A preliminary study of endoscopic acoustic stapedial reflex in chronic otitis media

OBJECTIVE: To introduce the endoscopic acoustic stapedial reflex (EASR) as a technique for assessing stapedial mobility in ears with chronic otitis media (COM).

METHODS: This prospective study was performed from February 2008 to February 2009, patients with COM presented to the Otology Clinic, King Abdul-Aziz University Hospital, Riyadh, Kingdom of Saudi Arabia were examined with a rigid ear endoscope to visualize the stapedius tendon and the head of stapes. The reflex is elicited by pulsed sound stimuli. The stapedius muscle contraction and the mobility of the stapes are visualized during exposure ipsilaterally, and contralaterally to sound stimuli.

RESULTS: Conventional tympanometry did not detect a stapedial reflex in any of the 10 patients. Acoustic stapedial reflex was detected in all ears. Despite a visible stapedial muscle contraction, one patient did not demonstrate stapes movement, and was confirmed to have stapes fixation at surgery. All patients tolerated the test with no complications, or side effects.

CONCLUSION: The EASR was introduced for the first time. In addition to the well-known value of the stapedial reflex testing, it provides a safe, and reliable method for assessment of stapes mobility.