Three observations to remember about tympanometry
1. Is not a hearing test. It is possible for a dead ear to produce a normal tympanogram.
2. Middle ear muscles (i.e., the stapedial reflex) in general, require acoustic stimulation (hearing) for activation of that activity, even under the most "normal" of middle ear conditions
3. The patient can be awake or asleep, and the results will be the same.