Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2026
Middle Ear Pressure Assessment to Detect the Stapedius Reflex: A Prospective Observational Feasibility Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Vargas Luna José Luis, Proksch Johannes, Geißler Katharina, Richter Daniel, Korth Daniela, Arnold Dirk, Volk Gerd Fabian, Guntinas-Lichius Orlando
Аннотация
OBJECTIVE: To evaluate the feasibility of detecting stapedius reflex (SR) through direct middle ear pressure monitoring during contralateral acoustic stimulation.
STUDY DESIGN: Prospective, observational, single-centre feasibility study.
SETTING: Tertiary referral centre; intraoperative setting during tympanotomy procedures.
PATIENTS: Eleven adult patients (≥18 y) with unilateral sudden sensorineural hearing loss undergoing transtympanic dexamethasone instillation, with an elicitable SR through contralateral stimulation, were included in this study. Patients with SR thresholds >100 dB HL were excluded.
INTERVENTION S: A pressure transducer was inserted intraoperatively into the middle ear. A tympanometer device on the contralateral side apply acoustic stimulation and monitored the SR on that side. Stimulation was ECG-synchronized, and filtering was applied to the pressure signal to enhance detection.
MAIN OUTCOME MEASURES: Detection of SR-related pressure changes using the pressure transducer, compared with tympanometry-based detection.
RESULTS: Out of 32 stimulus combinations, 24 elicited confirmed stapedius reflexes, while 8 did not. Among the 24 reflex-positive cases, the pressure-based method correctly identified reflex-related pressure changes in 20 instances, yielding a detection accuracy of 83.3% for confirmed reflexes. In the remaining 4 reflex-positive cases, the system failed to detect a response. In all 8 cases where no reflex was elicited, the system also did not detect any pressure changes, indicating no false positives.
CONCLUSIONS: Middle ear pressure monitoring is a feasible method for detecting SR. This approach demonstrates feasibility under intraoperative conditions and may, with further development and validation, support future objective reflex assessment in cochlear implant users.
STUDY DESIGN: Prospective, observational, single-centre feasibility study.
SETTING: Tertiary referral centre; intraoperative setting during tympanotomy procedures.
PATIENTS: Eleven adult patients (≥18 y) with unilateral sudden sensorineural hearing loss undergoing transtympanic dexamethasone instillation, with an elicitable SR through contralateral stimulation, were included in this study. Patients with SR thresholds >100 dB HL were excluded.
INTERVENTION S: A pressure transducer was inserted intraoperatively into the middle ear. A tympanometer device on the contralateral side apply acoustic stimulation and monitored the SR on that side. Stimulation was ECG-synchronized, and filtering was applied to the pressure signal to enhance detection.
MAIN OUTCOME MEASURES: Detection of SR-related pressure changes using the pressure transducer, compared with tympanometry-based detection.
RESULTS: Out of 32 stimulus combinations, 24 elicited confirmed stapedius reflexes, while 8 did not. Among the 24 reflex-positive cases, the pressure-based method correctly identified reflex-related pressure changes in 20 instances, yielding a detection accuracy of 83.3% for confirmed reflexes. In the remaining 4 reflex-positive cases, the system failed to detect a response. In all 8 cases where no reflex was elicited, the system also did not detect any pressure changes, indicating no false positives.
CONCLUSIONS: Middle ear pressure monitoring is a feasible method for detecting SR. This approach demonstrates feasibility under intraoperative conditions and may, with further development and validation, support future objective reflex assessment in cochlear implant users.