Traditional 226 Hz tympanometry has served as a routine clinical tool for middle-ear assessment for several decades; however, it provides a limited, single-frequency view of a complex, frequency-dependent system. Growing evidence supports the use of a more comprehensive and physiologically meaningful test battery that integrates wideband acoustic immittance, acoustic stapedial reflex assessment, and otoacoustic emissions. Together, these measures can improve clinical reasoning by providing complementary information about middle-ear transmission, cochlear function, and auditory pathway integrity.

This workshop will introduce the concept of a minimal yet clinically powerful test battery for assessing middle-ear function across the lifespan, including neonates, children, and adults. Emphasis will be placed on how wideband acoustic immittance, acoustic stapedial reflexes, and otoacoustic emissions can be interpreted together rather than in isolation. The session will focus on practical clinical applications, interpretation strategies, and case-based examples demonstrating how this integrated approach can improve the detection of conductive pathology, refine differential diagnosis, and support more evidence-based decision-making in audiology and otology settings.The workshop will be designed for audiologists, otologists, ENT specialists, hearing-care professionals, and researchers interested in improving the accuracy and clinical usefulness of middle-ear assessment. I recently delivered a related hands-on workshop at the World Congress of Audiology in Seoul, South Korea, and the topic generated strong interest and discussion among clinicians and researchers.

Proposed learning outcomes:

By the end of this workshop, participants will be able to:Describe the limitations of conventional 226 Hz tympanometry for assessing middle-ear function across different age groups.Describe the clinical significance of integrating wideband acoustic immittance, acoustic stapedial reflexes, and otoacoustic emissions into a fundamental middle-ear assessment battery.Interpret findings from wideband acoustic immittance, acoustic reflexes, and otoacoustic emissions in an integrated manner to support differential diagnosis.Apply an evidence-based minimal test battery concept to middle-ear assessment in neonates, children, and adults.Recognize clinical patterns that may suggest conductive involvement, cochlear dysfunction, or broader auditory pathway concerns.

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