Tympanic membrane mobility assessed with pneumatic otoscopy or tympanometry (OME)
CPT4 code
Name of the Procedure:
Tympanic membrane mobility assessed with pneumatic otoscopy or tympanometry (OME).
Summary
Tympanic membrane mobility assessment is a diagnostic procedure to evaluate the movement of the eardrum (tympanic membrane) in response to changes in air pressure. This can be done using either pneumatic otoscopy or tympanometry.
Purpose
This procedure is used to identify fluid in the middle ear, commonly known as Otitis Media with Effusion (OME), or other conditions affecting ear health. The main goal is to diagnose middle ear dysfunction, which can cause hearing problems, discomfort, or recurrent ear infections.
Indications
- Persistent ear infections
- Hearing loss or changes in hearing
- Ear fullness or pressure
- Balance problems
- Children with speech delay or learning difficulties that may be related to hearing issues
Preparation
For most patients, no special preparation is needed. It’s important to keep the ear canals clean and clear of earwax. Inform your healthcare provider about any recent ear infections or surgeries.
Procedure Description
Pneumatic Otoscopy:
- The healthcare provider uses an otoscope, a handheld device with a light and magnifying lens.
- A small, soft rubber bulb attached to the otoscope gently puffs air into the ear canal.
- The provider observes the eardrum’s response to the air pressure changes.
Tympanometry:
- A small probe is placed snugly in the ear canal.
- The probe emits sounds and changes air pressure within the canal.
- The device measures the eardrum’s movement and produces a tympanogram, a graphical representation of the findings.
No anesthesia or sedation is required for either method.
Duration
The assessment typically takes about 5-10 minutes per ear.
Setting
This procedure is performed in a doctor’s office, outpatient clinic, or audiologist’s office.
Personnel
- Primary care physician or pediatrician
- Otolaryngologist (ENT specialist)
- Audiologist
Risks and Complications
- Minimal risk, as the procedures are non-invasive.
- Rarely, discomfort or minor ear canal irritation due to the probe or otoscope.
Benefits
- Accurate diagnosis of middle ear conditions
- Helps guide treatment decisions, potentially preventing further ear damage or hearing loss
- Quick and non-invasive
Recovery
There is no recovery time needed. Patients can resume normal activities immediately after the procedure.
Alternatives
- Pure tone audiometry: Measures hearing sensitivity.
- Acoustic reflectometry: Uses sound waves to evaluate the middle ear.
- Visual examination: Less precise but can sometimes identify problems without air pressure.
Each alternative has its pros and cons regarding precision and invasiveness compared to tympanic membrane mobility assessment.
Patient Experience
- During pneumatic otoscopy, you might feel a mild puff of air.
- Tympanometry can cause a sensation of fullness or mild pressure changes.
- Both procedures are usually comfortable and safe, and any discomfort is brief and minimal.
Pain management is typically unnecessary, and measures such as instructing the patient to remain still can enhance comfort during the procedure.