Objective Tests

Acoustic Immittance Otoacoustic Emissions Auditory Evoked Potentials

Acoustic Immittance

Instrumentation

Ear Canal Measurements

Static Immittance (compliance) Tympanometry Acoustic Reflexes

Acoustic Immittance

Instrumentation

sound source
air pump analysis section acoustic reflex stimulus

Acoustic Immittance

Ear canal volume predicted by intensity of reflected sound

Acoustic Immittance

Ear Canal Volume Normative Data

Adults
Mean = 1.5 mL 90% range = 0.6 to 1.5 mL

Children
Mean = 0.7 mL
90% range = 0.4 to 1.0 mL

Acoustic Immittance

Static immittance is the measurement of tympanic membrane and middle ear mobility Normative Data for Adults Mean = 0.8 mL 90% range = 0.3 to 1.4 mL Normative Data for Children Mean = 0.5 mL 90% range = 0.2 to 0.9 mL

Acoustic Immittance

Tympanometry tracks changes in static immittance over time

Acoustic Immittance

Tympanometric (Jerger) types

Acoustic Immittance

Tympanometric (Jerger) types

Acoustic Immittance

Tympanometric Shape (as recommended by ASHA) Width of the tympanogram at the 50% amplitude point

Acoustic Immittance

Acoustic Immittance

Normative data for tympanomeric shape

Adults
Mean = 80 daPa 90% range = 50 to 110 daPa

Children
Mean = 100 daPa
90% range = 60 to 150 daPa

Acoustic Immittance

Acoustic Reflex Anatomy and Physiology

Acoustic Immittance
Acoustic Reflex Anatomy and Physiology

Acoustic Immittance

Acoustic Reflex Threshold Definition ART for pure tones = 85 to 95 dB HL for normally hearing people ART for Speech = 10 to 20 dB less for pure tones Doesnt change in people with cochlear loss (up to 50 dB HL)

Diagnostic Significance

Conductive Loss
Sensorineural Loss Cochlear Loss Retrocochlear Loss

Otoacoustic Emissions
Instrumentation

Otoacoustic Emissions
Function

Otoacoustic Emissions

Transient Otoacoustic Emissions (TOAEs)

Distortion Product Otoacoustic Emissions (DPOAE)

Otoacoustic Emissions

Application
neonatal hearing screening differential diagnosis monitoring cochlear damage

Auditory Evoked Potentials

Instrumentation Auditory Brainstem Response Audiometry (ABR) Other AEPs

Auditory Evoked Potentials

Instrumentation

Auditory Evoked Potentials

Auditory Evoked Potentials

Auditory Brainstem Response (ABR) Applications differential diagnosis auditory threshold testing neonatal hearing screening neurosurgical interoperative monitoring

Auditory Evoked Potentials

Interpertation for ABR

latency amplitude morphology

Auditory Evoked Potentials

Summary of Auditory Evoked Potentials AEP Site Application Electrocochleography VIII Nerve Hearing Testing ABR VIII Nerve and Brainstem See Previous Middle Latency Response Primary Auditory Cortex Hearing Testing Late Vertex Response Upper Level Cortex Central Auditory Problems P300 Frontal Lobe Physiological Psychology

Summary

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