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Impedance audiometry is a diagnostic hearing test that measures the movement of the eardrum in response to changes in air pressure. It is used to assess the condition of the middle ear and diagnose problems such as fluid buildup, ear infections, and Eustachian tube dysfunction. This test is also used to evaluate acoustic reflex pathways, including cranial nerves (CN) VII and VIII and the auditory brainstem.

The results of the impedance audiometry test alone do not provide a direct assessment of auditory sensitivity. However, audiologists can interpret these results in combination with other threshold measures to gain a more complete understanding of a patient’s hearing ability. This comprehensive approach allows audiologists to identify any hearing problems and develop an appropriate treatment plan.

During the test, a small probe is placed in the ear canal and sealed with a soft rubber tip. The probe contains a speaker that produces a tone and a microphone that measures the sound waves that bounce back from the eardrum. The probe also changes the air pressure in the ear canal, which causes the eardrum to move back and forth.

The test measures the amount of sound that is reflected back from the eardrum at different air pressures. A graph called a tympanogram is generated, which shows the amount of sound reflected at each air pressure. The shape of the tympanogram provides information about the condition of the eardrum and the middle ear.

A normal tympanogram has a peak in the middle, which indicates that the eardrum is moving normally. An abnormal tympanogram may indicate a problem such as fluid in the middle ear, a perforated eardrum, or Eustachian tube dysfunction.

The impedance audiometry test is painless and usually takes only a few minutes to complete. It is often performed as part of a comprehensive hearing evaluation, which may include other tests such as pure-tone audiometry and speech audiometry. The results of the test can help the audiologist or hearing healthcare professional determine the type and severity of hearing loss and develop a treatment plan.

The results of an impedance audiometry test are typically presented in the form of a tympanogram. A tympanogram is a graph that shows the amount of sound reflected from the eardrum at different levels of air pressure.

The shape of the tympanogram can provide valuable information about the condition of the middle ear. A normal tympanogram has a peak in the middle, indicating that the eardrum is moving normally. An abnormal tympanogram may indicate a problem such as fluid in the middle ear, a perforated eardrum, or Eustachian tube dysfunction.

The tympanogram can be classified into several types:

Type A: This indicates a normal middle ear function. The peak is in the middle of the graph, and the range of air pressure values falls within normal limits.

Type As: This indicates a stiffened eardrum. The peak is still in the middle, but the range of air pressure values is narrower than normal.

Type Ad: This indicates a flaccid eardrum. The peak is in the middle, but the range of air pressure values is wider than normal.

Type B: This indicates a blocked ear canal or a middle ear effusion (fluid in the middle ear). There is no peak in the tympanogram, and the air pressure values are low.

Type C: This indicates negative middle ear pressure. The peak is shifted to the left side of the graph, indicating that the eardrum is being pulled inward due to negative pressure.

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