American Speech-Language-Hearing Association
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Tests of the Middle Ear

Types of Tests: Auditory Brainstem Response (ABR) | Otoacoustic Emissions (OAEs) | Pure-Tone Testing | Speech Testing | Tests of the Middle Ear

The audiologist may also take measurements that will provide information about how the middle ear is functioning. These measurements include tympanometry, acoustic reflex measures, and static acoustic measures. This type of testing is particularly important in preschool children (ages 3–5), for whom hearing loss is more often associated with middle ear disease.

Tympanometry assists in the detection of fluid in the middle ear, perforation of the eardrum, or wax blocking the ear canal. Tympanometry pushes air pressure into the ear canal, making the eardrum move back and forth. The test measures the mobility of the eardrum. Graphs are created, called tympanograms. These can reveal a stiff eardrum, a hole in the eardrum, or an eardrum that moves too much. The tympanogram is often recorded when children have middle ear infections.

Acoustic reflex measures add information about the possible location of the hearing problem. Everyone has an acoustic reflex to sounds. A tiny muscle in the middle ear contracts when a loud sound occurs. The loudness level at which the acoustic reflex occurs—or the absence of the acoustic reflex—gives information to the audiologist about the type of hearing loss.

Static acoustic impedance measures the physical volume of air in the ear canal. This test is useful in identifying a perforated eardrum or checking the openness of ventilation tubes.

After the test battery is completed, the audiologist will review with you each component of the audiologic evaluation to obtain a profile of hearing abilities and needs. Additional specialized testing may be indicated and recommended based on these initial test results. The hearing evaluation may result in recommendations related to:

  • Further follow-up such as medical referral
  • Educational referral
  • Hearing aid/sensory aid assessment
  • Assessment for assistive listening devices
  • Hearing rehabilitation assessment
  • Speech and language assessment and/or counseling

As you can see, an audiologic evaluation is much more than “just a hearing test!”

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