Acoustic reflex contraction of the stapedius muscle stiffens the middle-ear, thus decreasing middle-ear admittance; this can be measured thanks to tympanometry. The acoustic stapedius reflex can also be recorded by means of extratympanic manometry (ETM). As the stapedius muscle is innervated by the facial nerve, a measurement of the reflex can be used to locate the injury on the nerve. If the injury is distal to the stapedius muscle, the reflex is still functional. A measurement of the reflex can also be used to suggest a retrocochlear lesion (e.g., vestibular schwannoma, acoustic neuroma). The acoustic reflex normally occurs only at relatively high
Stapedius muscle of the facial nerve, the stapedius is paralyzed and hyperacusis may result. Like the stapes bone to which it attaches, the stapedius muscle shares evolutionary history with other vertebrate structures. The mammalian stapedius evolved from a muscle called the depressor mandibulae in other tetrapods, the function of which was to open the jaws (this function was taken over by the digastric muscle in mammals). The depressor mandibulae arose from the levator operculi in bony fish, and is equivalent to the epihyoidean in sharks. Like the stapedius, all of these muscles derive from the hyoid arch and are innervated by cranial