The acoustic reflex test in cochlear and eighth nerve pathology ears.

The clinical interpretation of acoustic reflex test results in ears with sensorineural impairment should be based on a consideration of three characteristics of the response: the reflex threshold hearing level, the reflex threshold sensation level, and the decay of the reflex. Examination of results in 152 ears with cochlear pathology and in 152 ears with acoustic tumor indicated that in some cases the combination of characteristics may be contradictory as to site of lesion. Regarding a contradictory response pattern as questionable -- neither confirming nor denying a specific site of lesion -- improves the predictive accuracy of the test through a reduction in the number of false identifications.