Are Tympanometry and Acoustic Reflex Test the Same Thing?

[Stacken77]

Hi all,

Today, I had a Tympanometry test as it was required by my ENT. I had put it off before because I had read some bad experiences on Tinnitus Talk, but I decided to go through with it.

From reading about the Acoustic reflex on Wikipedia;

Acoustic reflex
[...]Most of the time, the stapedius reflex is tested with tympanometry.

What is your experience with the Acoustic Reflex Test, how does it sound?

In my case, a continuous 200 Hz tone played in my ears for a few seconds along with the air pressure. The tone was not "loud" (I have bad hyperacusis) but it was not completely comfortable either. Did I have the Acoustic Reflex Test or not?

As of writing this 6 hours later, I have not experienced any new levels or tones in my tinnitus, but I am quite scared of potential worsening in the coming days.

All the best,
Stacken

 

[Kriszti]

No, they are not the same, but I think they often carried out with the same device.

Tympanometry measures the state of your eardrum and the pressure in your middle ear and how your eardrum reacts to pressure changes, Acoustic Reflex Test examines the reaction of the stapedial reflex to loud noises.

I was given the two tests with the same device, but my stapedial reflex was tested by emitting 500, 1000, 2000, 4000 Hz quite loudly into my ear. It was not very uncomfortable at the time, but back then I only had the unilateral low hum in my left ear.

I don't think you had Acoustic Reflex Test, try not to worry about it, because focusing on the potential spikes can be quite detrimental to your mental state. I do that too, it's hard to avoid, but hopefully you are gonna be alright. More people are than not.

Did you get the test results? At the time I did not even know what I was tested for, nobody disclosed that info for me, but on the paper I got, I can find the tympano and the reflex test result.

(Actually, 1 week later, the bilateral ultra high freq sound joined the party and I can not rule out that Acoustic Reflex Test was the last straw that broke the camel's back, but I do have history of earbud use, I hadn't been sleeping at all for about a week by the time I had the tests, they actually did loudness discomfort test as well, I was out of my mind anxious, and I used neomycin topical ointment as well, and high dosage of Piracetam and Betahistine. Maybe all of this contributed to develop the bilateral tinnitus as well.)

 

[Stacken77]

I don't think you had Acoustic Reflex Test, try not to worry about it

Thank you so much Kriszti, I'll try to calm down and hopefully we won't see spike, temporary or permanent.

Did you get the test results?

I did not get the results with me home, but from what I understand my tympanometry test was completely fine, no abnormalities at all.

 

[Stacken77]

Just to update 2 days later.

No significant increase from the Tympanometry alone, and I have really bad hyperacusis with extreme reactive tinnitus.

Tympanometry seems safe, if done without the Acoustic Reflex Test, so be very vigilant if you intend to get the test.

All the best,
Stacken

 

[kingsfan]

I had several Tympanometry tests done when my tinnitus first spiked, and they had no ill effect on me.

A month later I had an Acoustic Reflex Test and it was loud. Messed me up. Gave me the nastiest, loudest new tone. I would advise never getting this test. I would probably be habituated and getting on with my life had it not been for this test.

 

[Wrfortiscue]

A month later I had an Acoustic Reflex Test and it was loud. Messed me up. Gave me the nastiest, loudest new tone. I would advise never getting this test. I would probably be habituated and getting on with my life had it not been for this test.

Was the worsening permanent? How long has it been?

 

[kingsfan]

Was the worsening permanent? How long has it been?

Yes, permanent. It's been 7 months.

 

[Wrfortiscue]

Yes, permanent. It's been 7 months.

Wtf

 

[Wrfortiscue]

Yes, permanent. It's been 7 months.

Has your vaccine-induced tinnitus at least improved? I feel like mine has, although part of me is thinking this up and down mess just may be the tinnitus type itself... volume slowly going down at times.

 

[kingsfan]

Wtf

It's a really loud test. I asked the technician if it was safe being that loud. What do you think he said? So naive in my tinnitus youth.

It's really hard to remember, but I think it amplified the tone I had already had for years but could only hear in the dead silence of night or with earplugs in — but it was still barely audible and very distant sounding.

It makes me wonder if all the other hissing and squealing sounds I have are from medication rather than noise, and that one tone that was amplified was built on from past noise exposure.

Not sure how, from that test, my tinnitus could have increased in only one lower frequency (4 kHz) tone and just one ear without raising all the hissing and higher frequency stuff I have in both ears.

 

[Wrfortiscue]

It's a really loud test. I asked the technician if it was safe being that loud. What do you think he said? So naive in my tinnitus youth.

