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To the Editor.—The article by Surr and Schuchman, "Measurement of the Acoustic Reflex Without a Pressure Seal," published in the March Archives (102:160-161, 1976), should be a reminder to those who use acoustic reflex measurements routinely, that such testing should not be abandoned simply because a hermetic seal cannot be obtained. In the sensorineural and normal middle ear, reflexes can be measured accurately in a "no seal" condition. It has been my experience, however, that the inability to obtain a seal in the external auditory canal is an infrequent occurrence.
After reading their article, I randomly selected 261 cases (522 ears) in which impedance audiometry was attemped in our clinic during the past year. In only three of the 522 ears could a seal not be obtained. I, therefore, do not wish those who are somewhat unfamiliar with impedance audiometry to visualize the procedure as being a time consuming
Cox HA. Acoustic Reflex Measurement. Arch Otolaryngol. 1976;102(10):644. doi:10.1001/archotol.1976.00780150112014
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