{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T19:02:24Z","timestamp":1780599744226,"version":"3.54.1"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01 020962"],"award-info":[{"award-number":["R01 020962"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008893","name":"University of Iowa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008893","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JARO"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>We describe a novel paradigm for evoking and measuring middle ear muscle reflex (MEMR), in which a train of broadband clicks act as probes, while a broadband noise elicitor is continuously swept in both ascending and descending sound levels. A new measure, total change, incorporates both magnitude and phase to quantify MEMR in a way that promotes meaningful averaging across a wide range of sound levels and frequencies. The aims of the study were to assess the retest reliability of the new swept-elicitor MEMR paradigm, to compare results with those obtained using traditional discrete-elicitor stimuli, and to preliminarily examine correlations with speech-in-noise performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEMR was measured in 38 young, normal-hearing participants (24 female, 14 male) using both the novel swept paradigm and a more conventional paradigm with elicitor noises that were discretely varied in level. Key measures of MEMR dynamics were obtained from the swept elicitor paradigm, including maximum total change, onset and offset thresholds, hysteresis, and reflex delay. Intraclass correlation coefficients (ICCs) were used to assess repeatability, and robust linear regression was used to examine correlations with QuickSIN performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The swept MEMR paradigm demonstrated excellent repeatability, with ICC values exceeding 0.90 for all extracted measures. MEMR thresholds from the swept elicitor correlated moderately with speech-in-noise performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our new MEMR paradigm provides fast, repeatable measurements. Several measures of MEMR dynamics can be obtained, improving upon traditional measurement approaches. Results suggest a possible link between MEMR dynamics and speech-in-noise performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10162-026-01037-z","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T14:26:05Z","timestamp":1774275965000},"page":"427-445","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rapid Characterization of Middle-Ear Muscle Reflexes Using Swept Elicitors"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7888-6599","authenticated-orcid":false,"given":"M. Ehsan","family":"Khalili","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia H.","family":"Roemen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery T.","family":"Lichtenhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2472-2318","authenticated-orcid":false,"given":"Shawn S.","family":"Goodman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"1037_CR1","unstructured":"Goodman SS (2017) ARLas (Version 6.2). https:\/\/github.com\/myKungFu\/ARLas. Accessed 1 Jun 2022"},{"key":"1037_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2025.109225","volume":"459","author":"A Baricevich","year":"2025","unstructured":"Baricevich A, Bassett D, Chan S, Lavi S, Siegel J (2025) Frequency and level dependence of the middle ear acoustic reflex and its decay measured in wideband absorbance with contralateral narrowband noise elicitors. Hear Res 459:109225. https:\/\/doi.org\/10.1016\/j.heares.2025.109225","journal-title":"Hear Res"},{"issue":"2","key":"1037_CR3","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/s0031-3955(03)00031-2","volume":"50","author":"CI Berlin","year":"2003","unstructured":"Berlin CI, Morlet T, Hood LJ (2003) Auditory neuropathy\/dyssynchrony: its diagnosis and management. Pediatr Clin North Am 