It's really hard to remember, but I think it amplified the tone I had already had for years but could only hear in the dead silence of night or with earplugs in — but it was still barely audible and very distant sounding.

It makes me wonder if all the other hissing and squealing sounds I have are from medication rather than noise, and that one tone that was amplified was built on from past noise exposure.

Not sure how, from that test, my tinnitus could have increased in only one lower frequency (4 kHz) tone and just one ear without raising all the hissing and higher frequency stuff I have in both ears.

I think I'm suffering from similar tinnitus as you. Right now the high pitched drill or electric noise is spiking but overall past two days were good.

Sucks bad though. Gut wrenching.

 

[Kriszti]

It's a really loud test. I asked the technician if it was safe being that loud. What do you think he said? So naive in my tinnitus youth.

This is criminal. I don't understand how experts in this field cannot grasp that maybe, just maybe giving patients with tinnitus loud tests and microsuction is not the best idea. I am not sure how ART and LDL test contributed to the emergence of my bilateral tinitus, because there was a week in between the audiology appointment and the onset. I had unilateral tinnitus, I went for testing because of that and it was so incredible loud that I may not have noticed the other sound, but 2 day later the low hum went away, bilateral hell begun.

Funny, that the results of the stapedial test according to one audiologist are alright, an other one said that I don't have stapedial reflex on the left side, but when I asked what does it mean, she said it's not important (?!). Ok, but then why test it?

 

[Juan]

What is your experience with the Acoustic Reflex Test, how does it sound?

A tympanometry is just a beep (if you have hyperacusis it sounds kind of loud) on your ears, or pressure (without loud sound) delivered to your ears. This is usually an OK test even for people with hyperacusis or tinnitus.

An acoustic reflex test is carried out with the same tool used to do a tympanometry, and there are beeps that increase in loudness or a single beep that increases in loudness, usually up to 100 dB, until the accoustic reflex is triggered, so this is a dangerous test for people with hyperacusis and tinnitus.

 

[Kriszti]

Is here anyone who got diagnostically significant results/findings regarding tinnitus from Acoustic Reflex Test or Loudness Discomfort Level Test?

 

[Jon R.]

So many tests to avoid. I am seeing an ENT sometime in the near future. What should I avoid?

1. LDL (Loudness Discomfort Level)
2. ART (Acoustic Reflex Test)
3. Tympanometry

Is the Tympanometry test okay without the noises --- only with the air?

 

[Stacken77]

So many tests to avoid. I am seeing an ENT sometime in the near future. What should I avoid?

1. LDL (Loudness Discomfort Level)
2. ART (Acoustic Reflex Test)
3. Tympanometry

You should definitely avoid LDL and ART, the anecdotes, hence the risk, is too great to do those.

I did Tympanometry, and while my state didn't worsen significantly, I'd never ever do it again as I found the test to be a bit uncomfortable for me, although it was quick.

Is the Tympanometry test okay without the noises --- only with the air?

A simple Tympanometry test features 2 parts; the air pressure, and the carrier sound wave which is around 200 Hz (pretty low frequency). This alone should be fine, especially if you don't spike to trivial noises or have severe hyperacusis.

Keep the following in mind though, because it's very important; if you intend on getting a Tympanometry test, make sure that it is not combined with an ART. It seems like in some countries Tympanometry tests and ART is carried out through the same device, so some people on the forum sadly was exposed to an ART while the ENT said it was a Tympanometry test.

I did my test in Sweden, and it seems the devices here does not have ART combined with Tympanometry, probably the reason why I was pretty alright after the test.

 

[kingsfan]

So many tests to avoid. I am seeing an ENT sometime in the near future. What should I avoid?

1. LDL (Loudness Discomfort Level)
2. ART (Acoustic Reflex Test)
3. Tympanometry

Is the Tympanometry test okay without the noises --- only with the air?

Tympanometry test is up in the air. I'd had it done multiple times and it didn't make anything worse. It just felt like a gust of air inside my ears. However, I have declined it since the Acoustic Reflex Test incident.

 

[kingsfan]

Adding a new one to the list to avoid: Otoacoustic Emissions Test.

 

[Stacken77]

Adding a new one to the list to avoid: Otoacoustic Emissions Test.

I've heard of people being hurt by OAE. Did you have it recently?

 

[kingsfan]

I've heard of people being hurt by OAE. Did you have it recently?

Yea a couple weeks ago. Was told it was a quiet test.

 

[Hottopic29]

I just had the test where they play loud sound in one ear and check the reflex on the other side.

My ears are more buzzy now and echoing. I hope it's temporary.

