Tympanometry
? Composed of loudspeaker, microphone, and air pump
? Measure the mobility of the ear drum in response to air pressure changes
? Admittance - how much energy is allowed through the middle ear system
? Impedance - how much the middle ear system resists ene
Type A
- medium peak at 0 (responds best at atmospheric pressure)
- Normal ear pressure
- Indicates a normal middle ear system
Type B
- Type B with normal ear canal volume
? Flat
? Suggests fluid behind the eardrum (otitis media) not allowing the eardrum to move
- Type B with large ear canal volume
? Flat
? Large volume
? Hole in the TM, or the patient (open) PE tube in the TM
Type C
- negative peak
- retracted
- Eustachian tube dysfunction (common with colds, after flights, if it persists will usually turn into otitis media, turn into fluid in the middle ear)
Type As
- small peak at 0 (0 = atmospheric pressure)
- Shallow
- High impedance/low admittance
- Stiff system = Otosclerosis
Type Ad
- high peak at 0
- Deep
- High admittance/low impedance
- TM is highly mobile
- Thin eardrum from previous infections
- ossicular discontinuity
functional hearing loss
- False hearing loss, exaggerated loss, pseudohypoacusis, psychogenic, malingering, hysterical/psychological hearing loss
- Rates of non-organic loss rise with compensation
? 25% chance of non-organic component with compensation related issues (lawsuit, v
Methods of testing
? Reinstruct or give them an "out" (change rooms/equipment)
? Physiological testing
? Ascending vs. descending
? Eye contact with kids
? "say no if you don't hear it" for kids
? Stenger for unilateral hearing loss
- Used when somebody is lying about one e
Disorders of the auditory system:
? Differential diagnosis - what caused the problem, what diagnosis, and what treatment do we need to do
? Case hx and terminology - case history (ask questions: how long have you had the problem, any other problems with it, ear drainage, etc.), gives clue