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MADSEN Zodiac 901 User Manual, EN version

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1. 10 25 PUSE REPLACEMENT oa coea 44 0 0 0 at aria LAA 11 GENERAL DESCRIPTION 13 31 GENERAL 424 4t IIIA des 13 32 FRONTPANELLAYOUT amp CONTROLS 13 321 MANUALMODE 15 38 29 AUTOMODE dg 2 2 S s sus m oie Q a b SF 15 AN 16 324 JLTSEDECTANDSETLUP wA 16 325 OTHER FRONT PANEL CONTROLS 17 326 INDICATORLAMPS 18 327 LIQUID CRYSTAL DISPLAY 18 33 STARUP siaa secats aro dae ei 19 24 MAINMENU 24244429 sas mapasa eio 230424 440 4 20 34 NEWPATENI 222025 IIIA IA 21 342 IDENTIFICATION 22 BAS DAIBYCALIBRATION poi on ya saus dae ka s 23 3 44 DEFAULT CONFIGURATION 24 345 EASYANDADVANCEDMODES 24 35 HEADSET AND PROBE 25 351 SY du LR 26 352 USING THE HEADSET AND PROBE 26 MANUAL MODE 3 5 94 36 844 4 KAD RE dns 29 41 TYMPANOMEIRY 30 ZLTI MANUAL 22250045 tas dir IRR ERROR d 31 412 AUTOSWEEP ous ai a s s gue 8 Gl as Et 33 413 ETF L INTACT EARDRUM 36 4 1 4 ETF P PERFORATED EARDRUM 37 4 2 REFLEX TESTIS u bad ss SS Q a aus Kaa 39 4 2 1 MANUAL REFLEX wi yz S sole suka aa ER EORR 40 4 2 2 SCREENING a v sss wawa ws ss s sk kwa wa 42 4 2 3 DECIAN ones S qdo She Sn ee a unik Das ds e SE S 43 4 2 4 USER
2. 85 GN Otometrics ZODIAC 901 Middle Ear Analyzer INTRODUCTION Chap 1 FEATURES OF THE ZODIAC 901 1 1 1 INTRODUCTION 1 1 FEATURES OF THE ZODIAC 901 With the ZODIAC 901 Middle Ear Analyzer Madsen Electronics have produced a precision impedance measuring instrument which offers the busy audiologist an unprecedented level of automation timesaving and versatility The Limited Version of the ZODIAC 901 is described in an Addendum located at the back of this manual The unique multilingual Liquid Crystal Display LCD reduces the re quired measurement data instantly to graphical analog and concise numerical forms The large clear presentation of the data from each test has been optimized for rapid diagnosis of patient condition All function selection and pre setting of parameters are controlled by a combination of single function pushbuttons plus softkeys The five softkeys are used together with multi choice menus displayed on the LCD All functions are driven by the software builtinto the instrument Thanks to this style of user interface using the ZODIAC 901 can be learnt quickly and easily This interface eliminates drudgery from the tasks of calibration and pre test setting up and allows the instrument to be configured for a very wide variety of tests Tympanometry and reflex testing may be performed with pressure and compliance indicated in real time as a graphic Cartesian display or on analog meters if preferred
3. Internal Printer Controller Type Up to 20 characters Up to 40 characters Left Right IPSI CONTRA 1000 2000 4000 500 Hz 70 75 80 85 90 95 100 105 50 55 60 65 dB 1000 2000 4000 Hz White N 500 Hz 70 75 80 85 90 95 100 105 50 55 60 65 dB 1000 2000 3000 4000 6000 8000 250 500 Hz 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100 105 dB Off On Internal External None Off 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 month Date Month Year Date Year Month Month Date Year Month Year Date Year Month Date Year Date Month No Yes 2 0 3 0 4 0 5 0 6 0 7 0 8 0 1 0 cc None 1 0 2 0 3 0 4 0 5 0 6 0 7 0 8 0 cc Tymp Sweep Tymp ETF I Tymp ETF P Tymp Manual Reflex Manual Reflex Screening Reflex Decay Reflex User1 Reflex User2 Threshold Reflex Threshold FastSCR Threshold Air Cond IF4113 Madsen Operation Manual 85 B APPENDIX ZODICON PARAMETERS GN Otometrics ZODIAC 901 Middle Ear Analyzer Print All Sequence External Printout Specification Page Size Left Margin Double Size Printout Tymp Default Setup Compliance Scaling Abs Volume Scaling Sweep Pump Speed Sweep Measure Dir Manual Measure Dir Manual Average Min Sweep Pressure Max Sweep Pressure Leak detect ETF Default Parameters ETF Y Axis ETF X Axis 11 12 inch 5 40 spaces Off
4. Operation Manual 29 MANUALMODE Chap 4 GN Otometrics TYMPANOMETRY 4 1 ZODIAC 901 Middle Ear Analyzer 4 1 TYMPANOMETRY Tymp Fig 4 1 Tymp Sub menu displayed when Tymp Is selected in Advanced Mode Version 4 x Only Tympanometry is the measurement of the variation of the compliance or immittance of the eardrum and the ossicular chain by means of con trolled changes in static pressure A graphic plot of these parameters is called a tympanogram The ZODIAC 901 can be used to perform manual tympanometry and generate tympanograms directly for display on the screen and printing out on paper see 5 3 Among the disorders which can be indicated or confirmed by tym panometry using the ZODIAC 901 are ossicular discontinuity otoscle rosis rigidity in the ossicular chain flaccid hyper mobile eardrum due to aging perforated eardrum obstruction of the ear canal middle ear fluid dried ear wax Eustachian Tube dysfunction In Advanced Mode the screen shown in Fig 4 1 will be displayed when Tymp is pressed Tame Left Operator Patient Select Manual pem If Easy Mode has been selected pressing Tymp will display the Auto Sweep screen illustrated in Fig 4 5 unless this has been altered using the ZODICON software In Advanced Mode the following operation modes may be selected from the Tymp Menu Manual Auto Sweep and ETF Eustachian Tube Function test perfo
5. vibration energy Resistive loss occurs when a mechanical vibration or sound wave passes through a material which is subject to hysteresis and part of the energy is absorbed into the material and thereby converted into heat 72 Operation Manual GN Otometrics PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 ZODIAC 901 Middle Ear Analyzer THE STRUCTURE OFTHEEAR 8 5 Hysteresis is a common feature of practical compliant materials It is characterized by a difference in the deflection resulting from the applica tion of a given pressure depending upon whether the pressure is in creasing or decreasing Although resistive loss results in a reduction of the amplitude of a wanted vibration it can also be beneficial in systems such as the human ear It can dampen the effects of resonances and standing waves It can also play its part in achieving matching of mechanical impedance Hysteresis in the eardrum may be observable in tympanometry if two different tympanograms are produced from the same ear measured un der conditions which are identical except for the sweep direction How ever this effect could also be caused by too great a pump speed 8 5 THE STRUCTURE OF THE EAR Hysteresis The ear comprises the parts of the body which convert sound waves into impulses in the human body s central nervous system The ear is a highly developed organ capable not only of detecting but also of analyzing weak sounds containing very small
6. 150 200 250 300 350 400 450 500 550 600 Max Pressure daPa 100 150 200 250 300 350 400 Measuring Direction positive or negative Leak Detect On Off Fig 4 7 L R Shift Ext Range Softkey 1 Tymp Sweep analog meter display Softkey 1 Alt Select Setup Parameters Operation Manual 35 MANUALMODE Chap 4 GN Otometrics TYMPANOMETRY 4 1 ZODIAC 901 Middle Ear Analyzer AFAP NOTE MEP Marker Version 4 x Only Fig 4 8 Intact Eardrum Eustachian Tube 4 9 Function When AFAP is selected the maximum rate of change of pressure varies from 400 daPa S before and after the peak to 200 daPa S during the peak The sweep speed is reduced automatically when the measured pa rameter is changing rapidly with pressure and speeded up automati cally when the measured parameter is not changing rapidly with pressure This advanced feature enables the ZODIAC 901 to complete the measurement in the minimum time consistent with achieving the specified accuracy Note that when AFAP is selected the measurement sweep stops as soon as a tymp is detected thus further abbreviating the duration of the measurement Using Setup to reduce the Pressure range can also be beneficial in mini mizing the measuring time by eliminating the flat uninformative parts of the healthy tympanogram 4 1 3 ETF I INTACT EARDRUM The Eustac
7. GN Otometrics PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 ZODIAC 901 Middle Ear Analyzer MECHANICAL IMPEDANCE 8 1 8 PRINCIPLES OF MIDDLE EAR ANALYSIS The ZODIAC 901 Middle Ear Analyzer is designed for screening and clinical diagnosis of audiological patients using objective measurement methods The ZODIAC 901 measures the mechanical impedance of the ear a pro cess known as tympanometry In contrast to audiometry mechanical im pedance measurements are not influenced by the patient s conscious response to the measurement stimulus The real time measurement capability of the ZODIAC 901 enables it to perform dynamic tests of the patient s reflex threshold and Eustachian Tube Function The following explanation of tympanometry is included in order to pro vide the user of the ZODIAC 901 with sufficient understanding of the physics and physiology of middle ear measurement to enable him or her to make the most effective use of this advanced and versatile instrument 81 MECHANICAL IMPEDANCE Sound is a particular case of mechanical vibration at frequencies within Sound and vibration the audible range namely more than about 20 Hz and less than about 20 000 Hz Mechanical vibration comprises a backwards and forwards mo tion about a mean position This motion takes place in the substance transmitting the vibration no vibration can be transmitted in a vac uum The backwards and forwards motion is characterized by changes in vi
8. ZODIAC 901 Middle Ear Analyzer via ZODIAC 901 on an external printer Please refer to the MIDIMATE 622 Operation Manual for full details Pressing Softkey 4 from the Printer Sub Menu selects whether printer out put from ZODIAC goes to an external or to the internal printer Pressing Printer displays a screen with the current test in the screen dis played in a tympanogram and the Printer Sub Menu the option shown here for Softkey 4 is only available for instruments with built in printer 85 3 2 below describes the different options available from the Printer Sub Menu in detail Fig 5 3 B 258 Extern Parer 2InterniFeed 5 3 1 PAPER LOADING Access the printer menu by pressing Printer Select internal printer by pressing Softkey 4 so that paper feed is en abled Using a pair of scissors cut the leading edge of the paper roll at the right corner so that the leading edge makes a diagonal Insert the paper roll into the printer compartment With the leading edge at the bottom of the roll insert the pointed edge into the left hand corner of the slot inside the printer compartment and press Softkey 5 for paper feed The paper will now feed through the printer mechanism and emerge through the slot in the ZODIAC s lid Put the cover provided for it over the printer compartment You are now ready to print Softkey 4 Printer Tymp Sweep Printer menu Printer S
9. 120 dB in Contra Softkey 4 allows the selection of either Ipsi or Contra Pressing Softkey 5 displays the pump position graphically at the top of the screen and when Softkey 5 is held down the Rotary Knob may be used to adjust the pressure In analog meter format the right hand me ter displays Volume instead of Compliance while Softkey 5 is held down Multi Curves Tone Switch Softkey 1 Softkey 2 Softkey 3 Softkey 4 Softkey 5 Reflex 225 ul 223 Stimulus 18H Hz Manual Left IPSI a 35 l g Jol 1 46 ml ation Meter PLA bn Pressure Gr arh 185 dB CONTRA daP Fig 4 15 Reflex Manual Operation Manual 41 MANUAL MODE Chap 4 GN Otometrics REFLEX TESTING 4 2 ZODIAC 901 Middle Ear Analyzer L R Shift Setup Parameters Leak Leak Detect On Off Version 3 x and Later Softkey 2 Tone Switch The second line of the display shows the type and level of stimulus used in the test recorded in the curve When starting to test the patient s other ear remember to register the change over on the ZODIAC 901 otherwise the data for the first ear will be overwritten To change to the other ear press Alt Select and then Softkey 4 Setup parameters available in Manual Reflex Mode see also 85 2 2 are Stimulus Step 1 2 5 or 10 dB Y axis scaling Auto 75 150 225 300 3
10. 84 3 1 84 3 2 and to present stimuli for reflex testing 84 2 1 and for air conduction testing 84 3 3 Pressing the Printer key displays the Printer sub menu which occupies only the five panels at the bottom of the screen leaving any test results visible This allows selection of the internal printer if fitted or external printer if connected and disabling of printout which overrides prepro grammed printout in the Auto tests control of the paper in the internal printer screen dump which includes the relevant sub menu printout of the data for the current test including data not shown on the test screen but specified in the Measurement Setup e g pump speed and printout of all data including test results for the current patient together with the Madsen Electronics logo and if it has been programmed the clinic s or audiologist s custom header See 85 3 Pressing the Air Release key provides a means of rapidly relieving the pressure in the ear canal of a patient who experiences sudden distress during a test Note that for patient safety this key is connected directly to the air release valve making it independent of the microprocessor The Air Release key also returns the pump to the middle position In Tymp Mode the normal range of pump pressures for middle ear test ing is from 400 daPa to 200 daPa Pressing the Ext Range button tog gles between the normal range and an extended range from 600 daPa to 44
11. Chap 3 ZODIAC 901 Middle Ear Analyzer MAINMENU 3 4 e Data from last patient tested may be erased by pressing Softkey 1 to se Softkey 1 lect New Patient Selecting LD by pressing Softkey 2 enables both operator and pa Softkey 2 tient identification to be entered e Daily Calibration may be performed by pressing Softkey 3 Softkey 3 Softkey 4enables you to Select Default Configuration thus restoring Softkey 4 the default configuration which may have been modified using ZODI CON software and removing any changes made using Setup 85 2 Softkey 5 may be used to toggle between Easy Mode and Advanced Softkey 5 Mode This facility is used to configure the use of three of the Manual Mode keys to suit the application In Easy Mode the three keys select three measurement functions directly Pressing the Tymp key accesses Automatic Sweep the Reflex key accesses Manual Reflex and the Threshold key accesses Reflex Threshold In Advanced Mode press ing any of these keys displays a related sub menu which invites a further selection of tests see 83 4 5 These facilities are described more fully in the following sub sections These are the factory default test modes Choice of test in Easy Mode ZODICON M may be altered by means of ZODICON 3 4 1 NEW PATIENT ZODIAC 901 has a built in automatic patient counter indicated by a Patient Counter number opposite t
12. bration pressure p which are proportional to the vibration velocity c of the motion except at very large amplitudes where the substance may become nonlinear p cZ The constant of proportionality Z is known as the mechanical imped Mechanical ance It is a characteristic of the substance or structure which is subject to impedance the vibration Stiff dense substances such as bone have relatively high mechanical impedances since a large pressure is required to produce a small deflection or motion Air has a relatively low mechanical imped ance since it is neither stiff nor dense and a small pressure results in a relatively large deflection In the special case of audible vibrations the term acoustic impedance Acoustic impedance is used instead of mechanical impedance Operation Manual 71 PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 GN Otometrics MISMATCHING OF MECHANICAL IMPEDANCES 8 2 ZODIAC 901 Middle Ear Analyzer The reciprocal of Z is the mechanical or acoustical admittance The term acoustic immitance is used collectively to refer to either of these pa rameters Measurement of changes in the acoustic impedance of the ear forms the basis for tympanometry 8 2 MISMATCHING OF MECHANICAL IMPEDANCES Mismatching of impedances During the transmission of a mechanical vibration through a homogene ous medium or along a homogeneous transmission line the ratio of vi bration pressure to vibration
