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A very brief word about speech audiometry. A couple of things that will be tested on, which is more advanced than the pure tone audiometry, one is something that is called the “Speech Reception Threshold” or SRT. That is defined as the lowest sound intensity in decibels at which a child can identify selected words in 50% of the trials. So give them a list of words and they can identify what those words are 50% of the time. In comparison you have the speech discrimination score where you have a percent of words on a standardized list that are correctly identified if presented at a sound level 25-40 decibels above the speech reception threshold. Kind of complicated, pretty unlikely to show up on the test but might be worth kind of noting. One fact worth remembering about these though, is that looking at speech discrimination scores, if you look at these in sensorineural hearing loss, they tend to be lower than conductive loss. So kids with hearing loss due to conductive problems actually probably can pick up speech better than if there is sensorineural hearing loss.
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On to tympanometry. In tympanometry what you are trying to assess is two things, essentially. One is mobility of the tympanic membrane and second is indirectly you are trying to measure the pressure, or estimate the pressure, in the middle ear. There are three key things that you want to look at when you are looking at audiometry. And that is, the peak of the curve. So the three things that you are looking at is the peak of the curve – so how high does this get? And the vertical axis here is compliant which is essentially looking at how much volume of air is displaced at different pressures. So a tympanometry machine is applying different pressures and measuring how much air is displaced and essentially gives you a sense of how well, indirectly, the tympanic membrane is moving. So the peak is the height in the compliance. Canadian viagra at discount pharmacy shop. The location along this pressure curve where the peak occurs – so here the peak is at zero – is completely normal. Also a key thing to look at is you may see this peak shifted to the left if there’s negative pressure in the eardrum or to the right if there’s positive pressure in the eardrum. And the third thing, which is a nice little trick as well, is to look at ear canal volume. Here it’s 1 cc which is normal. Kids can have ear canal volumes anywhere from 0.2 to 2.00 ml. So this is a normal curve. The peak falls within this box below this line, above this line so the mobility is normal. The pressure is normal, the peak falls at zero and the ear canal volume is normal at 1 cc.
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Next one, what you see here is the peak height or the height of the peak is normal so the eardrum can move normally but the problem is that the peak is coming out at the left of this box at negative 200. So what that means is that while there is normal mobility there is negative pressure behind that middle ear, or behind that tympanic membrane within the middle ear and that is consistent with eustachian tube dysfunction and a retracted eardrum.