Acoustic Reflex and Loudness Discomfort in Acute Facial Paralysis

Citron, David S.; Adour, Kedar K.

doi:10.1001/archotol.1978.00790060005001

Cited by 43 publications

(19 citation statements)

References 12 publications

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“…An important line of evidence for this hypothesis historically came from the ''rollover'' seen in the word recognition performance of Bell's palsy patients; this, on the assumption that Bell's is an isolated pathology of the facial nerve. The veracity of that assumption is in doubt, because there is neurological evidence in some Bell's palsy patients of involvement of other cranial nerve and brainstem systems ͑Adour, 1975; Citron and Adour, 1978;Rosenthal et al, 1983͒. In this regard, cochlear nerve or brainstem disease, with or without attendant stapedius reflex abnormalities, can be associated with significant rollover ͑Jerger and Jerger, 1971;Dirks et al, 1977;Hannley and Jerger, 1981;Meyer and Mishler, 1985͒. This means that it is important to tease out whether the absence of the stapedius reflex alone is capable of causing rollover in word recognition.…”

Section: Discussionmentioning

confidence: 99%

“…The difficulty with this line of evidence is that Bell's palsy may be a polyneuropathy of cranial nerve systems, including the auditory one ͑Adour, 1975; Citron and Adour, 1978;Lundgren et al, 1977;Phillips and Carr, 1998͒. Other authors have found auditory brainstem response abnormalities in Bell's palsy patients, but in the absence of cochlear nerve pathology ͑Rosenthal et al, 1983͒.…”

Section: Introductionmentioning

confidence: 99%

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Re-examination of the role of the human acoustic stapedius reflex

Phillips

Stuart

Carpenter

2002

The Journal of the Acoustical Society of America

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The "rollover" seen in the word recognition performance scores of patients with Bell's palsy (facial nerve paralysis) has historically been taken as an indicator of the role of the stapedius reflex in the protection from upward spread of masking. Bell's palsy, however, may be a polyneuropathy, so it is not clear that the poor word recognition performance at high levels is necessarily attributable specifically to impaired facial nerve function. The present article reports two new experiments that probe whether an isolated impairment of the stapedius reflex can produce rollover in word recognition performance-intensity functions. In experiment 1, performance-intensity functions for monosyllabic speech materials were obtained from ten normal listeners under two listening conditions: normal and low-frequency augmented to offset the effects of the stapedius reflex on the transmission of low-frequency vibrations to the cochlea. There was no effect of the spectral augmentation on word recognition for stimulus levels up to 107 dB SPL. In experiment 2, six patients who had undergone stapedectomy were tested for rollover using performance-intensity functions. None of the patients showed rollover in their performance-intensity functions, even at stimulus levels in excess of 100 dB HL. These data suggest that if the stapedius reflex has a role in protection from upward spread of masking, then this role is inconsequential for word recognition in quiet.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Re-examination of the role of the human acoustic stapedius reflex

Phillips

Stuart

Carpenter

2002

The Journal of the Acoustical Society of America

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“…12 The causes of hyperacusis appear to be multiple and varied as evidenced by the wide range of disorders that have hyperacusis as an associated symptom. This partial list includes traumatic head injury, 13 otitis media, 14,15,27 Bell's Palsy, [16][17][18][19][20][21][22] Ramsey Hunt syndrome, [23][24][25] William's syndrome, 15,26,27 autism, 28 acute acoustic trauma, 29 Lyme disease, 30 localized central auditory pathway lesions, 31 migraine, 32 depression, 28 childhood learning disability, 28 otosclerosis, 33,34 intracranial hypotension, 35 efferent dysfunction, 36 diminished serotonin function, 12 temporomandibular joint dysfunction, 37,38 perilymphatic fistula, 39 Meniere's disease, 40 and myasthenia gravis. 41 Because hyperacusis can occur with normal audiometric sensitivity, 11 the phenomenon is seemingly unrelated to either super-sensitivity (audiometric thresholds below 0 dB HL) or loudness recruitment (which assumes some amount of cochlear or sensorineural hearing loss).…”

Section: Hyperacusis and Its Treatment By Modified Trtmentioning

confidence: 99%

Modification of Loudness Discomfort Level: Evidence for Adaptive Chronic Auditory Gain and Its Clinical Relevance

Formby¹,

Gold²

2002

Semin Hear

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A vexing problem in audiology has been the modification of sound tolerance. Sound intolerance and restricted dynamic ranges are common conditions that audiologists encounter daily in the hearing-impaired population, especially in the fitting of hearing aids. To date, no clinical protocol has proven to be successful for modifying sound tolerance among the hearingimpaired population. This report describes the use of low-level, broadband sound in a habituation-based treatment protocol termed Tinnitus Retraining Therapy (TRT). Over the past decade, TRT has become increasingly popular as an intervention for severe tinnitus and hyperacusis. One of the primary treatment effects from TRT is that over the course of the intervention the patient's loudness discomfort level (LDL) thresholds routinely shift to higher levels. Ostensibly, the resulting higher LDL thresholds reflect treatment effects associated with the resetting of a plastic and adaptive auditory gain process that somehow regulates the supra-threshold sensitivity of the auditory system in response to chronic changes in the sound input from the auditory periphery to the central auditory pathways. Tinnitus patients with significant hearing losses and sound tolerance problems respond successfully to TRT and, as a consequence, their LDL thresholds are usually elevated (improved) and, concomitantly, their dynamic ranges are expanded. Many of these patients, who before the TRT intervention could not tolerate amplified sound, then have been able to make a comfortable transition into appropriate amplification after treatment. In principle, TRT would seem to offer a viable intervention strategy for modifying sound tolerance in the general hearingimpaired population. If so, then the clinical applications of TRT principles may extend well beyond the treatment of tinnitus and hyperacusis.

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“…The diagnostic application of the ASR in adult populations has been well documented in the literature. Applications of ASR for adults include estimation of hearing levels (Hall 1978;Jerger et al 1974a;Niemeyer & Sesterhenn 1974), site-of-lesion testing to diagnose conductive, cochlear, and retrocochlear pathologies (Ferguson et al 1996;Handler & Margolis 1977;Jerger et al 1974b), evaluation of facial nerve dysfunction (Alford et al 1973;Citron & Adour 1978), and confirmation of functional or nonorganic hearing loss (Gelfand 1994). Despite its clinical significance, the ASR test has, to date, not been widely applied to young infants (0 to 6 mo).…”

Section: Introductionmentioning

confidence: 99%

Test-Retest Reliability of the Acoustic Stapedial Reflex Test in Healthy Neonates

2009

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This study demonstrated that ASRs could be consistently elicited from healthy neonates who showed a single-peaked configuration in the high-frequency tympanometry test and passed the automated auditory brain stem response and TEOAE tests. The findings showed that the ASRTs did not vary significantly across the test-retest conditions, and the high intracorrelation coefficients illustrate the reliability of the ASR test. Given the high test-retest reliability, the ASR test holds promise as a useful diagnostic/screening instrument in ascertaining the hearing status in neonates.

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Acoustic Reflex and Loudness Discomfort in Acute Facial Paralysis

Cited by 43 publications

References 12 publications

Re-examination of the role of the human acoustic stapedius reflex

Re-examination of the role of the human acoustic stapedius reflex

Modification of Loudness Discomfort Level: Evidence for Adaptive Chronic Auditory Gain and Its Clinical Relevance

Test-Retest Reliability of the Acoustic Stapedial Reflex Test in Healthy Neonates

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