Tympanometry

What is tympanometry?

Tympanometry is a test that shows how well your middle ear is working. It does this by measuring how your eardrum moves.

Your ear consists of three parts: the outer ear, the middle ear and the inner ear. Sound enters through your outer ear as energy or vibrations. The energy strikes your eardrum (located in your middle ear) and travels to your inner ear and brain. There, the energy gets transformed into electrical signals your brain understands as sound.

Think of it this way: Your middle ear moves sound along a pathway where what starts as energy eventually becomes the experience of sound your brain processes as hearing. If something goes wrong along the pathway, you may have trouble hearing.

Tympanometry can help diagnose problems that arise along the middle ear part of the path where sound is conducted from your ear canal to your inner ear.

When would tympanometry be needed?

Tympanometry may be part of a routine hearing test. It can also be used to help diagnose conditions involving your middle ear that may cause hearing loss. It can help a healthcare provider decide why hearing loss is occurring. It can also help them determine if hearing aids will correct your hearing loss or if you’ll need a different treatment.

Tympanometry is often used in children, but can be used at any age to determine from where in the hearing pathway hearing loss originates. Young children often develop fluid in their ears that can cause hearing problems if left untreated.

Who performs tympanometry?

An audiologist performs tympanometry. An audiologist is a doctoral-level healthcare provider who helps people with hearing loss and balance issues. They prevent, diagnose and treat hearing-related issues affecting children and adults.

How does tympanometry work?

Tympanometry uses an instrument called a tympanometer to perform the test and record the results. The tympanometer has a probe that the audiologist will insert into your ear during the test. The probe has three ports:

• An air port that sends air into your ear canal.
• A speaker port that sends a tone (sound energy) toward your eardrum.
• A microphone port that records information about how your eardrum moves in response to the air pressure and the sound energy.

How is tympanometry done?

You’ll sit upright during the test. Children can sit on their parent’s or caregiver’s lap. It’s important to remain still during tympanometry. Moving, laughing, talking, coughing or swallowing can all interfere with the results.

1. The audiologist will perform a preliminary exam called an otoscopy. During an otoscopy, the audiologist looks inside of your ear using a lighted scope called an otoscope. The otoscope makes it easier to see your ear canal, eardrum and other parts of your middle ear.
2. They’ll insert the probe part of the tympanometer. The probe will have a soft end like an earplug. The end of the probe will create an airtight seal inside your ear canal.
3. The probe will send air into your ear while emitting a low tone. You may feel pressure building in your ear. The sensation may feel like the air pressure in an airplane before your ears “pop.”
4. The microphone on the probe will record how your eardrum moves in response to the sound and air pressure.
5. The tympanometer will create a graph called a tympanogram that shows how your eardrum moved.

What are the risks of this test?

Tympanometry isn’t a risky test, and there usually aren’t any side effects. Still, young children may be confused about what’s happening during the test. It’s a good idea to prepare them beforehand. Depending on your child’s age, you might explain what will happen or demonstrate it on a doll.

What type of results do you get and what do the results mean?

The shape of the tympanogram will show whether your results are normal or abnormal.

Normal results mean your eardrum is moving as it should. If your eardrum moves normally, the line on the graph will appear curved, like a hill or mountain. The highest part of the curve, or the mountain “peak,” will happen between -100 and +100 daPa on the graph if your eardrum is moving as expected. A decapascal (daPa) is the unit used to measure air pressure inside your ear canal.

What does an abnormal tympanogram mean?

An experienced audiologist can often tell what’s causing a stiff eardrum by studying the graph’s curve.

An abnormal tympanogram may mean you have:

• Blockage or fluid build-up in your middle ear (most common).
• A scarred eardrum (from an infection or fluid).
• Blocked or clogged eustachian tubes (the tubes that open and close to control air pressure inside your ears).
• Earwax that’s blocking your ear canal (completely or partially).
• Growths in your middle ear.
• Ossicles (bones in your middle ear) that aren’t moving as they should.
• A hole in your eardrum (or if you’ve had a hole in your eardrum previously).

The audiologist may recommend seeing an otolaryngologist (ENT physician) based on what’s preventing your eardrum from moving correctly. The most common causes, like fluid build-up, are often easy to treat. Importantly, tympanometry can’t differentiate fluid from infected fluid.

What is the difference between audiometry and tympanometry?

They test different things. Audiometry tests how well you hear sounds. This includes how well you can distinguish various types of sounds (tones) and how well you can hear quiet or loud sounds. Tympanometry tests how well your middle ear works by measuring eardrum movement. Both tests can help a healthcare provider diagnose problems related to hearing loss.

A note from Cleveland Clinic

Tympanometry is a quick and easy test that shows how well your middle ear is working. It doesn’t require any special preparation on your part. After the test, an audiologist can provide reassurance that your middle ear is working as it should. Or they can recommend more tests or treatments to correct whatever’s interfering with your hearing.