Coordinated field application of extratympanic manometry: Some indices of middle ear muscle reflex activity. (USN Air Material Cent. Air Crew Equipm. Lab. Rep., No. 473. BuMed Subtask No. MR005.13-2002.4).

1962 ◽  
Author(s):  
E. S. Mendelson ◽  
J. L. Fletcher
Keyword(s):  
Middle Ear ◽  
Field Application ◽  
Reflex Activity ◽  
Muscle Reflex

Application of negative expiratory pressure during expiration and activity of genioglossus in humans

1998 ◽  
Vol 84 (3) ◽  
pp. 1076-1082 ◽  
Author(s):  
Claudio Tantucci ◽  
Selma Mehiri ◽  
Alexandre Duguet ◽  
Thomas Similowski ◽  
Isabelle Arnulf ◽  
...  
Keyword(s):  
Reflex Response ◽  
Reflex Activity ◽  
Steady Increase ◽  
Flow Limitation ◽  
Upper Airways ◽  
Experimental Conditions ◽  
Surface Electromyogram ◽  
Genioglossus Muscle ◽  
Mouth Pressure ◽  
Muscle Reflex

The application of negative expiratory pressure (NEP) at end expiration has been shown to cause reflex-mediated activation of the genioglossus muscle in awake humans. To test whether a reflex contraction of pharyngeal dilator muscles also occurs in response to NEP applied in early expiration, the effect on genioglossus muscle reflex activity of NEP pulses of 500 ms, given 0.2 s after the onset of expiration and during the end-expiratory pause, was assessed in 10 normal awake subjects at rest. The raw and integrated surface electromyogram of the genioglossus (EMGgg) was recorded with airflow and mouth pressure under control conditions and with NEP ranging from −3 to −10 cmH2O. Intraoral EMGgg was also recorded under the same experimental conditions in two subjects. The application of NEP at the end-expiratory pause elicited a consistent reflex response of EMGgg in seven subjects with a mean latency of 68 ± 5 ms. In contrast, when NEP was applied at the onset of expiration, EMGgg reflex activity was invariably observed in only one subject. No relationship was found between steady increase or abrupt fall in expiratory flow and the presence or the absence of a reflex activity of genioglossus during sudden application of NEP at the beginning of expiration. Our results show that a reflex activity of genioglossus is elicited much more commonly during application of NEP at the end rather than at the onset of expiration. These findings also suggest that when NEP is applied in early expiration to detect intrathoracic flow limitation the absence of upper airways narrowing does not imply the occurrence of a reflex-mediated activation of genioglossus and vice versa.

scholarly journals The middle ear muscle reflex in the diagnosis of cochlear neuropathy

2016 ◽  
Vol 332 ◽  
pp. 29-38 ◽  
Author(s):  
Michelle D. Valero ◽  
Kenneth E. Hancock ◽  
M. Charles Liberman
Keyword(s):  
Middle Ear ◽  
Muscle Reflex ◽  
Cochlear Neuropathy

Anticipatory Middle-Ear Reflex Activity from Noisy Toys

1975 ◽  
Vol 40 (3) ◽  
pp. 320-326 ◽  
Author(s):  
Lynne Marshall ◽  
John F. Brandt ◽  
Larry E. Marston
Keyword(s):  
Middle Ear ◽  
Reflex Activity ◽  
Common Occurrence ◽  
Reflex Responses ◽  
Sound Exposure ◽  
Reflex Threshold ◽  
Acoustic Exposure

Middle-ear reflex activity was measured in 14 listeners in response to visual and acoustic exposure to each of seven noisy toys (such as a cap gun, party horn, cow bell, and so forth). Anticipatory middle-ear reflex (AMER) activity was a common occurrence. Normal middle-ear reflex generally occurred after the sound exposure. AMERs generally occurred in the two seconds prior to sound exposure but as early as 10 seconds before sound exposure. Loudness ratings and exposure SPLs were obtained. The presence of acoustically evoked middle-ear (ME) reflex activity and AMERs to the toys was generally unrelated to SPL or reflex threshold. Many reflex responses occurred in response to exposure SPLs below reflex threshold and with low anticipated loudness rating.

