Otolaryngology Book

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Tympanometry

Aka: Tympanometry, Tympanogram, Acoustic Reflectometry
  1. See also
    1. Pneumatic Otoscopy
  2. Indications
    1. Otitis Media
    2. Eustachian Tube Dysfunction
    3. Hearing Loss
    4. Otalgia
  3. Background
    1. Measures Tympanic Membrane and ossicle stiffness
    2. Techniques
      1. Pneumatic Otoscopy
        1. Visualize Tympanic Membrane move to insufflation
      2. Tympanogram
        1. Recorded as pressure-versus-compliance curve
  4. Curve Types
    1. Type A Curve: Pressue near 0 with normal curve width
      1. Type Ad curve: High peak height (high compliance)
        1. Tympanic Membrane thinning (healed post-rupture)
        2. Ossicular disarticulation (increased pressure also)
      2. Type As curve: low peak height (low compliance)
        1. Middle ear effusion
        2. Ossicular fixation decreasing TM mobility
    2. Type B Curve: Flat curve (low compliance)
      1. See decreased compliance below (based on volume)
      2. Normal volume (e.g. middle ear effusion, sclerosis)
      3. Low volume (e.g. Cerumen Impaction)
      4. High volume (e.g. TM Perforation or tube)
    3. Type C Curve (high negative pressure): Retracted TM
      1. Eustachian Tube Dysfunction
      2. Upper Respiratory Infection
  5. Findings: Compliance (measured along y or vertical axis)
    1. Normal compliance: 0.2 to 2.0 ml
      1. Reflects Tympanic Membrane mobility
      2. Measure air volume displaced by drum movement
    2. Increased compliance: flaccid Tympanic Membrane (Ad)
      1. Tympanic Membrane thinning (healed post-rupture)
      2. Ossicular disarticulation (increased pressure also)
    3. Decreased compliance (flat curves)
      1. Normal canal volume
        1. Flat curve (Type B)
          1. Middle ear effusion
          2. Scarred Tympanic Membrane (Tympanosclerosis)
          3. Cholesteatoma
          4. Middle Ear Tumor
        2. Convex peak with low compliance, normal volume (As)
          1. Middle ear effusion
          2. Ossicular fixation decreasing TM mobility
      2. Low canal volume, completely flat (Type B)
        1. Cerumen Impaction or ear debris present
        2. Incorrect probe placement
      3. High canal volume, flat curve (Type B)
        1. Tympanic Membrane Perforation (flat curve)
        2. Patent Tympanostomy Tube
        3. Prior mastoidectomy
  6. Findings: Pressure (measured along X or horizontal axis)
    1. Normal Pressure: +100 mmH2O to -150 mmH2O
    2. Negative Pressure (under -150 mmH2O)
      1. Eustachian Tube Dysfunction
    3. Increased Pressure (over 100 mmH2O)
      1. Ossicular disarticulation (increased compliance also)
      2. Some cases of Acute Otitis Media
  7. References
    1. Bredfeldt (1991) Am Fam Physician 44(6):2113-8 [PubMed]

Tympanometry (C0085853)

Definition (NCI) The study of the mobility of the tympanic membrane and conduction bones through air pressure changes. It is used to detect middle ear abnormalities.
Concepts Diagnostic Procedure (T060)
MSH D000158
SnomedCT 91573000
CPT 92567
Japanese 鼓膜聴力検査, コマクチョウリョクケンサ
Czech tympanometrie, Tympanometrie
Portuguese Timpanometria
Spanish Timpanometría, Timpanometria (prueba de impedancia), prueba de timpanometría, timpanometría (procedimiento), timpanometría
German Tympanometrie
English tympanometry, tympanometry (procedure), Tympanometry (impedance testing), Test;tympanometry, Tympanometry Test, Tympanometry testing (procedure), Tympanometry testing, Tympanometry testing, NOS, Tympanometry, NOS, Tympanometry, TYMPANOMETRY, tympanometry test
French Tympanométrie
Italian Timpanometria
Hungarian Tympanometria
Norwegian Tympanometri
Dutch tympanometrie, Tympanometrie
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Acoustic reflectometry (C0457462)

Concepts Diagnostic Procedure (T060)
SnomedCT 278320003
English Acoustic reflectometry, Acoustic reflectometry (procedure)
Spanish reflectometría acústica (procedimiento), reflectometría acústica
Sources
Derived from the NIH UMLS (Unified Medical Language System)


tympanogram (C0679573)

Concepts Diagnostic Procedure (T060)
English tympanogram, tympanograms, Tympanogram
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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