# Middle-ear reflex testing using wideband acoustic immittance

> **NIH NIH R44** · MIMOSA ACOUSTICS · 2021 · $787,151

## Abstract

PROJECT SUMMARY/ABSTRACT
The objective of this project is to build and evaluate a middle-ear muscle reflex (MEMR) test system that is
based on measurement of wideband acoustic immittance (WAI). This WAI-MEMR system will be accurate,
scientifically and technically sound, stable, reliable, safe, and clinician friendly. Acoustically elicited MEMRs
have a long history of value in the clinical evaluation of hearing loss. While sensitive to and affected by middle-
ear disorders linked to conductive hearing losses, MEMRs also demonstrate particular sensitivity to synaptic
and postsynaptic disorders related to the eighth nerve and auditory brainstem pathways through activation of
neural pathways ipsilateral and contralateral to the physiologic middle-ear response. MEMRs are objective in
providing information rapidly without requiring behavioral responses from the patient, and this objectivity
facilitates their use in infants. Measuring MEMRs in the context of WAI provides clear advantages over current
methods based on the ability to evaluate responses over a broader frequency range and to elicit responses to
lower-intensity stimuli. The broadband nature of WAI is a well-documented advantage in infant testing.
However, even though MEMR is a robust and sensitive measure, it is underutilized clinically on account of
concerns that include subjectivity in response determination, intrasubject variation, uncertainty about MEMR
response presence, and lack of confidence among clinicians in interpreting responses. The specific aims for
this Phase II project are to (1) build a dual-probe WAI-MEMR system that is capable of ipsilateral, contralateral,
and binaural stimulus paradigms and allows flexible and precise manipulation of test parameters; (2) develop
automated processes for analyzing and quantifying WAI-MEMR responses to provide a method for objective
test interpretation; (3) develop and test artifact rejection methods, a user-friendly probe, and calibration
methods; (4) define stimulus and acquisition parameters further through human-subject testing of infants,
children, and adults with normal hearing and with hearing loss; and (5) implement new paradigms and evaluate
the new Phase II dual-channel system in adults and infants with normal hearing. The accomplishments
completed during Phase I have resulted in a prototype dual-probe system that has been tested in adults with
normal hearing and hearing loss with promising results. Work has begun toward automated analysis as well as
defining frequency, amplitude, and threshold characteristics in infants and adults. The ongoing, productive
collaboration between Dr. Jeng at Mimosa Acoustics and Dr. Hood at Vanderbilt University will continue
throughout the Phase II project period for the development and evaluation of the WAI-MEMR approach.
Creating hardware and software that uses this approach should reduce subjectivity in clinician interpretation
and encourage increased clinical utilization and application in pati...

## Key facts

- **NIH application ID:** 10260596
- **Project number:** 5R44DC016780-03
- **Recipient organization:** MIMOSA ACOUSTICS
- **Principal Investigator:** LINDA J. HOOD
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $787,151
- **Award type:** 5
- **Project period:** 2018-01-05 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10260596

## Citation

> US National Institutes of Health, RePORTER application 10260596, Middle-ear reflex testing using wideband acoustic immittance (5R44DC016780-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10260596. Licensed CC0.

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