13. but they have not been tested by Madsen Electronics and we therefore can not make any recommendation regarding their use 3 5 2 USING THE HEADSET AND PROBE The ZODIAC 901 probe is designed to provide the user with a choice of three ways in which it may be supported in use The transducer may be mounted on the headset Dimples on opposite sides of the transducer engage in a pair of lugs on the saddle shaped clip on top of the headset The transducer cable should be pressed into the clip provided for it on top of the headset The miniature jack plug connecting the TDH 39 earphone may be plugged into the socket on the side of the transducer The probe itself is connected to the transducer by three fine plastic flexible tubes If the probe is attached to the trans ducer slide the small slotted cover in the end of the transducer upwards and gently pull the probe out Take care not to pull the tubes 26 Operation Manual GN Otometrics GENERAL DESCRIPTION Chap 3 ZODIAC 901 Middle Ear Analyzer HEADSETANDPROBE 3 5 e The transducer may be held in the hand and used to guide the probe into the patient s ear canal This is most practical for fast screening of patients as the transducer must be supported all the time If the probe is not fixed to the transducer slide the small slotted cover in the end of the transducer upwards position the probe so that the flexible tube at tachments lie snugly in the recess in the bottom
14. membrane which has only a small influence on the impedance presented to acoustic waves travelling through the outer ear The main constituent 74 Operation Manual GN Otometrics PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 ZODIAC 901 Middle Ear Analyzer MEASURING ACOUSTIC IMPEDANCE 8 7 of this impedance is the impedance presented by the oval window as transformed by the hammer anvil and stirrup It is because of this that impedance measurements taken at the entrance to the outer ear can sup ply detailed information on conditions in the middle and inner ear The arrival of very loud sounds in the middle ear would result in over loading of the mechanisms of the ear This would cause distortion and reduce the effectiveness of the sense of hearing If the loudness were ex cessive permanent damage could occur When the central nervous system perceives a rise in sound level in either Stapedius reflex ear it issues an instruction to the tensor tympani and stapedius muscles in both ears to contract Contraction of these muscles results in a tensioning of the ear drum The tense ear drum presents a higher impedance to the outer ear and consequently most of the energy in the loud sound is re flected back the way it came This mechanism is part of the body s reflex system It is known as the auditory or stapedius reflex It serves as a form of automatic volume control Its speed and effectiveness may be determined by applying a loud
15. 02 0 3 0 4 Sec 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Sec PreTime 0 5 0 1 0 2 0 3 0 4 Sec StimTime 2 0 2 1 22 2 3 2 4 0 0 1 1 9 Sec PostTime 0 5 0 6 2 8 2 9 0 1 0 2 0 3 0 4 Sec 86 Operation Manual GN Otometrics ZODIAC 901 Middle Ear Analyzer B APPENDIX ZODICON PARAMETERS Refler Decay Timing X Axis PreTime Stim Time PostTime Speed Reflex User1 Timing X Axis PreTime StimTime PostTime Reflex User2 Timing X Axis PreTime StimTime PostTime Threshold Reflex Timing X Axis PreTime StimTime PostTime Threshold FastSCR Timing X Axis PreTime StimTime PostTime 12 13 14 15 16 17 18 Sec 1 0 1 1 2 0 0 1 0 2 ee 0 9 Sec 10 0 TO ee 11 7 11 8 0 0 0 T 9 8 9 9 See 10 1 1 12 7 12 8 0 1 0 2 0 8 0 9 Sec Slow Fast 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Sec 0 5 0 1 0 2 0 3 0 4 Sec 2 0 2 1 22 2 3 2 4 0 0 1 1 8 1 9 Sec 0 5 0 6 2 8 29 0 1 0 2 0 3 0 4 Sec 6 7 8 9 10 11 12 13 14 15 16 17 18 Sec 0 5 0 1 0 2 0 3 0 4 Sec 5 0 0 0 0 1 4 8 4 9 Sec 0 5 0 6 3 3 3 4 0 1 0 2 0 3 0 4 Sec 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Sec 0 5 0 1 0 2 0 3 0 4 Sec 1 5 0 0 0 1 1 3 14 Sec 1 0 0 1 0 2 0 3 0 4 0 5 0 6 0 7 0 8 0 9 Sec 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Sec 0
16. 1 4 spaces No Yes 3 0 4 5 mL Auto 0 3 0 6 0 9 1 5 mL 9 0 3 0 4 5 mL 6 0 7 5 mL 400 daPa Sec AFAP 50 100 200 daPa Sec Neg Pos Pos Neg Neg Pos Off On 400 350 300 250 200 150 100 600 550 500 450 daPa 200 250 300 350 400 100 150 daPa Yes No Pos Neg Neg Pos 45 46 98 99 10 11 43 44 Sec Reflex And Threshold Default Setup Scaling Y Axis Pressure Control Att Incr Leak detect Manual Reflex Use Threshold Level in Decay Reflex Fast Slow Mode TH Level Incr TH FastSCR Max Meas Add Threshold Search Use Pump in TH AirCond Threshold Detection Criteria TH Detect Delta Volume TH Detection Time TH Detection Dir Reflex Manual Timing X Axis PreTime PostTime Reflex Screening Timing X Axis 150 225 300 375 uL Auto 75 uL Pos Neg Auto Neg Pos Manual Auto MEP 5 10 15 20 25 25 20 15 10 5 5 10 1 2 dB Yes No Multi Curves Single Curve Off 0 5 10 15 20 dB Fast Slow 10 20 20 10 5 22 1 1 2 5 dB 3 4 5 6 7 8 9 10 11 12 13 14 15 16 1 2 Off 0 5 10 dB No Yes 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100 10 15 uL 500 600 700 800 900 1000 100 200 300 400 mSec Neg Pos Neg 4 5 6 7 5 9 10 11 12 13 14 15 16 17 18 2 3 Sec 0 5 0 6 3 4 3 5 0 1 0 2 0 3 0 4 Sec 0 5 0 6 9 8 3 9 0 1
17. 1 ml 1 ml daP daF daF B 9 a B Fig 4 10 Intact Eardrum Example of Normal Eustachian Tube Function B E Operation Meter Start nta Pume Sr ah 5 toP A closed Eustachian Tube will exhibit the same positive MEP in both sweeps A patulous spread Eustachian Tube will exhibit an MEP close to zero for both sweeps and probably a pair of broad irregular tym panograms as well 55 ml This test is not included in Version 2 x of the ZODIAC 901 The Intact Eardrum test is included on the Tymp intermediate menu Press Tymp to obtain this menu and then press Softkey 4 to access the Intact display The menu functions and Setup parameters are in other re spects similar to Tymp Sweep 84 1 2 Measurement Setup parameters available for the Intact Eardrum test are the same as for Tymp Auto Sweep page 35 The Alt Select pushkey allows you to use the Smooth facility to opti mize the curves see Fig 4 10 below and refer to 84 1 35 1 2 for further de tails re this function Just press Softkey 2 from the Alt Select sub menu Softkey 4 Alt Select Risht a B a E HA Operation Meter T Start isa le Sr ah rotor Smooth Pume pane Fig 4 9 As in Fig 4 11 above but after using the Smooth facility 4 1 4 ETF P PERFORATED EARDRUM In Advanced Mode the Eustachian Tube Function ETF P test may be performed to test the fu
18. 1 7 IMPACTED CERUMEN DRIED EAR WAX Excessive production of earwax will reduce the Ear Canal Volume and may completely obstruct the ear canal In this case the tympanogram will exhibit an absence of a peak 9 1 8 PATULOUS EUSTACHIAN TUBE A patulous spread Eustachian Tube will not close with the result that the patient s breathing interferes with hearing The static compliance will be normal but the tympanogram will be broadened abnormally large tympanogram width and may exhibit irregularities because of in terference from the patient s breathing If the eardrum is not perforated this condition may be investigated using the Intact Eardrum test avail able in Tymp Advanced Mode not Version 2 x of the ZODIAC 901 9 1 2 COCHLEAR HEARING LOSS Cochlear and retrocochlear hearing loss will be characterized by in creased reflex thresholds and increased air conduction thresholds The tympanogram should not be affected 82 Operation Manual GN Otometrics ZODIAC 901 Middle Ear Analyzer A APPENDIX TECHNICAL SPECIFICATIONS A APPENDIX TECHNICAL SPECIFICATIONS Standards Audiometric Headset Impedance Patient Safety Compliance Measuring System Probe Tone Total Range Reflex Ranges Display Range Tympanogram Air Pressure System Range Accuracy Air Pump Air Release Acoustic Refler Contralateral Stimulation ISO 389 ANSI S3 6 IEC 1027 ANSI 3 39 EN 60601 1 class I type B 226
19. 10 dB Y Axis scaling Auto 75 150 225 300 375 ul Speed slow or fast Y Axis Auto negative positive positive negative Use Middle Ear Pressure on or off Leak Detect On Off In Version 3 x and later this function is called Press C Pressure Con trol and is extended to Manual Auto MEP 0 5 10 15 20 25 25 20 15 10 5 daPa 4 2 3 DECAY A weak Stapedius Muscle is unable to sustain tension in the eardrum Decay during the prolonged application of a sound loud enough to provoke Reflex This test measures a reflex on a 12 second time scale baseline 1 sec stimulus 10 sec and 1 second of recovery time unless these have been modified using the ZODICON software and can be used to rec ord the decay caused by a weakening Stapedius Muscle Operation Manual 43 MANUAL MODE Chap 4 REFLEK TESTING 4 2 GN Otometrics ZODIAC 901 Middle Ear Analyzer Curve For Each Freguency Softkey 3 Fig 4 17 Refler Decay Softkey 1 Softkey 2 Softkey 3 Ext Range Softkey 4 Softkey 5 L R Shift In Version 3 x and later this test has been expanded so that the curve for each frequency measured Ipsi and Contra for both ears may be stored and subsequently printed out Press Main Menu and use Softkey 5 to select Advanced Mode unless this requirement has been changed using the ZODICON software Press
20. 22 Threshold AirCond Lett Air ConductionThreshold before measurement Oreration SPL 2B dB Press the Tone Switch to present the stimulus Tone Switch The threshold values may be plotted on an audiogram on the dis Softkeys 1 3 play just select frequency using Softkey 1 and Sound Pressure Level in dB using Softkey 3 or the Rotary Knob The range 0 100 dB may be extended by pressing the Ext Range button Ext Range to 120 dB Press Softkey 2 to plot each threshold on the audiogram Any values Softkey 2 may be entered Fig 4 23 shows an example Fig 4 23 Threshold HirCond Left Air ConductionThreshold after measurement reration CSPL 3 35 dE When starting to test the patient s other ear remember to register the L R Shift change over on the ZODIAC 901 otherwise the data for the first ear will be overwritten To change to the other ear press Alt Select and then Softkey 4 Operation Manual 51 MANUALMODE Chap 4 GN Otometrics THRESHOLD TESTING 4 3 ZODIAC 901 Middle Ear Analyzer Setup Parameters Pump On Gell s test Setup parameters available in the Air Conduction Threshold Mode see also 85 2 3 3 are Intensity Level increment 1 2 5 or 10 dB Pump on or off If the pump is on pump pressure can be increased or decreased manu ally by holding down Softkey 5 and turning the rotary knob to the left or right Pressure
21. CARE AND MAINTENANCE Cleaning Display Protective Cover KEEP AWAY FROM LIOUIDS Dust Cover CAUTION Eartips The ZODIAC 901 reguires no preventive maintenance However it is recommended that the following guidelines be observed The instrument should be kept clean and as free of dust as possible e Clean the LCD display periodically with an anti static non solvent solu tion using a soft lint free cloth Note that the display is laminated for maximum readability and must therefore be treated with care The LCD can be protected against transport damage i e scratching by means of the supplied protective plastic cover Remove dust using a soft brush and take special care to dislodge any accumulations of dirt on or around the pushbuttons on the front panel e To clean the cabinet and the front panel use a soft slightly damp cloth with a small amount of mild detergent on it Do not allow any moisture inside the instrument WARNING Chemical cleaning agents containing ammonia or alcohol will damage the cabinet and display If your ZODIAC 901 has been supplied with the optional plastic dust cover you should keep the instrument covered at all times when it is not in operational use However the instrument should NOT be left switched on with the dust cover in place as this may cause severe overheating and damage to the instrument Avoid exposing the instrument to direct sunlight and keep it well ventilated
22. Curves this function can be de selected by pressing Setup More and then Softkey 1 In addition the default duration x axis has been ex tended to 24 seconds Multiple reflexes can be obtained at different lev els for each frequency and each reflex curve can be individually erased by means of the Marker Function 85 1 6 If the default has been modified using the ZODICON software the fol lowing default settings may differ from those indicated in this section stimulus frequency and level choice of ear graph meter Ipsi Contra x axis scale pre stimulus delay time and post stimulus display time The test is started by pressing the Tone Switch and terminated by re leasing it When performing Multi Curves a stimulus is presented each time you press and hold down the Tone Switch Press Softkey 1 to set the desired stimulus type 500 1000 2000 4000 Hz tone or White Noise note that White Noise is only available if Contra has already been selected Multi Curves Note that all reflexes made at each frequency are retained in memory until a new patient is selected Softkey 2 changes the display from graphic to analog meter format Softkey 3 increases the stimulus Sound Pressure Level in increments of 5 dB increments of 1 2 and 10 dB are available via Setup alternatively use the Rotary Knob to increase or reduce SPL HL Range of 50 to 100 dB SPL HL may be extended by pressing the Ext Range button to 115 dB
23. Tube function will be indicated by re duced pressure drops When starting to test the patient s other ear remember to register the change over on the ZODIAC 901 otherwise the data for the first ear will be overwritten To change to the other ear press Alt Select and then Softkey 4 42 REFLEX TESTING Fig 4 13 Tame ETF P Left 285 Eustachian Tube Function Perforated Eardrum Impaired Eustachian Tube Function L R Shift Reflex testing in audiology refers to the Stapedius Reflex a mechanism which automatically tensions both eardrums after the onset of particularly loud sounds in order to prevent overload and possible damage to the hear ing mechanism The ZODIAC 901 allows a very wide range of measure ments of patients Reflexes to be performed by applying a controlled acoustic stimulus and measuring the change in acoustic impedance which will be observed if the ear is healthy The change in Compliance which results from the functioning of the re flex mechanism is very small and will be further diminished if the ear drum is tensioned by a static pressure differential between the ear canal and the middle ear If there is any doubt about whether the Middle Ear Pressure is close to atmospheric pressure this should be checked first of all by means of a tymp measurement The Setup facility for reflex and threshold testing allows the ZODIAC 901 to set the static pressure in the ear canal automatically to a level related
