Tympanometers

A tympanometer is a medical device used to evaluate the condition and mobility of the middle ear. This can also be referred to as a middle ear analyser, impedance meter, or admittance meter.

The device measures how the eardrum responds to changes in air pressure in the ear canal. Clinicians call this type of hearing test tympanometry. During the test, the clinician places a small probe in the ear canal. The device changes the air pressure while delivering a sound wave or tone. This measures how much sound the eardrum reflects back.

This allows clinicians to assess how well the eardrum moves and whether the middle ear system is functioning properly. A graph called a tympanogram displays the results and shows eardrum mobility at different pressure levels. Further tests can include measurement of the interaural muscles (acoustic reflex, decay and latency tests) as well as eustachian tube tests.

In simple terms, an audiometer measures how well someone hears. A tympanometer measures how well the middle ear works.

Clinicians often perform tympanometry alongside audiometry. While audiometry measures hearing sensitivity, tympanometry evaluates how well the eardrum and middle ear system are functioning.

This helps determine whether hearing loss is caused by problems in the middle ear (conductive hearing loss) or whether it originates from the inner ear or auditory nerve. Conditions that can affect eardrum mobility or middle ear pressure include:

• Middle ear effusion (Otitis media)
• Perforation or cicatrisation of the ear drum
• Ear grommets
• Eustachian tube dysfunction
• Tympanosclerosis
• Otosclerosis
• Cholesteatoma

By detecting abnormalities in middle ear pressure or compliance, tympanometry provides valuable diagnostic information that complements audiometric findings.

Clinicians and screening staff use tympanometers in a variety of clinical and screening environments to assess middle ear function. They are most often found in audiology clinics, ENT (Ear, Nose, and Throat) practices, and hospitals. You can also find them in hearing care centers, primary care clinics, and pediatric clinics.

In addition, schools, community health services, public health initiatives, occupational health, and mobile health services use tympanometry. They do this as part of broader hearing evaluations when needing to assess the middle ear.

You interpret a tympanogram by examining the shape of the graph, the position of its peak, and the height of that peak. Together, this information reflects how well the eardrum moves in response to changes in air pressure.

A normal result shows a clear peak near normal atmospheric pressure, indicating healthy middle ear function. A flat trace with no peak may suggest middle ear fluid, a perforated eardrum, or ear canal blockage. A peak shifted toward negative pressure can indicate Eustachian tube dysfunction.

Abnormally shallow or excessively deep peaks may point to stiffness or hypermobility of the middle ear system. Interpretation should always consider ear canal volume and be correlated with clinical findings, otoscopy, and audiometry results for an accurate assessment. Learn how to interpret a tympanogram.