Tympanometry

The Tympanometry element simulates a clinical tympanogram — the trace of middle-ear admittance (compliance) as ear-canal pressure is swept from negative to positive. From that curve a clinician reads the peak admittance, the peak pressure, the tympanometric width (gradient), and the ear-canal volume (ECV), then classifies the result into a Jerger type (A, As, Ad, B, C, or a small/large ear-canal-volume pattern).

In a submission, the learner presses Run to sweep each ear, watches the curve draw in, reads off the measurements shown beneath the chart, and records a tympanogram type for the right and left ears. Theta then compares the learner's classification against the one you designed.

Each element holds both ears (Right and Left), so a single tympanometry element gives the learner a complete bilateral result to interpret.

Design

You design each ear independently. The two charts sit at the top of the editor and update live as you change the fields below them, so you can see exactly what the learner will see.

Choosing a type

The quickest way to build an ear is to pick a Tympanogram type. Selecting a type regenerates realistic peak, pressure, gradient and volume values that match that classification:

The three flat types (B, small ECV, large ECV) have no peak, so the chart shows no peak marker and the peak readouts display NA. They differ only in ear-canal volume, which is what distinguishes, for example, a flat trace with a perforation or patent grommet (large ECV) from one with an occluded probe or impacted canal (small ECV).

The values you set per ear

After choosing a type you can fine-tune any value directly. Each field feeds the curve drawing and the measurement readouts:

If you hand-tune the numbers far enough that the curve no longer reads as the type you chose — dropping the peak admittance below the normal floor while the type still says A, say — the editor warns you under that ear. Leaving it unresolved means learners get marked wrong for reading the trace correctly, so either move the value back or change the type to match.

Artifact (patient movement)

You can add a realistic artifact to either ear to simulate the spike-and-dip noise that patient movement, talking, or swallowing produces on real equipment. Tick Artifact and choose a level:

• Low — a couple of small spikes.
• Medium — several moderate spikes.
• High — many large spikes that noticeably disturb the trace.

Artifacts are layered onto the underlying curve, so the type and peak you designed are still there — the learner just has to read through the noise, as they would in clinic.

Template vs. fixed

Like every Theta element, tympanometry can be fixed or a template.

• Fixed — every learner sees the exact curve and values you entered.
• Template — at submission time Theta generates a fresh tympanogram of the same type within normative ranges, so each learner gets slightly different numbers but the same correct classification. This is ideal for assessment, since the answer can't simply be shared.

When the element is a template, each ear shows a Generate Preview button. Press it to roll a sample tympanogram of that type so you can confirm the generated curves still read as the intended classification; Reset clears the preview.

Settings

The Settings tab holds two independent things: the display scale (the window the curve is drawn in) and the normative ranges (what counts as normal).

Display scale

A chart-wide setting controlling the axes the curve is drawn against. This sets the window, not the values.

The display scale is shared across both ears so the two charts stay directly comparable. Axis gridlines are placed at round values automatically whatever scale you choose. These defaults can also be supplied by your course's clinical preset.

Normative ranges

Below the display scale you set the normative range for each ear independently — the boundaries of "normal" that define every type:

These boundaries do real work in three places, so they're worth setting deliberately:

1. They are the shaded "normal" box learners can toggle on during a submission.
2. They constrain what a template generates — a template As is always placed below your admittance minimum, whatever you set it to.
3. When a learner applies an element preset to a Theta platform case, the expected type is re-derived against that preset's boundaries, so the same designed curve can legitimately grade as A under one set of norms and As under a stricter one.

Ranges are per-ear on purpose: an asymmetric preset stays asymmetric. Reset to Defaults returns both ears and the display scale to the Theta values.

Testing

When a learner reaches a tympanometry element they see the two charts side by side (stacked on phones), each with a Run button in the ear's colour — red for the right ear, blue for the left.

1. Run the test. Pressing Run animates the pressure sweep and draws the curve in. When the sweep finishes, the measurement readouts appear beneath the chart: peak pressure, peak admittance, tympanometric width, and estimated ECV. Flat types show NA for the peak measurements. The learner can re-run a sweep as often as they like.
2. Read the curve. A peak marker labels the peak admittance, and a dashed half-peak line shows where the width is measured — the same cues a clinician uses to judge sharpness and centre pressure.
3. Classify. Below each chart is a Tympanogram type dropdown. The learner chooses the type (A, As, Ad, B, C, small/large ECV) that matches the trace. This selection is the answer that gets scored.

A settings (gear) menu in the corner lets learners overlay the normative range box as a study aid — a shaded region marking where a normal peak should fall.

The learner's selections save automatically as they work, and their run actions and type selections are logged so an instructor can later reconstruct how they worked through the test.

Scoring

Tympanometry scoring is deliberately focused on the clinical bottom line: the tympanogram type for each ear. For each of the Right and Left ears you set the type field to one of three states (see Scoring overview):

By default the type is scored for both ears. A Sync ears toggle (on by default) applies the same state to both ears at once; turn it off to score the ears independently — useful when only one ear carries the teaching point.

Because scoring compares the type, a template element still grades cleanly: the generated numbers differ per learner, but the correct classification is fixed, and that's what's checked.

Report

When a submission is reported, each ear's tympanogram is redrawn in the PDF on the same axes the learner saw — including a widened sweep or an adaptive y-axis — so the report shows the curve they interpreted, in the ear's colour, with:

• The plotted curve (including any designed artifact) and a peak marker labelled with the peak admittance.
• A dashed half-peak line for the tympanometric width.
• A measurements block listing peak pressure, peak admittance, tympanometric width, estimated ECV, and the type — with the peak measurements shown as NA for flat types.

Alongside the visual, the data table compares the designed type against the learner's selected type for each scored ear and marks it correct or incorrect. Report-only fields appear in the table for context but are not counted.