Tympanometry: test and results

Understanding Tympanometry

Tympanometry is a diagnostic test used to assess middle ear function. It measures how the eardrum responds to changes in air pressure, helping healthcare professionals identify potential issues that may affect hearing.

What is Tympanometry?

The middle ear plays a key role in the hearing process, transmitting sound vibrations from the outer ear to the inner ear, where they are converted into signals that the brain interprets as sound. Disruptions in this pathway—due to issues such as fluid buildup, blockages, or pressure imbalances—can result in hearing difficulties.

Tympanometry focuses specifically on assessing the middle ear’s ability to conduct sound effectively. By examining how the eardrum moves under varying air pressures, the test provides essential insights into the health of this part of the auditory system, helping to pinpoint problems that might interfere with hearing.

What does tympanometry measure?

Tympanometry measures the movement and flexibility of the eardrum in response to changes in air pressure. This movement reflects the condition of the middle ear, including the presence of fluid, pressure imbalances, or structural abnormalities. The test provides a detailed picture of how well sound is conducted from the ear canal to the inner ear.

When is Tympanometry necessary – and when is it not?

Tympanometry is recommended when symptoms suggest middle ear problems, such as ear infections, fluid buildup, Eustachian tube dysfunction, or hearing loss. It’s also used in routine hearing assessments to evaluate middle ear function and identify potential causes of ear-related symptoms.

However, tympanometry should not be performed if there are obstructions in the ear canal (such as earwax or foreign objects), or if the eardrum has visible perforations. The test is also contraindicated following recent ear surgery or if there are significant structural issues in the ear, as these can affect the accuracy of the results.

Can Tympanometry diagnose all types of hearing loss?

Tympanometry is particularly effective for diagnosing conductive hearing loss, which occurs when there are issues in the outer or middle ear that prevent sound from being transmitted properly to the inner ear. 

Can Tympanometry diagnose sensorineural hearing loss?

No, tympanometry can't diagnose s ensorineural hearing loss, which is caused by damage to the inner ear or auditory nerve. This type of hearing loss requires additional tests, such as audiograms, to assess the function of the inner ear and nerve pathways.

Who conducts Tympanometry?

Tympanometry is typically carried out by an audiologist or an ENT specialist. These professionals are trained to use the tympanometer to measure the eardrum’s response to pressure changes, allowing them to assess the health of the middle ear and diagnose potential hearing issues. Since it is a medical test, it is important to consult with a specialist to ensure accurate results and proper interpretation of the data.

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How is a Tympanometry test performed?

A tympanometry test is a quick and straightforward procedure that helps assess the health and function of the middle ear.

Here's what to expect during the test:

Placement of the probe

An audiologist or healthcare professional will insert a small, soft probe into the ear canal. This probe is designed to be comfortable and is specifically shaped to fit securely without causing discomfort.

Sound emission and air pressure adjustment

Once the probe is in place, it emits a series of sounds while adjusting the air pressure in the ear canal. This helps measure how the eardrum responds to pressure, providing insights into the middle ear’s function.

Measuring eardrum movement

The device will measure the eardrum’s movement in response to the pressure changes. The results help identify whether there is fluid in the middle ear, problems with the Eustachian tube, or other issues that may affect hearing.

Is the tympanometry test painful?

The entire process is generally painless, and the test usually takes just a few minutes per ear. You may feel slight pressure in your ear during the procedure, but it’s not uncomfortable.

Tympanometry results

After the test, the results are presented as a tympanogram, which shows how the eardrum responds to pressure changes. There are three main types:

  • Type A: indicates normal middle ear function. The eardrum moves properly, and pressure levels are within the expected range, suggesting no issues with sound transmission.
  • Type B: suggests a problem, such as fluid behind the eardrum or a perforated eardrum. The eardrum shows limited movement, often due to ear infections or fluid buildup, requiring further treatment or investigation.
  • Type C: indicates negative pressure in the middle ear, often caused by Eustachian tube dysfunction. This can affect hearing and may be temporary or require medical attention to resolve.

What is the normal tympanogram curve

The normal tympanogram curve is Type A, which shows a peak at 0 daPa (decapascals), indicating normal middle ear pressure and eardrum movement. This suggests that the eardrum is functioning properly, with no fluid buildup or other obstructions.

What is abnormal tympanometry?

Abnormal tympanometry occurs when the test results show Type B or Type C curves. Type B suggests issues like fluid in the middle ear or a perforated eardrum, while Type C indicates negative pressure, often due to Eustachian tube dysfunction, which can affect hearing.

Tympanometry and specific conditions

Tympanometry is useful for diagnosing several conditions related to the middle ear. By evaluating how the eardrum reacts to pressure changes, this test can help healthcare professionals identify underlying causes of ear problems such as:

  • Eustachian tube dysfunction: when the Eustachian tube fails to regulate pressure in the middle ear properly, tympanometry can detect abnormal pressure levels, which may cause discomfort or hearing difficulties
  • Otitis media with effusion: fluid in the middle ear is often linked to ear infections. Tympanometry is effective in detecting fluid buildup, which may not be visible during a routine physical exam.
  • Middle ear obstructions: tympanometry can identify blockages or other issues affecting sound transmission from the eardrum to the inner ear.

This diagnostic tool is particularly valuable in pinpointing conditions that may otherwise go unnoticed, helping specialists make informed decisions about further treatment or hearing management.

What is the difference between audiometry and tympanometry?

Audiometry measures hearing ability by testing how well you can hear different sounds at various frequencies and volumes. It assesses inner ear function and hearing sensitivity.

Tympanometry, on the other hand, evaluates the middle ear by measuring how the eardrum responds to changes in air pressure. It helps diagnose issues like fluid buildup, Eustachian tube dysfunction, or eardrum perforations that may affect hearing.

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