Tympanogram and Audiogram


An audiogram represents an individual’s hearing ability by frequency (pitch) and intensity (volume). The softest sounds that a person can hear at a particular frequency is called their hearing threshold. This is usually represented by markings on their graph; red represents the right ear and blue represents the left.

Hearing within normal limits.

Bilateral moderate conductive hearing loss – this loss would warrant further medical investigation.

Bilateral mild to moderately severe sensorineural hearing loss – this person would benefit from hearing aids.

Bilateral moderate to profound sensorineural hearing loss – this client would most likely be a Cochlear implant candidate.

Note: It should be remembered that the audiogram quantitatively measures hearing; it doesn’t measure the client’s perceived quality of the sound.


Tympanometry is a test of middle ear functioning. It looks at the flexibility (compliance) of the eardrum to changing air pressures, indicating how effectively sound is transmitted into the middle ear. This objective test also allows us to view the functioning of the Eustachian Tube, the upper auditory pathways and the reflex contraction from the middle ear muscles. Impedance testing is crucial in distinguishing a conductive loss from a sensorineural hearing loss. A typical tympanometry result indicates the ear canal volume (cm3), the max pressure (daPa) and the peak compliance (ml).


  • Suggests normal middle ear functioning
  • Peak is between +/- 100 daPa
  • Compliance from 0.3-1.5 ml


  • Suggests a highly compliant middle ear system
  • Peak is between +/- 100 daPa
  • Compliance is more than 1.5 ml


  • Suggests a less compliant middle ear system
  • Peak is between +/- 100 daPa
  • Compliance is less than 0.3 ml


  • Suggests middle ear involvement from fluid (middle ear effusion)
  • There is no identifiable peak
  • Ear canal volume is normal


  • Suggests middle ear involvement from a perforation or patent grommet
  • There is no identifiable peak
  • Equivalent ear canal volume exceeds normal limits; much larger than 1.5cm3


  • Suggests Eustachian Tube dysfunction (often seen just before or after effusion)
  • Peak is below – 100 daPa
  • Compliance from 0.3-1.5 ml


Ohio Administrative Code 4747-1-19 (H)

(H) Medical referral:
A licensee should advise a prospective hearing aid user to consult promptly with a licensed physician (preferably an ear specialist) before dispensing a hearing aid to the perspective hearing aid user, and promptly document the fact that such a referral was made in the individual’s case record, if it is determined through documented case history, actual observation, or review of any other available information concerning the prospective user, that any of the following conditions exist:
(1) Visible congenital or traumatic deformity of the ear.
(2) Visible evidence of cerumen accumulation or a foreign body in the ear canal.
(3) History of active drainage from the ear within the previous ninety days.
(4) Acute or chronic dizziness.
(5) Unilateral hearing loss of sudden or recent onset within the previous ninety days.
(6) History of sudden or rapidly progressive hearing loss within the previous ninety days.
(7) Pain or discomfort in the ear.
(8) Audiometric air-bone gap equal to or greater than fifteen decibels at five hundred, one thousand, and two thousand Hertz.
(I) Except as noted in paragraph (J) of this rule, a licensee shall not sell a hearing aid unless the prospective user has presented to the licensee a written statement signed by a licensed physician that states the patient’s hearing loss has been medically evaluated and the patient may be considered a candidate for a hearing aid. The medical evaluation must have taken place within the preceding six months.
(J) An exception to medical referral can be made only if the prospective hearing aid user is eighteen years of age or older and following viewing of the ear canals, taking a case history and completing appropriate testing. The licensee may, in such cases, afford the prospective user an opportunity to waive the medical evaluation provided that the licensee:
(1) Informs the prospective user that the exercise of the waiver is not in the user’s best health interest;
(2) Does not in any way actively encourage the prospective user to waive such medical evaluation

Patient Reviews

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4.8 out of 5 Stars based on 143 Reviews on Google.

Read what some of our patients have to say about our staff and our office!

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Jeannie Waddell, on Google

Derek goes out of his way at the Lancaster office to provide top quality care and advice related to your hearing needs. He really helps you to feel comfortable and at ease when selecting a quality hearing aid. He is prompt with any questions you may have and provides top...

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Debra Scarberry, on Google

Found Echo-Norvell by chance, and so happy we did. I talked with Derek a couple times on the phone. Told him our situation and previous experience the week prior. Derk was very kind and respectful with my mom and I. The visit was quick and easy. Thank you Derk for...

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Barb Stevison, on Google

I got hearing aids from Derek last year. I was having some issues recently with the app & 1 of my hearing aids. Derek explained the app & how to fix & the difference in ears & adjusted my aids accordingly. He has the best personality & cares about his...

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anita Smith, on Google

The hearing test was very well done. I got an accurate reading for my hearing loss. The selection of a hearing aid was easy. No pressure. Everything explained. Very happy with the service I got.

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Michael McDevitt, on Google

Amazing service !! Hearing aides are wonderful!!

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Dianna Lynn, on Google

My representative Derek always takes care of everything fast.

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Shannon Yoders, on Google

Awesome experience ☺️

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Kenya Walker, on Google

Derek was great to work with. He was very knowledgeable and took his time to make we understood all our options. Would highly recommend him and his company!

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Steve, on Google

I was very happy and satisfied with all my interactions with Dr. Norvell, I'm excited to be able to hear. He was kind and patient and answered all my questions and concerns. Thank you for my family, who have had to repeat themselves for many years. When I got home...

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Deb Jones, on Google

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Angela Mash, on Google

Very pleased

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Roger Morgan, on Google

Very friendly, little to no wait, procedures explained and easily understood, nice atmosphere. Suggestion: I found it better to close my eyes during the headset test so I wouldn’t anticipate the sound if I watched the keyboard being pushed.

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Deborah Music, on Google

My mom recently got hearing aids and I would recommend this place to anyone looking. The are very knowledgeable and even more helpful than my expectations. Keep up the good work!

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Tricia Tilley, on Google

Every good. And warm setting made me feel comfortable had good visit.

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Kathi Hurst, on Google

Derek is great Very helpful

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Jack Davidson, on Google

Very pleasant visit. Derek was very attentive and informative!

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Juile Duncan, on Google

Always friendly and Very Professional would definitely recommend to everyone looking for hearing aids and LOVE there waiting area one of the best I have ever seen

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Jerry “JAX71” Kidder, on Google

Very good people. Explain everything. Very comfortable

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Doug McCanna, on Google

Very patient and caring!! No high pressure sales or gimmicks.

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Brenda Wooten, on Google

Really nice people working there they answered all my questions give me a fair price I will go back

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M Marcum, on Google

Very Professional & Informative. All questions answered with accurate evaluation of the degree of my hearing loss.

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