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Vol. 65. Issue 6.
Pages 332-338 (November - December 2014)
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Vol. 65. Issue 6.
Pages 332-338 (November - December 2014)
Original Article
Diagnostic Utility of the Acoustic Reflex in Predicting Hearing in Paediatric Populations
Utilidad diagnóstica del reflejo acústico para predecir audición en población pediátrica
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Yolanda E. Pérez-Villaa, María E. Mena-Ramíreza, Laura E. Chamlati Aguirrea, Ignacio Mora-Magañab, Ileana S. Gutiérrez-Farfána,
Corresponding author
gtzfarfanileana@hotmail.com

Corresponding author.
a Servicio de Audiología, Instituto Nacional de Rehabilitación, Distrito Federal, Mexico
b Instituto Nacional de Perinatología, Instituto Nacional de Pediatría, Distrito Federal, Mexico
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Figures (7)
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Tables (7)
Table 1. Criteria for Predicting Auditory Loss.
Table 2. Criteria for the Auditory Loss in Agreement With the Pure-tone Average.
Table 3. Frequency of Otorrhea by Ear.
Table 4. Frequency of Exanthematous Diseases.
Table 5. SPAR Prediction by Degree of Hearing Loss for the Right Ear Confirmed by Audiometry.
Table 6. SPAR Prediction by Degree of Hearing Loss for the Left Ear Confirmed by Audiometry.
Table 7. Diagnostic Usefulness of SPAR Compared With Audiometry Tonal.
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Abstract
Introduction and objectives

The sensitivity of prediction of acoustic reflex, in determining the level of hearing loss, is especially useful in paediatric populations. It is based on the difference between the pure tone stapedius reflex threshold and contralateral white noise. The white noise threshold was 60dB and that of pure tone was 80dB.

Our objective was to determine the diagnostic sensitivity of the prediction of the acoustic reflex.

Methods

We studied children aged <10 years, from October 2011 to May 2012, by measuring the acoustic reflex with white noise and pure tone. We used contrast tests, with χ2 and Student's t-test. Concordance was measured with Kappa. Results were considered significant at P≤.05. Our protocol was approved by Institutional Ethics Committee. Informed consent was obtained from the parents in all cases.

Results

Prediction of normal hearing was 0.84 for the right ear and 0.78 in left ear, while for hearing loss of an unspecified grade, it was 0.98 for the right ear and 0.96 in the left ear. Kappa value was 0.7–0.6 for the right ear and left ear.

Conclusions

The acoustic reflex is of little diagnostic utility in predicting the degree of hearing loss, but it predicts more than 80% of normal hearing. The clinical utility of the reflex is indisputable, as it is an objective method, simple and rapid to use, that can be performed from birth and whose results are independent of the cooperation and willingness of the subject. It is proposed as an obligatory part of hearing screening.

Keywords:
Acoustic reflex
Broadband noise
Resumen
Introducción y objetivos

La sensibilidad de predicción del reflejo acústico determina el nivel de pérdida auditiva, útil sobre todo en población pediátrica. Se basa en la diferencia entre el umbral del reflejo estapedial con tono puro y con ruido blanco contralateral. El umbral con ruido blanco es de 60dB y con tono puro de 80dB.

El objetivo de este estudio fue determinar la utilidad diagnóstica de la sensibilidad de predicción del reflejo acústico.

Métodos

Previo consentimiento informado, se estudió a niños menores de 10 años, de octubre del 2011 a mayo del 2012, midiendo el reflejo estapedial con ruido blanco y tono puro. Se realizaron pruebas de contraste con χ2 y t de Student. La concordancia se midió con kappa. Se consideró significativo un valor de p ≤ 0,05. El proyecto fue aprobado por el Comité de Ética. En todos los casos se obtuvo el consentimiento informado de los padres.

Resultados

Predicción de audición normal: 0,84 para el oído derecho y 0,78 en el oído izquierdo y para hipoacusia sin especificar el grado: 0,98 para el oído derecho y 0,96 en el oído izquierdo. Valor de kappa de 0,7 para el oído derecho y 0,6 para el oído izquierdo.

Conclusiones

La utilidad diagnóstica del reflejo acústico tiene muy poco valor para predecir el grado de pérdida auditiva, pero predice en más del 80% la audición normal. Por lo que se sugiere utilizar como una prueba objetiva obligada como parte del Cribado auditivo.

Palabras clave:
Reflejo acústico
Ruido de banda ancha

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