Tips for successful immittance testing in a busy clinic

You’re busy and you need fast and easy immittance testing. We asked our in-house audiologist and training expert, Mariana Roslyng-Jensen, to give us her tips for faster immittance testing using Madsen Zodiac.


Seven tips for successful immittance testing in a busy clinic

  1. Size matters! The correct size probe tip is important to achieving a reliable seal. And it can be difficult to estimate what size ear tip to use. So if you have trouble getting the seal on the first or second attempt, go up one or two sizes until you find the size that fits your patient’s ear.

  2. Make sure the probe tip fits securely on the probe. After selecting the ear tip, firmly push and twist the ear tip onto the probe tip until it rests firmly against the base of the probe tip.

  3. Look first. Ensure you have a good view of the ear canal before you place the probe. Grasp the pinna and gently pull the pinna back and slightly away from the patient's head. This opens the ear canal so you can see the opening and makes it easier to place the probe correctly in the ear canal.

  4. Place the probe securely in the ear canal. Press the probe against the patient's ear canal so that an airtight seal is achieved. It may help to gently push or twist the probe for firm and accurate placement.

  5. Silence is golden. Ask your patient to remain completely still and silent during the test. This can be difficult with children. Therefore, make sure the child is situated where they feel comfortable and safe before testing.

  6. Know your colors. Before testing your patient, be sure to familiarize yourself with the color signals from the lighted probe tip and shoulder pad. (See the chart below.) Note that the color pink means the probe tip is occluded or is angled incorrectly and touching the sides of the ear canal. You can also get the pink light if you touch the probe tip with your fingertip. Also, during the test, pay attention to the probe light – not the light on the shoulder pad.
  7. Speed things up! Do you suspect a perforated tympanic membrane? When testing children, you need to be as fast as possible as you might have only one chance. The AFAP test supports this need for speed and accuracy. It is a special test that can be accessed using Options and selecting Extra Fast Leak Detection. For stand-alone Madsen Zodiac units, just select the PE Tube Protocol from the main menu on the device.

For more information consult the Madsen Zodiac user manuals. Tell Mariana your experiences with Madsen Zodiac. Write to her:

Probe color

Red - The right test ear has been selected
- The device is in idle mode
Blue - The left test ear has been selected
- The device is in idle mode
Green - The test is running
Yellow - Leak

OTOsuite indications


Green - During measurements, OTOsuite shows a green
   background to the online values

Fitting the eartip on the probe

Madsen Zodiac
  • Firmly push and twist the eartip onto the probe tip, until it rests firmly against the base of the probe tip.
  • To remove the eartip, grasp the stem of the eartip and pull the eartip straight off the probe tip.

Learn more about the Madsen Zodiac.