Tympanometry

Question 1

What is the normal range for ME compliance?

Answer 1

0.3 - 1.6cm3

Question 2

What is the normal range for ME pressure?

Answer 2

-50 - +50 daPa

Question 3

What is the normal range for Ear Canal Volume?

Answer 3

0.6 - 2.5cm3

Question 4

What are the normative calibration volumes?

Answer 4

Cavity Acceptable value
• 0.5cm3 • 0.5cm3
• 2.0cm3 • 1.9 - 2.1cm3
• 5.0cm3 • 4.8 - 5.2cm3

Question 5

What connects the middle ear to the nasopharynx?

Answer 5

Eustachian tube - also known as the auditory tube

Question 6

What equalises the pressure between the outside environment and the ME?

Answer 6

Eustachian tube

Question 7

What are the 3 components of a tympanometer probe?

Answer 7

• Loudspeaker
• Microphone
• Pump

Question 8

What are the two types of probe tips?

Answer 8

Mushroom and Umbrella

Question 9

What are 4 ABSOLUTE contraindications for Tympanometry?

Answer 9

• Otorrhea/Blood
• Acute Otitis Media (red bulging TM)
• Foreign Body (except grommet NB: must be sufficient time post surgery)
• Ear Surgery within last 2 months (unless ENT surgeon agrees)

Question 10

What are some of the CAUTIONARY contraindications for Tympanometry?

Answer 10

• Wax
• Partial Stenosis
• Comfort/Tenderness or Soreness
• Ear Surgery more than 2 months ago
• Any previous ossicular surgery or eardrum reconstruction
• Testing under general anaesthetic

Question 11

If the graph shows abnormal ME compliance but normal ECV what could that mean?

Answer 11

Otitis media with effusion (OME) e.g., glue ear

Question 12

If the ECV is high and ME compliance is abnormal what could that mean?

Answer 12

Perforation or grommet in-situ

Question 13

If the ECV is low what could that mean?

Answer 13

Occluding body
Wax/foreign object

Question 14

If the graph shows abnormally high ME pressure then what could this mean?

Answer 14

Possible Eustachian Tube dysfunction or retracted TM

Question 15

If the ME pressure is too low then what could this suggest?

Answer 15

ME too compliant such as ossicular chain dislocation

Question 16

If the ME pressure is too low and the ME compliance produces a shallow curve, then what could that mean?

Answer 16

Suggest possible Otosclerosis or stiffened TM

Question 17

Describe Tympanometry

Answer 17

Assesses the impedance of the Ear drum to the ME
Objective test - no pt cooperation needed

Question 18

Which tone stimulus is used in adults?

Answer 18

Pure tone
226kHz

Question 19

How does wideband tympanometry differ to conventional?

Answer 19

More frequencies can be used to measure the movement of the ME
Click stimulus is used instead of a tone
Maybe more helpful in detecting different pathologies