Impedance hearing and admittance hearing refer to two related but opposite ways of describing how the ear interacts with sound, particularly in the context of **middle ear testing** or **tympanometry**. These terms are primarily used to evaluate the functioning of the middle ear system, including the tympanic membrane (eardrum), ossicles (middle ear bones), and eustachian tube.
Let’s break down the two concepts:
### 1. **Impedance Hearing (Acoustic Impedance)**
- **Impedance** is a measure of how much the middle ear system **resists the flow of sound energy**.
- It’s a complex quantity, meaning it has both a **magnitude** (how much resistance) and a **phase** (the timing relationship between the pressure and motion).
- **Impedance (Z)** has two components:
- **Resistance (R)**: This is the part of impedance that corresponds to the frictional forces in the ear (e.g., from the ligaments of the ossicles).
- **Reactance (X)**: This is the part of impedance that involves storage and release of energy in the middle ear system. Reactance comes in two forms:
- **Mass reactance** (from the inertia of the ossicles)
- **Stiffness reactance** (from the stiffness of the tympanic membrane and other structures).
- **Higher impedance** means that more sound energy is reflected back, and less energy is transmitted through the middle ear.
- Impedance tests focus on how much **resistance** the middle ear system offers when sound is presented, indicating possible issues like **fluid in the middle ear**, **ossicular chain dysfunction**, or **tympanic membrane abnormalities**.
### 2. **Admittance Hearing (Acoustic Admittance)**
- **Admittance** is the reciprocal of impedance. Instead of measuring resistance, it measures how **easily sound energy flows through** the middle ear system.
- The concept of **admittance (Y)** is defined as the inverse of impedance:
- **Y = 1/Z**
- **Admittance** also has two components:
- **Conductance (G)**: The inverse of resistance, measuring how much of the sound energy is allowed to pass through the ear.
- **Susceptance (B)**: The inverse of reactance, representing how the ear system stores and releases sound energy.
- **Higher admittance** means that more sound energy passes through the middle ear with less being reflected.
- Admittance testing focuses on how well the ear admits or **accepts sound energy**, giving insight into the mobility of the middle ear system. Too much admittance could suggest issues like a **dislocated ossicular chain** or a **perforated eardrum**, while too little could indicate stiffness due to conditions like **otosclerosis** (abnormal bone growth in the middle ear).
### Key Differences:
- **Impedance** refers to how much the ear resists sound, while **admittance** refers to how easily sound passes through.
- **Impedance** measures the resistance to energy flow, whereas **admittance** measures the ease of energy flow.
- Both are used in tympanometry but offer opposite perspectives on middle ear function. Impedance is higher when the ear is stiff (e.g., fluid in the ear), and admittance is higher when the ear system is too loose (e.g., ossicular dislocation).
### Tympanometry: Using Both
- In practice, both impedance and admittance measurements are used in **tympanometry**, a common clinical test to assess middle ear function.
- Tympanometry measures how the eardrum moves in response to changes in air pressure in the ear canal and sound stimuli.
- **Clinicians interpret impedance or admittance curves** to diagnose various middle ear disorders like:
- **Middle ear effusion** (fluid in the middle ear)
- **Eustachian tube dysfunction**
- **Ossicular chain problems**
In summary, impedance hearing emphasizes the **resistance** or opposition to sound energy, while admittance hearing emphasizes the **ease** or acceptance of sound energy. Both concepts are vital for understanding the middle ear’s role in hearing and are used complementarily in diagnostic hearing tests.