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Balance and hearing assessment (TMD)

In the non-invasive intracranial pressure assessment (NIPA) unit we lots of experience in understanding the signs and symptoms associated with intracranial hypertension and hypotension, and disorders of the middle ear that are of an obscure nature.

We combine this understanding with objective measurements that can be made using the MMS-11 cerebral and cochlear fluid pressure analyser (also known as the MMS-11 tympanic membrane displacement analyser).

If you have the following symptoms, you may be referred to the NIPA unit for further investigation:

  • hearing, balance and tinnitus problems of an obscure nature, for example a Meniere’s-like symptom profile
  • low frequency whooshing or pulsatile tinnitus, especially if combined with imbalance or vertigo
  • aural or head pressure sensations
  • unexplained low frequency or fluctuating hearing loss, especially if combined with any of the above symptoms
  • persistent Eustachian tube function where a patulous (open) Eustachian tube may be a possible diagnosis 
  • aural clicking sounds that may be due to middle ear muscle myoclonus.

Having a TMD

The tympanic membrane displacement is simple, painless and non-invasive. A detector is placed within your ear canal. You may hear a series of clicks or tones. The measurement takes up to 40 minutes. TMD is also used in non-invasive intracranial pressure measurement.

Meet the team

Dr Bob Marchbanks is head of service for TMD. He pioneered the TMD technique, and is involved in many research projects many research projects relating to its use.

You can email Dr Marchbanks at

Contact us

Call us on 023 8120 6109.