Describes the procedure for tympanometry using a 226Hz tone
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| What is the first thing to do before any procedures? | Wash hands :)
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| What history should be taken in relation to tympanometry? | Any discomfort, pain or discharge - Surgery - currently being treated for ear related problems
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| How should they remain seated? | Still! Adults can be told, Children may need to be held by a parent
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| Tympanometry should be preceded by... | Otoscopy
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| What are the contraindications for tympanometry? (A things) | Active infection (senior), Perforation, Outer ear defects, Acute otitis media, Pain in the ear, Foreign body, Excessive (Impacted) wax, Past surgery
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| Instructions | Soft tip in ear and box on shoulder - few tries to get right fit - May hear low tone and feel a small change in pressure like taking off in a plane - ear may feel full - should only take a few seconds - don't need to do anything just sit still - stop at a
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| Procedure | Find correct probe tip size and insert into ear, pointing towards tympanic membrane. May need to twist to sealPress Start and measure trace
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| What to do before taking probe out???? | PRESS STOP!!!
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| What if an unexpected result is obtained? | Repeat the test in it's entirety
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| What should be checked on the screen before commencing? | Tone frequency, EAR and whether it's on manual or automatic
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| Normative value for pressure with unit | +50 to -50 daPa although outside this range may not be pathological
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| Normative value for compliance with unit | 0.3 - 1.6 cm3
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| Ear Canal volume in adults with unit | 0.6 - 2.5 cm3
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| Ear canal volume in children with unit | 0.4 - 0.9
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| Jerger - Liden Class A | Normal tympanogram, Non pathalogical
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| Jerger - Liden Class As | Peak is in the correct place but is abnormally shallow, Could indicate ossicular fixation or otosclerosis
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| Jerger - Liden Class Ad | Peak is in the right place but is abnormally compliant leading to an exagerated peak, could indicate ossicular chain discontinuity or hyper compliance of the tympanic membrane
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| Jerger - Liden Class B with normal ECV | Flat Trace with normal ear canal volume, could indicate fluid behind the tympanic membrane (OME) or very advance stages of As (can also indicate impacted wax of probe against canal wall)
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| Jerger - Liden Class B with abnormally high ECV | flat trace with a high ear canal volume, Could indicate a perforation
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| Jerger - Liden Class C | Peak of normal compliance but with a negative pressure in the ear canal, can indicate eustachian tube dysfunction/developing OME
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| Double Peaks | Can indicate scarring on the tympanic membrane, Should be repeated
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| When describing the tympanogram what should be included? | a copy of the tympanogram and numerical values for all descriptors in the journal as compared with normative values
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| How should the tympanogram be interpreted? | in the context of other findings, such as otoscopy and PTA etc.
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