50(2):331\u2013340. https:\/\/doi.org\/10.1016\/s0031-3955(03)00031-2","journal-title":"Pediatr Clin North Am"},{"key":"1037_CR4","doi-asserted-by":"publisher","first-page":"746821","DOI":"10.3389\/fnins.2021.746821","volume":"15","author":"S Boothalingam","year":"2021","unstructured":"Boothalingam S, Goodman SS, MacCrae H, Dhar S (2021) A time-course-based estimation of the human medial olivocochlear reflex function using clicks. Front Neurosci 15:746821","journal-title":"Front Neurosci"},{"issue":"1\u20136","key":"1037_CR5","doi-asserted-by":"publisher","first-page":"19","DOI":"10.3109\/00016488209130848","volume":"93","author":"E Borg","year":"1982","unstructured":"Borg E (1982) Dynamic properties of the intra-aural reflex in lesions of the lower auditory pathway: an experimental study in rabbits. Acta Otolaryngol 93(1\u20136):19\u201329","journal-title":"Acta Otolaryngol"},{"key":"1037_CR6","doi-asserted-by":"crossref","unstructured":"Borg E, Counter SA, Rosler G (1984) Theories of middle ear muscle functions. In Silman S (ed) The acoustic reflex: Basic principles and clinical applications (pp. 63\u2013101). New York, NY: Academic Press","DOI":"10.1016\/B978-0-12-643450-7.50008-1"},{"issue":"1","key":"1037_CR7","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1044\/2021_AJA-21-00133","volume":"31","author":"NF Bramhall","year":"2022","unstructured":"Bramhall NF, Reavis KM, Feeney MP, Kampel SD (2022) The impacts of noise exposure on the middle ear muscle reflex in a veteran population. Am J Audiol 31(1):126\u2013142. https:\/\/doi.org\/10.1044\/2021_AJA-21-00133","journal-title":"Am J Audiol"},{"issue":"1","key":"1037_CR8","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1044\/2024_AJA-24-00110","volume":"34","author":"NF Bramhall","year":"2025","unstructured":"Bramhall NF, Whittle NK, Feeney MP, McMillan GP (2025) Test\u2013retest differences in the wideband middle ear muscle reflex. Am J Audiol 34(1):149\u2013159. https:\/\/doi.org\/10.1044\/2024_AJA-24-00110","journal-title":"Am J Audiol"},{"issue":"5","key":"1037_CR9","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1097\/mao.0b013e3180577919","volume":"28","author":"G Caner","year":"2007","unstructured":"Caner G, Olgun L, G\u00fcltekin G, Balaban M (2007) Optimizing fitting in children using objective measures such as neural response imaging and electrically evoked stapedius reflex threshold. Otol Neurotol 28(5):637\u2013640. https:\/\/doi.org\/10.1097\/mao.0b013e3180577919","journal-title":"Otol Neurotol"},{"issue":"6","key":"1037_CR10","doi-asserted-by":"publisher","first-page":"552","DOI":"10.3109\/00206098409081538","volume":"23","author":"GD Causey","year":"1984","unstructured":"Causey GD, Hood LJ, Hermanson CL, Bowling LS (1984) The Maryland CNC test: normative studies. Audiology 23(6):552\u2013568","journal-title":"Audiology"},{"issue":"11","key":"1037_CR11","doi-asserted-by":"publisher","first-page":"2175","DOI":"10.1121\/1.1919340","volume":"36","author":"PJ Dallos","year":"1964","unstructured":"Dallos PJ (1964) Dynamics of the acoustic reflex: phenomenological aspects. J Acoust Soc Am 36(11):2175\u20132183","journal-title":"J Acoust Soc Am"},{"issue":"4","key":"1037_CR12","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1097\/00003446-200108000-00006","volume":"22","author":"MP Feeney","year":"2001","unstructured":"Feeney MP, Keefe DH (2001) Estimating the acoustic reflex threshold from wideband measures of reflectance, admittance, and power. Ear Hear 22(4):316\u2013332","journal-title":"Ear Hear"},{"key":"1037_CR13","doi-asserted-by":"crossref","unstructured":"Feeney MP, Keefe DH, Marryott LP (2003) Contralateral acoustic reflex thresholds for tonal activators using wideband energy reflectance and admittance. J Speech Lang Hear Res 46(1):128-36","DOI":"10.1044\/1092-4388(2003\/010)"},{"issue":"5","key":"1037_CR14","doi-asserted-by":"publisher","first-page":"278","DOI":"10.3766\/jaaa.16.5.3","volume":"16","author":"MP Feeney","year":"2005","unstructured":"Feeney