What to Expect from a Hearing Test – Otoscopy and Tympanometry

Audiologist carrying out hearing beep test of patients ear canal in Brisbane

Otoscopy and Tympanometry

Our series of blogs continues with part three: objectively testing the health of the entire hearing system. We start with Otoscopy and Tympanometry and move onto the ‘beep test’. Below I’ll explain each of these in simple terms, so you understand why they are performed. This will give you some things to look out for when you are having your next hearing test.

At a Glance

  1. A hearing test is not simply a ‘beep test’
  2. Otoscopy involves looking into the ear to visually assess the health of the ear canal, ear drum and middle ear
  3. Tympanometry uses controlled air pressure and sound to test the condition of the middle ear
  4. Otoscopy and Tympanometry are important, painless and easy tests to perform

What to expect from Otoscopy and Tympanometry

Otoscopy is the clinical term for looking into the ear canal using a specialised tool. This is done with an otoscope – a small, magnified torch, commonly used by hearing specialists and your local GP when examining the ear canal and the tympanic membrane. The Tympanic membrane is the ear drum, 3 delicate layers of skin about 0.1mm thick and 8mm in diameter, which sits at the end of the ear canal. The tympanic membrane creates a watertight seal to protect the middle ear, as well as assisting in the mechanical amplification of sound waves for hearing.

Looking into the ear allows us to assess of the health of the ear canal. It can reveal blockages of wax, infections or fungal growth, inflammation, bony growths, lodgement of foreign bodies, and more. It also shows the condition of the ear drum. The ear drum is translucent, so can reveal the presence of fluid or disease within the middle ear. Otoscopy can reveal a lot about hearing in the earliest stage of the auditory pathway.

Tympanometry tests the function and health status of the middle ear (the ear drum and pea-sized space behind it). This test is quick and painless to administer, takes only a short amount of time and gives the clinician a wealth of information. A small mushroom shaped tip is inserted into the ear canal which sends out a quiet humming sound, and records how much of this sound is admitted into the middle ear whilst the air pressure within the canal is gently altered from positive to negative (it feels a little bit like when you climb in altitude, but less dramatic). In a few seconds we can deduce if the ear drum is intact, how flexible it is, if fluid is present behind the ear drum and how well the Eustachian tube is functioning (the tube which connects your airways to your middle ear). As the middle ear is responsible for amplifying sound, any disfunction revealed by this test gives us clues as to what we may expect from the ‘beep test’ and possible referral pathways for medical attention.

Red flags and warning signs

Little can go wrong with these tests if they are performed with care. It’s not uncommon however for tympanometry to be skipped though. Make sure you received this test however because as you can see above, it can reveal problems with the middle ear.

In Conclusion

The results of Otoscopy and Tympanometry reveal the health of the outer and middle ears, the mechanical parts of the ear and hearing, providing important information to help understand your experience of hearing.

In the following post we will discuss “Pure Tone Audiograms” – what to expect and what they tell us.