24. Tymp Auto Sweep and ETF I modes selecting More changes the sub Setup More Version menu choices to optional use of a measurement pressure level a selected 4 x Only interval above or below Middle Ear Pressure MEP and Leak Detect on or off Version 4 x Press Setup again to return to the function currently selected In Reflex testing Setup More enables the addition of Leak Detect on or off Version 4 x Here follows an overview of the parameters that may be altered in tym panometry reflex and threshold test modes To change any test parame ter in Setup press the corresponding Softkey repeatedly until the required choice is shown in the panel above it Alternatively hold the corresponding Softkey down and turn the Rotary Knob in either direc tion 5 2 1 TYMPANOMETRY INCL ETF I Pump Speed The settings available are 50 100 200 400 daPa sec Pump Speed and AFAP as fast as possible This parameter is not available in Manual Tymp Y axis Scaling The following settings are available 0 3 0 6 0 9 1 5 Scaling Compliance 3 0 4 5 ml or Auto In Auto the minimum possible scaling for the measured curve is automatically selected Averaging On Off Manual Tymp only Averaging Min Pres Minimum Pressure 100 150 200 250 300 350 Min Pressure Max Max Pres 400 450 500 550 600 daPa Pressure Maximum Pressure 100 150 200 250 300 350 400 daPa Operation Manual 57
25. amounts of en ergy These capabilities are possible because the construction of the ear is such as to minimize the loss of energy incurred by a sound wave in its passage through the ear Losses can occur as a result of reflection and absorption of the energy in the sound wave as discussed above Both of these kinds of losses can be pathologically increased by defects of the inner ear Much of the construction of the healthy ear owes its form to the need to provide an impedance transformation from the low impedance of free space to the relatively high impedance of the inner ear Each ear consists of three main constituents an outer ear a middle ear and an inner ear Fig 8 1 The outer ear comprises the visible external ear pinna plus the audi tory canal ear canal meatus which is terminated by a delicate mem brane the eardrum tympanum The outer ear serves to protect the eardrum from damage and provide a continuous impedance transfor mation from free space to the middle ear The air in the outer ear is con nected to the atmosphere The bone behind the ear is called the mastoid Structure of the Ear Outer Ear Operation Manual 73 PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 GN Otometrics THE EFFECT OF LOUD SOUNDS 8 6 ZODIAC 901 Middle Ear Analyzer Fig 8 1 Section through the ear Middle Ear Auditory Ossicular Chain Inner Ear Malleus incus Stapes Semicircular Canal Oval Window Hammer Muscle Te
26. during programming Continue Auto Test Softkey 5 reratar Patient 1 Select Testi gt Prosr PEH EndFr a Press Softkey 1 2 3 or 4 to select the test you wish to program It is then possible to define a test by simply operating the instrument in the nor mal way ZODIAC 901 will memorize all your key entries and settings The number of program steps for which the current test has memory available will be displayed at the top of the screen and will be reduced by 1 each time a further program step is added see Fig 7 3 PROGRAM MODE 62 Steps available User Test Menu Lett jm ss Dec 14 1998 Drerator Patient 1 Select Testi S gt Prosr PEH EndFr a Use Continue to insert pauses in your test sequence for inspecting curves altering Setup parameters or operating the instrument manually The beeper sounds each time Continue is pressed It will also sound each time a pause is encountered when the program is run After entering the last step in the User Test Programming sequence press Auto Test to return to the Program Menu Press Softkey 5 to end programming This displays the Program Mode Operation screen shown in Fig 7 5 which allows you to enter a name for the test you have just programmed 66 Operation Manual GN Otometrics POWER ON OPTIONS Chap 7 ZODIAC 901 Middle Ear Analyzer USER TEST PROGRAMMING 7 1 Fig 7 5 Prosram Mode Pro
27. first ear will be overwritten To change to the other ear press Alt Select and then Softkey 4 Setup parameters available in Reflex Threshold Mode see also 85 2 3 1 are Stimulus increment 1 2 5 or 10 dB TH Step 1 2 5 10 20 20 10 5 2 1 dB Y axis scaling Auto 75 150 225 300 375 ul Y Axis Auto negative positive positive negative Use Middle Ear Pressure on or off Leak Detect On Off Add Threshold None 0 5 10 dB 48 Operation Manual GN Otometrics MANUALMODE Chap 4 ZODIAC 901 Middle Ear Analyzer THRESHOLD TESTING 4 3 In Version 3 x and later this function is called Press C Pressure Con trol and is extended to Manual Auto MEP 0 5 10 15 20 25 25 20 15 10 5 daPa 4 3 2 FAST SCREENING This test mode permits automatic reflex threshold search at up to 16 dif ferent levels Data from all stimulus frequencies 500 1000 2000 and 4000 Hz tone plus White Noise if Contra has already been selected is memorized and displayed in tabular form on the right of the screen The display is organized very differently from that used for Threshold Reflex see 84 3 1 If the default has been modified using ZODICON soft ware the x axis pre stimulation delay stimulation time and post stimulation delay may be different from those indicated NOTE that it is not possible to export any graphic data from this test mode i e only measured threshold values may be print
28. is detected until a volume is de tected the green Status lights on the front panel and probe will flash In effect this enables you when testing children to initiate the test even prior to inserting the probe into the patient s ear If there is a leak before the sweep starts the Leak lights on the front panel and probe will light yellow Before proceeding ensure that you are using the right size eartip and try pulling down the ear lobe while at the same time rotating the eartip in the ear canal Meanwhile the ana lyzer will continue to attempt a sweep until the pump reaches the end position whereupon the Status lamp lights red until the pump is reset Then the instrument will continue the procedure automatically If Leak Detect has been disabled Version 4 x only the analyzer stops after one sweep see Setup 85 2 1 It is worth noting that in Version 3 x and later a leak encountered after the sweep begins provokes a beep and the Leak lights go yellow If Gra dient and TW can be calculated on the basis of the interrupted sweep the test is halted and the relevant data displayed If not the analyzer will repeat the test as described above Press Tymp and then Softkey 2 to access the screen shown in Fig 4 5 Press Softkey 2 again or the Start Stop Button on the Probe to start the test During the sweep a scale at the top of the display indicates the current pump position graphically i e what proportion of the pump s capacity
29. is used to obtain the static pressure used for the measurement Both the pressure range and the direction of the sweep are selectable under Meas urement Setup see page 35 Pump speed is also selectable and includes the function AFAP As Fast As Possible please refer to page 36 for fur ther details When the sweep is completed the computed values for Ear Canal Vol ume ECV Middle Ear Pressure MEP Static Compliance at MEP SC Gradient Grad and Tympanogram Width TW are shown on the left Setup Parameters Alt Select Auto Sweep Leak Leak Detect On Off Version 3 x Only Softkey 2 Pump Pressure Operation Manual 33 MANUALMODE Chap 4 GN Otometrics TYMPANOMETRY 4 1 ZODIAC 901 Middle Ear Analyzer Fig 4 5 Tymp Sweep before measurement Fig 4 6 Tymp Sweep after measurement Definitions of ECV MEP SC Grad TW Version 4 x Only Air Release CAUTION s Sweer Risht ml daP ml daP H B ma SI Oreration Meter Start dt Gr arh Stop hand side of the display see Fig 4 6 If MEP can be calculated the pump pressure will now be set at that pressure ml Tam is Sueer B B 3 B Hk Oreration Meter Start dt Gr arh Stop ml ECV is recorded at the start of the sweep i e with the maximum pres sure when the sweep is in the negative direction or the minimum pres sure when positive sw
30. need to touch the front panel controls This feature may be used to speed up the screening of large numbers of patients The top line of the LCD will display AUTOMATIC MODE when the ZODIAC 901 is in Auto Mode regardless of the function it is perform ing Whenever it also displays STANDBY it is waiting to give the user time to perform some action before pressing Continue to proceed with the current test To interrupt a test sequence in Auto Mode stop test if one is in progress Softkey 2 and press Escape 6 1 MADSEN ELECTRONICS PRESET TEST MENU Programmable User Tests ME Preset Tests Remote Control of ZODIAC 901 Continue Escape Pressing Auto Test accesses one of two parallel menus the ME Preset Test Menu or User Test Menu Press Auto Test again to select the other test menu and to toggle between these two menus The ME Preset Test Menu enables the operator to start any of the five automatic factory defined tests listed below by pressing the correspond ing Softkey These tests are defined by Madsen Electronics and programmed at the factory there is no provision for the user to alter them Each of them in cludes provision to change the patient I D and the ear at the start of the test Each Madsen Electronics Preset Test performs a Print All when the last measurement is complete Screen performs a Tymp Sweep test and then an Ipsi Reflex Screening test 1000 Hz 95 dB HL fol
31. of the eartip first When inserting the probe and eartip into the ear canal pull the earlobe back to straighten the ear canal and at the same time ask the pa tient to open the jaw as this will have the effect of widening the ear canal Rotate the probe and eartip during insertion as this will facilitate entry and reduce patient discomfort Although tymp and reflex measurements made using the ZODIAC 901 are less vulnerable to errors resulting from unwanted noise than pure tone audiometry measurements it is nevertheless important that the pa tient keep quiet during a measurement This is especially important dur ing reflex measurements where small changes in compliance are measured in real time If the transducer is being held in the hand keep it still and avoid adjusting the eartip while a measurement is in progress to prevent microphony Noisy office machinery in the room should be switched off and conversations terminated A patient with a cold may usefully be invited to clear his throat and blow his nose before the meas urement begins whereafter the patient must equalize pressure prior to CAUTION Inspection Of The Patient s Ear Operation Manual 27 GENERAL DESCRIPTION Chap 3 GN Otometrics HEADSET ANDPROBE 3 5 ZODIAC 901 Middle Ear Analyzer measurement If unexpected noises occur during a measurement repeat the measurement when the interruption has ceased Before making a tymp measurement tell the patient
32. of the transducer and gently push the probe backwards into the transducer until resistance is felt Slide the slotted cover back to lock the probe in position Thetransducer may be held in the hand while the probe connected to the transducer only by the flexible tubes is inserted with an eartip into the patient s ear CAUTION On no account should the integrity of the three plastic tubes be violated Before inserting the probe into the patient s ear make a careful inspec tion of the ear to identify any possible problems If necessary brush the patient s hair away from the ear to gain a clear view Gently pull the ear lobe pinna back and press the tragus forwards towards the face to in spect the part of the ear canal which will be in contact with the eartip Excessive ear wax will interfere with the measurement and block the probe channels Other foreign objects and dirt could have similar unde sirable consequences Remove them Sores cuts or warts could lead to patient distress during measurement Signs of blood or pus could indi cate infection Excessive growth of hair around the ear canal may make an airtight seal impossible The Leak lamp on the probe will light if this problem occurs during an automatic measurement It may be possible to cure a leak with a smear of petroleum jelly but too much of this is likely to block the probe channels Choose an eartip of a suitable size and insert the probe into the narrower end
33. reassuringly to ex pect a change of pressure in the ear and tell him about the probe tone Before measuring reflex warn the patient about the sudden onset of the stimulus Remember To Change When starting to test the patient s other ear remember to register the Ear On ZODIAC change over on the ZODIAC 901 otherwise the data for the first ear will 901 be overwritten The ear to be tested may be selected as follows 1 Press Alt Select Softkey 4 2 Press Softkey 4 to toggle between left and right The ear selected Left or Right is displayed in the uppermost line of the Main Menu and every other menu associated with a measurement Fig 3 7 28 Operation Manual GN Otometrics MANUALMODE Chap 4 ZODIAC 901 Middle Ear Analyzer 4 MANUAL MODE ZODIAC 901 features three dedicated pushbuttons Tymp Refler and Threshold enabling the user to access any of the corresponding three test modes from any other function or part of the instrument From any test in Manual Mode you may press Setup to access the Measurement Setup sub menu thus enabling you to change whichever test parameters are valid at that given time The relevant parameters are listed after the description of each test given below NOTE The Setup pushbutton is inactive while a test is in progress i e nothing will happen if this button is pressed dur
34. see the display in Fig 1 1 The ZODIAC 901 is an intelligent instrument that can be taught which tests to perform Five Madsen Electronics Preset Tests plus the capabil ity for four user programmable test routines are built in for optimal operating efficiency The ZODIAC 901 may also be operated entirely manually or programmed for the user s own combination of manual and automatic operation User programmable tests enable the user to select the default parameters of a particular test The user can also select a combination of tests to form a battery of preset tests Intelligence in the ZODIAC 901 is not confined to its memory If a measurement is interrupted by an air leak or acoustic interference the instrument not only erases the data for the aborted measurement but also keeps on re trying the measurement from the beginning until it completes it without interruption or until the operator intervenes The ZODICON Madsen Electronics Zodiac Configuration pro gram enables your Madsen Electronics distributor to configure your ZODIAC 901 to suit your own particular needs thus customizing the instrument into your personal middle ear analyzer User programmable test routines and custom configuration changes made using ZODICON are stored in non volatile memory and are Liquid Crystal Display Multi Choice Menus Analog Meter Display Option User Programmable Tests Intelligent Response To Interference ZODICONTM Configura
35. sound to the ear and measuring the timing of the change in the me chanical impedance of the outer ear 87 MEASURING ACOUSTIC IMPEDANCE If air is injected into a cavity the pressure inside the cavity will increase Acoustic impedance Provided the temperature does not change and the cavity walls are rigid the relationship between the volume V and the pressure P will conform to Boyle s Law P k V where k is constant Differentiating the right hand expression gives dP dV k log V i e dP dV P V log V This relationship tells us that the change in pressure resulting from the injection of a small known volume of air dV will depend not only on dV but also on the initial pressure P and the volume V of the cavity Since dV and P are known measuring dP would enable V log V and hence V to be calculated The practical and convenient way to make this measurement is to use a calibrated electroacoustic transducer to inject a sound wave into the cav ity The resulting value of dP can be measured using a calibrated micro phone connected to the cavity Operation Manual 75 PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 GN Otometrics TENSIONING OF THE EARDRUM 8 8 ZODIAC 901 Middle Ear Analyzer Frequency for tympanometry It is important to perform this measurement at a frequency which is not too high with the undesirable result that the changing pressure in the cavity would cease to be the same everywhere in the cavity This