MP, Sanford CA (2005) Detection of the acoustic stapedius reflex in infants using wideband energy reflectance and admittance. J Am Acad Audiol 16(5):278\u2013290. https:\/\/doi.org\/10.3766\/jaaa.16.5.3","journal-title":"J Am Acad Audiol"},{"issue":"3","key":"1037_CR15","doi-asserted-by":"publisher","first-page":"e142","DOI":"10.1097\/AUD.0000000000000399","volume":"38","author":"MP Feeney","year":"2017","unstructured":"Feeney MP, Keefe DH, Hunter LL, Fitzpatrick DF, Garinis AC, Putterman DB, McMillan GP (2017) Normative wideband reflectance, equivalent admittance at the tympanic membrane, and acoustic stapedius reflex threshold in adults. Ear Hear 38(3):e142\u2013e160","journal-title":"Ear Hear"},{"key":"1037_CR16","doi-asserted-by":"publisher","unstructured":"Goodman SS, Haysley S, Jennings SG (2024) Human olivocochlear effects: a statistical detection approach applied to the cochlear microphonic evoked by swept tones. J Assoc Res Otolaryngol 25(5):451\u2013475.\u00a0https:\/\/doi.org\/10.1007\/s10162-024-00956-z","DOI":"10.1007\/s10162-024-00956-z"},{"key":"1037_CR17","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.neuroscience.2018.12.019","volume":"407","author":"H Guest","year":"2019","unstructured":"Guest H, Munro KJ, Plack CJ (2019) Acoustic middle-ear-muscle-reflex thresholds in humans with normal audiograms: no relations to tinnitus, speech perception in noise, or noise exposure. Neuroscience 407:75\u201382","journal-title":"Neuroscience"},{"issue":"6","key":"1037_CR18","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1097\/00003446-199912000-00006","volume":"20","author":"LL Hunter","year":"1999","unstructured":"Hunter LL, Ries DT, Schlauch RS, Levine SC, Ward WD (1999) Safety and clinical performance of acoustic reflex tests. Ear Hear 20(6):506\u2013513","journal-title":"Ear Hear"},{"issue":"8","key":"1037_CR19","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1001\/archotol.1977.00780250039002","volume":"103","author":"S Jerger","year":"1977","unstructured":"Jerger S, Jerger J (1977) Diagnostic value of crossed vs uncrossed acoustic reflexes: eighth nerve and brain stem disorders. Arch Otolaryngol 103(8):445\u2013453. https:\/\/doi.org\/10.1001\/archotol.1977.00780250039002","journal-title":"Arch Otolaryngol"},{"issue":"1","key":"1037_CR20","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1121\/1.402733","volume":"91","author":"DH Keefe","year":"1992","unstructured":"Keefe DH, Ling R, Bulen JC (1992) Method to measure acoustic impedance and reflection coefficient. J Acoust Soc Am 91(1):470\u2013485","journal-title":"J Acoust Soc Am"},{"issue":"1-2","key":"1037_CR21","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.heares.2009.09.008","volume":"263","author":"DH Keefe","year":"2010","unstructured":"Keefe DH, Fitzpatrick D, Liu YW, Sanford CA, Gorga MP (2010) Wideband acoustic-reflex test in a test battery to predict middle-ear dysfunction. Hear Res 263(1\u20132):52\u201365. https:\/\/doi.org\/10.1016\/j.heares.2009.09.008","journal-title":"Hear Res"},{"issue":"09","key":"1037_CR22","doi-asserted-by":"publisher","first-page":"838","DOI":"10.3766\/jaaa.16172","volume":"28","author":"DH Keefe","year":"2017","unstructured":"Keefe DH, Archer KL, Schmid KK, Fitzpatrick DF, Feeney MP, Hunter LL (2017) Identifying otosclerosis with aural acoustical tests of absorbance, group delay, acoustic reflex threshold, and otoacoustic emissions. J Am Acad Audiol 28(09):838\u2013860","journal-title":"J Am Acad Audiol"},{"issue":"45","key":"1037_CR23","doi-asserted-by":"publisher","first-page":"14077","DOI":"10.1523\/JNEUROSCI.2845-09.2009","volume":"29","author":"SG Kujawa","year":"2009","unstructured":"Kujawa SG, Liberman MC (2009) Adding insult to injury: cochlear nerve degeneration after \u201ctemporary\u201d noise-induced hearing loss. J Neurosci 29(45):14077\u201314085","journal-title":"J Neurosci"},{"issue":"1\u20132","key":"1037_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.heares.2009.02.002","volume":"256","author":"E