Acoustic Reflex Latency Test in the Evaluation of Nontumor Patients with Abnormal Brainstem Latencies

The acoustic reflex latency test (ARLT), an indirect measure of neural conduction time utilizing the electroimpedance method, was used to evaluate 43 highly suspect, nontumor patients who demonstrated abnormal latency results on brainstem electric response audiometry (BERA), false-positive for tumor. Normative values and criteria for tumor-positive ARLT results were established on a control group using a second generation test unit, comprised of dual impedance bridges and a digital signal averager, designed especially to perform the ARLT. When cut-off criteria for both absolute reflex latency and interaural latency difference (ILD) values were applied to this BERA false positive population, the ARLT correctly identified 93% of patients as having end-organ lesions. Differences in ARLT and BERA test results are attributed to differences in 1) method of measurement, 2) characteristics of the eliciting signal, and 3) generation of the response. These factors are discussed as sources of variability. Both ARLT and BERA are recommended as tandem procedures when screening for acoustic or angle tumors.