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Open Access Guide To Audiology and Hearing Aids For Otolaryngologists
Open Access Guide To Audiology and Hearing Aids For Otolaryngologists
Open Access Guide To Audiology and Hearing Aids For Otolaryngologists
Between the tip of the tympanometer and Figure 2: A: Normal type-A tympano-
the eardrum a small “chamber” is thus grams; AD: hypermobile; AS: restricted
created in the deep ear canal in which the
sound level is constantly measured while
the pump alters the air pressure in this Types of tympanogram readings
“chamber”. The least amount of sound is
reflected when the eardrum is in a normal The reflected sound has its lowest value
and relaxed position since most of the when the eardrum is in its most relaxed
sound passes through the eardrum and and normal position. Tympanogram
middle ear. When the eardrum is however tracings are classified as type A (normal),
pressed outwards or retracted inwards it type B (flat, clearly abnormal indicating
becomes stiffer and more sound is fluid in the middle ear or a perforation), or
reflected back from its surface into the type C (indicating a significantly negative
“chamber”. pressure in the middle ear (< -200 daPa).
(Figure 3)
Tympanogram
What can “tympanometry” tell us?
The tympanometer displays the reflected
sound in the ear canal “chamber” relative 1. Pressure in the middle ear: A
to changes in stiffness of the eardrum negative pressure of < -200 daPa
(achieved by changes in ear canal pressure (Type C curve) is considered patho-
produced by the tympanometer) as a logic (Figure 3). To have an idea what
tympanogram. The tympanogram curve is this means, you may think of it as the
plotted upside-down - the inverted reflec- pressure of a 20cm column of water.
ted sound level is called “compliance”.
The pressure is expressed along the X-axis 2. Is the middle ear fluid-filled? One
in deca-Pascal (daPa) and the compliance then sees a flat tympanogram (Type
along the Y-axis in “volume of air in cm3” Bcurve) with a normal ear canal
required putting the system “under volume (Figure 3)
pressure”. The resulting curve is called a
2
Figure 3: Typical tympanogram tracings
Advantages of tympanometry
Pitfalls of tympanometry
4
References OPEN ACCESS GUIDE TO
AUDIOLOGY & HEARING AIDS
1. Takata GS et al. Evidence assessment
of the accuracy of methods of FOR OTOLARYNGOLOGISTS
diagnosing middle ear effusion in www.entdev.uct.ac.za
children with otitis media with
effusion. Pediatrics. 2003;112(6 Pt
1):1379-87
Professor in ENT
ENT Unit
Department of Clinical Science
University of Umeå
Umeå
Sweden
claude.laurent@ent.umu.se
Editor
Editor