Impedance Audiometry Tests – Purpose, Procedure, Types & Results Explained

Impedance Audiometry is one of the most important tests used to evaluate the function of the middle ear. It helps audiologists understand how well the eardrum (tympanic membrane), ossicles (middle ear bones), and Eustachian tube are functioning.
This test is painless, quick, and highly accurate—making it essential for diagnosing various ear problems.

⭐ What Is Impedance Audiometry?

Impedance Audiometry is a group of middle-ear tests used to measure how the eardrum and middle ear react to sound and pressure.
It is commonly recommended for:

• Ear infections

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  Eustachian tube dysfunction

• Fluid in the middle ear

• Hearing loss in children

• Dizziness or balance issues

• Suspected perforation of the eardrum

⭐ Why Is Impedance Audiometry Done?

This test helps diagnose:

• Middle ear fluid (Otitis Media)

• Eardrum stiffness or floppiness

• Ossicular chain problems (bones not moving properly)

• Perforated eardrum

• Eustachian tube blockage

• Ear pressure imbalance

• Otosclerosis (bone fixation in middle ear)

It also helps guide treatment decisions like medications, surgery, or hearing aids.

⭐ Types of Impedance Audiometry Tests

Impedance testing includes:

1️⃣ Tympanometry (Most Common Test)

Tympanometry measures how the eardrum moves when air pressure changes.

What It Detects:

• Fluid in middle ear

• Ear infection

• Eardrum perforation

• Eustachian tube dysfunction

• Stiff or hypermobile eardrum

Tympanogram Types:

• Type A: Normal middle ear function

• Type B: Fluid or perforation

• Type C: Negative pressure / Eustachian tube problem

• Type As: Stiff eardrum (otosclerosis)

• Type Ad: Excessively mobile eardrum

2️⃣ Acoustic Reflex Testing

Measures the reflexive tightening of tiny inner-ear muscles when exposed to loud sounds.

What It Shows:

• Facial nerve function

• Middle ear nerve pathway health

• Retrocochlear pathologies

• Early hearing loss detection

3️⃣ Acoustic Reflex Decay Test

Checks how long the reflex stays active.

Used to Detect:

• Auditory nerve issues

• Early signs of tumors on hearing nerve (rare cases)

⭐ How Is Impedance Audiometry Done?

The test is very simple and takes only 2–5 minutes.

Step-by-Step Process:

1. You sit comfortably.

2. A soft ear-tip is inserted into the ear.

3. The machine sends gentle air pressure and sound.

4. The device measures the eardrum’s movement.

5. The audiologist reads the results immediately.

No pain. No discomfort. No loud noise.

⭐ Who Should Get an Impedance Audiometry Test?

It is recommended for:

• Children with repeated ear infections

• Adults with hearing loss

• People with Eustachian tube problems

• Those with ear pain or pressure imbalance

• Those with blocked-ear feeling

• Patients before & after ear surgery

• People with tinnitus or dizziness

⭐ Benefits of Impedance Audiometry

✔ Quick (3–5 mins)
✔ Non-invasive and painless
✔ Detects middle-ear problems early
✔ Helps plan accurate treatment
✔ Useful for all age groups (infants to elderly)
✔ Essential for pediatric hearing evaluations

⭐ What Do Tympanometry Results Look Like?

• Normal: Good eardrum movement

• Flat graph (Type B): Possible fluid or perforation

• Shifted graph (Type C): Eustachian tube block

• Shallow graph (Type As): Stiff eardrum

• High peak (Type Ad): Weak or floppy eardrum

An audiologist explains these results and recommends further tests if needed.

⭐ Conclusion

Impedance Audiometry is a vital test that provides detailed insights into the health of your middle ear. It helps detect infections, Eustachian tube problems, fluid buildup, and other conditions that affect hearing.
Quick, safe, and reliable—this test is an essential part of a complete hearing evaluation.