REFLEXES THE CODES OF NEUROLOGY

reflexesneurologytaskindumankapak21432

ACOUSTIC REFLEXES

Pınar Atabey

Yüksek İhtisas University, Faculty of Medicine, Medical Park Batıkent Hospital, Department of Ear Nose Throat and Head Neck Surgery, Ankara, Türkiye

Atabey P. Acoustic Reflexes. In: Duman T, editor. Reflexes The Codes of Neurology. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.193-211.

ABSTRACT

Middle Ear Muscles (MEM) and Reflexes the tensor tympani and stapedius are distinct muscles located in the middle ear, attaching to the malleus and stapes bones, respectively. The middle ear muscle (MEM) reflexes, named after these muscles, represent one of the two major systems within the auditory pathway. In humans, the stapedius muscle contracts in response to intense low-frequency acoustic stimuli, increasing the impedance of the middle ear and reducing the intensity of sound energy transmitted to the inner ear (cochlea). The tensor tympani is believed to contract in response to self-generated noise (e.g., chewing, swallowing) and non-auditory stimuli. MEM reflex pathways involve the transmission of sound through the cochlea, culminating in an action potential conveyed to the cochlear nucleus in the brainstem. unidentified interneurons in the ventral cochlear nucleus project either directly or indirectly to MEM motor neurons located elsewhere in the brainstem. These motor neurons provide efferent innervation to the MEMs. Acoustic Startle Reflex (ASR) The early component of the ASR represents the fastest response of the fear system, with onset latencies ranging between 20 and 120 milliseconds. It is mediated by the caudal brainstem and exhibits a fixed rostro-caudal recruitment pattern. The amygdala modulates the reflex, which is heightened in anxiety disorders. When a low-salience stimulus from any sensory modality (auditory, visual, tactile) precedes an unexpected startle-like stimulus, the startle motor response becomes less pronounced or may even be suppressed entirely. Olivocochlear Efferent System Olivocochlear efferents enable the central auditory system to regulate cochlear unction during active and passive listening. Although many aspects of the efferent anatomy, physiology, and function are wellcharacterized, some remain controversial. The auditory efferent system originates in the auditory cortex, projecting to the medial geniculate body (MgB), inferior colliculus (IC), cochlear nucleus (CN), and superior olivary complex (SOC) before reaching the cochlea via olivocochlear (OC) fibers. Cochleopalpebral Reflex (CP-R) The CP-R involves an involuntary blink resulting from the contraction of the orbicularis oculi muscle in response to high-intensity sounds. It represents the initial phase of auditory behavioral observation in neonates and infants. however, clinical examination of the CP-R in neonates is rarely used today, having been replaced by neurophysiological hearing tests.

Keywords: Stapedius reflex; Tensor tymoani syndrome; Acoustic startle reflex; Olivocochlear efferents; Cochleopalpabral reflex

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