36. to a previously measured value of Middle Ear Pressure In automatic reflex testing the Status lamp on the front panel flashes green until a compliance is detected whereupon it lights steady green The Stimulus lamp then lights during the application of the stimulus If there is too much noise the Status lamp lights red and Operation Manual 39 MANUAL MODE Chap 4 REFLEX TESTING 4 2 GN Otometrics ZODIAC 901 Middle Ear Analyzer Leak Detect On Off Reflex Fig 4 14 the Leak lamp lights yellow the measurement is then automatically re peated If a small leak is detected the Leak lamp lights yellow and the measurement continues However if a leak greater than 20 daPa is de tected the measurement will be repeated In Version 4 x this repeated sweep can be disabled if Leak Detect under Setup is Off If Advanced Mode has been selected pressing Reflex displays the screen shown in Fig 4 14 Reflex sub menu obtained when Reflex is selected in Advanced Mode Reflex Time Date Left IPSI 12 15 22 May 1992 User 1 User 2 Softkey 1 rFeratar Patient 1 Select Manual ep sd w 1 n z The following operation modes may be selected from the Reflex Menu Manual Screening Decay User 1 and User 2 Screening is used to test a succession of patients rapidly to identify those whose reflex reveal middle ear disorders The Reflex Decay test is used to examine patie
37. to return to the function currently selected 5 1 1 ERASE DATA This function appears on the display only if there are any data for your patient in the current test Only data for the current ear and the current test are erased e g a tym panogram In Reflex Decay and Reflex Threshold all measured curves in that test for the current ear in either Ipsi or Contra not both are erased Note that you are given an opportunity to change your mind after press ing Softkey 1 the first time Erase Data Yes No Please refer to Erase Curve in the Marker Function 5 1 2 SMOOTH The Smooth facility may be used to electronically clean up tympano grams and any other Cartesian graphs recorded for the current patient in the event of irregularities caused by for example a fidgety child or a patulous Eustachian Tube The facility is not included in earlier versions of the ZODIAC 901 This facility is only available in the following test modes Manual Tymp Auto Tymp Sweep and ETF I 5 1 3 DATA TRANSMIT ZODIAC 901 is supplied with an RS 232C data interface as standard However it should be noted that data transfer in fact any form of com munication with a PC is possible only if your PC has been Operation Manual Additional Sub Menu Alt Select Softkey 1 Softkey 2 53 SUPPLEMENTARY FUNCTIONS Chap 5 GN Otometrics ALT SELECT 5 1 ZODIAC 901 Middle Ear Analyzer Zodi Link f
38. 00 daPa The Ext Range lamp lights red when the extended range is selected In Reflex Mode when extended range is selected the maxi mum Sound Pressure Level of the stimulus available in Reflex and Threshold tests is also increased from 100 dB to 115 dB in Ipsi and from 100 dB to 120 dB in Contra Rotary Knob Tone Switch Printer Air Release Ext Range Operation Manual 17 GENERAL DESCRIPTION Chap 3 GN Otometrics FRONT PANEL LAYOUT amp CONTROLS 3 2 ZODIAC 901 Middle Ear Analyzer Stimulus Ext Range Power Status Leak Liquid Crystal Display Contrast Menu Main Display 3 2 0 INDICATOR LAMPS The Stimulus lamp lights green while a stimulus is being presented The Ext Range lamp lights red when the extended pump pressure range of 600 daPa to 4400 daPa or the extended sound pressure range are selected The Power lamp lights green when the ZODIAC 901 is switched on The Status lamp lights steadily green when a measurement is in prog ress It flashes green if the ZODIAC 901 is waiting to make a measure ment when no cavity is detected It lights red when a measurement has been interrupted by a leak a noise or the pump reaching the end posi tion This lamp is duplicated on the probe The Leak lamp lights yellow if the seal between the eartip also called the probe tip or probe cuff and the ear canal is not airtight This lam
39. 1 USER2 45 4 2 5 MARKER FUNCTION 45 4 3 THRESHOLD TESTING 46 4 3 1 THRESHOLD REFLEX 2 4 0200 e usb a a e en 47 4 3 2 FAST SCREENING wa wa k an k k wapus 49 4 3 3 AIR CONDUCTION 51 SUPPLEMENTARY FUNCTIONS 53 5 1 ADI SELECT ios aaa sak kuu a et ad ee HE 53 5 11 ERASE DATA 53 5 1 2 SMOOTH 2 6 at dea KAA le oO Se we eee 53 5 1 3 DATA TRANSMIT 53 5 1 4 EET RIGHT SHIFT REUS bw eb be ee w 54 5 1 5 CONTRAST 3 4 4 2 4 04 4 yaspa 2H a5 558 YU AD SHE en 54 5 1 6 MARKER x e 2 Z bee e e Se 2 p St Seer ewe xs 54 5 2 SETUP Ra poo ro pu abs Gah aoe a ee ee 56 5 2 1 TYMPANOMETRY INCL ETE I 57 5 2 2 REFLEX TESTING rn 32 2 a 4 Gs edie ae io xs 58 5 2 3 THRESHOLD LA IAEA ee Se Q 59 5 2 3 1 REFLEX cs is aaa as a W wash WAA 59 5 2 3 2 FAST SCREENING 60 5 2 3 3 AIR CONDUCTION 60 5 3 PRINTER sg 240 422 606 a oua eo R US eres us PUS Q iius 60 53 1 PAPER LOADING 61 5 3 2 PRINTOUT x a Wb 9 eS EAS Ee DU gr ke BORE x 62 5 3 2 1 SCREEN DUMP tia dedo SQ SUR diia 8 62 5 3 2 2 PRINT DATA 1 2 s sus e a A Saw a e QC Qn a 62 5323 PRINT ALL cae iaa a Sk aa a Qa 62 AUTO MODE 63 6 1 MADSEN ELECTRONICS PRESET TESTMENU 6
40. 2 Softkey 3 Rotary Knob Softkeys 4 amp 5 Air Release L R Shift Ext Range Users who find it more informative to perform tympanometry using analog meters instead of the graphic display of a tympanogram can press Softkey 1 and a screen similar to the one shown in Fig 4 4 below will appear Tame Manual Lett z B 4 z O S Aly kite um Come 3 4 ml Jol 2 86 ml Come 6 84 ml Oreration 3Heter Gone Md Lane Pume Gr arh Uolumei zii daPFl z Note that pressing Softkey 1 again after completion of the tymp meas urement will return you to the graphic display and show you the tym panogram you have just made using the analog meters Press Softkey 2 to record the ECV and display a Compliance tympano gram instead of a Volume tympanogram The measured values of ECV and Compliance at the current pump pressure are shown on the upper left of the graphic display The ECV and thus the y axis origin on the Compliance tympanogram may be reset at any value of pump pressure by toggling Softkey 2 back to Volume Softkey 3 has no effect during this measurement The current pump pressure is displayed in the window above it The pump pressure may be set by turning the Rotary Knob A scale will appear temporarily at the top of the display to indicate the pump position graphically This shows what proportion of the pump s capacity i
41. 3 0 1 0 2 Sec 1 2 1 3 1 4 0 0 1 1 0 1 1 Sec 0 5 0 6 1 8 1 9 0 1 0 2 0 3 0 4 Sec Operation Manual 87 B APPENDIX ZODICON PARAMETERS GN Otometrics ZODIAC 901 Middle Ear Analyzer This page has been intentionally left blank 88 Operation Manual SUBJECT INDEX A AC cable s os sm phd Guara ow es 19 Acoustic impedance See Impedance Acoustic Reflex See Reflex Acoustic Reflex Latency See Reflex Latency CE Matkk 5 Cerumen See Impacted cerumen Cleaning of ZODIAC 901 10 Clinical tests 2 AI wore e A Cochlea Bo4 wch x a oa wx A Cochlear hearing fos edo ue dw 82 Compliance sb ae o 1 27 Computer 29 69 Add Threshold Ex 48 59 See also Personal Computer Admittance lt lt as asia oc es es 72 Configuration Program Advanced Mode 15 21 24 29 See ZODICON AFAP wi a as a 36 Connection Panel TP Setup 3 0 57 Connections ZODIAC 900 8 Air Conduction Threshold oed de Q 5 Continue 16 66 Air Conduction Threshold 4 15 17 19 24 51 Contra 4 19 49 Air Release 17 29 Contrast of LCD to adjust 16 18 29 54 Alt Select 16 18 28 29 53 Controls front panel 13 18 Menu b odas gx x od ge R Cuff probe Analog Meter Display Ls des dS See Eartip Anvil Eos G ee GR E 2 4 6 4 A S Rode ex ob E 322 Applications of ZODIAC 901 SR Ue Rooms ee Ook Auditory ossicula
42. 3 6 2 USER PROGRAMMABLETESIS 64 POWER ON OPTIONS 65 Zl USER TEST PROGRAMMING 65 7 2 SYSTEM SETUP 34 x kGeEG Ge AI wo ues 69 PRINCIPLES OF MIDDLE EAR ANALYSIS 71 8 1 MECHANICAL IMPEDANCE 71 8 2 MISMATCHING OF MECHANICAL IMPEDANCES 12 8 3 MATCHING OF MECHANICAL IMPEDANCES 72 8 4 RESISTIVE LOSS OF VIBRATION ENERGY 72 8 5 THESIRUCTUREOFEFTHEEAR 73 8 6 THE EFFECT OF LOUD SOUNDS 454 23 9 459 X po ee x 74 8 7 MEASURINGACOUSTICIMPEDANCE 75 88 TENSIONINGOFTHEEARDRUM 76 89 THEPRINCIPLEOFTYMPANOMETRY 77 810 PRACTICAL CONSIDERATIONS 78 811 TYMPANOGRAM CHARACTERISTICS 79 9 DIAGNOSIS OF AUDITORY DISORDERS 81 9 1 DISORDERS AND THEIR SYMPTOMS 81 911 MIDDLE EAR FLUID AND EFFUSION 81 912 DISRUPTION OF THE OSSICULAR CHAIN 81 943 OIOSOLEROSIS estos read nd Sa 81 914 PERFORATED EARDRUM 81 915 OCCLUDEDEUSTACHIANTUBE 81 916 FLABBY TYMPANIC MEMBRANE 82 917 IMPACTED CERUMEN DRIED EARWAX 82 918 PATULOUSEUSTACHIANTUBE 82 919 COCHLEARHEARINGLOSS 82 A APPENDIX TECHNICAL SPECIFICATIONS 83 B APPENDIX ZODICON PARAMETERS
43. 3 1 below Fivesoftkeys whose functions are identified in the lower sector of each menu displayed Four hard keys for selecting the Main Menu and the three Manual Test Modes Three keys for Auto Mode e Three keys for accessing the Alt Select Menu the context sensitive Setup Menu and the Printer Menu Keys for Air Release and Extended Range Operation Manual 13 GENERAL DESCRIPTION Chap 3 FRONT PANEL LAYOUT amp CONTROLS 3 2 GN Otometrics ZODIAC 901 Middle Ear Analyzer Stimulus Ext Range 1 2 Main Moni EE Em E 67 Tyme Select Escape Alt Select Setup Printer we E Continue Threshold E Standby Manual Mode Auto Mode Air Release fa ZODIAC 901 Middle Ear Analyzer Power Status Leak Ext Range Madsen lectronics Fig 3 1 There are five indicator lamps showing Stimulus Extended Range Power Status and Leak In Advanced Mode ZODIAC 901 has six principal menus which can be accessed by pressing the following pushbuttons Main Menu Tymp Reflex and Threshold in the Manual Mode and Auto Test The printout submenu can be accessed from the Printer pushbutton These menus may be accessed from any point in the instrument s opera tion enabling the operator to move quickly from one part of the program to another typically after pressing a maximum of two buttons 14 Operation Manual
44. 600 baud when communicating with MIDIMATE 622 or MateBasel Fig 7 6 Setup ZODIAC 901 System Setup menu Softkey 1 Softkey 2 Softkey 3 Softkey 4 Selecting Baud Rate for External Communications Operation Manual 69 POWER ON OPTIONS Chap 7 SYSTEM SETUP 7 2 GN Otometrics ZODIAC 901 Middle Ear Analyzer Fig 7 7 Real Time Clock Setup menu Softkey 5 Press Softkey 5 to access the screen shown in Fig 7 7 Time 14 58 Date zz Mas 1327 Real Time Clock Setur Oreration TimeFmt eo z4 Hours Line i Softkey 1 Press Softkey 1 to select 12 or 24 hour time format Softkey 3 Pressing Softkey 3 Select toggles between Time and Date as can be seen from the cursor to the left of the words Time and Date in the dis play Softkeys 4 5 e The smaller cursor indicates the unit of time to be altered Use arrow controls Softkeys 4 5 to select desired unit Tone Switch e Turn the Rotary Knob to change unit the Tone Switch may also be used here to select unit The date goes up to Dec 31 2190 Note that the Date Format date Month Year is the factory default can be changed by means of ZODI CONAPA Setup Press Setup to return to the previous display and Setup again to exit The ZODIAC 901 then goes through the normal self test procedure 70 Operation Manual
45. 75 ul Speed slow or fast Y Axis Auto negative positive positive negative Multi Curves 4 2 2 SCREENING If there is a leak during the measurement the Leak lights on the front panel and the probe LED will light yellow Before proceeding ensure that you are using the right size eartip and try pulling down the ear lobe while at the same time rotating the eartip in the ear canal The in strument will continue the procedure automatically unless a leak of more than 18 daPa is encountered The Status LED will light red and you will hear a beep If Leak Detect has been disabled Version 4 x only the Leak lights on the front panel but the analyzer will continue until the end of the measurement assuming that a volume is present see Setup 85 2 1 It is worth noting that in Version 3 x and later a leak encountered after the measurement begins provokes a beep and the Leak lights go yellow Ensure that you are in Advanced Mode press Main Menu and use Soft key 5 to select Advanced Mode unless this requirement has been changed using the ZODICON software Press Reflex to display the Reflex Menu Press Softkey 2 from the Reflex Menu to select Reflex Screening Select stimulus frequency and intensity Ipsi or Contra as desired Press Softkey 2 or the Start key on the Probe to start the test Two re flex measurements will be made one after the other baseline 0 5 sec stimulus 2 sec and baseline 0 5 sec unless these have been m
46. ELUCET Zodiac 901 Middle Ear Analyzer User Manual Doc no 7 25 1800 11 Part no 7 25 180 e C otometrics MADSEN AURICAL ICS Copyright notice No part of this Manual or program may be reproduced stored in a retrieval system or transmitted in any form or by any means electronic mechanical photocopying recording or otherwise without the prior written con sent of GN Otometrics A S Copyright 2011 GN Otometrics A S Printed in Denmark by GN Otometrics A S Denmark All information illustrations and specifications in this manual are based on the latest product information available at the time of publication GN Otometrics A S reserves the right to make changes at any time with out notice Version release date 8 September 2011 Technical support Please contact your supplier FM template version 01 02 2010 TABLE OF CONTENTS 1 INTRODUCTION 4 6 48 4 44 44h s a wow mn A 1 11 FEATURESOFTHEZODIAC901 1 12 APPLICATIONSOFTHEZODIAC901 3 13 ABOUTTHISMANUAL 5 14 STANDARDS 4 2 iii E es hee ARR 02 eR ded 5 c 000 ae Aes eee ee Ee Ae eee 6 16 SERVICEANDREPAIRR 6 INSTALLINGTHEZODIAC901 7 21 UNPACKING AND INSPECTION 7 22 STORAGE AND SHIPMENT 7 23 INSTALLATION Wei dedicada 8 24 CAREANDMAINTENANCE 10 241 CLEANINGTHEPROBE
47. Ear Analyzer SYSTEM SETUP 7 2 7 2 SYSTEM SETUP Changes made to parameters using System Setup will be preserved in the non volatile memory of the ZODIAC 901 when the power is switched off and will remain in effect unless altered again subsequently using the System Setup facility To enter this mode switch off the instru ment and power it on again with Setup held down Keep it held down until the screen shown in Fig 7 6 System Setup appears ZOCIAC 381 Hiddle Ear Ae id Prosram Version 3 Instrument 54H 35006 System Setur Lanauase Beerer ras Baud clock Enalish 47 2r 9664 Setur Pressing Softkey 1 scrolls through the languages available for the text on the Liquid Crystal Display and printouts Alternatively hold Softkey 1 down and turn the Rotary Knob clockwise or anticlockwise Earlier versions of the ZODIAC 901 allow a choice of English Italian Spanish and German Version 2 03 and higher also include French Hold down Softkey 2 and turn the Rotary Knob to adjust the sound level of the beeper Hold down Softkey 3 and turn the Rotary Knob to adjust the contrast Press Softkey 4 to scroll through the different baud rates 300 600 1200 2400 4800 9600 the baud rate determines the speed of data transfer wnen communicating with an external computer Alternatively hold down Softkey 4 and turn the Rotary Knob clockwise or anticlockwise IMPORTANT The baud rate must be set to the correct value 9
