Tympanometry and Reflexometry (Impedance Audiometry)


Audio-Reflexometry measures the level of hearing through the observation of involuntary responses resulting from acoustic stimulation. The stapedius muscles get contracted when elicited by an acoustically loud sound. This is called acoustic reflex. Acoustic reflex results draw a major contribution to differential diagnosis and should be part of every basic audiological evaluation. They can provide information about the type and degree of hearing loss. An acoustic stimulation to one ear causes reflex contractions in both ears, and therefore we measure both the ipsilateral and contra lateral reflex pathways.

Stapedius Reflexometry is a simple objective test for the diagnosis of myasthenia gravis.

What is Tympanometry? The primary purpose of impedance audiometry is to determine the condition of the tympanic membrane and middle ear via Tympanometry. The secondary purpose of this test is to evaluate acoustic reflex pathways. Tympanometry is an objective test and not a hearing test, it rather a measure of energy transmission through the middle ear. The test should not be used to assess the sensitivity of hearing and the results of this test should always be viewed in conjunction with pure tone audiometry.

Examination under microscope – to visualise Tympanic membane


The otoscopic examination evaluates the condition of the ear canal, tympanic membrane and the middle ear.

The ear canal and tympanic membrane are relatively inaccessible and need both magnification and illumination to examine. The standard tools for clinical assessment of the tympanic membrane include the microscope and oto-endoscope. There are a number of alternative means of checking the ear canal and visualizing the tympanic membrane. These include a vorascope, headlight and microscope. All these methods have the advantage of visualization of the ear canal with binocular vision. The otoscope has the great advantage of convenience and portability. Intravital fluorescence microscopy is used for the analysis of blood flow in the tympanic membrane and the thickness of the tympanic membrane is measured with confocal microscopy.
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