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The relationship between acoustic reflex threshold and air-bone gap.

M E Lutman

    British Journal of Audiology
    |November 1, 1984
    PubMed
    Summary
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    Acoustic reflex threshold (ART) is more sensitive than air-bone gap (ABG) for detecting middle ear hearing loss. Measuring both ART and ABG provides a more complete clinical assessment.

    Area of Science:

    • Audiology
    • Otolaryngology
    • Hearing Science

    Background:

    • Middle ear sound transmission abnormalities can be challenging to diagnose definitively.
    • Neither air-bone gap (ABG) nor acoustic reflex presence/absence alone provides unequivocal indication of middle ear dysfunction.

    Purpose of the Study:

    • To investigate the interrelationships between acoustic reflex threshold (ART) and air-bone gap (ABG) in a stratified population sample.
    • To determine the relative sensitivity and specificity of ART and ABG in identifying middle ear abnormalities.

    Main Methods:

    • A stratified population sample of 1725 ears was analyzed.
    • Data on acoustic reflex threshold (ART), air-bone gap (ABG), tympanic membrane appearance, and middle ear pressure were collected and examined.

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    Main Results:

    • 1450 ears had normal ART and ABG; 70 had abnormal ART and ABG; 160 had abnormal ART with normal ABG; 45 had abnormal ABG with normal ART.
    • Acoustic reflex threshold (ART) was found to be a more sensitive indicator of middle ear abnormality than air-bone gap (ABG).
    • ART showed a marginally higher rate of false positives compared to ABG.

    Conclusions:

    • Acoustic reflex threshold (ART) is a more sensitive diagnostic measure for middle ear hearing loss than air-bone gap (ABG).
    • A comprehensive clinical evaluation of middle ear status is best achieved by measuring both ART and ABG.