Design Factors in the Characterization and Identification of Otitis Media and Certain Related Conditions

1979 ◽  
Vol 88 (5_suppl) ◽  
pp. 13-28 ◽  
Author(s):  
Charles D. Bluestone ◽  
Erdem I. Cantekin
Keyword(s):  
Otitis Media ◽  
Sensitivity And Specificity ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Interobserver Reliability ◽  
Diagnostic Value ◽  
The State ◽  
Related Condition ◽  
Muscle Reflex ◽  
High Degree

Because the state of our knowledge of many aspects of the etiology and pathogenesis of otitis media and related conditions is deficient, precise characterizations of certain aspects of the disease may not be possible. In fact although most studies in the past have failed to define the specific disease state to be investigated, the specific type of otitis media or related condition to be studied must be as clearly defined as is clinically possible in order for any prospective study of otitis media to be valid. The state of the art of the presently available methods to identify these conditions also poses certain limitations; at present, there are five methods to identify otitis media and related conditions: history, audiometry, tympanocentesis/myringotomy, otoscopy (including otomicroscopy), and impedance measurements (tympanometry and assessment of the middle ear muscle reflex), and they all have inherent elements of unreliability. Historical information obtained from parents or the child is usually unreliable; a positive history may aid in defining the problem, but a negative otologic history does not rule out the presence of otitis media since it is frequently asymptomatic. Audiometry has been shown to be a poor method of identifying otitis media. Although tympanocentesis or myringotomy is the most reliable way to identify otitis media with effusion (OME), it is invasive, frequently requires an anesthetic, and is usually a confounding variable. In an effort to establish the diagnostic value of otoscopy, tympanometry, and the presence or absence of the middle ear muscle reflex in identifying OME, the diagnostic findings by these three methods were compared with the findings at myringotomy in 239 children (425 ears). The study showed that even experienced clinicians had some difficulty in identifying those ears with effusion (sensitivity) and had even greater difficulty in making a diagnosis of those ears without an effusion (specificity). Tympanometry employing patterns that have been validated with myringotomy findings was found to be as accurate as expert otoscopy. On the other hand, the presence or absence of the middle ear muscle reflex was found not to be a useful method of diagnosing the presence of OME due to its extremely low specificity. An algorithm derived from the combination of the three methods had highest sensitivity and specificity. From this study, the following recommendations regarding the identification of OME are suggested. All investigators who employ otoscopy should be validated by comparing their assessments either with the findings at myringotomy or with a previously validated otoscopist. Interobserver reliability of all otoscopists should be established prior to and maintained during clinical studies of OME. Only electroacoustic impedance instruments in which the tympanometric patterns have been validated should be used. Tympanometry employing validated tympanometric patterns has a high degree of sensitivity and specificity, and as such can provide an objective method to identify OME. Middle ear muscle reflex measurements should not be used as the only method to identify OME. An algorithm that includes otoscopy, tympanometry, and, to a lesser degree, the middle ear muscle reflex measurement should be employed for research purposes when a noninvasive method to identify OME is required.

The White Noise Middle Ear Muscle Reflex Threshold in Patients with Sensorineural Hearing Impairment

1976 ◽  
Vol 5 (3) ◽  
pp. 131-135 ◽  
Author(s):  
N. J. Johnsen ◽  
D. Osterhammel ◽  
K. Terkildsen ◽  
P. Osterhammel ◽  
F. Huis in't Veld
Keyword(s):  
White Noise ◽  
Hearing Impairment ◽  
Middle Ear ◽  
Sensorineural Hearing ◽  
Sensorineural Hearing Impairment ◽  
Reflex Threshold ◽  
Muscle Reflex

scholarly journals Weak Middle-Ear-Muscle Reflex in Humans with Noise-Induced Tinnitus and Normal Hearing May Reflect Cochlear Synaptopathy

eNeuro ◽  
2017 ◽  
Vol 4 (6) ◽  
pp. ENEURO.0363-17.2017 ◽  
Author(s):  
Magdalena Wojtczak ◽  
Jordan A. Beim ◽  
Andrew J. Oxenham
Keyword(s):  
Middle Ear ◽  
Normal Hearing ◽  
Muscle Reflex
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