48. GN Otometrics GENERAL DESCRIPTION Chap 3 ZODIAC 901 Middle Ear Analyzer FRONT PANEL LAYOUT amp CONTROLS 3 2 The front panel has been laid out for optimal ergonomic efficiency with the different functions separated by boxes according to function The front panel control functions and indications are classified and de scribed in detail in the following sub sections 3 2 1 MANUAL MODE Pressing Main Menu displays the Main Menu This is used to perform the following functions see 83 4 e Erase the current patient data and advance the patient counter ready for a new patient e Enter identification details for patient and operator Perform daily calibration Restore default settings to cancel changes made using Measurement Setup or Auto Test sequences Select Easy Mode or Advanced Mode which determine the facilities available from the other Manual Mode pushkeys In Easy Mode intermediate menus are omitted thus speeding access to the following measurement screens Pressing Tymp displays the Tymp Automatic Sweep screen in Easy Mode or the Tymp sub menu allowing additionally selection of Tymp Manual Sweep and Eustachian Tube Function Tests ETF I and ETF P in Advanced Mode See 8 Pressing Reflex displays the Reflex Manual screen in Easy Mode or the Reflex sub menu allowing additionally selection of Reflex Screening Re flex Decay User 1 and User 2 in Advanced Mode See 842 Pressing Threshold
49. Hz at 85 dB SPL 0 1 ml to 8 0 ml Oto 75 pl 0 to 150 pl 0 to 225 ul 0 to 300 pl 0 to 375 pl Auto scaling and definition of positive negative or both types of axis 0 to 1 5 ml 0 to 3 0 ml 0 to 4 5 ml Normal 200 to 400 daPa Extended 400 to 600 daPa 10 or 10 daPa whichever is greater Plunger type stepper motor digitally controlled Speeds as fast as possible AFAP 400 daPa sec 200 daPa sec 100 daPa sec 50 daPa sec Manual speed control Mechanical safety release valve set to 600 and 800 daPa Manual amp automatic air release Pure tones 0 5 1 2 4 kHz Frequency Accuracy 0 5 White Noise Step size 1 2 5 10 dB Normal range 50 100 dB HL Extended range 50 120 dB HL Operation Manual 83 A APPENDIX TECHNICAL SPECIFICATIONS GN Otometrics ZODIAC 901 Middle Ear Analyzer Ipsilateral Stimulation Audiometric Mode Freguency Accuracy Pure Tones Step Size Normal Range Extended Range Display Built in Printer Paper Type Paper Width External Printer RS232C Data Interface Power Supply Power Consumption Dimensions Weight Net Weight Miscellaneous Pure tones 0 5 1 2 4 kHz Frequency Accuracy 0 5 Step size 1 2 5 10 dB Range at 0 5 1 2 KHz 50 115 dB HL Range at 4 kHz 50 90 dB HL t 0 5 0 25 0 5 1 2 3 4 6 8 kHz 1 2 5 10 dB 0 100 dB HL 0 120 dB HL Graphic supertwist LCD with backlighting 256 lines x 128 dots White text g
50. LMODE Chap 4 GN Otometrics THRESHOLD TESTING 4 3 ZODIAC 901 Middle Ear Analyzer Tone Switch Softkey 3 Ext Range Softkey 4 Softkey 5 L R Shift Setup Parameters Alternatively press the Tone Switch to start the test and only one reflex measurement will be made If required change frequency or intensity and press the Tone Switch again another reflex measurement will be made Softkey 3 increases the Sound Pressure Level in increments of 5 dB in crements of 1 2 and 10 dB are available via Setup alternatively use the Rotary Knob to increase or reduce intensity level The range of 50 to 105 dB may be extended by pressing the Ext Range button to 115 dB in Ipsi and to 120 dB in Contra Softkey 4 allows the selection of either Ipsi or Contra Pressing Softkey 5 displays the pump position graphically at the top of the screen and allows you to adjust the pressure with the Rotary Knob as long as Softkey 5 is kept pressed The graphic scale shows how much of the pump capacity is used to obtain the pressure shown When Soft key 5 is released the scale is removed and turning the Rotary Knob re verts to controlling intensity Note that if the MEP function has been selected in Measurement Setup the pressure will be automatically changed by the selected level before the reflex measurement is started The ear canal pressure may also be set to be automatically equal to th
51. MATEBASEI Zodicon manual pe eas 15 21 24 29 Software Version 19 manual clinical tests 4 Software configuration Manual Mode 13 See ZODICON menu 14 Sound and vibration 71 mode 19 Sound Pressure Level 17 Need for quiet 27 Specifications Technical presentation of measurement results 1 See Technical Specifications scaling Setup 98 SPL Screening 42 See Sound Pressure Level Screening 15 Staircase Curve 39 screening tests 4 Standards International 4 Setup 58 Standby 16 SPL 1 17 Stapedius Stapedius description ZO muscle 74 stimulus 17 See also Reflex Testing 39 45 Stapes 74 Threshold 47 Start Up waa 19 Threshold 21 24 Start Stop Button b uw fuu OLD Threshold Fast Screening ex 49 Status lamp 14 18 23 25 Threshold fast screening 4 15 19 24 Stimulus Threshold Setup 59 lamp 14 18 warn patient 28 SPL eee YA Reflex manual 40 SPL iuctemene Setup 58 60 Remote control 3 25 Tone Switch 17 Remote indication warn patient 28 Resistive loss of energy co 72 Stimulus Rotary Knob 13 17 22 29 SPL increments sig 59 RS 232C interface bos 53 Stirrup 74 Storage of ZODIAC 901 WA S Structure of the ear i 73 Supplementary functions 53 62 Safety 6 Sweep Screen dump 17 62 See Tympanometry Auto sweep Screening 4 1924 Symptoms of hearing disorders 81 82 See also Reflex System Setup 18 20 Se
52. N Chap 3 ZODIAC 901 Middle Ear Analyzer START UP 3 3 The Modes are Main Menu Identification Daily Calibration Tymp Re flex Threshold User Test Menu Program Mode Real Time Clock Setup The Activities are Manual Sweep Eustachian Tube Function ETF I ETF P Screening Decay Reflex Fast Screening FastSCR Air Conduc tion AirCona The Ear is identified as Left or Right and in tests where it is relevant additionally as CONTRA or IPSI In tests which make use of an Ear phone this will also be identified if it is connected and Contra is selected e g TDH39 If Contra is selected and either an insert phone or noth ing is plugged in it will indicated insert In all tests where the ear canal may be pressurized or depressurized via the probe by the use of the ZODIAC 901 s built in pump a horizontal scale appears at the top of the display during and immediately after changes in the static pressure The purpose of this is to show graphically how much of the pump s capacity is required at any instant Pump capacity In all tympanometric tests the Volume Vol of the ear canal is meas Volume ured computed and shown continuously in milliliters ml in one corner of the main sector of the display 3 3 START UP WARNING ATTENTION To avoid damage to the probe s electronics NEVER connect or disconnect the probe while the instrument is powered on 1 Connect the headset via its cable to the rear pane
53. N Chap 1 APPLICATIONS OF THE ZODIAC 901 1 2 GN Otometrics ZODIAC 901 Middle Ear Analyzer Unlike pure tone audiometers the ZODIAC 901 can be used successfully in environments which are not perfectly quiet since its measuring cir cuits are immunized against external interference The ZODIAC 901 is intended for Clinical tests on patients Screening of populations The clinical tests which the ZODIAC 901 is designed to perform are Manual Auto Tympanometry Eustachian Tube Function Ipsi and Contra Manual Acoustic Reflex Ipsi and Contra Reflex Decay Acoustic Reflex Latency Pure tone audiometry Air Conduction Threshold Gell s Test The screening tests are Automatic Tympanometry Ipsi and Contra Acoustic Reflex Ipsi and Contra Fast Acoustic Reflex Threshold Pure tone audiometry Air Conduction Threshold The ZODIAC 901 complies with the international standards for acoustic impedance measurement referred to in its Specifications Appendix 1 Operation Manual GN Otometrics INTRODUCTION Chap 1 ZODIAC 901 Middle Ear Analyzer ABOUT THISMANUAL 1 3 13 ABOUT THISMANUAL Operation of the ZODIAC 901 Middle Ear Analyzer is extremely easy Key Words In and consequently easy to learn This manual has therefore been de Margins signed for easy reference to specific guestions or problems The margins contain corresponding key words to help you to quickly find what you are looking for and the
54. Reflex to display the Reflex Menu Press Softkey 3 from the Reflex Menu to select Decay and then press Softkey 2 or the Tone Switch or the start button on the probe to start the test The screen shown in Fig 4 17 will be displayed the curve in this illustration is typical of a normal ear Reflex Decas Left IPSI 16Q6Hz 166d0B 225 ul 225 lol 1 91 ml Stimulus Start Penati H SIPSI Pressure 1666 Hz gt StoF 166 dE CONTRA 8 daF Press Softkey 1 to set the desired stimulus type 500 1000 2000 4000 Hz or White Noise note that White Noise is only available if Contra has al ready been selected Softkey 2 starts or stops the test Softkey 3 increases the intensity in increments of 5 dB increments of 1 2 and 10 dB are available via Setup alternatively use the Rotary Knob to increase or reduce stimulus intensity The intensity range of 50 to 105 dB may be extended by pressing the Ext Range button to 115 dB or to 120 dB in Contra Softkey 4 allows the selection of either Ipsi or Contra Pressing Softkey 5 displays the pump position graphically at the top of the screen and enables you to adjust the pressure with the Rotary Knob as long as Softkey 5 is kept pressed When Softkey 5 is released the pump position scale disappears and the Rotary Knob reverts to control ling intensity Note that if the MEP function has been selected in Meas urement Setup the pressure will be automatically changed by t
55. SUPPLEMENTARY FUNCTIONS Chap 5 SETUP 5 2 GN Otometrics ZODIAC 901 Middle Ear Analyzer Measurement Direction Leak Detect On Off NOTE Stimulus SPL Increments Scaling Sweep Speed Y Axis Use MEP Threshold Level Measurement Direction Leak Detect This last function is not applicable for Manual Tymp and may be over ridden by Ext Range You may select between negative or positive and positive negative in Manual Tymp On or Off NOTE These Setup parameters do not apply to the ETF Perforated Eardrum test 5 2 2 REFLEX TESTING Stimulus SPL Increments Y axis Scaling Compliance Speed Y Axis Use MEP Press C Use THL The following settings are available 1 2 5 10 dB Together with the Y axis parameter it is possible to select numerous different reflex threshold configurations Here it is possible to select 75 150 225 300 375 ul of volume or Auto If Auto is selected the instrument will automatically select the volume which displays the measured curve in the greatest detail Display filter speed may be selected as fast or slow the latter setting gives less noise but is less accurate when measuring reflex latency It is possible to select between Pos itive Neg ative Pos Neg and Auto If Auto is selected the instrument will automatically select whichever Y axis displays the measured curve in the greatest detail Selects whether automatic adj
56. T PROGRAMMING 7 1 ZODIAC 901 Middle Ear Analyzer Auto Test Use Default Config An example of a simple program sequence is given below in Advanced Mode This sequence performs an automatic tymp sweep on each ear in turn with A F A P pump speed and auto scaling prints the two tym panograms out and advances the patient counter One pause is in cluded to allow the operator to insert the probe into the patient s other ear Execute the following keystrokes from the Program Mode Select menu see Fig 7 2 Softkey 1 Test1 Tymp Softkey 2 Sweep Setup Softkey 1 Pump Speed A F A P Softkey 3 Scaling 4 5 ml Softkey 3 Scaling Auto Setup Softkey 2 Start Standby Alt Select Softkey 4 L R Softkey 2 Start Printer Softkey 3 Print All Alt Select Softkey 4 L R Main Menu Softkey 1 New Pt Softkey 1 Yes Auto Test Softkey 5 End Program Enter Test Name use rotary switch Auto Test Softkey 1 save user test Power instrument off to disable programming mode Now power instrument on again press Auto Test and Softkey 1 to start your own User Test NOTE Since existing test parameters are included in your User Test we suggest that you return the instrument to its default configuration immediately after starting to program User Tests Main Menu Softkey 4 Default Config Softkey 1 68 Operation Manual GN Otometrics POWER ON OPTIONS Chap 7 ZODIAC 901 Middle
57. Use MEP Selects whether automatic adjustment of MEP Press C middle ear pressure is on or off In Version 3 x Pressure Control includes Manual Auto MEP 5 10 15 20 25 25 20 15 10 5 daPa When Auto is selected an automatic offset to MEP is calculated on the basis of Gradient and TW Leak Detect On or Off 5 2 3 3 AIR CONDUCTION Stimulus The following settings are available 1 2 5 10 dB Increments Pump Switches pump on or off see Gell s Test 4 3 3 External Printer MIDIMATE 622 The ZODIAC 901 Middle Ear Analyzer is equipped with a thermal printer as standard it may however be supplied without the built in printer Whether you have a built in printer or not your ZODIAC 901 has a parallel port on its rear panel for connection to an external printer Default installed in ZODIAC 901 is the HP generic Laserjet printer driver which can be used together with any printer where PCL may be selected A Centronics cable for connection to a printer may be supplied as an optional accessory Other drivers for external printer may be de fined by means of ZODICON Y e g Epson FX HP Deskjet 500 and IBM Proprinter In addition ZODIAC 901 may be connected via the RS232C Data Inter face serial port to the MIDIMATE 622 Audiometer to allow the MIDI MATE 622 to print out audiograms on ZODIAC 901 s built in printer or 60 Operation Manual GN Otometrics SUPPLEMENTARY FUNCTIONS Chap 5 PRINTER 5 3
58. and intact referring to the enclosed Packing Specification Note that the LCD is protected by a plastic cover which may be Unpacking Inspection Protective Cover removed after unpacking the instrument This cover should not be on LCD discarded 2 2 STORAGE AND SHIPMENT To protect the instrument and accessories during storage or shipment al Storage amp Shipment ways use the best packing available If it is necessary to return the in strument to the Madsen Electronics distributor or to the factory for repair use the original shipping cartons and replace the protective cover on the LCD Always store the ZODIAC 901 in a clean dry environment and never leave the power on when the instrument is in an enclosed container When shipping the ZODIAC 901 please remember the following 1 Seal shipping container securely 2 Mark container FRAGILE to ensure careful handling 3 In any correspondence please refer to the instrument by model serial number and software version Operation Manual INSTALLING THE ZODIAC 901 Chap 2 GN Otometrics INSTALLATION 2 3 ZODIAC 901 Middle Ear Analyzer 2 3 INSTALLATION KEEP AWAY FROM LIQUIDS Connections PLEASE READ BEFORE SWITCHING ON Mains Line Connection On Off Switch Site the instrument in a well ventilated location away from all liquids and sources of heat Connect the headset and if required the optional external printer and or a personal com
59. anually 84 1 1 When starting to test the patient s other ear remember to register the change over on the ZODIAC 901 otherwise the data for the first ear will be overwritten To change to the other ear press Alt Select and then Softkey 4 Note that the pressure range of 400 to 200 daPa the factory default may be expanded to 600 to 400 daPa by pressing Ext Range Users who find it more informative to perform tympanometry using analog meters instead of the graphic display of a tympanogram can press Softkey 1 and a screen similar to the one shown in Fig 4 7 below will appear Tam Sweep Lett a 314714 A dE Pur Come B ml Jol 1 76 ml Oreration Meter Start Presque JE Pume Pun Graph Stop i Note that pressing Softkey 1 again after completion of the tymp meas urement will return you to the graphic display and show you the tym panogram you have just made using the analog meters The Alt Select pushkey allows you to use the Smooth feature to opti mize the curves see Fig 4 10 below and refer to 84 1 35 1 2 for further de tails re this function Just press Softkey 2 from the Alt Select sub menu Setup parameters available in Auto Tymp Mode see also 85 2 1 are Pump Speed 50 daPa S decaPascals per sec 100 daPa S 200 daPa S 400 daP S AFAP AS FAST AS POSSIBLE Y axis Scaling Compliance Auto 0 3 ml 0 6 ml 0 9 ml 1 5 ml 3 0 ml 4 5 ml Min Pressure daPa 100
