audiometry

1. Aditya Ghosh Roy
PGT2
MS ENT

2.  MIDDLE EAR PATHOLOGY TWO TYPES
 STATIC COMPLIANCE REPRESENTIVE OF THE
MORE LATERAL PATHOLOGY
EAC T
M
MEC COCHLEA

3.  1.STAPEDIAL FIXATION AND COMMON COLD
 -- MEP WITH LOW COMPLIANCE EXPECTED
 BUT -- MEP WITH LOW COMPLIANCE
 OTITIS MEDIA WITH EFFUSION

4.  STAPEDIAL FIXATION AND SCARRED / HEALED
TM
 NORMAL MEP WITH HIGH
COMPLIANCE
 BUT NORMAL MEP WITH HIGH
COMPLIANCE
 OSSICULAR DISCONTINUITY

5.  THICKENED TM OT TYMPANOSCLEROTIC PATCH
 NORMAL MEP WITH LOW COMPLIANCE
 NORMAL MEP WITH LOW COMPLIANCE
 STAPEDIAL OTOSCLEROSIS

6.  SMALL PERFORATION OF TM
 FLAT TYPE TYMPANOGRAM
WITH NORAL VOLUME
 FLAT TYPE TYMPANOGRAM WITH NORAL
VOLUME
 ADHESIVE OTITIS MEDIA, OTITIS MEDIA WITH
EFFUSION

7.  OSSICULAR DISCONTINUITY WITH THIKENED TM
 NORMAL MEP WITH LOW COMPLIANCE
 NORMAL MEP WITH LOW COMPLIANCE
 STAPEDIAL OTOSCLEROSIS

8. FUNCTION OF
EUSTACHIAN TUBE
MAINTAINANCE OF
EQUALITY OF AIR
PRESSURE BETWEEN THE
MIDDLE EAR AND
AMBIENT ATMOSPHERE
DRAINAGE OF MUCUS
FROM EAR TO THE
NASOPHARYNX

9.  AIR IN MIDDLE EAR CAVITY CONSTANTLY BEING
ABSORBED
 STEADY FALL IN MIDDLE EAR PRESSURE
 CONTRACTION OF TENSOR PALATINI AND LEVATOR
PALTINI MUSCLE DURING SWALLOWING
 INTERMITTENT OPENING OF ET
 AIR PASSING THROUGH IT INTO MEC
 PRESSURE IN MEC BROUGHT BACK TO NORMAL

10.  FOR TESTING WE SEE WHETHER
VALSALVA
SWALLOWING DECREASE MEP
INCREASE MEP

11.  TWO TYPES OF TEST ARE AVAILABLE
WILLIAMS
TOYNBEES PERFORATED TM
INTACT TM

12.  MEP MEASURED
RESTING PRESSURE
SWALLOING WITH NOSE MOUTH CLOSED
VALSALVA

13. NORMAL PARTIALLY IMPAIRED GROSSLY
IMPAIRED
RESTING
PRESSURE
0 mm WATER
SWALLOING
WITH NOSE
MOUTH
CLOSED
NEGATIVE NEAGATIVE NO
CHANGE
NO CHANGE
VALSALVA POSITIVE NO
CHANGE
POSITIVE NO CHANGE

14. NORMAL
RESTING PRESSURE 0 mm WATER
SWALLOING WITH NOSE MOUTH
CLOSED
NEGATIVE
VALSALVA POSITIVE

15. PARTIALLY IMPAIRED
SWALLOING WITH NOSE MOUTH
CLOSED
NEAGATIVE NO CHANGE
VALSALVA NO CHANGE NEAGATIVE

16. GROSSLY IMPAIRED
SWALLOING WITH NOSE MOUTH
CLOSED
NO CHANGE
VALSALVA NO CHANGE

17.  AUDIOMETER
 ARTIFICIALLY INC OR DEC MEP
 RECORD CHANGE IN PRESSURE EACH TIME
PT. SWALLOWS
 TEST CARRIED OUT FOR FIXED DURATION
 40SEC TO MAX 160 SEC

18.  MEP CHANGED EITHER TO +250 OR -250
 PT. ASKED TO SWALLOW
 CHANGE IN MEP EITHER DEC OR INC NOTED IN A STEP
LADDER PATTERN