 

[kingsfan]

I just had the test where they play loud sound in one ear and check the reflex on the other side.

My ears are more buzzy now and echoing. I hope it's temporary.

I'm sorry I didn't see this sooner. I only come around here every so often to check on research updates.

The only advice I can give is to try supplements. There's research that suggests that a combination of Vitamins A, C, and E paired with Magnesium can help clear up free radicals from acoustic trauma. Also NAC has been shown to do the same.

So a combination of A, C, E, Magnesium and high dose NAC may help you.

 

[Nemoriri]

I did my test in Sweden, and it seems the devices here does not have ART combined with Tympanometry, probably the reason why I was pretty alright after the test.

As an audiologist in Sweden, I'll say that no, the devices are usually made for being able to perform both tests. However ART is a rarely performed test in regular audiology clinics here, my clinic never does it, it's more common in deeper diagnostics. And tympanometry is not very loud, I can also handle it. It is a very good and informative test. I have never heard a complaint from a patient on it.

ART can be quite a bit louder, but definitely not levels that would damage your hearing/hair cells. But it can certainly be uncomfortable. And the audiologist, if doing their job right, should inform the patient to signal if they find it uncomfortable and want to abort. You definitely don't have to do any tests you don't want to.

 

[Stacken77]

As an audiologist in Sweden, I'll say that no, the devices are usually made for being able to perform both tests. However ART is a rarely performed test in regular audiology clinics here, my clinic never does it, it's more common in deeper diagnostics.

Thank you for the clarification, appreciate it!

ART can be quite a bit louder, but definitely not levels that would damage your hearing/hair cells.

But undoubtedly loud enough to cause permanent worsening in tinnitus and hyperacusis, especially if some degree of hyperacusis is present. Additionally, I personally don't think we can be so sure about which levels and durations that are damaging to the inner ear. I for one damaged my hearing and developed tinnitus due to sound exposure within the safety limit - I think one can pre-fatigue their ears from years of abuse, while some genetics also may be at play.

You definitely don't have to do any tests you don't want to.

It isn't easy for newbies to know which tests they should or shouldn't do. Some on here have been exposed to ART's without explanation, and even if they could request to cancel the test upon discomfort, that very discomfort could have been one exposure too much.

 

[Nemoriri]

But undoubtedly loud enough to cause permanent worsening in tinnitus and hyperacusis

I said hearing loss because that's more certain, that no, your actual hearing should not be damaged by a few seconds of at most 95 dB, even if your ears are more sensitive, (and I consider my own ears feeling more sensitive than normal ears), but still despite that, no, a few seconds of 95 dB should not damage your actual hearing. I did not say anything about effect on tinnitus however because that's a different story, everyone's completely different and it's just less known about.

Speaking of hyperacusis I've seen people on here being worried about taking showers because it makes them spike (really time to see a professional), and those people are most likely overprotecting. Even if you get a spike from a moderate sound it definitely does not equal that you damaged your hearing.

You're indeed right that it's difficult for newbies to know which tests are important, but the audiologist should definitely explain the reason for the test, if they're doing their job well.

 

[Stacken77]

Speaking of hyperacusis I've seen people on here being worried about taking showers because it makes them spike (really time to see a professional), and those people are most likely overprotecting. Even if you get a spike from a moderate sound it definitely does not equal that you damaged your hearing.

Yeah, definitely agree with this. I've screwed over my tolerance to sound through 24/7 protection. I spike to 20 dB sound.

 

[kingsfan]

I said hearing loss because that's more certain, that no, your actual hearing should not be damaged by a few seconds of at most 95 dB, even if your ears are more sensitive, (and I consider my own ears feeling more sensitive than normal ears), but still despite that, no, a few seconds of 95 dB should not damage your actual hearing. I did not say anything about effect on tinnitus however because that's a different story, everyone's completely different and it's just less known about.

Speaking of hyperacusis I've seen people on here being worried about taking showers because it makes them spike (really time to see a professional), and those people are most likely overprotecting. Even if you get a spike from a moderate sound it definitely does not equal that you damaged your hearing.

You're indeed right that it's difficult for newbies to know which tests are important, but the audiologist should definitely explain the reason for the test, if they're doing their job well.

My test was ordered by my ENT and given by the audiologist's tech or assistant or something. They ran through each test very quickly, I did not even have time to think about what was going on. I only saw the audiologist in his office afterwards where he went on about his tinnitus and how he only heard it if he focused on it. I originally went for the exam because I wanted an extended high-frequency audiogram. I was already doing good with my tinnitus - could even wear earplugs without it bothering me. I've been struggling every day since that exam 2.5 years ago.