ARCHETYPE Tympanogram Result (openEHR-EHR-OBSERVATION.tympanogram.v1)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.tympanogram.v1
ConceptTympanogram Result
DescriptionRecord of measurements of movement at the tympanic membrane in response to changes in air pressure in the ear canal and their clinical interpretation as an indication of middle ear function.
UseUse to record movement of the tympanic membrane in response to various levels of air pressure, for a single ear at a time. Use to record the interpretation all measurements to infer middle ear function for each ear, plus an overall interpretation (or tympanometric diagnosis). All of the data elements are recorded using a single method or protocol. If, during the test, any of the protocol parameters need to be modified, then the subsequent part of the test will need to be recorded within a separate instance of the test data, using the updated protocol parameters.
MisuseNot to be used to record other hearing tests. Use other archetypes as appropriate, for example OBSERVATION.audiogram.
PurposeTo record measurements of movement at the tympanic membrane in response to changes in air pressure in the ear canal and to infer middle ear function.
References
Copyright© openEHR Foundation
AuthorsAuthor name:
Other Details LanguageAuthor name:
Other Details (Language Independent)
  • MD5-CAM-1.0.1: AF92F2119AD9A60B21F6BC374DB04F15
Keywordstympanogram, tympanometer, admittance, pressure, compliance, immittance, static, tympanometry
LifecycleCommitteeDraft
Language useden
Citeable Identifier1013.1.73
events
BaselineBaseline: *
Post ValsalvaPost Valsalva: Measurments are recorded after the patient does a valsalva manoevre
Post ToynbeePost Toynbee: Measurments are recorded after the patient does a toynbee manouvre
Any eventAny event: *
protocol
Pre-test Calibration Cavity SizePre-test Calibration Cavity Size: A cavity with a known volume used to check the calibration of the tympanometer
Property: Volume
Units: 0.5..5.0 cc
Limit decimal places: 1
Assumed value: 1.0cc
Limit decimal places: 1
Probe Tone FrequencyProbe Tone Frequency: The frequency of the tone emitted by the probe inserted into the test ear
Property: Frequency
Units: Hz
Assumed value: 226.0Hz
Limit decimal places: -1
Direction of Pressure ChangeDirection of Pressure Change: The change of pressure in the ear canal which can be either ascending or descending
  • Descending [The pressure changes from positive to negative.]
  • Ascending [The pressure changes from negative to positive.]
Rate of Pressure ChangeRate of Pressure Change: The rate of change of pressure used in tympanometry
Property: Flow rate, volume
Units: ml/s
AdmittanceAdmittance: Acoustic admittance is the reciprocal of impedance
  • Ambient or Peak [The option of calculating static immittance at ambient or at peak pressure]
  • Static or Compensated [Peak compensated static immittance is the measure obtained with ear canal pressure adjusted to produce a peak in the measured immittance]
Pressure RangePressure Range: *
Start PressureStart Pressure: *
Stop PressureStop Pressure: *
Property: Pressure
Units:
  • -600.0..-200.0 daPa
  • -600.0..-200.0 mm[H20]

Assumed value: -200.0mm[H20]
Limit decimal places: -1
TympanometerTympanometer: A device that performs tympanometry
Include:
openEHR-EHR-CLUSTER.device.v1 and specialisations
data
TestTest: The tympanogram test result which can be recorded per ear .
Test EarTest Ear: Identification of the ear being tested.
  • Left Ear [The left ear was tested in isolation.]
  • Right Ear [The right ear was tested in isolation.]
MeasurementsMeasurements: Values of middle ear function
Pressure vs Compliance MeasurementPressure vs Compliance Measurement: The measured pressure/compliance pair.
Multiple instances of this measurement will form the basis for the graphical display of the tympanogram.
Peak PressurePeak Pressure: Peak pressure (also called middle ear pressure or MEP) is the ear canal pressure at which the peak of the tympanogram occurs (Margolis & Hunter, 2000).
Also known as Middle Ear Pressure (MEP). It is plotted on the horizontal axis on a tympanogram.
Property: Pressure
Units:
  • mm[H20]
  • -600.0..400.0 daPa
Static ComplianceStatic Compliance: Static compliance (SC) “is the greatest amount of acoustic energy absorbed by the middle ear system (the vertical peak of the tympanic tracing)” (Onusko, 2004, p. 1716).
Also known as 'Static Admittance'. It is plotted on the verical axis of a tympanogram.
Property: Volume
Units:
  • cc
  • 0.0..5.0 ml
Ear Canal VolumeEar Canal Volume: An estimate of the volume of air between the probe tip and the tympanic membrane if the tympanic membrane is intact, or the volume of the ear canal and the middle ear space if the tympanic membrane is perforated. (Fowler & Shanks, 2002, p. 180).
Property: Volume
Units:
  • 0.0..5.0 cc
  • ml
Tympanometric WidthTympanometric Width: The pressure interval corresponding to a 50% reduction in the peak static admittance.
This value is typically derived from the Tympanogram curve.
Property: Pressure
Units: 0.0..400.0 daPa
Tympanometric GradientTympanometric Gradient: Tympanometric gradient is an objective measure that describes the steepness of the slope of the tympanogram near the peak (Fowler & Shanks, 2002, p.182).
This value is typically derived from the Tympanogram curve.
Property: Electrical conductance
Units: mmho
No Test ResultNo Test Result: No test result is available for the test ear.
Record as True if the clinician was unable to record a result for the test ear.
Allowed values: {true}
Reason for No Test ResultReason for No Test Result: Reason why no result is available for the test ear.
For example, patient was not co-operative; patient was not capable; ran out of time; no seal; presence of tympanic membrane perforation, impacted wax or discharge.
Tympanogram TypeTympanogram Type: Classification of tympanogram curve using Jerger categories.
  • Type A [A distinctive sharp peak, around atmospheric pressure (between +50 to -99 daPa), static compliance = 0.3 to 1.6cc (adults) or 0.2 to 0.9cc (children 3 – 5yrs), and normal ear canal volume]
  • Type B [Rounded line/no measurable peak pressure, reduced static compliance (<2cc), ear canal volume within normal range]
  • Type C [As for Type A but Peak Pressure less than -99 daPa i.e., a significant negative middle ear pressure]
  • Type As [As for Type A but with reduced static compliance (< 0.3cc)]
  • Type Ad [As for Type A but with increased static compliance (>1.6cc)]
  • Indeterminate [It is not possible to determine the exact type of middle ear function.]
Clinical InterpretationClinical Interpretation: Clinical interpretation of all measurements for the test ear.
Overall InterpretationOverall Interpretation: Overall clinical interpretation of the measurements and related findings using an tympanometer.
Coding with a terminology is preferred, where possible. This data element is effectively an audiological diagnosis.
Test Result ImageTest Result Image: Digital representation of the entire result.
image/cgm, image/gif, image/png, image/tiff, image/jpeg
CommentComment: Additional narrative about the test results and intepretation not captured in other fields.
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