Impedance Audiometry

Impedance Audiometry

Q. 1

A young man presents with an accident leading to loss of hearing in the right ear. On otoscopic examination, the tympanic membrane was intact. Pure tone audiometry shows an Air – Bone gap of 55 dB in the right ear with normal cochlear reserve. Which of the following will be the likely tympanometry finding?

 A

As type tympanogram

 B

Ad type tympanogram

 C

B type tympanogram

 D

C type tympanogram

Q. 1

A young man presents with an accident leading to loss of hearing in the right ear. On otoscopic examination, the tympanic membrane was intact. Pure tone audiometry shows an Air – Bone gap of 55 dB in the right ear with normal cochlear reserve. Which of the following will be the likely tympanometry finding?

 A

As type tympanogram

 B

Ad type tympanogram

 C

B type tympanogram

 D

C type tympanogram

Ans. B

Explanation:

The threshold of bone conduction is a measure of cochlear function in pure tone audiometry.

The difference in the thresholds of air and bone conduction (A-B) is a measure of the degree of conductive deafness.

Here this patient is having a normal cochlear function.

So A-B gap of 55 dB will be because of defect in air conduction.

Otoscopic examination showed an intact tympanic membrane means the ossicular discontinuity will be the reason for the hearing loss.

Therefore the tympanometry finding in this patient will be Ad type tympanogram.
 

Q. 2

A 31 year old female patient complaints of bilateral impairment of hearing for the past 5 years. On examination, tympanic membrane is normal and audiogram shows a bilateral conductive deafness. Impedance audiometry shows normal curve and acoustic reflexes are absent. All of the following constitute part of its treatment, EXCEPT:

 A

Gentamicin

 B

Hearing aid

 C

Stapedectomy

 D

Sodium fluoride

Q. 2

A 31 year old female patient complaints of bilateral impairment of hearing for the past 5 years. On examination, tympanic membrane is normal and audiogram shows a bilateral conductive deafness. Impedance audiometry shows normal curve and acoustic reflexes are absent. All of the following constitute part of its treatment, EXCEPT:

 A

Gentamicin

 B

Hearing aid

 C

Stapedectomy

 D

Sodium fluoride

Ans. A

Explanation:

The patient is showing features of otosclerosis.

It is a condition due to new spongy bone formation.

About 50% of the cases may have a positive family history and deafness starts between the age of 20-30 years.

Non surgical treatment of otosclerosis includes use of hearing aid and sodium fluoride.

Use of high doses of sodium fluoride is thought to increase the remineralization of otospongotic foci.

It has been reported to stabilize progressive inner ear hearing loss and tinnitus. Surgical treatment of choice is stapedectomy.
 

Q. 3

Impedance audiometry is done in?

 A

Otomycosis

 B

Meniere’s disease

 C

Pressure changes in middle ear

 D

Cholesteatoma

Q. 3

Impedance audiometry is done in?

 A

Otomycosis

 B

Meniere’s disease

 C

Pressure changes in middle ear

 D

Cholesteatoma

Ans. C

Explanation:

It is an objective test, widely used in clinical practice and is particularly useful in children. It consists of:

  • Tympanometry
  • Acoustic reflex measurements

By changing the pressure in a sealed external auditory canal and then measuring the reflected sound energy, it is possible to find the compliance or stiffness of the tympano-ossicular system and thus find the healthy or diseased status of the middle ear.


Q. 4

A lady has B/L hearing loss since 4 years which worsened during pregnancy. Type of impedance audiometry graph will be:

 A

Ad

 B

As

 C

B

 D

C

Q. 4

A lady has B/L hearing loss since 4 years which worsened during pregnancy. Type of impedance audiometry graph will be:

 A

Ad

 B

As

 C

B

 D

C

Ans. B

Explanation:

 

The gradual stiffening of the ossicular chain produced by progressive stapes fixation leads to specific patterns of change on tympanometry. Progressive stapes fixation results in a Type As (A-shallow) tympanogram. 
 
