Tympanometry, a diagnostic procedure used to assess middle ear and eardrum mobility, has been limited by its reliance on a single tone. However, with the introduction of wideband tympanometry (WBT), which uses a broader range of sound frequencies, we can gain a more comprehensive understanding of middle ear health.
What is WideBand Tympanometry
Wideband tympanometry is an advanced diagnostic technique used to assess middle ear function and health by using a broader range of frequencies. Unlike classic tympanometry, which typically uses a single tone (e.g., 226 Hz) to evaluate the middle ear, WBT utilizes multiple frequencies across a wider spectrum, typically ranging from 226 Hz to 8000 Hz or higher.
This broader frequency range provides more detailed information about the middle ear's response to different sound frequencies, allowing for improved diagnosis of middle ear disorders such as fluid in the middle ear (effusion), Eustachian tube dysfunction, and otosclerosis. Wideband tympanometry offers enhanced accuracy and sensitivity compared to traditional tympanometry, making it a valuable tool in audiological assessments and treatment planning.
Key Benefits of WBT
Wideband tympanometry offers significant advantages in diagnosing middle ear pathologies in both adults and children.
Reliable and Clear Results: Wideband averaged tympanograms deliver consistent results by blending information from different frequencies, thereby reducing the effects of noise or patient movement. This technique enhances accuracy by combining tympanograms collected at multiple frequencies, effectively minimizing external factors like noise or patient motion. As a result, WBT is particularly effective for testing children, as it can produce precise measurements even when they may not be fully cooperative.
Comprehensive Assessment: By using multiple frequencies, WBT provides a more comprehensive evaluation of middle ear function. This allows for a detailed analysis of how the middle ear responds to different frequencies of sound, which can reveal abnormalities that might not be detected with a single-tone tympanogram.
Identifying Middle Ear Conditions: WBT makes it easier to identify middle ear conditions such as otitis media with effusion (OME). It also helps in diagnosing type C tympanograms.
Middle Ear Function with PE Tubes: Wideband tympanometry can help evaluate middle ear function with pressure equalization (PE) tubes.
Overall, WBT enhances the diagnostic capabilities for middle ear disorders, improving treatment decisions and patient outcomes across all age groups.
How to Perform WBT
Wideband tympanometry is conducted similarly to single frequency tympanometry. A probe is inserted into the ear canal to create a tight seal. The patient hears a series of wideband clicking sounds while the pressure in the ear canal is varied from +200 to -400 daPa.
The test results show standard measurements like ear pressure, ear size, and how well the eardrum moves. It also measures how wide the eardrum moves at different frequencies. Additionally, WBT provides a graph showing middle ear absorbance, offering more comprehensive diagnostic information.
WBT Test Results
Wideband tympanometry provides a comprehensive set of measurements, including traditional tympanograms and a graph depicting middle ear absorbance. Absorbance refers to the amount of sound that traverses the middle ear system. This measurement is expressed as a percentage of acoustic energy transmitted or absorbed by the middle ear across the frequencies of the wideband click stimulus.
During WBT, the stimulus is automatically adjusted to 85 dB SPL (Sound Pressure Level) in the ear canal and evaluated during a pressure sweep. The acoustic energy transmitted through the middle ear is known as absorbance, while the amount measured in the ear canal during the sweep is called reflectance, which is the inverse of absorbance.
The outcomes of WBT are presented in an absorbance graph, illustrated below. The x-axis of the graph represents the frequency range of the wideband click stimulus, aligning with the frequencies used in standard audiometry. The absorbance graph serves as a middle ear audiogram, with the y-axis showing the percentage of the stimulus absorbed into the middle ear system. Normative data are accessible for infants, children, and adults to aid in interpreting WBT results effectively.
Wide Band Tympanometry Absorbance Graph from the GSI TympStar ProTM
On the GSI TympStar ProTM, individual tympanograms can also be viewed.
Single Frequency Tracing from the GSI TympStar ProTM
WideBand Tympanometry Terminology
Average Tympanogram: Encompassing a wider frequency range, facilitating assessments in pediatric patients or challenging conditions.
Absorbance Curve Analysis: Offering insights into middle ear function and assisting in differential diagnosis of various middle ear pathologies.
With comparable speed to traditional tympanometry and significantly improved diagnostic sensitivity, WBT offers a compelling alternative for clinicians seeking enhanced middle ear assessment capabilities. Its ability to provide comprehensive assessments across a range of frequencies contributes to more accurate diagnoses and personalized treatment strategies. As technology continues to evolve, wideband tympanometry stands as a valuable tool for improving patient outcomes and advancing our understanding of middle ear health.
The Grason-Stadler Tympstar ProTM is equipped with WBT capabilities, allowing for testing across multiple frequencies to provide detailed insights into middle ear function. It offers flexibility with various probe tone options and customizable test protocols, accommodating different patient needs and clinical preferences.
The intuitive touchscreen interface and user-friendly software streamline the testing process, making it easier for clinicians to navigate and interpret results efficiently. Additionally, the TympStar ProTM includes advanced features such as reflex testing and high-resolution graphics, ensuring thorough and precise assessments of middle ear health.
The GSI TympStar ProTM is equipped with an intuitive touchscreen interface and user-friendly software.
Overall, the Grason-Stadler TympStar ProTM represents an innovative solution for comprehensive tympanometry, empowering clinicians with the tools needed for accurate diagnosis and optimal patient care.
To learn how to conduct WBT using the GSI TympStar ProTM check out GSI's blog: Performing WideBand Tympanometry with the TympStar Pro
Do you have further questions about WBT? Our local experts are here to help.
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