Audiology SLP314
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| Tympanometry intro | Assesses what we cannot see: health of middle ear. Provides pathology clues. No participation required.
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| 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.
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| Impedance | opposition to flow of acoustic energy
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| Admittance | relative ease with which energy flows through the system
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| Immitance | refers to either impedance or admittance. Measures condition of TM and middle ear
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| Immitance testing (2) | Tympanometry. Acoustic reflex.
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| Tympanometry components (3) | 1. Puretone generator 2. Microphone (measures) 3. Air pump (neg/pos pressure)
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| Tympanometry defined | measurement of the mobility of the middle ear when air pressure in the external canal is varied from +200 to −400 daPa.
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| Tympanogram | x-axis, air pressure daPa. y-axis, immitance ml (compliance/mobility).
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| 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
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| 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)
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| Interpretation of tympanometry | 1. Location of peak along pressure axis 2. Max compliance (height of peak). 3. Ear canal volume (ECV)
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| Pressure peak norm | -150 to +40 daPa
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| Max compliance norms | 0.2 - 2.0 ml
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| 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.
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| Type A tympanogram | Probably normal ME/TM function
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| Type As | -Abnormal, reduced compliance -Early otosclerosis, tympanosclerosis
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| Type Ad | -Abnormal, increased compliance. -Ossicular disarticulation, interruption. TM flaccidity (healed perforation-middle layer doesn't heal)
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| Type B | -Abnormal pressure and compliance. -Extreme stiffness of TM and ME (ME effusion, advanced otosclerosis, impacted cerumen) -use ear canal vol to discriminate
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| Type C | -Abnormal, negative ME pressure (normal compliance). -Eustacian tube dysfunction, early or resolving OM
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| Uses of tympanometry | 1.Determine cause of conductive loss. 2.BC can't be tested (kids) 3.Otitis media monitoring
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| Ear Canal Volumes for Type B | Normal ECV: Extreme stiffness, otosclerosis. Low ECV: impacted cerumen. High ECV: perforated TM
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| Acoustic reflex | Involuntary contractions of the middle ear muscles that occur in response to high intensity sound. Depends on hearing status
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| Acoustic reflex threshold | Lowest intensity needed to elicit a contraction of ME muscles. Typically 65 - 95dB HL. Triggers both ears (ipsilateral).
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| Acoustic reflex testing | Present sound. Observe. Increase by 5dB. Repeat at 0.5, 1, 2, 4 kHz ipsi- and contralaterally.
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