 

 


Q. 5

Secretory otitis media is diagnosed by:

 A

Impedance audiometry

 B

Pure tone audiometry

 C

X-ray

 D

a and c

Q. 5

Secretory otitis media is diagnosed by:

 A

Impedance audiometry

 B

Pure tone audiometry

 C

X-ray

 D

a and c

Ans. A

Explanation:

 

Pure tone audiometry gives information about the quantity and quality of hearing loss.

In secretory otitis media: conductive deafness of 20-40 dB is seen (which is not a specific finding as conductive deafness can be seen in many other conditions). Therefore, pure tone audiometry is not diagnostic of serous otitis media but provides an assessment of the hearing loss and is therefore important in monitoring the progress of the condition and provides information useful for management decisions

On otoscopy: Tympanic membrane appears dull, opaque with loss of light reflex

X-ray mastoid: Shows clouding of air cells. (not diagnostic)

Impedance audiometry is an accurate way of diagnosing serous otitis media. It shows type B tympanogram which is diagnostic of fluid in ear.


Q. 6

Lady has B/L hearing loss since 4 years which worsened during pregnancy.Type of impedance audiometry graph will be:

 A

Ad

 B

As

 C

B

 D

C

Q. 6

Lady has B/L hearing loss since 4 years which worsened during pregnancy.Type of impedance audiometry graph will be:

 A

Ad

 B

As

 C

B

 D

C

Ans. B

Explanation:

Q. 7

A 31 year old female patient complains of bilateral impairment of hearing for the 5 year. On examination, tympanic membrane is normal and audiogram shows a bilateral conductive deafness. Impedance audiometry shows As type of curve and acoustic reflexes are absent. All constitute part of treatment, except:

 A

Hearing aid

 B

Stapedectomy

 C

Sodium fluoride

 D

Gentamicin

Q. 7

A 31 year old female patient complains of bilateral impairment of hearing for the 5 year. On examination, tympanic membrane is normal and audiogram shows a bilateral conductive deafness. Impedance audiometry shows As type of curve and acoustic reflexes are absent. All constitute part of treatment, except:

 A

Hearing aid

 B

Stapedectomy

 C

Sodium fluoride

 D

Gentamicin

Ans. D

Explanation:

 

Gentamicin is used to treat Meniere’s disease.



Q. 8

Impedance denotes:

 A

Site of perforation

 B

Disease of cochlea

 C

Ds. of ossicles

 D

Higher function disorder

Q. 8

Impedance denotes:

 A

Site of perforation

 B

Disease of cochlea

 C

Ds. of ossicles

 D

Higher function disorder

Ans. C

Explanation:

 

Impenance audiometry, measures the resistance of tympanic membrane and middle ear and also compliance of tympanic membrane and ossicular chain to sound pressure transmission.

Tympanogram is the graphic representation of compliance and impendance of tympanic osscular system with air pressure changes.

 



Q. 9

A 70-year-old male presents with Neck nodes. Examination reveals a Dull Tympanic Membrance, deaf­ness and tinnitus and on evaluation Audiometry gives Curve B. The most probable diagnosis is:

 A

Nasopharyngeal carcinoma

 B

Fluid in middle ear

 C

Tumor in interior ear

 D

Sensorineuronal hearing loss

Q. 9

A 70-year-old male presents with Neck nodes. Examination reveals a Dull Tympanic Membrance, deaf­ness and tinnitus and on evaluation Audiometry gives Curve B. The most probable diagnosis is:

 A

Nasopharyngeal carcinoma

 B

Fluid in middle ear

 C

Tumor in interior ear

 D

Sensorineuronal hearing loss

Ans. A

Explanation:

 

 

 



Q. 10

A 35 years old pregnant female complaining of hearing loss, which aggravated during pregnancy, was sent for tympanometry. Which of the following graph will be seen?

 A

As

 B

Ad

 C

B

 D

C

Q. 10

A 35 years old pregnant female complaining of hearing loss, which aggravated during pregnancy, was sent for tympanometry. Which of the following graph will be seen?

 A

As

 B

Ad

 C

B

 D

C

Ans. A

Explanation:

 

A 35 years old pregnant female complained of hearing loss, which was aggravated during pregnancy. This patient is most probably suffering from otosclerosis, which is more common in females and aggravated during pregnancy. Type As tympanogram is seen in otosclerosis



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