Audiology 2
Acoustic reflex testing or stapedial reflex testing using tympanometry to
check how the involuntary muscle responds to loud stimuli. A normal acoustic
reflex threshold (ART) is about 70Db SPL. In conductive hearing loss ART is
higher or missing.1 The auditory brainstem response (ABR) testing. ABR testing is
essential in recording how the child’s brain activity is responding to different
sounds. ABR will help to determine how the cochlea is working or whether his
hearing loss is in the neurons leading to the brain.2
2) What could be the cause of the hearing loss?
Unilateral hearing loss in the child may be due to several problems in the
past 10-years of life. The child has moderate hearing loss and may have
difficulties listening to high-pitched sounds. His poor speech score and difficulties
listening in noise can mean that sound transmission from the outer into the inner
ear is poor. Therefore, he may be suffering from conductance hearing loss that is
caused by several factors. Otitis media can cause conductance hearing loss in
the child. If the fluid is present in the otitis canal, the transmission of sound
vibrations to the eardrum is hindered. The other cause may be an unfunctional
Eustachian tube due to fluid in the middle ear draining into it. Benign tumors
such an acoustic neuroma grows and develops in the main vestibule thus
affecting the nerves that are responsible for hearing. Complications with the
child’s eardrum can also cause this type of hearing loss.
3) What would you do to improve his performance?
1 Reiss, N. M., & Reiss, G. (2000). Differential diagnosis of unilateral hearing loss.
Praxis,
89(6), 241-247.
2 Levit, Y., Mandel, D., & Matot, I. (2018). Frequency-specific auditory brainstem response
testing with age-appropriate sedation.
International journal of pediatric
otorhinolaryngology,
108, 73-79.

A normal acoustic reflex threshold

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