• Tympanometry directly measures the compliance
of the tympanic membrane and ossicular chain, estimating middle
• Tympanometry is primarily used to detect the presence of middle
ear fluid, enhancing the diagnosis of acute otitis media and otitis
media with effusion.
• The procedure is also useful for detecting tympanic membrane
perforation, ossicular chain disruption, and the patency of eustachian
• Tympanometry is commonly performed as part of the early evaluation
of hearing loss.
• Age younger than 7 months. Studies have shown
that tympanometry in infants 0–7 months of age is inaccurate
due to the high compliance of the ear canal in these patients.
• Recent ear surgery, such as stapedectomy, myringoplasty, or tympanoplasty.
• Before beginning the procedure, make sure that
the probe assembly is securely fastened together; leaks will obscure the
• Also, ensure that the probe tube and tips are dry; wet equipment
may clog, making it impossible to continue the test.
• Describe the procedure to the parents and patient
and answer any questions.
• Be sure to inform the patient that he or she will be hearing some
brief, but potentially loud, sounds.
• Hearing results from the conduction of sound
into the ear canal. Sound stimulates the tympanic membrane, which then
• The malleus (the first bone of the ossicular chain, attached
to the eardrum) also starts vibrating, which sets the incus and
stapes into motion (Figure 44–1).
• The stapes is set in the oval window, the opening
of the inner ear. The sound is conducted into the inner ear, which translates
sound energy into nerve impulses to the brain.
• The eustachian tube, an extension of the nasopharynx, equalizes
middle ear pressure with atmospheric pressure (the pressure within
the ear canal).
• Using an otoscope, examine the ear canal and
remove any occluding cerumen.
• Choose the appropriate sized ear tip for the patient’s
ear canal and affix it to the probe.
• Grasp the helix and pull back and up gently to straighten the
• Insert the probe into the entrance of the ear canal, obtaining
an airtight ...
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