(A) The effect of otitis media with effusion on PR (also called energy reflectance) in adults (Feeney et al. 2003) (Reprinted with permission from Feeney, M.P., et al., Journal of Speech, Language, and Hearing Research, 46, 901ā911. Copyright (2003)). The shaded area represents 5ā95% of normal ears. (B) PR measured in a cadaveric temporal bone for incremental increase in fluid volume replacing air in the middle-ear cavity (Voss et al. 2012) (Reprinted with permission from Voss, S., et al., Ear and Hearing, 33, 195ā208. Copyright (2012)). The black thick line represents the initial value with normal air volume.