Tympanograms are type A bilaterally: static compliance is 1.1 ml in the right ear with peak pressure of 10 daPa. The left ear has 0.9 ml static compliance and -20 daPa peak pressure.
Acoustic Reflex Data
Thresholds
| (dB HL) | 500 | 1000 | 2000 | 4000 |
| Right Ipsi | 85 | 105 | 110 | Absent |
| Right Contra | 80 | 100 | Absent | Absent |
| Left Ipsi | 90 | 105 | 110 | Absent |
| Left Contra | 95 | 110 | Absent | Absent |
Reflex Decay
Reflex decay was tested at 500 Hz in the contralateral condition for each ear: there was no significant decay. By 5 seconds the traces had declined in amplitude by 25% in the right ear and 30% in the left ear.
Hearing Thresholds
| 500 | 1000 | 2000 | 4000 | |
| Right Ear | 20 | 50 | 55 | 75 |
| Left Ear | 20 | 45 | 60 | 70 |
Classify the acoustic reflex thresholds, established in dB HL.
Which are:
- Present at normal hearing levels?
- Present at elevated hearing levels?
- Are any reflex thresholds disproportionately high?
- Absent?
Compute the sensation level of the reflexes (that are present).
Which are:
- Present at normal sensation levels?
- Present at reduced sensation levels?
- Present at elevated sensation levels?
- What is the clinical significance of absent acoustic reflexes and how does the degree of hearing loss affect the clinical significance?
- What is the clinical significance of the presence of reduced sensation level reflexes?
- If reflex decay is present, which site of lesion does that suggest? What is the significance of absent reflex decay?
- Look at all site of lesion information. We have a bilaterally symmetrical sensorineural loss. How do word recognition scores, and indicators of recruitment influence your thinking on this case? Are concerns raised by the reflex data – could there be retrocochlear involvement? What is the conclusion, viewing all data, about the site of lesion?