An introduction to wideband tympanometry (WBT)

Wideband tympanometry (WBT) is an emerging hearing test that is available on the Titan tympanometer, but still lacks adoption.

With this resource, we hope to provide some clarity on the test and how it can benefit you and your patients.

We’ll cover the following:

• What is wideband tympanometry?
• Benefits with wideband tympanometry
• How to interpret your test results
• Case studies on results interpretation

What is wideband tympanometry?

Wideband tympanometry, also known as wideband acoustic immittance (WAI), is a branch of tympanometry that repeats a click stimulus very quickly to test the frequency range of 226 Hz to 8000 Hz.

This has clear diagnostic benefits, such as an improved ability to identify otitis media, otosclerosis, and other middle ear infections.

“The wideband tympanometry feature has proven to be clinically beneficial in our busy ENT setting. We have found that the wideband-averaged tympanograms produce a more consistent and clearer picture of the related pathology. Once the physicians understood the concept, they have come to rely on the wideband-averaged tympanograms – especially when the conventional 226 Hz tympanograms are questionable.” - Jon Schee, Audiologist, Minneapolis, US.

4 benefits with wideband tympanometry

Truth be told there are many benefits with wideband tympanometry, also evident by the case studies below.

But here are four of the main benefits.

1. Only one recording is needed

By repeating the click stimulus across the whole frequency range, you get over 100 tympanograms in a single sweep, which are produced at the same time it would take to generate a single tympanogram.

2. Stable and robust recordings

You get clear results with wideband-averaged tympanograms. The benefit of taking an average is not only that you include information for many frequencies, but also the fact that the measurement is less sensitive to noise or patient movement.

3. Know your type C tympanogram

With wideband tympanometry, it is easy to establish if otitis media with effusion (OME) is present in the middle ear.

4. See through pressure equalization (PE) tubes

Applying wideband tympanometry, you can examine the middle ear beyond PE tubes.

“Wideband absorbance can provide extra information of middle ear function when tympanometry is inconclusive, which improves the identification of middle ear pathologies.” - Dr. Sree Aithal, Audiologist, Queensland, Australia.

How to interpret your test results

Watch the three short videos below to learn more about how to interpret your wideband tympanometry results.

1. Know your quality indicators

This video tutorial discusses how to inspect and assess the quality of wideband tympanometry results to be confident with interpretation.

2. Know your pathologies

This video tutorial provides an overview of how to analyze wideband tympanometry results to identify different middle ear pathologies.

3. Know your middle ear function

This video tutorial provides guidance on using wideband tympanometry for the purposes of differential diagnosis.

“Wideband absorbance is a valuable clinical tool in difficult-to-test patients such as children with Down’s syndrome.” - Dr. Lisa Hunter, Professor and Scientific Director, University of Cincinnati, US.

Case studies: What do I do with my test results?

This series of videos take you deeper into the benefits of wideband tympanometry and explain how to interpret your test results. Presented by Amanda Goodhew, BSc (Hons) MSc Audiology, and Lillian Nielsen, MSc Technical Audiology.

Otosclerosis

Learn what test results may indicate otosclerosis.

Type C tympanogram and fluid in the middle ear

In this case, the picture changes dramatically once diving into wideband tympanometry.

Ossicular disarticulation and perforated eardrum

OAE would yield a pass in this patient, but wideband tympanometry may suggest separate issues in each ear.

Four-year-old patient with DiGeorge syndrome

A rather interesting and complex case in a difficult-to-test patient.

Bilateral superior semicircular canal dehiscence (SSCD)

In this case, wideband tympanometry helps to identify SSCD in a 66-year-old patient with an extensive case history.

Concerns of hearing deteriorating

This patient has a history of noise exposure and is anxious about her hearing deteriorating. But is anything wrong at all?

About the authors

Shane Seiger-Eatwell is a Master of Linguistics and Communication (cand.ling.merc.), having graduated from Aarhus University in 2018. He joined Interacoustics in January 2019 as a Marketing Communications Specialist.

Lillian B. Nielsen, MSc Technical Audiology, graduated from the University of Southern Denmark in 2013. During her time at Interacoustics, she has been the Clinical Product Manager of ABR/OAE, followed by Audiometry and Impedance, and is currently the Senior Product Manager of Audiometry and Impedance.

Related Interacoustics Academy courses

[1] Wideband Tympanometry for Beginners

[2] Wideband Tympanometry for Intermediates

[3] Getting Started: Wideband Tympanometry in Pediatrics

Related resources

[1] Thais Antonelli Diniz Hein, Stavros Hatzopoulos, Piotr Henryk Skarzynski and Maria Francisca Colella-Santos (March 29, 2017). Wideband Tympanometry, Advances in Clinical Audiology, Stavros Hatzopoulos, IntechOpen, DOI: 10.5772/67155. Available from: https://www.intechopen.com/books/advances-in-clinical-audiology/wideband-tympanometry.

[2] Stuppert L, Nospes S, Bohnert A, Läßig AK, Limberger A, Rader T. Clinical benefit of wideband-tympanometry: a pediatric audiology clinical study. Eur Arch Otorhinolaryngol. 2019 Sep;276(9):2433-2439. doi: 10.1007/s00405-019-05498-2. Epub 2019 Jun 7. PMID: 31175454.

[3] Leigh Martin (March 1, 2019). Multifrequency tympanometry. ENT & AUDIOLOGY NEWS. 2019 Mar/Apr;28(1). Available from: https://www.entandaudiologynews.com/features/audiology-features/post/multifrequency-tympanometry.

[4] Şule Kaya, Betül Çiçek Çınar, Merve Özbal Batuk, Burçe Özgen, Gonca Sennaroğlu, Gülsüm Aydan Genç, Levent Sennaroğlu. Wideband tympanometry findings in inner ear malformations. Auris Nasus Larynx. 2020 Apr;47(2):220-226. ISSN 0385-8146. doi: 10.1016/j.anl.2019.09.001.

[5] Hougaard, D.D., Lyhne, N.M., Skals, R.K. et al. Study on wideband tympanometry and absorbance within a Danish cohort of normal hearing adults. Eur Arch Otorhinolaryngol. 2020 Mar;277:1899-1905. Doi:10.1007/s00405-020-05909-9.