Larsen","year":"2009","unstructured":"Larsen E, Liberman MC (2009) Slow build-up of cochlear suppression during sustained contralateral noise: central modulation of olivocochlear efferents? Hear Res 256(1\u20132):1\u201310. https:\/\/doi.org\/10.1016\/j.heares.2009.02.002","journal-title":"Hear Res"},{"issue":"6","key":"1037_CR25","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1016\/s0021-9924(98)00019-7","volume":"31","author":"MC Liberman","year":"1998","unstructured":"Liberman MC, Guinan JJ Jr. (1998) Feedback control of the auditory periphery: anti-masking effects of middle ear muscles vs. olivocochlear efferents. J Commun Disord 31(6):471\u2013482. https:\/\/doi.org\/10.1016\/s0021-9924(98)00019-7","journal-title":"J Commun Disord"},{"issue":"2","key":"1037_CR26","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1037\/h0047660","volume":"61","author":"M Loeb","year":"1964","unstructured":"Loeb M (1964) Psychophysical correlates of intratympanic reflex action. Psychol Bull 61(2):140","journal-title":"Psychol Bull"},{"issue":"1","key":"1037_CR27","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/0022-460X(79)90578-9","volume":"64","author":"ME Lutman","year":"1979","unstructured":"Lutman ME, Martin AM (1979) Development of an electroacoustic analogue model of the middle ear and acoustic reflex. J Sound Vib 64(1):133\u2013157. https:\/\/doi.org\/10.1016\/0022-460X(79)90578-9","journal-title":"J Sound Vib"},{"issue":"1","key":"1037_CR28","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/00003446-199302000-00002","volume":"14","author":"RH Margolis","year":"1993","unstructured":"Margolis RH (1993) Detection of hearing impairment with the acoustic stapedius reflex. Ear Hear 14(1):3\u201310","journal-title":"Ear Hear"},{"issue":"1","key":"1037_CR29","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1037\/1082-989X.1.1.30","volume":"1","author":"KO McGraw","year":"1996","unstructured":"McGraw KO, Wong SP (1996) Forming inferences about some intraclass correlation coefficients. Psychol Methods 1(1):30\u201346. https:\/\/doi.org\/10.1037\/1082-989X.1.1.30","journal-title":"Psychol Methods"},{"key":"1037_CR30","doi-asserted-by":"publisher","unstructured":"Mepani AM, Kirk SA, Hancock KE, Bennett K, de Gruttola V, Liberman MC, Maison SF (2020) Middle ear muscle reflex and word recognition in \u201cnormal-hearing\u201d adults: evidence for cochlear synaptopathy? Ear Hearing 41(1):25\u201338. https:\/\/doi.org\/10.1097\/aud.0000000000000804","DOI":"10.1097\/aud.0000000000000804"},{"issue":"2","key":"1037_CR31","doi-asserted-by":"publisher","first-page":"e72","DOI":"10.1097\/AUD.0000000000000244","volume":"37","author":"IB Mertes","year":"2016","unstructured":"Mertes IB, Goodman SS (2016) Within- and across-subject variability of repeated measurements of medial olivocochlear-induced changes in transient-evoked otoacoustic emissions. Ear Hear 37(2):e72-84. https:\/\/doi.org\/10.1097\/AUD.0000000000000244","journal-title":"Ear Hear"},{"key":"1037_CR32","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2024.109108","volume":"453","author":"IB Mertes","year":"2024","unstructured":"Mertes IB (2024) Associations between the medial olivocochlear reflex, middle-ear muscle reflex, and sentence-in-noise recognition using steady and pulsed noise elicitors. Hear Res 453:109108. https:\/\/doi.org\/10.1016\/j.heares.2024.109108","journal-title":"Hear Res"},{"issue":"1","key":"1037_CR33","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1288\/00005537-195801000-00009","volume":"68","author":"AR M\u00f8ller","year":"1958","unstructured":"M\u00f8ller AR (1958) Intra\u2010aural muscle contraction in man, examined by measuring acoustic impedance of the ear. Laryngoscope 68(1):48\u201362","journal-title":"Laryngoscope"},{"issue":"3","key":"1037_CR34","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1177\/1084713810381771","volume":"14","author":"S