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Clinical impedance audiometry.

This manuscript has attempted to briefly outline the most important areas of clinical impedance audiometry. The author has emphasized the use of impedance audiometry in differentiating different types of middle ear pathology and utilizing the stapedial reflex in the determination of malingering as well as an overall test of the normal function of the auditory nervous system from the inner ear to brain stem. Finally, the use of Eustachian tube function can also be utilized by the trained audiologist in determining whether or not there is Eustachian tube dysfunction. It is important to again emphasize that impedance audiometry is objective and does not involve the cooperation of the patient. Thus in the autistic child and in the child who is uncooperative, it is of particular help to the clinical otologist and audiologist. In patients who are malingering the stapedial reflex may assist in determining a valid response in routine autiometry. Finally, with special types of tests which have not been discussed in this manuscript, such as stapedial reflex decay, one may be able to determine the presence of an early acoustic neurinoma.