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What is an acoustic-reflex threshold test for hearing loss?

David M. Vernick, MD
Ear, Nose & Throat (Otolaryngology)
Although it's not new, acoustic reflex threshold test for hearing loss is being used more frequently because of a growing recognition that it's helpful in diagnosing problems beyond the inner ear -- in the pathways leading to the brain. The purpose of the test is to see if the ear's natural reflex to lower the volume of very loud sounds is working properly. The test is conducted like tympanometry, but in addition to using the pressurized probe, the audiologist (a health professional who assesses hearing and balance, as well as fits and dispenses hearing aids) delivers a sound of about 80 dB to see if the muscles in the middle ear contract to decrease the volume sent to the middle ear. The audiologist keeps increasing or decreasing the volume to find the decibel level at which this reflex occurs. It normally occurs at 65 to 95 dB. A reflex that starts at a higher decibel level or doesn't occur at all suggests that your hearing loss may be at least partially the result of a neurological problem.

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