19.  MEP WHEN TUBE CLOSED
 SUDDEN OPENING OF TUBE
 DEC IN MEP
 AGAIN PASSIVE CLOSURE OF TUBE
 MEP BECOMES STEADY
 AGAIN PT. ASKED TO SWALOW
 CHANGE IN MEP
 HENCE A STEP LADDER PATTERN GRAPH OBTAINED

20. OPENING OF TUBE
DEC IN MEP
PASSIVE CLOSURE OF
TUBE
MEP BECOMES STEADY

21. NORMAL PRESSURE NEUTRALISES
BY 3 TO 4 SWALLOWS
PARTIALLY IMPAIRED SOME PRESSURE
PERSISTS EVEN AFTER
MORE THAN 5 SWALLOWS
GROSSLY IMPAIRED NOT NEUTRALISED AT
ALL BY EPEATED
SWALLOWING

22. NORMAL
PRESSURE
NEUTRALISES
BY 3 TO 4
SWALLOWS

23. PARTIALLY IMPAIRED SOME PRESSURE
PERSISTS EVEN AFTER
MORE THAN 5 SWALLOWS

24. GROSSLY IMPAIRED
NOT NEUTRALISED
AT ALL BY EPEATED
SWALLOWING

25. MIDDLE EAR CAVITY
STAPEDIUS TENSOR TYMPANI
7TH NERVE 5TH NERVE
EFFECT OF CONTRACTION OF STAPEDIUS MUSCLE
MORE PRONOUNCED THAN THAT OF TENSOR
TYMPANI
ACOUSTIC REFLEX TESTED BY CONTRACTION OF
STAPEDIUS MUSCLE

26.  CONTRACTION OF TENSOR TYMPANI TESTED
SEPARATELY
 STIMULATION OF TRIGEMINAL NERVE AND DOING
AUDIOMETRY
 STARTLE TYPE REFLEX
 FATIGUEBLE IN NATURE
 UNSTABLE
 LONG LATENCY PERIOD
 DONE IN PT. WITH SEVERE DEAFNESS IN WHOM
ACOUSTIC REFLEX CANT BE PERFORMED BUT
MIDDLE EAR STATUS HAS TO BE KNOWN

29.  DIAGRAMMATIC REPRESENTATION OF ACOUSTIC
REFLEX
 Stimulus of 85 db of 1 sec

30. NORMAL EAR DEAF EAR
IPSILATERAL CONTRALATERAL IPSILATERAL CONTRALATERAL
PRESENT ABSENT ABSENT ABSENT

31. NORMAL EAR
DEAF EARNORMAL EARNORMAL EAR

32. DEAF EAR
DEAF EAR DEAF EAR NORMAL EAR

33. DEAF EAR DEAF EAR
IPSILATERAL CONTRALATERAL IPSILATERAL CONTRALATERAL
ABSENT ABSENT ABSENT ABSENT
BILATEAL MODERATE TO SEVERE
CONDUCTIVE HEARING LOSS

34. DEAF EAR
NORMAL EARDEAF EARDEAF EAR

35. NORMAL DEAF EAR
IPSILATERAL CONTRALATERAL IPSILATERAL CONTRALATERAL
PRESENT ABSENT ABSENT PRESENT

36. NORMAL EAR
DEAF EARNORMAL EAR NORMAL EAR

37. DEAF EAR
NORMAL EAR

38. DEAF EAR DEAF EAR
IPSILATERAL CONTRALATERAL IPSILATERAL CONTRALATERAL
ABSENT ABSENT ABSENT ABSENT
DEAF EAR DEAF EAR
IPSILATERAL CONTRALATERAL IPSILATERAL CONTRALATERAL
PRESENT PRESENT PRESENT PRESENT
SEVERE NEURAL IN
NATURE
MODERATE DEGREE
AND COCHLEAR IN
NATURE

39. DEAF EAR
NORMAL EARDEAF EAR DEAF EAR

40. NORMAL EAR NORMAL EAR
IPSILATERAL CONTRALATERAL IPSILATERAL CONTRALATERAL
PRESENT ABSENT PRESENT ABSENT

41. CENTRAL LESION