IHS Audiometric Testing Procedures 4 — Questions and Answers
Question 1: What is the purpose of otoscopic examination prior to audiometric testing?
- To measure middle ear pressure
- To visually inspect the ear canal and tympanic membrane for conditions that may affect testing (Correct answer)
- To screen for sensorineural hearing loss
- To determine the correct masking level
Correct answer: To visually inspect the ear canal and tympanic membrane for conditions that may affect testing
Otoscopic examination allows the hearing specialist to identify cerumen impaction, perforations, or other conditions that could influence audiometric results.
Question 2: What does Type A tympanogram indicate?
- Eustachian tube dysfunction
- Normal middle ear pressure and compliance (Correct answer)
- Otosclerosis
- Perforated tympanic membrane
Correct answer: Normal middle ear pressure and compliance
A Type A tympanogram shows peak compliance near 0 daPa with normal peak height, indicating normal middle ear function.
Question 3: Which tympanogram type is most associated with otitis media with effusion (fluid in the middle ear)?
- Type A
- Type As
- Type B (Correct answer)
- Type C
Correct answer: Type B
A Type B (flat) tympanogram with no discernible peak indicates reduced or absent tympanic membrane mobility, consistent with middle ear fluid.
Question 4: What does a Type C tympanogram indicate?
- Normal middle ear pressure
- Hypermobile tympanic membrane
- Negative middle ear pressure, often due to Eustachian tube dysfunction (Correct answer)
- Complete absence of middle ear reflexes
Correct answer: Negative middle ear pressure, often due to Eustachian tube dysfunction
A Type C tympanogram shows peak compliance at a significantly negative pressure (beyond -100 daPa), indicating Eustachian tube dysfunction.
Question 5: At what frequency is the acoustic reflex most commonly elicited in clinical testing?
- 250 Hz
- 500 Hz
- 1,000 Hz (Correct answer)
- 4,000 Hz
Correct answer: 1,000 Hz
The acoustic reflex is most reliably elicited at 1,000 Hz, which is the standard test frequency used in clinical tympanometry.
Question 6: In a patient with normal hearing, at what approximate HL level is the acoustic stapedial reflex typically elicited?
- 40–60 dB HL
- 70–90 dB HL (Correct answer)
- 95–100 dB HL
- 110–120 dB HL
Correct answer: 70–90 dB HL
In individuals with normal hearing, the acoustic reflex threshold is typically elicited between 70 and 90 dB HL above audiometric threshold.
Question 7: What is the primary advantage of insert earphones over supra-aural earphones in audiometry?
- They are less expensive and easier to calibrate
- They increase interaural attenuation, reducing the need for masking (Correct answer)
- They provide more accurate bone conduction measurements
- They are more comfortable for patients with normal ear canals
Correct answer: They increase interaural attenuation, reducing the need for masking
Insert earphones provide interaural attenuation of approximately 70–80 dB, significantly higher than supra-aural earphones, which reduces cross-hearing and masking requirements.
IHS Audiometric Testing Procedures 4
What is the purpose of otoscopic examination prior to audiometric testing?