Acoustic reflex threshold tenth percentiles and functional hearing impairment

Area of Science:

• Audiology
• Hearing Science
• Otoacoustic Emissions

Background:

• Functional hearing impairments, often termed non-organic hearing loss, present diagnostic challenges.
• Objective audiological measures are crucial for confirming subjective hearing complaints.

Purpose of the Study:

• To evaluate the efficacy of tonal acoustic reflex thresholds (ARTs) in identifying and confirming functional hearing impairments.
• To compare ARTs in ears with functional impairments against normative data.

Main Methods:

• Tonal ARTs were measured in 74 ears with reported functional impairments.
• ARTs were compared to the 10th percentiles of established ARTs for normal and cochlear-impaired ears (500-2000 Hz).
• A control group of 50 ears with sensorineural hearing loss was used to assess the false positive rate.

Main Results:

• ARTs correctly identified functional losses in 70.9% to 85.7% of ears with voluntary thresholds ≥ 60 dB HL.
• Only 5.3% of ears with voluntary thresholds ≤ 55 dB HL were correctly identified.
• The false positive rate in the control group was low, ranging from 5% to 7%.

Conclusions:

• Tonal ARTs serve as an effective nonbehavioral tool for identifying functional hearing loss when thresholds are ≥ 60 dB HL.
• ARTs are not reliable for detecting functional hearing loss components when thresholds are ≤ 55 dB HL.
• ARTs can help substantiate the presence of functional hearing impairments in specific audiological ranges.