Mukerji","year":"2010","unstructured":"Mukerji S, Windsor AM, Lee DJ (2010) Auditory brainstem circuits that mediate the middle ear muscle reflex. Trends Amplif 14(3):170\u2013191. https:\/\/doi.org\/10.1177\/1084713810381771","journal-title":"Trends Amplif"},{"issue":"5","key":"1037_CR35","doi-asserted-by":"publisher","first-page":"2925","DOI":"10.1121\/1.423876","volume":"104","author":"ST Neely","year":"1998","unstructured":"Neely ST, Gorga MP (1998) Comparison between intensity and pressure as measures of sound level in the ear canal. J Acoust Soc Am 104(5):2925\u20132934","journal-title":"J Acoust Soc Am"},{"issue":"1","key":"1037_CR36","doi-asserted-by":"publisher","first-page":"82","DOI":"10.5152\/iao.2015.1408","volume":"12","author":"A Ozgur","year":"2016","unstructured":"Ozgur A, Mujdeci B, Terzi S, Ozergin Coskun Z, Yigit E, Dursun E (2016) Wideband tympanometry normative data for different age groups in Turkish population. J Int Adv Otol 12(1):82\u201386. https:\/\/doi.org\/10.5152\/iao.2015.1408","journal-title":"J Int Adv Otol"},{"key":"1037_CR37","doi-asserted-by":"crossref","unstructured":"Pang XD, Guinan (1997) Effects of stapedius-muscle contractions on the masking of auditory-nerve responses. J Acoust Soc Am 102(6):3576\u20133586","DOI":"10.1121\/1.420399"},{"issue":"6","key":"1037_CR38","doi-asserted-by":"publisher","first-page":"3607","DOI":"10.1121\/1.2722213","volume":"121","author":"KS Schairer","year":"2007","unstructured":"Schairer KS, Ellison JC, Fitzpatrick D, Keefe DH (2007) Wideband ipsilateral measurements of middle-ear muscle reflex thresholds in children and adults. J Acoust Soc Am 121(6):3607\u20133616","journal-title":"J Acoust Soc Am"},{"issue":"2","key":"1037_CR39","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1097\/AUD.0000000000001102","volume":"43","author":"KS Schairer","year":"2022","unstructured":"Schairer KS, Putterman DB, Keefe DH, Fitzpatrick D, Garinis A, Kolberg E, Feeney MP (2022) Automated adaptive wideband acoustic reflex threshold estimation in normal-hearing adults. Ear Hear 43(2):370\u2013378","journal-title":"Ear Hear"},{"issue":"6","key":"1037_CR40","doi-asserted-by":"publisher","first-page":"3882","DOI":"10.1121\/1.3655878","volume":"130","author":"RA Scheperle","year":"2011","unstructured":"Scheperle RA, Goodman SS, Neely ST (2011) Further assessment of forward pressure level for in situ calibration. J Acoust Soc Am 130(6):3882\u20133892","journal-title":"J Acoust Soc Am"},{"key":"1037_CR41","doi-asserted-by":"publisher","unstructured":"Shehorn J, Strelcyk O, Zahorik P (2020) Associations between speech recognition at high levels, the middle ear muscle reflex and noise exposure in individuals with normal audiograms. Hear Res 392:107982. https:\/\/doi.org\/10.1016\/j.heares.2020.107982","DOI":"10.1016\/j.heares.2020.107982"},{"issue":"3","key":"1037_CR42","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1044\/jshd.4603.312","volume":"46","author":"S Silman","year":"1981","unstructured":"Silman S, Gelfand SA (1981) The relationship between magnitude of hearing loss and acoustic reflex threshold levels. J Speech Hear Disord 46(3):312\u2013316. https:\/\/doi.org\/10.1044\/jshd.4603.312","journal-title":"J Speech Hear Disord"},{"key":"1037_CR43","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/BF00316804","volume":"203","author":"A Sokolovski","year":"1973","unstructured":"Sokolovski A (1973) The protective action of the stapedius muscle in noise-induced hearing loss in cats. Archiv f\u00fcr klinische und experimentelle Ohren-, Nasen-und Kehlkopfheilkunde 203:289\u2013309","journal-title":"Archiv f\u00fcr klinische und experimentelle Ohren-, Nasen-und Kehlkopfheilkunde"},{"issue":"1","key":"1037_CR44","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1121\/10.0016853","volume":"153","author":"M Trevino","year":"2023","unstructured":"Trevino M, Zang A, Lobarinas E (2023) The middle ear muscle reflex: current and future role in assessing noise-induced