Stapedial Reflexes

A Stapedial Reflex provides an objective measurement of the involuntary muscle contraction that occurs in the middle ear when a sound stimuli is presented.  This can be used to help identify Cochlear and middle ear problems. 

Acoustic Reflex (AR) patterns and types of pathology * 

  • i. Bilateral Conductive Hearing Loss
  • Contralateral and ipsilateral AR’s will likely be absent for both ears
  • ii. Unilateral Conductive Hearing Loss
  • Ipsilateral AR would likely be present at normal Sensation Levels (SL’s) for the normal ear, all other AR’s would be absent.
  • Ipsilateral AR’s from the ‘bad ear’ are absent because the hearing loss in that ear prevents the AR stimulus tones presented to that ear from being heard loudly enough to cause an AR.
  • iii. Bilateral Mild to moderate Sensorineural Hearing Loss (SNHL)
  • Ipsilateral AR’s often present but at reduced SL’s for both ears
  • iv. Unilateral Mild to Moderate SNHL
  • Contralateral and Ipsilateral AR’s present at normal Sensation Levels (SL’s) for the good ear. For the bad ear, contralateral and Ipsilateral AR’s will likely be present but at reduced SL’s.
  • v. Bilateral Severe to Profound SNHL
  • Contralateral and Ipsilateral AR’s will likely be absent for both ears.
  • vi. Unilateral Severe to profound SNHL
  • Contralateral and ipsilateral AR’s would be present at normal SL’s for the good ear. Contralateral and ipsilateral AR’s would be absent for the bad ear.
  • vii. VIII Nerve Tumor
  • The AR pattern would be similar to that for the severe to profound SNHL.
  • * Venema, T., 2012. Tympanometry The Hearing Professional, 61(1), pp. 22-29.