What could cause a deep peak in a Type Ad tympanogram?

A deep peak in a Type Ad tympanogram typically indicates an abnormal compliance in the middle ear, suggesting that there is an increased mobility of the tympanic membrane and ossicular chain. This condition is most commonly associated with ossicular discontinuity, where the chain of small bones in the middle ear is disrupted or not properly connected. This can lead to excessively large movements of the tympanic membrane in response to changes in air pressure, resulting in the characteristic deep peak seen on the tympanogram.

Otosclerosis generally presents with a Type As tympanogram, showing reduced compliance, rather than deep compliance. Eustachian tube dysfunction often leads to negative pressure in the middle ear and would typically result in a Type C tympanogram. Middle ear infections can produce varying tympanometric findings depending on their nature but do not typically result in a Type Ad response. Thus, the identification of ossicular discontinuity is crucial for understanding the implications of a deep peak in a Type Ad tympanogram.