, 2000 Hz) was used. The time course of the contralateral acoustic reflex was monitored using a fast-response impedance meter. The stapedius reflex was observed in about half of the cases. Reflex threshold was observed at a stimulation level close to uncomfortable loudness. The time course in case of electrical stimulation differs in some aspects (rise time, onset) from acoustic stimulation in hearing individuals. Temporal integration of the stapedius reflex was observed also in case of electrostimulation through the cochlear implant.

Acoustic Reflex Response during Curare-Induced Weakness

1980 ◽  
Vol 89 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Roger A. Ruth ◽  
Michael E. Johns ◽  
Thomas F. Gal
Keyword(s):  
Muscle Strength ◽  
Respiratory Muscle ◽  
Reflex Response ◽  
Acoustic Reflex ◽  
Progressive Muscle Weakness ◽  
Hand Grip ◽  
The Face ◽  
Stapedial Reflex ◽  
Inspiratory Muscle Strength ◽  
Dose Dependent

The acoustic stapedial reflex (AR) was measured in five healthy subjects during intravenous administration of d-tubocurarine in four equal doses totaling 0.2 mg/kg. The behavior of the reflex in the face of progressive muscle weakness was assessed. Amplitude changes in the AR elicited by pulsed tones were compared to measurements of maximum respiratory pressures reflecting respiratory muscle strength. Total curare dose averaged 16.1 mg and produced symptoms progressing from mild diplopia with the initial dose to absence of hand-grip and head-lifting ability with the final dose. Peak-to-peak amplitude of the AR decreased progressively with each dose of curare. Effects were not strictly additive but showed the largest change with the last dose. Decreases in expiratory muscle strength closely paralleled changes in the AR, whereas changes in inspiratory muscle strength were less marked than the AR, especially with mild weakness. The dose-dependent reduction of the AR corresponded to changes in respiratory muscle as well as general muscle strength. Therefore we concluded that the AR is a valid and sensitive index of neuromuscular transmission which has an advantage over most tests of muscle strength since subject effort and cooperation do not influence test results.

A017 The effect of peri-modiolar cochlear implant positioning on evoked stapedial reflex threshold

2011 ◽  
Vol 75 ◽  
pp. 4
Author(s):  
M. Mehdi Ghassemi ◽  
M. Rajati ◽  
M. Reza Tale ◽  
M. Bakhshaee
Keyword(s):  
Cochlear Implant ◽  
Implant Positioning ◽  
Stapedial Reflex ◽  
Reflex Threshold

Contralateral Acoustic Reflex Thresholds for Tonal Activators Using Wideband Energy Reflectance and Admittance

2003 ◽  
Vol 46 (1) ◽  
pp. 128-136 ◽  
Author(s):  
M. Patrick Feeney ◽  
Douglas H. Keefe ◽  
Lindsay P. Marryott
Keyword(s):  
Correlation Method ◽  
New Method ◽  
Acoustic Reflex ◽  
Probe Tone ◽  
Clinical Method ◽  
Sound Levels ◽  
Reflex Testing ◽  
Reflex Threshold ◽  
Threshold Testing ◽  
Acoustic Reflex Threshold

The purpose of this study was to evaluate a new method for estimating the acoustic reflex threshold incorporating wideband (250–8000 Hz) measures of energy reflectance and admittance (M. P. Feeney & D. H. Keefe, 2001). The wideband technique incorporates both a correlation method to assess the pattern of the reflex-induced shifts in reflectance and admittance across frequency and a magnitude method to determine if the amplitude of the shifts exceeds baseline variability. Contralateral reflex thresholds for 1000- and 2000-Hz activators were obtained for 34 young adults with both the wideband method and a clinical method using a 226 Hz probe tone. Average reflex thresholds obtained with the new method were 12 to 13.7 dB lower than those obtained with the clinical method. When the bandwidth of analysis of admittance and reflectance responses was limited to 250 to 2000 Hz, the reduction in reflex thresholds was accompanied by the rejection of 96% of nonactivator-baseline responses as reflexes. The method holds promise for extending reflex threshold testing to patients with reflexes elevated beyond current equipment limits, for reducing the sound levels used in reflex testing, and for obtaining sensitive measures of reflex threshold in infants.

Influence of the Acoustic Reflex on Vowel Recognition

1986 ◽  
Vol 29 (3) ◽  
pp. 420-424 ◽  
Author(s):  
Michael Dorman ◽  
Ingrid Cedar ◽  
Maureen Hannley ◽  
Marjorie Leek ◽  
Julie Mapes Lindholm
Keyword(s):  
Auditory System ◽  
Sound Pressure ◽  
Dynamic Range ◽  
Recognition Accuracy ◽  
Pressure Level ◽  
Acoustic Reflex ◽  
The Poor ◽  
Stapedial Reflex ◽  
Vowel Recognition ◽  
High Sound

Computer synthesized vowels of 50- and 300-ms duration were presented to normal-hearing listeners at a moderate and high sound pressure level (SPL). Presentation at the high SPL resulted in poor recognition accuracy for vowels of a duration (50 ms) shorter than the latency of the acoustic stapedial reflex. Presentation level had no effect on recognition accuracy for vowels of sufficient duration (300 ms) to elicit the reflex. The poor recognition accuracy for the brief, high intensity vowels was significantly improved when the reflex was preactivated. These results demonstrate the importance of the acoustic reflex in extending the dynamic range of the auditory system for speech recognition.

Change of Stapedial Reflex Threshold according to the Depth of Intravenous Propofol Anesthesia

2010 ◽  
Vol 53 (8) ◽  
pp. 475
Author(s):  
Jin-Woo Lee ◽  
Kyong-Myong Chon ◽  
Eui-Kyung Goh ◽  
Il-Woo Lee ◽  
Soo Keun Kong ◽  
...  
Keyword(s):  
Stapedial Reflex ◽  
Reflex Threshold

Effects of Alcohol on the Acoustic Reflex Threshold

2008 ◽  
Vol 4 (1) ◽  
pp. 48-51
Author(s):  
Mee-Hye Park ◽  
Hyun-Woo Kyun ◽  
Boo-Eem Kim
Keyword(s):  
Acoustic Reflex ◽  
Reflex Threshold ◽  
Acoustic Reflex Threshold
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