Understanding Tympanometry: A Comprehensive Guide

11 June 2026

Tympanometry is one of the most valuable tools in audiology for evaluating middle ear function. By measuring how the eardrum responds to changes in air pressure, tympanometry provides essential insight into the health of the tympanic membrane, the ossicular chain, and the eustachian tube.

This guide explains what tympanometry is, how the tympanometry test works, how to interpret tympanometry results across the different tympanometry types, and how clinical and portable tympanometers compare.

What is Tympanometry?

Tympanometry is a non-invasive audiological test used to evaluate the health and functionality of the middle ear. It provides valuable insights into the condition of the eardrum (tympanic membrane) and the middle ear, including the mobility of the ossicular chain (the tiny bones in the middle ear) and the presence of any fluid, eardrum perforations, or blockages.

Tympanometry involves the application of both negative and positive pressure to the middle ear while maintaining a constant probe tone. Through this process, hearing care professionals evaluate how the probe tone is absorbed and reflected within the middle ear system.

This assessment helps clinicians better understand the behavior and functionality of the:

Tympanic membrane
Ossicular chain
Eustachian tube

What is a Tympanometry Test?

A tympanometry test evaluates the middle ear’s ability to transmit sound effectively. It measures the impedance of the middle ear by varying the air pressure within the ear canal and recording the corresponding changes in eardrum movement.

During a typical tympanometry test, the tester inserts a small probe into the ear canal. The probe contains three key components:

A speaker that emits a pure tone into the ear canal
A microphone that measures the sound reflected from the eardrum
An air pressure tube connected to a pump that varies pressure in the ear canal

As the air pressure changes, the device records the amount of reflected sound. This data is then used to create a tympanogram, which clinicians use to assess middle ear function.

What is a Tympanogram?

A tympanogram is the graphical representation generated through tympanometry. It typically displays the motion of the tympanic membrane and often takes on a pyramid-like shape.

The highest point on a tympanogram corresponds to the moment when the eardrum experiences equilibrium between negative and positive pressure. Using a classification framework such as Jerger’s template, clinicians can determine whether the tympanic membrane is moving freely or whether there may be an underlying middle ear disorder.

Tympanometry Type A:

Type A tympanograms reflect normal middle ear function.

The graph shows a clear peak when the eardrum has its highest compliance
Sound is conducted efficiently through the middle ear
Considered the ideal tympanogram pattern

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Figure 1. Tympanogram Type A

Tympanometry Type As:

Type As tympanograms indicate reduced compliance in the middle ear system.

The peak appears shallow on the tympanogram
Often associated with stiffness or reduced ossicular mobility
Commonly seen in conditions such as otosclerosis

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Figure 2. Tympanogram Type As

Tympanometry Type Ad:

Type Ad tympanograms reflect increased compliance in the middle ear.

Features a deeper, more exaggerated peak
Often associated with a flaccid eardrum or ossicular discontinuity
May be caused by trauma or other ear-related issues

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Figure 3. Tympanogram Type Ad

Tympanometry Type B:

Type B tympanograms typically show a flat line, indicating little or no compliance in the middle ear.

May suggest a perforated eardrum
Can indicate fluid in the middle ear
May reflect issues with the ossicles
Requires further examination to identify the specific cause

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Figure 4. Tympanogram Type B

Tympanometry Type C:

Type C tympanograms show a peak that occurs at more negative pressure than Type A.

Suggests negative pressure in the middle ear
Often points to eustachian tube dysfunction
May indicate the early or resolving stages of an ear infection

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Figure 5. Tympanogram Type C

Tympanometry for Eardrum Perforation:

Tympanometry can also help identify a perforated tympanic membrane.

Typically shows a flat or abnormally low peak
Equivalent ear canal volume is larger than normal
Indicates little to no compliance in the middle ear
Suggests sound is not being effectively transmitted, requiring further evaluation

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Figure 6. Tympanogram for Eardrum Perforation

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Figure 7. Tympanogram types as purposed by Jerger

What is a Tympanometer?

A tympanometer is a device used to perform tympanometry testing. To conduct the test, a probe is carefully placed into the ear canal to ensure an airtight seal. The tympanometer then administers varying levels of air pressure while simultaneously tracking changes in middle ear impedance.

The collected data is plotted on a tympanogram, giving audiologists a clear, objective view of middle ear function. Tympanometers are essential tools across audiology, ENT, pediatric, and primary care settings.

Figure 8: The basic components of a tympanometer. The loudspeaker introduces a 226-Hz tone to the ear canal while the pump varies the air pressure above and below atmospheric pressure in the ear canal. The microphone records the level of the tone at various ear canal pressures.

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Clinical Tympanometers

Clinical tympanometers, often called Middle Ear Analyzers or Clinical Immittance Systems, are designed for in-depth diagnostic testing.

Widely used in audiology and ENT clinics, university training programs, and hospitals
Offer customizable testing options for comprehensive middle ear assessment
Support both manual and automatic testing procedures
Provide advanced protocols including eustachian tube function testing, acoustic reflex decay, acoustic reflex latency, and wide band tympanometry

Clinical Tympanometer Examples:

Grason-Stadler TympStar Pro™

Interacoustics Titan

Portable Tympanometers

Portable or screening tympanometers are designed for quick, efficient middle ear screening. They are ideal for high-volume or mobile clinical environments.

Compact and lightweight, with many handheld models
Automatic testing initiation once the probe is properly inserted
Often include basic acoustic reflex testing
Some models include a screening audiometer function
Require minimal training to operate
Ideal for pediatricians, school nurses, and primary care settings

Screening Tympanometer Examples:

MAICO touchTymp MI 24

Amplivox Otowave 102 | Portable Tympanometer | e3 Diagnostics

Grason-Stadler Allegro | GSI Tympanometer | e3 Diagnostics

Frequently Asked Questions About Tympanometry

What does a tympanometry test diagnose?

Tympanometry helps diagnose middle ear conditions such as fluid in the middle ear, eustachian tube dysfunction, tympanic membrane perforation, otosclerosis, and ossicular chain abnormalities.

Is tympanometry the same as a hearing test?

No. Tympanometry evaluates middle ear function, while a hearing test (audiometry) measures hearing sensitivity. The two tests are often used together to provide a complete picture of auditory health.

Is tympanometry painful?

No. Tympanometry is non-invasive and generally well tolerated. Patients may feel slight pressure changes in the ear, similar to changes in altitude.

How long does a tympanometry test take?

A tympanometry test is typically very fast, often completed within a few seconds per ear.

What is the difference between a clinical and portable tympanometer?

Clinical tympanometers offer in-depth diagnostic capabilities for audiology and ENT clinics, while portable tympanometers are designed for fast screening in settings such as pediatric offices AND schools.

Why Tympanometry Matters in Hearing Care

Tympanometry is a vital tool for hearing care professionals because it provides objective, measurable insight into middle ear function. By understanding tympanometry test results and recognizing the various tympanometry types, audiologists can:

Identify middle ear pathology earlier
Differentiate between conductive and sensorineural concerns
Guide referrals and treatment decisions
Monitor patients over time

Whether used in a comprehensive diagnostic clinic or a fast-paced screening environment, tympanometry continues to be one of the most reliable assessments in audiology.

Explore Tympanometry Equipment

If you are considering purchasing a clinical or screening tympanometer, you can explore the full selection here:

Tympanometry and middle ear analyzers

Other Good Reads: The Benefits of Wide Band Tympanometry