60. ar drum is equivalent to an enlargement of the volume of the ear canal What is actually measured is this equivalent change in volume which is a useful representation of compliance for diagnostic purposes The eardrum will be most compliant when the static pressures on oppo Middle Ear Pressure site surfaces of the eardrum are equal or only slightly different The peak maximum of the tympanogram occurs at this pressure which may dif fer from atmospheric pressure depending on conditions in the middle ear The difference between the pressure at which the peak occurs and atmospheric pressure is therefore referred to as the Middle Ear Pressure MEP This pressure is computed and recorded by the ZODIAC 901 when it performs a tympanogram sweep and can be used automatically for subsequent reflex tests on the same patient The maximum increase in measured volume i e the height of the peak Static Compliance on a tympanogram is the compliance at Middle Ear Pressure This is known as the Static Compliance SC The SC is computed and recorded by the ZODIAC 901 when it performs a tympanogram sweep For comparing tympanometric data between patients or between healthy ears and ears subject to disorder it is helpful to have data which express the shape of the tympanogram rather than its absolute dimen sions After performing a tympanogram sweep the ZODIAC 901 com putes and records two such parameters The Gradient Grad is the valu
61. at all times to prevent overheating The headset is in constant contact with your patients so care should be taken to ensure that it is kept clean especially the earphone Just wipe it regularly with a moist cloth 2 4 1 CLEANING THE PROBE Please refer to 83 5 1 for further details Therubber eartips supplied with the instrument and available as op tional accessories are disposable However they may be washed an unspecified number of times in a commercial dishwasher before losing their elasticity 10 Operation Manual GN Otometrics INSTALLING THE ZODIAC 901 Chap 2 ZODIAC 901 Middle Ear Analyzer FUSE REPLACEMENT 2 5 e There are no special requirements for disposal of the rubber eartips Theprobetip must be frequently checked for cerumen ear wax even a partial blockage will affect the accuracy of your measure ments Ce rumen may be removed by means of the supplied metal pin cleaning wire see below Do NOT attempt to clean any of the tubes in the probe tip without first removing the attached plastic tubes as described below 1 First detach the probe tip from the 3 plastic tubes 2 Use the supplied metal pin cleaning wire to push out cerumen from each metal tube in the probe tip 3 Re attach the 3 plastic tubes to the probe tip 2 5 FUSE REPLACEMENT Disposal Probe Tip Procedure For Cleaning Probe Tip TO REPLACE A FUSE OR TO CHANGE VOLTAGE WARNING Before replacing a
62. ches for selecting fundamental parameters nor potentiometers for calibration of inputs probe liquid crystal display LCD etc Instead parameters are selected by using pushbuttons on the front panel in com bination with the display while the conventional potentiometers have been replaced by electronic level controls which are also operated by means of pushbuttons and display ZODIAC 901 may be operated manually or automatically in Manual Mode either Tymp Reflex or Threshold is selected and the instrument is then set up by means of the pushbuttons under the display In Auto Mode the various test combinations and parameters are prepro grammed both by Madsen Electronics and the user and may be se lected by pressing Auto Test and then the corresponding softkey under the display Note that toggling the Auto Test button accesses the Madsen Preset Test Menu and the User Test Menu respectively Madsen Preset Tests may not be altered but the User Tests may be pro grammed to suit individual requirements see 7 1 3 2 FRONT PANEL LAYOUT amp CONTROLS Manual Mode Auto Mode Auto Test On the front panel there is a Rotary Knob for manual pump control stimulus level contol and for setting up parameters and a Tone Switch interrupter for administering stimuli starting reflex tests and for enter ing identification data There are a total of 17 pushbuttons with the following functions please refer to Fig
63. d If the self test fails or displays a specific error make a note of the error message call your Madsen Electronics distributor right away and report exactly what was displayed remember to state serial no and software version If the ZODIAC 901 has been programmed to do so by the ZODICON software it may give a warning that it has not been calibrated suffi ciently recently If it has been programmed to perform Daily Calibration automatically during power up it may give a message requesting that the probe be inserted into the Precision Cavity In either case you may proceed by pressing Main Menu Main Menu Fig 3 2 Following power on or after selecting Main Menu the screen shown in Fig 3 2 is displayed indicating which ear has been selected time date operator I D patient number or I D and a sub menu Main Menu Left Time 12 14 Date 22 May 1992 Drerator Patient 1 Select pails Default Easshod Hew Pt 11 D Calibr Confis gt AduMode The default ear left or right may be set using the ZODICON software and may be different from that shown in the illustration The format of the date may also differ from that shown if it has been modified using ZODICON The time and or date setting may be altered using ZO DIAC 901 System Setup see 7 2 The following functions may be accessed from the Main Menu 20 Operation Manual GN Otometrics GENERAL DESCRIPTION
64. d be tween the graphics and the sub menu lines Fig 5 1 Version 4 x Only Tympanometry and ELFA Auto Tymp Sweep ETF I MEP Marker Softkey 2 Softkey 2 He gBBBHz Ade Reflex Screening with Marker 158 Es Operation Manual 55 SUPPLEMENTARY FUNCTIONS Chap 5 GN Otometrics SETUP 5 2 ZODIAC 901 Middle Ear Analyzer Softkey 4 Softkey 1 Softkey 5 5 2 SETUP Tl time elapsed from measuring start for Marker 1 T2 time elapsed from measuring start for Marker 2 R1 size of reflex in microliters for Marker 1 R2 size of reflex in microliters for Marker 2 dT difference in elapsed time between the two markers in 1 100ths sec dR difference in size of reflex between the two markers in ul Softkey 4 enables you to move the marker from the first curve to other reflex curves in all reflex modes where there are more than one Softkey 1 Erase Curve enables you to erase any individual curve first select curve by using Softkey 4 and the marker then press Softkey 1 to erase curve In all reflex modes with the exception of Fast Screening Softkey 5 en ables you to select whether the marker s will be included on the print out or not Two Kinds Of Setup Version 4 x Only Setup ZODIAC 901 has two kinds of setup one mode for altering test parame ters Measurement Setup which may be entered by means of the Setup pushbutton
65. d level in the ear canal The amplitude of the sound needed to produce a given measured sound level in the ear canal will be proportional to the volume of the canal The ZODIAC 901 uses this principle to calculate the volume If the eardrum has been tensioned giving it a large impedance mismatch so that it re flects most of the sound energy arriving at it the calculated volume will be that of the outer ear alone However if the eardrum is functioning normally so that most of the sound energy arriving at it is transmitted onwards to the inner ear the calculated volume will be considerably greater Intermediate states of the eardrum will result in intermediate calculated volumes Acoustic flow tympanometry Reflection of sound at the eardrum Operation Manual 77 PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 GN Otometrics PRACTICAL CONSIDERATIONS 8 10 ZODIAC 901 Middle Ear Analyzer Cartesian Tympanometry is the measurement of the change in the ear canal vol tympanometry ume resulting from the tensioning of the eardrum by the application of varying pressure in the ear canal A tympanogram is a Cartesian graphi cal representation of this measurement Reflex tympanometry Reflex tympanometry is the measurement of the change in the ear canal volume the Delta volume resulting from the tensioning of the ear drum by muscles acting on the ossicular chain following the application of an external acoustic stimulus The result
66. displays the Threshold Reflex screen in Easy Mode or the Threshold sub menu allowing additionally selection of Fast Screening and Air Conduction in Advanced Mode See 84 3 These are the factory default test modes Choice of test in Easy Mode may be altered by means of ZODICON 3 2 2 AUTO MODE Toggling the Auto Test pushbutton displays alternately the Madsen Electronics Preset Test or User Test Menu See 86 1 and 862 respec tively When a user test is being programmed pressing Auto Test is used to terminate the program sequence See 87 1 Auto Test is used to execute test sequences Main Menu Tymp Reflex Threshold ZODICON Auto Test Operation Manual 15 GENERAL DESCRIPTION Chap 3 GN Otometrics FRONT PANEL LAYOUT amp CONTROLS 3 2 ZODIAC 901 Middle Ear Analyzer Escape Continue Softkeys 1 to 5 Alt Select L R Ear Shift Setup Escape is used to terminate a pre programmed test See 87 1 This pushkey has two functions as indicated on the front panel when running a pre programmed auto test containing one or more pauses pressing Continue is used to resume the running of the program after it has paused see 86 2 and 87 1 When the program pauses the screen will display Standby and beep to show that it is waiting for a re sponse Standby is used to insert a
67. e previously measured value of Middle Ear Pressure MEP using Setup 85 2 3 2 When starting to test the patient s other ear remember to register the change over on the ZODIAC 901 otherwise the data for the first ear will be overwritten To change to the other ear press Alt Select and then Softkey 4 Setup parameters available in Fast Screening Threshold Mode see also 85 2 3 2 are Stimulus increment 1 2 5 or 10 dB TH Step 1 2 5 10 20 20 10 5 2 1 dB Max no of Measurements 1 to 16 Y Axis Auto negative positive positive negative Use Middle Ear Pressure on or off Leak Detect On Off In Version 3 x and later this function is called Press C Pressure Con trol and is extended to Manual Auto MEP 0 5 10 15 20 25 25 20 15 10 5 daPa 50 Operation Manual GN Otometrics MANUAL MODE Chap 4 ZODIAC 901 Middle Ear Analyzer THRESHOLD TESTING 4 3 4 3 3 AIR CONDUCTION This test mode enables the operator to use TDH 39 contra headphones Air Conduction for determining air conduction thresholds It also allows a bone Thresholds conductor to be used for performing Gell s test to investigate the mo bility of the ossicles and especially of the stapes Press Main Menu and use Softkey 5 to select Advanced Mode Press Softkey 3 Threshold to display the Threshold Menu Press Softkey 3 from the Threshold Menu to access the screen shown in Fig 4 22 Fig 4
68. e Instruction manual conventions Patient Counter 21 Manual Mode 13 15 19 21 24 29 52 Patient data Manual Reflex See Identification details See Reflex Manual Patient I D Manual sweep See Identification details See Tympanometry manual sweep Patulous Eustachian Tube 82 Manual tympanometry PC See d EL Manual sweep See Personal Computer Marker i i 16 18 45 54 Perforated eardrum Mastoid jiu Ss e 1S diagnosis 81 Matching of Impedances bop ow az test 37 MateBaseI 54 Personal Computer 8 MateBasel software 2 Petroleum jelly 27 MaxMeas 60 Pinna 27 73 ME Preset Tests Power cord See Preset Tests See AC cable Measurement Direction 58 Power lamp 14 18 19 Meatus bo eek mox o ZB Power On 19 25 Mechanical Impedance options 65 70 See Impedance Pre programmed tests 16 Memory non volatile 2 Precision Cavity 3 20 23 Memory volatile s 2 Preset Tests 1 13 15 63 Menus T 1 18 Pressure 29 MEP Marker bcs 30 34 36 55 Print All 62 Microphony 27 Print Data 62 Middle ear structure 2 74 Printer 2 14 17 18 60 62 Middle ear analysis principles 71 80 Menu 13 Middle ear fluid a S a a Gl Printer external 60 MIDIMATE 622 Audiometer Laa E e a 00 Printout 62 Mismatching of impedances 72 Probe Ne a 3 18 23 25 28 Movin
69. e g with difficult or unsettled pa tients you can manually move the marker in either direction by means of Softkeys 4 and 5 and read out the computed values on the left of the display Note that an asterisk appears to the right of the MEP value if the marker has been moved In the Eustachian Tube Function test for intact eardrum a second sweep is made without erasing the data from the first The values of Ear Canal Volume ECV and Middle Ear Pressure MEP from both tests are re corded and after the second test the difference between the latter MEPd MEP2 minus MEP1 is also computed and displayed The MEP marker implemented in Version 4 x enables the marker for the second sweep to be moved in either direction displaying computed values for MEP2 and MEPd Softkeys 4 and 5 are used for moving the marker to the left or right Reflex and reflex threshold testing The marker is accessed by pressing the Alt Select button from any re flex test mode and then Softkey 2 to activate the Marker Mode Pressing Softkey 2 then toggles between Track Marker 1 and Marker 2 where Track means that both markers move simultaneously The screen in Fig 5 1 shows Marker 1 and Marker 2 set Reflex Screening Risht IPSI BH E z fl za arf ul 8555 ul zi 2150 ul aber Mode Er ase Mode Um E Cur ve Marker 1 1 Ho The markers are moved by turning the rotary knob When the Marker Mode is selected the following data is displaye
70. e of compliance at which the width of the Gradient hump of the tympanogram is 100 daPa divided by the Static Compli ance Operation Manual 79 PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 GN Otometrics TYMPANOGRAM CHARACTERISTICS 8 11 ZODIAC 901 Middle Ear Analyzer Tympanogram Width The Tympanogram Width TW is the pressure difference between the two points on the curve at which the compliance is half the Static Com pliance 80 Operation Manual GN Otometrics DIAGNOSIS OF AUDITORY DISORDERS Chap 9 ZODIAC 901 Middle Ear Analyzer DISORDERS AND THEIR SYMPTOMS 9 1 9 DIAGNOSIS OF AUDITORY DISORDERS 9 1 DISORDERS AND THEIR SYMPTOMS 9 1 1 MIDDLE EAR FLUID AND EFFUSION Serous otitis is a disease which can lead to a build up of fluid and a re duced pressure in the middle ear The resulting middle ear dysfunction with fluid effusion in the middle ear space produces a very shallow tym panogram with a reduced static compliance and a reduced gradient Only in a small proportion of cases is a peaked tympanogram produced The pressure reduction results in a tympanogram shifted to the left Ipsi lateral acoustic reflex is often absent 9 1 2 DISRUPTION OF THE OSSICULAR CHAIN If there is a discontinuity in the ossicular chain the impedance of the cochlea and oval window will have little or no influence on the imped ance of the eardrum Disruption of the ossicular chain results in a very tall tympanogram with increa
71. eans of ZODICON to remind you when this period has expired Your ZODIAC 901 is dispatched from the factory in Denmark together Test Report with a Test Report Calibration Certificate The Test Report specifies which transducers have been calibrated i e those which have been sup plied together with the instrument according to which standards and what equipment was used for calibration Results are listed for each transducer at all standard frequencies In general the instrument is calibrated in dB SPL or dB HL using the stated reference equivalent thresholds dB HL are related to sound pres sure levels db SPL dB re 20 uPA 1 cc 1 ml Note that calibration has only been performed on the supplied trans ducers If you wish to use any other transducer for testing with the ZODIAC 901 please contact your local Madsen distributor first However since the weather and barometric pressure vary from day to day the probe measuring system should be calibrated on a daily basis in order to achieve the greatest possible measurement accuracy With the ZODIAC 901 this procedure is very quick and easy to perform Softkey 3 maximum 15 seconds just press Softkey 3 from the Main Menu to ac cess the screen shown in Fig 3 4 Fig 3 4 Daily Calibration reration Cavity Start 2 4cc Stor Er ase If provision for calibration with a second Precision Cavity having a dif Softkey 1 fere
