Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing
CPT4 code
Name of the Procedure:
Acoustic Immittance Testing
- Commonly includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing.
Summary
Acoustic immittance testing evaluates the function of the middle ear and the reflex pathways of hearing. It involves a series of tests that measure the ear’s response to sound and pressure, including tympanometry and acoustic reflex tests.
Purpose
Acoustic immittance testing is designed to identify middle ear problems, assess hearing loss, and detect issues in the auditory pathway.
Indications
This procedure is indicated for patients experiencing:
- Hearing loss
- Ear pain
- Tinnitus (ringing in the ears)
- Balance problems or dizziness
- Fluid in the ear or recurrent ear infections
Patient factors that make the procedure appropriate include significant changes in hearing and symptoms suggestive of middle ear dysfunction.
Preparation
- No special preparation is generally needed.
- Avoid inserting anything into the ear (e.g., Q-tips) before the test.
- Inform the healthcare provider of any ear infections or injuries.
Procedure Description
- Tympanometry (Impedance Testing):
- A probe is inserted into the ear canal.
- The probe changes air pressure in the ear and produces a pure tone.
- The machine measures how the eardrum responds to these changes.
- Acoustic Reflex Threshold Testing:
- The same probe emits loud sounds.
- The device measures the reflex of the stapedius muscle in response to sound.
- Acoustic Reflex Decay Testing:
- Continuation of acoustic reflex testing.
- Measures the stability of the reflex over time.
Tools include an immittance audiometer. Typically, no anesthesia or sedation is required.
Duration
The entire procedure usually takes about 30 minutes to 1 hour.
Setting
Performed in an audiology clinic, outpatient facility, or hospital setting.
Personnel
- Audiologist or trained healthcare professional.
Risks and Complications
- Minimal risks, primarily discomfort due to the probe or loud sounds.
- Rarely, a slight ear injury if there is existing damage or infection.
Benefits
- Helps diagnose middle ear issues.
- Identifies types and causes of hearing loss.
- Facilitates appropriate treatment planning.
- Benefits are usually realized immediately after the procedure.
Recovery
- No significant recovery period.
- Normal activities can be resumed immediately.
- Follow-up as advised by the healthcare provider, especially if abnormal results are found.
Alternatives
- Pure-tone audiometry: Tests hearing sensitivity but does not evaluate middle ear function.
- Auditory Brainstem Response (ABR) testing.
- Otoacoustic Emissions (OAE) testing. Each alternative has its own pros and cons regarding detectability and specificity of hearing issues.
Patient Experience
- There may be mild discomfort due to pressure changes in the ear canal and loud sounds.
- Most people tolerate the procedure well with minimal discomfort.
- Pain management is generally not needed, but patient comfort is always a priority.