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10.AUD-Acst Immit

Audiology SLP314

Tympanometry intro Assesses what we cannot see: health of middle ear. Provides pathology clues. No participation required.
Tympanometry intro (cont) Does not provide us with any information regarding the hearing status.  Only assesses the possible physical abnormalities of the outer and/or middle ear.  Helps us distinguish between a conductive and sensorineural hearing loss.
Impedance opposition to flow of acoustic energy
Admittance relative ease with which energy flows through the system
Immitance refers to either impedance or admittance. Measures condition of TM and middle ear
Immitance testing (2) Tympanometry. Acoustic reflex.
Tympanometry components (3) 1. Puretone generator 2. Microphone (measures) 3. Air pump (neg/pos pressure)
Tympanometry defined measurement of the mobility of the middle ear when air pressure in the external canal is varied from +200 to −400 daPa.
Tympanogram x-axis, air pressure daPa. y-axis, immitance ml (compliance/mobility).
Patient preparation 1.No talking, chewing, moving excessively (be still). 2. Pull the ear up and back. 3.Place probe in the opening of the ear canal (appropriate seal) 4.Use distraction techniques with children
5 results of tympanometry 1. Type A (normal) 2. Type B - flat (no movement). 3. Type C - Negative peak (ET dysfunction, before/after otitis). 4.Deep A / Ad (disarticulated ossicles, poor heeling of TM) 5. Shallow A / As (fluid in ME or stuck stapes)
Interpretation of tympanometry 1. Location of peak along pressure axis 2. Max compliance (height of peak). 3. Ear canal volume (ECV)
Pressure peak norm -150 to +40 daPa
Max compliance norms 0.2 - 2.0 ml
Ear canal volume (ECV) Volume from probe tip to TM. Child - 0.3 to 1.0 ml. Adult - 0.65 to 1.75 ml. Excessive vol: perforation or PET. Excessively small vol: wax plug or probe against canal.
Type A tympanogram Probably normal ME/TM function
Type As -Abnormal, reduced compliance -Early otosclerosis, tympanosclerosis
Type Ad -Abnormal, increased compliance. -Ossicular disarticulation, interruption. TM flaccidity (healed perforation-middle layer doesn't heal)
Type B -Abnormal pressure and compliance. -Extreme stiffness of TM and ME (ME effusion, advanced otosclerosis, impacted cerumen) -use ear canal vol to discriminate
Type C -Abnormal, negative ME pressure (normal compliance). -Eustacian tube dysfunction, early or resolving OM
Uses of tympanometry 1.Determine cause of conductive loss. 2.BC can't be tested (kids) 3.Otitis media monitoring
Ear Canal Volumes for Type B Normal ECV: Extreme stiffness, otosclerosis. Low ECV: impacted cerumen. High ECV: perforated TM
Acoustic reflex Involuntary contractions of the middle ear muscles that occur in response to high intensity sound. Depends on hearing status
Acoustic reflex threshold Lowest intensity needed to elicit a contraction of ME muscles. Typically 65 - 95dB HL. Triggers both ears (ipsilateral).
Acoustic reflex testing Present sound. Observe. Increase by 5dB. Repeat at 0.5, 1, 2, 4 kHz ipsi- and contralaterally.
Created by: ashea01



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