AudiologyOnline Phone: 800-753-2160


Rexton Hearing Aid - October 2022

Common Types of Tympanograms

Jen Duffey, MS, CCC-A

January 22, 2007

Share:

Question

As a speech pathologist, I routinely come across reports documenting tympanogram results. Can you run down the list of common tympanogram types?

Answer

To understand the types of tympanograms, you should first understand the meaning behind the parts of the graph itself. A tympanogram provides information regarding the compliance of the middle ear system (how well sound passes through the eardrum to the middle ear system), ear canal volume, and middle ear pressure. Compliance is plotted vertically on the tympanogram, and is measured in ml or mmho. Maximum compliance of the middle ear system occurs when the pressure in the middle ear cavity is equal to the pressure in the external auditory canal. This compliance (static acoustic admittance) is represented by the highest peak of the curve on the graph (Figure 1). Pressure is indicated on the horizontal axis of the graph, and is measured in decaPascals.



Figure 1. Tympanogram showing maximum peak compliance.

The classification system for tympanograms commonly used today was developed by Liden (1969) and Jerger (1970). There are three main types of tympanograms: A, B, and C. Type A tympanograms look like a teepee, and indicate a normal middle ear system, free of fluid or physiological anomalies which would prevent the admittance of sound from the middle ear into the cochlea. Figure 1 shows an example of a Type A tympanogram.

Type B tympanograms are a flat line (Figure 2), which is consistent with middle ear pathology, such as fluid or infection behind the ear drum. In some cases, these tympanograms are seen when there is a hole in the ear drum; the difference lies in the ear canal volume: a larger ear canal volume indicates a perforation in the ear drum.



Figure 2. Type B tympanogram

Type C tympanograms (Figure 3) are still shaped like a teepee, but are shifted negatively on the graph. This indicates negative pressure in the middle ear space, often consistent with sinus or allergy congestion, or the end-stages of a cold or ear infection.



Figure 3. Type C tympanogram


References

Jerger, J.F. (1970). Clinical experience with impedence audiometry. Archives of Otolaryngology, 92, 311-324.

Liden, G. (1969). The scope and application of current audiometric tests. Journal of Laryngology and Otology, 83, 507-520.

Jen Duffey, M.S., CCC-A has been an audiologist for Maico-Diagnostics (www.maico-diagnostics.com) for three years. She provides audiological support and education, input for new product design and function, and technical assistance. Previously, she worked for three years as an educational audiologist providing clinical services to students, ages 2 to 21 years old.


Jen Duffey, MS, CCC-A


Related Courses

Innovation in Hearing Healthcare, presented in partnership with the National Acoustic Laboratories
Presented by Brent Edwards, PhD, Vicky Zhang, PhD, Joaquin Tomas Valderrama-Valenzuela, PhD, Simon Alperstein, MSc BE, Paola Incerti, MAudiology, AAudA, Jorge Mejia, PhD, Nicky Chong-White, PhD
Recorded Webinar
AudiologyOnline

Presenters

Brent Edwards, PhDVicky Zhang, PhDJoaquin Tomas Valderrama-Valenzuela, PhDSimon Alperstein, MSc BEPaola Incerti, MAudiology, AAudAJorge Mejia, PhDNicky Chong-White, PhD
Course: #37216Level: Intermediate4 Hours
  'Concise points, easy to read slides'   Read Reviews
Build your knowledge with this four-course series presented in partnership with the National Acoustic Laboratories (NAL). A world leader in hearing research and innovation, NAL shares applied research outcomes that are practical to a wide range of expertise, from clinical appointments to technology innovation. Maximize your skills and incorporate evidence-based research in your practice with these short, high-impact webinars designed to improve hearing healthcare.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Guidelines for Determining CI Candidacy, presented in partnership with the ACIA
Presented by Sandra Prentiss, PhD, CCC-A, Daniel Zeitler, MD, FACS, Donna L. Sorkin, MA, Andrea Warner-Czyz, PhD, Margaret Dillon, AuD, CCC-A, Matthew Carlson, MD, Lisa Park, AuD, CCC-A, Nancy Young, MD
Recorded Webinar
AudiologyOnline

Presenters

Sandra Prentiss, PhD, CCC-ADaniel Zeitler, MD, FACSDonna L. Sorkin, MAAndrea Warner-Czyz, PhDMargaret Dillon, AuD, CCC-AMatthew Carlson, MDLisa Park, AuD, CCC-ANancy Young, MD
Course: #37498Level: Intermediate4 Hours
  'I loved the content in this course'   Read Reviews
Considerable variation exists across the medical and audiologic communities regarding determination of cochlear implant (CI) candidacy. While criteria exist from the FDA for children and adults and from CMS for Medicare beneficiaries, different clinics and even audiologists within the same clinic use varying protocols to determine CI candidacy in different age groups and also considering factors other than hearing status. To provide guidance on this topic, the ACI Alliance Board of Directors commissioned four papers to provide guidelines for candidacy for children and adults with bilateral hearing loss and those with single-sided deafness. Task forces were appointed to develop the guidelines with membership drawn from across the care continuum to include audiologists, surgeons, speech-language pathologists, and others involved in CI patient care. This course will review each of those four candidacy guidelines.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Rethinking Your Audiology Test Battery
Presented by James W. Hall III, PhD
Recorded Webinar
AudiologyOnline

Presenter

James W. Hall III, PhD
Course: #29608Level: Intermediate3 Hours
  'well organized'   Read Reviews
This course reviews the evidence and rationale for creating individualized audiologic diagnostic and screening test batteries with an emphasis on maximizing diagnostic value and enhancing clinical efficiency. It provides practical information for audiologists to review their protocols and implement value-added changes.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

20Q: Extended High Frequency Hearing Loss - Translating Science into Clinical Practice
Presented by Srikanta Mishra, PhD, CCC-A
Text/Transcript
AudiologyOnline

Presenter

Srikanta Mishra, PhD, CCC-A
Course: #37590Level: Intermediate1 Hour
  'I love Q&As, it makes easy learning for me'   Read Reviews
Hearing impairment in the extended high frequencies (EHFs) can occur in the presence of a normal audiogram. This 20Q reviews the current knowledge on EHF hearing impairment and the usefulness of EHF audiometry in the clinic.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Novel Diagnostic and Evaluation Tools, presented in partnership with NAL
Presented by Vicky Zhang, PhD, Joaquin Tomas Valderrama-Valenzuela, PhD
Recorded Webinar
AudiologyOnline

Presenters

Vicky Zhang, PhDJoaquin Tomas Valderrama-Valenzuela, PhD
Course: #37111Level: Intermediate1 Hour
  'Great Information and presentation'   Read Reviews
This course will provide new diagnostic approaches and remediation strategies for hearing difficulties that are currently undetected. Participants will also receive a review of current tools that may be used in clinics to evaluate auditory speech discrimination skills in infants and toddlers.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $99/yr

Learn More

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.