72. easured Y axis scaling Y axis origin posi tion Selecting More changes the sub menu choices to optional use of a measurement pressure level a selected interval above or below Middle Ear Pressure MEP and Leak Detect on or off Version 4 x Press Setup again to return to the function currently selected See 85 2 Setup is also used for the ZODIAC 901 System Setup which is one of the power on options This facility enables a large number of measure ment parameters to be pre set as required The key is held down while the power is switched on See 87 2 16 Operation Manual GN Otometrics GENERAL DESCRIPTION Chap 3 ZODIAC 901 Middle Ear Analyzer FRONT PANEL LAYOUT amp CONTROLS 3 2 3 2 5 OTHER FRONT PANEL CONTROLS The Rotary Knob is used to select the characters for operator and pa tient identification 83 4 2 to adjust pump pressure 84 1 1 4 1 49 1 4 84 2 1 84 2 3 84 3 1 84 3 2 to vary Sound Pressure Level 84 2 1 84 2 3 84 3 1 84 3 2 84 3 3 to move the marker 85 1 6 to adjust display con trast 85 1 5 87 2 and to set beeper level time and date 87 2 It may also be used to adjust any other test parameter with more than two pos sible values hold the corresponding Softkey down and turn the Rotary Knob in either direction as required The Tone Switch is used to key in the characters for operator and pa tient identification 83 4 2 to start reflex test measurements 84 2 2 84 2 3 84 2 4
73. ectronics Ear Simulator allows trouble free training and checking of the capabilities of the ZODIAC 901 e The comfortable lightweight headset features a single integral cable with specially developed connectors which carry both the electrical signals and the air line from the pump The stainless steel spring band and genuine leather headband enable the headset to be adjusted quickly and easily for each patient A smaller headset for children is also available as an optional accessory The standard TDH 39 earphone supplied may easily be replaced by an optional insert phone or bone conductor 1 2 APPLICATIONS OF THE ZODIAC 901 Remote indication Remote Control Built In Calibration Data Calibration For Both Types Of Phone Precision Cavity Ear Simulator Headset The ZODIAC 901 is designed for acoustic impedance and static pressure measurements on the ear canal These measurements by themselves or in combination with pure tone audiometry enable a variety of middle ear and other disorders to be diagnosed The measurement techniques embodied in the ZODIAC 901 have the ad vantage of being objective Unlike pure tone audiometry they depend only on passive co operation from the patient not on the patient s sub jective judgement They can be performed more reliably than pure tone audiometry measurements on children and other patients whose ability to co operate may be limited Operation Manual INTRODUCTIO
74. ed out or transmitted via the data interface Press Main Menu and use Softkey 5 to select Advanced Mode Press Threshold to display the Threshold Menu Press Softkey 2 from the Threshold Menu to access the screen shown in Fig 4 21 Threshold FastSCR Risht CONTRA TDH39 388 Dreration s i Start Pressure i H 5top uH dE B 24 daF Note that when Contra is selected the type of phone is displayed as well as White Noise stimulus if selected Press Softkey 1 to set the desired stimulus type Press it repeatedly or keep it pressed and turn the Rotary Knob left or right The stimuli avail able are tone at 500 1000 2000 and 4000 Hz plus White Noise if Contra has been selected Softkey 2 starts or stops the test The pushkey on the probe may also be used to do this The ZODIAC 901 will conduct three tests automatically using the elected stimulus at 70 dB 80 dB and 90 dB in turn If it finds a reflex it will show its threshold level in the panel in the right hand part of the display and stop further testing If not it will display NR No Reflex The number of tests conducted in turn the step size from each step to the next etc may be changed using Setup The tests may be re peated with each of the available stimuli in turn Fig 4 21 Reflex NOTE Softkey 2 WA SBE Threshold Fast Screening Contra Softkey 1 Softkey 2 Operation Manual 49 MANUA
75. ee L R ear selection smoothing 29 Eardrum tensioning 76 Operation Manual 89 Earphone Immunization against interference 4 See TDH 39 Earphone Impacted cerumen 82 Eartip26 Impedance el tg e cete deste er da iy 34 71 Eartip 18 27 Matching x x k s k e o 72 Sanitization 26 measuring 75 Easy Mode 15 21 24 Mismatching 72 Effusion 81 NCUS Knee vos ox wo ger res dA Erase Curve 46 56 Indicator lamps TTC Erase data 16 18 29 53 Inner ear structure 74 Erase Line 22 Insert phone s s Q Q w 44 4 44 4 4 a8 Error Messages 20 display ps Abos eo oh 19 Escape 16 63 Inspection of Patient s Bar zs a the we se 2 ETF Inspection ZODIAC 901 on delivery or ae eA See Eustachian Tube Function Installation of ZODIAC 901 89 ETF I 95 Instruction manual conventions 5 Eustachian Tube Intact Eardrum Test 36 occluded 81 Interference L4 patulous Ro 82 Introduction 2 1 6 Eustachian Tube Function E 4 15 19 24 36 Ipsi E Perforated eardrum 37 Eustachian Tube structure 74 K Ext Range 17 Ext Range lamp 1418 Key Words 5 Extended Range 32 35 38 External Printer 60 E F L R ear selection 54 L R ear selection 16 19 21 24 28 29 54 Fast Screening 26 lLabynnth u
76. eep has been selected using Setup MEP is the pump pressure at the peak of the tympanogram i e when the pressures on both surfaces of the eardrum are equal The Gradient is calculated as follows static compliance minus the compliance where width 100 daPa divided by static compliance SC C width 100daPa SC TW is the pressure difference between the two points on the curve at which the compliance is half the peak compliance The MEP marker appears automatically and is located at the peak of the sweep i e at O daP In cases where it is difficult to carry out a normal sweep and obtain compliance data e g with difficult or unsettled pa tients you can manually move the marker in either direction by means of Softkeys 4 and 5 and read out the computed values on the left of the display Note that an asterisk appears to the right of the MEP value if the marker has been moved To restore the static pressure to zero quickly press Air Release which automatically resets the pump position Where the patient is already experiencing pain or discomfort caution should be exercised in selecting pressure range and pump speed particularly in the positive pressure direction 34 Operation Manual GN Otometrics MANUALMODE Chap 4 TYMPANOMETRY 4 1 ZODIAC 901 Middle Ear Analyzer In such cases it is better to use Measurement Setup to increase the Min Pressure and or reduce the Max Pressure Alternatively change the air pressure m
77. ftkey 5 L R Shift Setup Parameters Alternatively press the Tone Switch to start the test and only one curve will be made If required change frequency or intensity and press the Tone Switch again another curve will be made Threshold Reflex Risht IPSI S9HE OHR SIHR S2HE 2dB THE lol 1 93 ml eration Stimulus Start Perse 3 FIPSI Pressure 2666 Hz 2Stor 55 dB CONTRA 3 daF Softkey 3 increases the Sound Pressure Level in increments of 5 dB in crements of 1 2 and 10 dB are available via Setup alternatively use the Rotary Knob to increase or reduce intensity level Range of 50 to 105 dB may be extended by pressing the Ext Range but ton to 115 dB 120 dB in Contra Softkey 4 allows the selection of either Ipsi or Contra Pressing Softkey 5 displays the pump position graphically at the top of the screen and enables you to adjust the pressure with the Rotary Knob as long as Softkey 5 is kept pressed The graphic scale shows how much of the pump capacity is used to obtain the pressure shown When Soft key 5 is released the scale is removed and turning the Rotary Knob re verts to controlling intensity Note that if the MEP function has been selected in Measurement Setup the pressure will be automatically changed by the selected level before the reflex measurement is started When starting to test the patient s other ear remember to register the change over on the ZODIAC 901 otherwise the data for the
78. fuse or changing voltage first switch off instrument and disconnect from mains power supply 1 Switch off the instrument and disconnect from mains 2 Remove the two Phillips screws at the back of the top panel 3 Tilt the top panel forwards and remove 4 The voltage selector is located next to the power switch see Fig 2 3 on next page 115 V or 230 V may be selected 5 Two identical fuses are located beside the voltage selector see Fig 2 3 The current of the fuses varies according to the voltage see below Component Voltage Fuses Type Dimensions F301 F302 115 V 400mA Slow Blow 5x20mm F301 F302 230 V 200mA Slow Blow 5x20mm Voltage Select Fuse Replacement Voltage Select Fuse Replacement Operation Manual 11 INSTALLING THE ZODIAC 901 Chap 2 GN Otometrics FUSE REPLACEMENT 2 5 ZODIAC 901 Middle Ear Analyzer 1083 O Z AI 2 Fig 2 3 Voltage Selector amp Fuses Inside ZODIAC 901 Operation Manual GN Otometrics GENERAL DESCRIPTION Chap 3 GENERAL 3 1 ZODIAC 901 Middle Ear Analyzer 3 GENERAL DESCRIPTION 3 1 GENERAL Unlike most other impedance audiometers ZODIAC 901 has no swit
79. g coil meter Calibration 20 See Analog Meter ee replacement 26 Multi Curves Row hoe w a e AL Probe calibration data See Calibration data N See Calibration data in probe Probe cuff New Patient 18 21 See Eartip NOAH ess a s s s s s 594 Probe tip Non volatile memory Los Pos be we ee EA See Eartip Nonlinearity of the eardrum 76 Program Mode 19 Program Configuration O See Zodicon Programmable User tests Occluded Eustachian Tube 81 See User Programmable Tests Operation of ZODIAC 901 18 Programming Ossicular chain to end 66 disruption Roo 4 e OL to start 66 Ossicular chain auditory sos ow v v 7A Pump 29 impedance 76 capacity 19 Otosclerosis 8 on off 60 Outer ear structure 73 power on 19 Oval window 74 pressure 17 speed 57 P Pump Pressure IN S Pure tone audiometry 34 27 Operation Manual 91 R parameters 33 35 42 43 45 48 50 52 restoring default 15 21 24 Real Time Clock 19 stimulus SPL increments 60 Reflex Setup System activity 19 See System Setup Advanced Mode 24 Shipment of ZODIAC 901 zA Decay 43 Siting of ZODIAC 901 A gt Decay 15 19 24 Smooth 16 29 53 Decay clinical tests 4 Softkeys 1 to 5 I 16 18 Easy Mode 24 Software 1 Latency DC 445 See also
80. gram Mode Entering name of test Testi FJK 412345367189 A E Dreration Erase Cursor Curzor Line leas Jeu Erase the previous name by means of Softkey 1 and enter the new pro Softkey 1 gram name in the same way as for operator and patient I D described in 3 4 2 Press Auto Test again to save the new test program You are asked to Auto Test confirm that you really wish to save it thus overwriting the old one Fig 7 4 Fig 7 4 Prosram Mode Program Mode Save Confirmation menu Testi FJK 41234567189 A EMIL A Save User Test 7 Yes Ha Press Softkey 1 to save and you are returned to the first screen in the Softkey 1 programming sequence see Fig 7 1 Press any key to exit this screen and enter the desired test mode To Exit Whenever the test which has been programmed is subsequently ac cessed exactly the same sequence will be repeated and your Setup set tings restored Automatic Mode and status will be displayed at the top of the screen If you have programmed a break or pause into your test sequence you will hear a beep when the break is reached and STANDBY will appear in the top line To continue press Continue Continue To interrupt or exit a test sequence first press Softkey 2 Stop if a test is Escape running and then Escape Operation Manual 67 POWER ON OPTIONS Chap 7 GN Otometrics USER TES
81. he selected level before the reflex measurement is started When starting to test the patient s other ear remember to register the change over on the ZODIAC 901 otherwise the data for the first ear will 44 Operation Manual GN Otometrics MANUALMODE Chap 4 ZODIAC 901 Middle Ear Analyzer REFLEX TESTING 4 2 be overwritten To change to the other ear press Alt Select and then Softkey 4 Setup parameters available in Reflex Decay Mode see also 85 2 2 Setup Parameters Stimulus increment 1 2 5 or 10 dB Use Threshold 0 5 10 15 or 20 dB above or off Y axis scaling Auto 75 150 225 300 375 ul Y Axis Auto negative positive positive negative Use Middle Ear Pressure on or off Leak Detect On Off In Version 3 x and later this function is called Press C Pressure Con trol and is extended to Manual Auto MEP 0 5 10 15 20 25 25 20 15 10 5 daPa 4 24 USER 1 USER 2 These tests can be programmed from an external PC via the instrument s User 1 User 2 RS 232C data interface and with the help of Madsen s ZODICON con figuration program see also 86 2 ZODICON may be used to custom ize the ZODIAC 901 for individual preferences Please refer any inquiry about these facilities to your local distributor The User 1 and User 2 tests are similar to Reflex Screening except that there is only one reflex measurement made and each test allows the x axis duration pre stimulati
82. he item Patient in the Main Menu display Each time the instrument is powered on the patient counter is reset at 1 If preferred the patient may be identified by name or healthcare number see Identification below However each time you finish testing a pa tient and wish to start a new patient press Main Menu to enter the Main Menu press Softkey 1 New Pt to display the New Patient sub menu and press Softkey 1 again to confirm your choice Note that the display indicates the next number on the patient counter which you may then change to an alphanumeric entry if desired by re turning to the Main Menu press Main Menu and pressing Softkey 2 to select I D NOTE Selecting New Patient WARNING erases all data on previous patient The selection of New Patient must be confirmed because all the data Previous Patient concerning the last patient is automatically erased from the instrument s Data Erased memory whenever you confirm selection If a mistake has been made pressing Softkey 2 from the New Patient sub menu prevents the data from being erased Operation Manual 21 GENERAL DESCRIPTION Chap 3 GN Otometrics MAINMENU 34 ZODIAC 901 Middle Ear Analyzer Patient I D Entry WARNING Softkey 2 Fig 3 3 Softkey 1 Softkey 3 Rotary Knob To Exit Identification Sub menu 3 4 IDENTIFICATION Entry of patient and operator identification data is enabled fro
83. hian Tube connects the middle ear to the throat but is nor mally sealed except during swallowing Its purpose is to prevent a static pressure differential from building up across the eardrum This test is similar to Tymp Sweep but provides for a second sweep to be made without erasing the data from the first The values of Ear Canal Volume ECV and Middle Ear Pressure MEP from both tests are re corded and after the second test the difference between the latter MEPd MEP2 minus MEP1 is also computed and displayed please see Fig 4 8 The MEP marker implemented in Version 4 x enables the marker for the second sweep to be moved in either direction displaying computed values for MEP2 and MEPd B 6 B a El i 1 77 688 Oreratior Meter Start Wi eS Pune Pune Gr arh rotor The procedure for using the test is to get the patient to try to create an over pressure in the middle ear by closing the mouth holding the nose blowing to create the over pressure in the throat and swallowing to open the Eustachian Tube The patient can then relax while the first sweep is made Then the patient drinks a glass of water relieving the over pressure if the Eustachian Tube Function is normal The second sweep will then reveal a negative MEP please see example in Fig 4 9 36 Operation Manual GN Otometrics ZODIAC 901 Middle Ear Analyzer MANUAL MODE Chap 4 TYMPANOMETRY 4 1 ETF I Risht
