Measurement of the acoustic reflex without a pressure seal.

Obtaining a hermetic seal in the external auditory canal is often a major obstacle in impedance audiometry. In the present study, the acoustic reflex threshold was determined for three groups of subjects, first with and then without a pressure-tight seal. It was found that for subjects with normal hearing or sensorineural hearing loss and normal tympanograms, 96% of the measurements obtained without a pressure seal were within 5 dB of those obtained with a seal. Among the subjects who exhibited negative middle ear pressure, the acoustic reflex could be measured consistently at the point of maximum compliance, while no response was observed without a pressure seal.