Case 4 Immittance

  • What is the left ear’s Liden/Jerger tympanogram type?
  • The Y226 Hz tympanogram for the left ear is not notched. What does this mean about the middle ear resonant frequency?
  • Calculate the tympanometric width in daPa and interpret it.

Acoustic Reflex Data

Thresholds

500 1000 2000 4000
Right Ipsi 90 90 90
Right Contra DNT
Left Ipsi AB AB AB
Left Contra PRESENT PRESENT PRESENT
  • Review, please, where is the probe and where is the sound for a left contralateral reflex. What does the presence of this reflex point to?  What is the significance of the left ipsilateral reflex being absent? Does this make sense?

  • As you know, notching of the Y tympanogram is an indication that middle ear resonant frequency has been reached or exceeded.  What do you think this middle ear resonant frequency is, and would that frequency be high, low, or normal?  What does that mean about the relative mass and stiffness of this middle ear?