The Lever Ratio

Purpose of ME
To transmit sound energy from the air space in the EAC to the fluid in the cochlea This is accomplished by vibration of the ossicles

So what if we didnt have a TM or any ossicles?

99.9% of sound waves would bounce off the oval window This energy reflected off oval window gives about a 30 dB hearing loss Purpose of the TM and the ossicles -- eliminate IMPEDANCE MISMATCH IMPEDANCE the resistance to flow of energy

Two Forms of Impedance

Resistance Reactance
 

Stiffness Mass

Area Advantage
TM

OW

Lever Advantage

Area & Lever Ratio

17 * 1.3 = _______ 22 to 1
therefore the overall increase in pressure equals:

26.84 dB or 27 dB 20 Log 22 = _________________

The Acoustic Reflex

STAPEDIUS vs.
6 mm in length
Arises in bony canal adjoining the facial canal and inserts on the head of the stapes Cranial Nerve VII Activates by acoustic (acoustic reflex) and nonacoustic means

TENSOR TYMPANI
25 mm in length
Arises from wall of Eustachian tube and inserts on the upper margin of the manubrium of malleus

Cranial Nerve V
Activates by startle response and/or tactile stimulation of the orbital area

Neuronal Organization of Acoustic Stapedius Reflexes

Clinical Acoustic-Reflex Protocols AcousticAcoustic-reflex thresholds Acoustic 

AR thresholds vs. auditory thresholds Reduction of .6 - .7 dB per dB

INPUT 80 81 90 95 108

INNER EAR 80 80.3 - 80.4 83 - 84 84.5 - 86 88.4 - 91.2

We only measure up to 110 dB HL

Acoustic Reflex Profiles in Specific Pathologies

Middle ear disorders Facial nerve disorders Cochlear disorders Eighth nerve disorders Central (Brainstem) disorders