cochlear damage. J Acoust Soc Am 153(1):436\u2013445. https:\/\/doi.org\/10.1121\/10.0016853","journal-title":"J Acoust Soc Am"},{"key":"1037_CR45","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.1000304","volume":"16","author":"JT Valderrama","year":"2022","unstructured":"Valderrama JT, de la Torre A, McAlpine D (2022) The hunt for hidden hearing loss in humans: from preclinical studies to effective interventions. Front Neurosci 16:1000304. https:\/\/doi.org\/10.3389\/fnins.2022.1000304","journal-title":"Front Neurosci"},{"key":"1037_CR46","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.heares.2015.11.005","volume":"332","author":"MD Valero","year":"2016","unstructured":"Valero MD, Hancock KE, Liberman MC (2016) The middle ear muscle reflex in the diagnosis of cochlear neuropathy. Hear Res 332:29\u201338. https:\/\/doi.org\/10.1016\/j.heares.2015.11.005","journal-title":"Hear Res"},{"key":"1037_CR47","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.heares.2018.03.012","volume":"363","author":"MD Valero","year":"2018","unstructured":"Valero MD, Hancock KE, Maison SF, Liberman MC (2018) Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice. Hear Res 363:109\u2013118. https:\/\/doi.org\/10.1016\/j.heares.2018.03.012","journal-title":"Hear Res"},{"issue":"1","key":"1037_CR48","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/S0378-5955(00)00177-5","volume":"150","author":"SE Voss","year":"2000","unstructured":"Voss SE, Rosowski JJ, Merchant SN, Peake WT (2000) Acoustic responses of the human middle ear. Hear Res 150(1):43\u201369. https:\/\/doi.org\/10.1016\/S0378-5955(00)00177-5","journal-title":"Hear Res"},{"issue":"3","key":"1037_CR49","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1097\/00003446-199806000-00007","volume":"19","author":"H Wada","year":"1998","unstructured":"Wada H, Koike T, Kobayashi T (1998) Clinical applicability of the sweep frequency measuring apparatus for diagnosis of middle ear diseases. Ear Hear 19(3):240\u2013249","journal-title":"Ear Hear"},{"issue":"1","key":"1037_CR50","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1121\/1.381706","volume":"63","author":"RH Wilson","year":"1978","unstructured":"Wilson RH, McBride LM (1978) Threshold and growth of the acoustic reflex. J Acoust Soc Am 63(1):147\u2013154","journal-title":"J Acoust Soc Am"},{"key":"1037_CR51","doi-asserted-by":"publisher","DOI":"10.1523\/ENEURO.0363-17.2017","author":"M Wojtczak","year":"2017","unstructured":"Wojtczak M, Beim JA, Oxenham AJ (2017) Weak middle-ear-muscle reflex in humans with noise-induced tinnitus and normal hearing may reflect cochlear synaptopathy. eNeuro. https:\/\/doi.org\/10.1523\/ENEURO.0363-17.2017","journal-title":"eNeuro"}],"container-title":["Journal of the Association for Research in Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10162-026-01037-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10162-026-01037-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10162-026-01037-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:34:17Z","timestamp":1780598057000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10162-026-01037-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,23]]},"references-count":51,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["1037"],"URL":"https:\/\/doi.org\/10.1007\/s10162-026-01037-z","relation":{},"ISSN":["1438-7573"],"issn-type":[{"value":"1438-7573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,23]]},"assertion":[{"value":"1 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with protocols approved by the University of Iowa Institutional Review Board (IRB ID #202202103). Informed consent was obtained from all participants prior to participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"No traditional or generative AI technologies were used for any aspect of this project.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Use of AI"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}