[Inverted acoustic reflex in patients with otosclerosis]

The presence of inverted acoustic reflex (IAR) was observed in patients with surgically-confirmed otosclerosis. The characteristics of intensity, stimuli, and thresholds were analyzed. IAR was found in 90% of the patients stimulated on the same side at 110 dB HL with 500, 1000, and 2000-Hz frequencies. The intensity of IAR was higher at 1000-Hz and in patients with mixed hearing loss. We conclude that the detection of IAR in patients with conductive hearing loss and normal tympanic membrane allows otosclerosis to be differentiated from other pathologies that produce ossicular chain fixation. This sign can be used as a diagnostic test because it has a high positive predictive value, 98% in our series.