# Immittance Audiometry: Accoustic Immittance Testing

> Acoustic immittance testing (e.g., tympanometry, acoustic reflex threshold, acoustic reflex decay) uses a probe to evaluate a patient’s middle ear health.

![Immitance With Auditdata Measure](https://www.auditdata.com/media/pj5f1muy/immitance-with-auditdata-measure.png)

## Obtain Information on a Patient’s **Middle Ear Status With Immittance**

In short, immittance testing is any test which involves placing a probe in the ear to obtain information on a patient’s middle ear status. Not only do immittance tests provide value information on their own, they can also be used to corroborate the results of other assessments.

Frequently-Asked-Questions

## **What Tests** Does Immittance Testing Include?

## Tympanometry

Tympanometry is a non-invasive hearing test that assesses the health and function of the middle ear. It involves a small probe placed in the ear canal, which varies air pressure to measure how effective sound energy is transmitted via the middle ear into the cochlea. This helps identify issues like fluid behind the eardrum or problems with the ossicles. Tympanometry is crucial in diagnosing various ear conditions and guiding appropriate treatment.

## Acoustic Reflex Thresholds (ART)

The acoustic reflex is an involuntary contraction of the stapedial muscle in response to loud sounds. When the stapedial muscle contracts, it stiffens the ossicles and tympanic membrane decreasing admittance, or the absorption of sound. This stiffening can be measured in the same way as during tympanometry. During ART testing, loud sounds (70 – 115 dB), typically presented at 500, 1000, 2000, and at times 4000 Hz are introduced into the ear alongside a constant probe tone. These loud sounds induce the acoustic reflex while the probe tone detects the contraction.

## Acoustic Reflex Decay (ARD)

Acoustic reflex decay testing is performed nearly identically to acoustic reflex threshold testing but evaluates the maintenance of the reflex contraction over time. ARD testing is useful in differentiating between cochlear and retrocochlear losses, as the reflex will often weaken during continuous stimulation in retrocochlear pathologies. During ARD testing, a tone is presented typically at 500 and 1000 Hz above the patient’s threshold at that frequency. The tone is presented for 10 seconds as the reflex contraction is measured.

Measure Tympanometers

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## PC-Based Tympanometer

![PC Rased Tumnanometer EDIT](https://www.auditdata.com/media/n2hbgwzk/pc-rased-tumnanometer-edit.jpg)

## Standalone Tympanometer

![Standalone Tumnanometer EDIT](https://www.auditdata.com/media/j2ib4m1d/standalone-tumnanometer-edit.jpg)

## Why is **Immittance Testing Valuable?**

## Quick and Low cost

A comprehensive immittance test battery, including [tympanometry](https://www.auditdata.com/audiology-solutions/measure/hearing-assessment/immittance/tympanometry/ "Tympanometry"), acoustic reflex threshold (ART), and reflex decay (ARD) testing, can be efficiently conducted in a matter of minutes. Additionally, these three measures can be seamlessly performed using a single device. Take, for instance, the [Measure Standalone Tympanometer](https://www.auditdata.com/audiology-solutions/measure/hearing-assessment/immittance/tympanometry/tympanometers/ "Tympanometer"), a device capable of executing these assessments and more, all in one compact unit.

## No Behavioral Responses Required

Unlike other audiologic assessments that require patient responses or feedback, immittance measures are completely objective requiring nothing of the patient. This lack of patient involvement makes immittance measures well-suited for a wide range of individuals, including infants, young children, and those with communication challenges or cognitive impairments. This inclusivity in testing is particularly crucial in the field of audiology, where patients span various age groups and backgrounds.

As results are solely based on the physiology of the middle ear, they provide an objective and unbiased picture of middle ear function. This objectivity is a cornerstone in corroborating the results of other assessments and ensuring accurate diagnoses.

## Provide Valuable Diagnostic Information

While other assessments, like pure tone audiometry, can detect the presence of a conductive or sensorineural loss, they lack the diagnostic specificity of immittance testing. With immittance testing, providers can gain valuable information on not only middle ear status, and thus what is contributing to the conductive loss, but the status of the entire auditory pathway through ART and ARD testing.