Wideband ipsilateral measurements of middle-ear muscle reflex thresholds in children and adults.

The goals of the current study were to: 1) evaluate the feasibility of a new wideband approach to measuring middle-ear muscle reflex (MEMR) status, and 2) to test the hypothesis that ipsilateral thresholds elicited with 1 or 2 kHz tones and broadband noise activators on a wideband acoustic transfer function (WATF) system are lower than thresholds elicited on a clinical system. Clinical MEMR tests have limitations, including the need for high activator levels to elicit a shift in a narrowband probe (e.g., a 0.226 or 1 kHz tone). Wideband MEMR tests using WATFs may elicit the reflex at lower levels because a wideband probe (click) is used and the threshold detection criterion can be wideband. Mean wideband MEMR thresholds across 40 normal-hearing adult ears were 2.2-4.0 dB lower than clinical MEMR thresholds, depending on the activator and specific WATF test used (admittance magnitude or energy reflectance). Wideband MEMR has potential clinical utility beyond the adult population, including use in newborn and preschool hearing screenings. In a newborn hearing screening, for example, wideband MEMR could be completed with the same system as otoacoustic emissions. However, further investigations in infants and young children are needed.