title: Diagnostic utility of the acoustic reflex in predicting hearing in paediatric populations.
abstract: OBJECTIVE
  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 60 dB and that of pure tone was 80 dB. 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 X2 and student 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 to 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.
authors.affiliation: Servicio de Audiología, Instituto Nacional de Rehabilitación, Distrito Federal, México.
authors.forename: Yolanda E
authors.initials: YE
authors.lastname: Pérez-Villa
authors.affiliation: Servicio de Audiología, Instituto Nacional de Rehabilitación, Distrito Federal, México.
authors.forename: María E
authors.initials: ME
authors.lastname: Mena-Ramírez
authors.affiliation: Servicio de Audiología, Instituto Nacional de Rehabilitación, Distrito Federal, México.
authors.forename: Laura E Chamlati
authors.initials: LE
authors.lastname: Aguirre
authors.affiliation: Instituto Nacional de Perinatología, Instituto Nacional de Pediatría, Distrito Federal, México.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mora-Magaña
authors.affiliation: Servicio de Audiología, Instituto Nacional de Rehabilitación, Distrito Federal, México. Electronic address: gtzfarfanileana@hotmail.com.
authors.forename: Ileana S
authors.initials: IS
authors.lastname: Gutiérrez-Farfán
mesh_terms: D001301:Audiometry, Pure-Tone; D002648:Child; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D012022:Reflex, Acoustic; D012680:Sensitivity and Specificity
keywords: Acoustic reflex; Broadband noise; Reflejo acústico; Ruido de banda ancha