Detection of the acoustic reflex below 80 dB HL

A new method for detecting the acoustic reflex that utilizes standard otoacoustic emissions recording techniques is introduced and discussed. Two successive identical tone bursts of 100 ms duration and 10 ms interstimulus interval are presented in the occluded ear canal at a repetition rate of one per second. If the acoustic reflex is elicited, the contraction of the stapedius muscle is delayed with respect to the onset of the first stimulus. Hence, the acoustic compliance in the ear canal decreases primarily during the second stimulus. The difference of the microphone signals produced by the two stimuli is computed and averaged across a certain number of repetitions of the sequence. The presentation level is increased until this difference is larger than -40 dB (with respect to the stimulus level) and if its signal-to-noise ratio exceeds 20 dB. For normal-hearing subjects, the acoustic reflex threshold measured with this method is on average 8 dB lower than in a standard clinical setup. In 5 out of the 10 tested hearing-impaired subjects, the new method could detect an acoustic reflex at one or more frequencies where no reflex was detected in the clinical setup.