Acoustic reflex Question

Hi
I have been told I have sensorineural (cochlear) hearing loss
Right ear 500Hz=45dB ,1000Hz=50, 2000Hz=60,4000Hz=70
Left ear 500hz=30 dB, 1000Hz =35 2000Hz=50 4000Hz=65
I was also told I have acoustic reflex threshold elevated/absent in some frequencies,
I would appreciate if someone could tell me roughly what reflex treshold(as a number in dB) expecting to have for each ear at frequencies 500,1k,2k,4kHz for the above loss

There really isn’t any specific normative data that would indicate if you have X amount of hearing loss at Y frequency your reflex threshold should be Z. When you have hearing loss, we expect to see a corresponding elevation in reflex thresholds. The two support each other nicely.

Here’s my personal opinion about reflex thresholds. Unless you are suspecting an acoustic neuroma or trying to establish Inner hair cell function, they don’t provide very much valuable data. They’re too likely to be influenced by middle ear pathologies of the past or other possible things that could have effected the muscle responsible for the reflex. I’ve seen people with perfectly normal hearing who had totally wacky reflex thresholds and people with hearing loss who had reflex thresholds that I would never have suspected. Taken in isolation, they have little diagnostic value to me. Now if you combine odd results with an asymmetrical SNHL and other tests that could point to acoustic neuroma or something like that then they obviously help to complete a larger picture and can help indicate whether additional testing such as an MRI is warranted. Personally, if an acoustic neuroma is suspected it’s better to just go straight to the MRI, IMHO.

I’m sure that there are professionals that consider it a valuable part of their diagnostic test…I’ve just found that over the years there is too much inconsistency and variability for my taste.

I agree with my fellow female as usual.

In isolation, reflexes are minimally useful. But, as she said, they are useful as part of the big picture of the hearing system. Given your hearing loss, elevated and absent reflexes are expected. In fact, it would be an anomaly if you had normal reflexes.

dr.amy

girls rock.
:smiley:

Thank you for your explanation.
When you are talking about elevated you are taking about reflex may accrue with some intensity am I correct?
Would it be possible my hearing threshold for reflex to be
Left ear 500hz= 90db, 1Khz=95db, 2Khz=100dB
Right ear 500hz= 95db 1Khz= 95db, 2Khz=110dB

And then drawn conclusion it is elevated, if so it is elevated by how much?
My apology to be hard on this question, because I am engineer and I work with numbers, I need too understand your concept of “elevation

Normal Acoustic Reflex Thresolds (ART’s) are basically below about 90-95dBHL. Anything above that is considered elevated. I understand your desire to want information about it, but really you have to let this idea of these values having any real meaning go. They don’t. There is no correlation between ART’s and hearing level that I would put a significant value to in the context you are wanting it. There is no quantifiable value of “how much” they are elevated being relative to severity of loss or any other correlation to hearing, they are just elevated. Being more elevated doesn’t carry any additional meaning. Being absent wouldn’t have any real additional diagnostic value. The levels you reported are absolutely as expected given your hearing. That said, I wouldn’t be surprised to see something totally different.

Here’s my super-honest opinion. I think ART’s are nearly worthless in most cases. I hardly ever do them. They just don’t bring enough additional information to the table that I can’t generally get from other sources for me to feel like they are a valuable part of my diagnostic test procedure that I need to perform regularly. I reserve them for cases when they can provide more information and even then, I take what I get with a grain-of-salt.

To demonstrate Doc’s point:

I have completely normal hearing in both ears. I have absent reflexes in both ears at all tested frequencies (500 Hz, 1K, 2K, 4K). I have had MRIs and scans for other medical issues - and no, not mental issues :stuck_out_tongue: But everything is completely normal.

ENTs may postulate that the absent reflexes are due to my severe TMJ, but they are just guessing.

And like Doc said, we categorize them as normal, elevated or absent. They are only presented at high levels, so the measurement is not as concise as a hearing threshold.

I know the engineer in you wants a more concise answer - sorry!

dr.amy

Thank you for your explanation