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
Anatomy of the cerebellum the face; it can also cause hearing impairment. Moreover, it could cause an infarct of the cerebellopontine angle. This could lead to hyperacusia (dysfunction of the stapedius muscle, innervated by CN VII) and vertigo (wrong interpretation from the vestibular semi-circular canal's endolymph acceleration caused by alteration of CN VIII). The PICA branches off the lateral portion of the vertebral arteries just inferior to their junction with the basilar artery. Before reaching the inferior surface of the cerebellum, the PICA sends branches into the medulla, supplying blood to several cranial nerve nuclei. In the cerebellum, the PICA supplies blood to the