84. ilable for accu rately reading out test data Typically the marker s are moved by means of pressing one of the softkeys or by pressing Alt Select and us ing the Rotary Knob In tympanometry Tymp Sweep and ETF I modes have a marker function for automatic indication of MEP Version 4 x only All reflex and reflex threshold testing modes have a marker function for the purpose of accurately measuring the duration and degree of an elic ited reflex The marker function may be used to measure Acoustic Reflex Latency which is the delay of the onset of the reflex from the instant when the stimulus is initiated This function also enables the deletion of a single curve 54 Operation Manual GN Otometrics SUPPLEMENTARY FUNCTIONS Chap 5 ZODIAC 901 Middle Ear Analyzer ALT SELECT 5 1 From Version 4 x of the ZODIAC 901 including the Limited Version a Middle Ear Pressure MEP marker has been implemented in Tymp Auto Sweep and ETF I testing Softkeys 4 and 5 no longer are used for moving the pump but for moving the marker instead When moving the MEP marker the current values for MEP SC Gradient and TW are dis played in real time on the left of the screen An asterisk appears to the right of the MEP value to indicate that the marker has been moved The MEP marker appears automatically and is located at the peak of the sweep i e at 0 daP In cases where it is difficult to carry out a normal sweep and obtain compliance data
85. in daPa can be read out from the display When the pump is enabled the pressure range is changed to extended range 600 daPa to 4400 daPa The Air Conduction Threshold mode may also be used to perform Gell s test using the probe to apply a static pressure or depression to the ear canal in Air Conduction Threshold mode there is no probe tone Remember to disconnect the TDH 39 headphone from the miniature jack in the side of the probe if connected An audiometer is required to perform audiometry with bone conduc tion Apply the bone conductor to the patient at the mastoid Record the pati ent s audiogram several times with different pump pressures Lack of variation of threshold between the different audiograms indicates a probable fixation of the stapes 52 Operation Manual GN Otometrics SUPPLEMENTARY FUNCTIONS Chap 5 ZODIAC 901 Middle Ear Analyzer ALT SELECT 5 1 5 SUPPLEMENTARY FUNCTIONS 5 1 ALT SELECT As described previously 83 2 4 the Alt Select pushbutton offers an ad ditional sub menu which appears on the display in place of the sub menu of whichever test mode is operational at the time The Alt Select pushbutton accesses the following functions at any time except when a test is in progress Erase Data Smooth not Version 2 x of the ZODIAC 901 Marker Data Xmit L R shift from one ear to the other Contrast for adjusting the display s contrast Afterwards press Alt Select again
86. in the center of the front panel and one mode System Setup for basic instrument functions such as language and clock which may only be entered by pressing Setup when powering on please refer to 87 2 From Version 4 x additional setup choices have been added to some sub menus with the result that Softkey 5 More may be used to access these functions As previously stated on page 29 the Setup sub menus may be accessed from any function or test mode enabling the user to alter many of the test parameters as desired Simply press Setup to access the appropriate setup sub menu Note that Setup may be accessed only from a test mode and then not during an actual measurement From Tymp Sweep for example the Setup sub menu can be seen in the display illustrated in Fig 5 2 56 Operation Manual GN Otometrics SUPPLEMENTARY FUNCTIONS Chap 5 ZODIAC 901 Middle Ear Analyzer SETUP 5 2 Fig 5 2 Tame Sweer Lett 8 3 Tymp Sweep Setup ml daP 4 6 ml dap 43 a d 44 B zag Setur Pnesresd MeasDir Scalins MigPres MaxPres 4aBdP 5 Hes Auto zHBHdaP 2646 daP Test parameters that may be altered vary according to which test mode To Exit Setup is currently selected e g there is no provision for changing pump speed in reflex measurements nor for adjusting the y axis in tympanome try only relevant parameters may be changed Setup may be exited simply by pressing the Setup pushbutton again In
87. ing a test Pressing one of the three Manual Mode pushbuttons accesses a sub menu when Advanced Mode has been selected from the Main Menu enabling the user to select the desired test This Chapter describes how to perform each of the range of tests available from these menus If it is required to erase the current test data smooth a tymp curve Car tesian graph not available with Version 2 x of the ZODIAC 901 access the marker function transmit data to an external computer register a change of ear or adjust the contrast of the Liquid Crystal Display press Alt Select at any time except while a measurement is in progress see 85 1 The ZODIAC 901 Middle Ear Analyzer incorporates a pump which is used to apply a small static pressure or depression to the patient s ear canal Although this pressure is no more than would be experienced by ducking one s head just below the surface of the water in a bath it may occasionally be sufficient to cause unexpected distress to a patient with an ear disorder The pressure may be relieved promptly by pressing the Air Release button which automatically resets the pump position Most of the parameters used in the following tests which can be set by pressing a Softkey repeatedly can also conveniently be adjusted by holding the same Softkey down and turning the Rotary Knob in either direction Setup Setup Inactive During Test Alt Select Air Release
88. ing start for Marker 1 T2 time elapsed from measuring start for Marker 2 Reflex Screening Fisht IPSI KAA 165d Zani 1685d6 156 y B i B 21 B B ul izB ul izB ul Er ase qo Mode Made ine eee Marker 1 1 Ha Cur vae R1 size of reflex in microliters for Marker 1 R2 size of reflex in microliters for Marker 2 dT difference in elapsed time between the markers in 1 100ths sec dR difference in size of reflex between the two markers in ul Softkey 4 enables you to move the marker from the first curve to other reflex curves in all reflex modes where there are more than one Softkey 1 Erase Curve enables you to erase any individual curve first select curve by using Softkey 4 and the marker then press Softkey 1 to erase curve In Manual Reflex if you have made multiple curves select curve s by placing Marker 1 to the left of the curve s you want to erase and Marker 2 to the right of the curve s Then press Softkey 1 Erase Curve In all reflex modes with the exception of Fast Screening Softkey 5 en ables you to select whether the marker s will be included on the print out or not 4 3 THRESHOLD TESTING Threshold If Advanced Mode has been selected pressing Threshold displays the screen shown on the next page in Fig 4 19 The following operation modes may be selected from the Threshold Menu Reflex Threshold Fast Screening and Air Conduction If Easy Mode has been se
89. is an expression of the requirement that the wavelength of the chosen fre quency should be much longer than the largest dimension of the cavity For mechanical or acoustic impedance measurements on the ear the fre quency to be used has been standardized at 226 Hz The expression P V log V is related to the mechanical impedance of the outer ear cavity but is not equal to it This is because it relates the acous tic pressure to the change in volume not to the acoustic velocity The ve locity is a function not only of the change in volume but also of the frequency However at a fixed frequency there will be a one to one cor respondence between the mechanical impedance and the volume of the cavity Tympanometry is concerned with measuring not the absolute value of the mechanical impedance but changes in its value 88 TENSIONING OF THE EARDRUM Nonlinearity of the eardrum Tensioning the eardrum As explained above the impedance of the healthy ear under normal con ditions will be determined not only by the volume of the outer ear but also by the impedance of the inner ear as transformed by the auditory ossicular chain and presented at the eardrum The deflection of the eardrum in response to acoustic vibrations is very small and its behaviour is normally linear That is to say its mechanical impedance is independent of the sound pressure level Its deflection is proportional to the sound pressure However for changes in pre
90. is enables accurate measurements to be taken in ordinary environ ments without the use of a special quiet room It enables the ear canal volume to be measured continuously during the application of an acous tic reflex stimulus which can be at a much higher level than the 85 dB SPL used for the 226 Hz probe tone 78 Operation Manual GN Otometrics PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 ZODIAC 901 Middle Ear Analyzer TYMPANOGRAM CHARACTERISTICS 8 11 8 11 TYMPANOGRAM CHARACTERISTICS A tympanogram has a number of characteristics which are often used for comparison and diagnosis by audiologists and can be computed automatically by the ZODIAC 901 A volume tympanogram is a graph showing the measured volume as a Volume function of pressure The measured volume will at no point be less than tympanogram the volume of the ear canal alone ear canal volume ECV It is therefore more instructive to generate a compliance tympanogram in which the origin has been moved up the y axis to lie level with the flat part of the curve The measured volume is related to the compliance and the ECV as follows volume ECV compliance The name compliance requires some elucidation The audiologist is in Compliance terested in using the tympanogram to determine the compliance of the tympanogram eardrum Compliance is conventionally expressed as a displacement di vided by a pressure However any transmission of sound by the e
91. l 2 Plug the AC cable into the power inlet on the rear panel and then connect the analyzer to a power source 3 Switch on the ZODIAC 901 by depressing the power switch located on the left of the rear panel 4 Thepower LED illuminates and the screen displays Memory test fora couple of seconds and then which version of the software is installed and the date and time of calibration while the instrument runs an automatic self test The lowest line of the display indicates the status of the test and error messages if any 5 The power up process takes about a minute during which time the pump is run audible click and hum probe data is loaded and the system memory and the calibration memory are checked In addition analog and electrical circuits are checked and optimized Connect Headset Connect AC Cable Power On Software Version Automatic Self Test Operation Manual 19 GENERAL DESCRIPTION Chap 3 GN Otometrics MAINMENU 34 ZODIAC 901 Middle Ear Analyzer Main Menu Remember to Connect Headset Error Messages To Bypass Daily Calibration 3 4 MAIN MENU 6 When this process has been completed the Main Menu is loaded and you are ready to enter your I D together with the I D of your first patient of the day see 83 4 NO WARM UP TIME IS REQUIRED NOTE If the headset has not been connected the analyzer will not continue and the following message will be displayed Headset not connecte
92. l other relevant data printed out together For the ZODIAC 901 Middle Ear Analyzer Madsen Electronics have developed a unique lightweight probe that may either be worn com Operation Manual GN Otometrics INTRODUCTION Chap 1 ZODIAC 901 Middle Ear Analyzer APPLICATIONS OF THE ZODIAC901 1 2 fortably on the headset for clinical testing or used asa hand held probe for fast screening purposes A smaller headband is available for testing children e Colored lights on the probe indicate when a measurement is in prog ress and also give warning in the event of air leakage instability in the measured ear cavity volume or measurement interruption owing to air leakage The start stop button on the probe permits remote operation of the ZODIAC 901 e Each probe supplied by Madsen Electronics has its calibration parame ters and serial number stored electronically in the probe permitting exchange of probe and or cable without recalibration e The probe can be calibrated to both TDH39 and insert phone and will automatically change from one set of phone calibration data to the other when one changes phone e The built in Madsen Electronics 2 cc 2 ml Precision Cavity enables the ZODIAC 901 to be calibrated on a daily basis to take account of baro metric pressure altitude etc The cavity incorporates a built in rubber seal enabling calibration to be performed without the use of a separate eartip e Built in Madsen El
93. lank and Softkey 2 has no effect 5 3 2 3 PRINT ALL Pressing Softkey 3 Print All not only prints out all test data for both ears for the current patient but also the Madsen Electronics header to gether with your own if it has been entered via the ZODICON con figuration program The sequence of tests in the printout may also be defined by means of ZODICON Pressing Softkey 3 Print All displays a new sub menu offerring you the choice between printing out all data as described in the previous para graph or printing out only new data i e data gathered from measure ments made since the last Print All 62 Operation Manual GN Otometrics AUTO MODE Chap 6 ZODIAC 901 Middle Ear Analyzer MADSEN ELECTRONICS PRESET TESTMENU 6 1 6 AUTO MODE The ZODIAC 901 not only has the capability for manual and automatic middle ear testing but also has the unigue capacity to run a seguence of tests set up for the operator s own convenience and according to his her preferences see User Test Programming in 87 1 Up to four of these sequences may be programmed and they may also include pauses printouts in fact anything that you can do in Manual Mode In addition the instrument leaves the factory with five Madsen Electron ics Preset tests which may not be altered The ZODIAC 901 can be user programmed so that all the measurements required are remotely controlled from the Stop Start pushbutton on the Probe without the
94. lect e 16 18 Select Default Configuration 18 T Select Line 22 Self Test 19 TDH 39 earphone 9 19 26 Semi circular canales 74 Technical Specifications 83 84 Service and Repair 6 Technical Specifications 2 4 Setup 56 59 Tensor tympani 74 Setup 5 16 29 Test Modes 29 exit 57 Threshold jid ue d a 29 46 inactive during testing 29 Advanced Mode 21 24 Menu oes Detection 47 mode 18 19 Easy Mode 24 92 Operation Manual Manual Mode 13 24 Programmable 63 menu 14 User Programmable Tests L 64 mode 19 User Programmable Tests Defined 65 pushbutton 15 Reflex 15 V Setup 59 step Setup 5960 Version 3 x i 33 42 Stimulus SPL 17 Version 4 x i 33 34 36 40 42 55 Testing 46 52 Version Software 19 Threshold Air Conduction Vibration 71 See Air Conduction Threshold Volatile memory 2 Time 17 Voltage Tip probe Operating 8 See Eartip Select 11 Tone Switch 13 17 22 51 Volume 19 Tragus gt 27 Transmit Data 29 X See Data Transmit Tympanic cavity 74 Xmit Tympanogram See Data Transmit Liquid Crystal de ue 18 Tympanometry 30 38 Y Tympanometry o 1 Advanced Mode 24 Y axis Analog Meter Display 18 Range Reflex 58 Auto Sweep s eo BO Range Threshold 59 60 Auto Sweep 4 5 19 21 24 Scaling Reflex 58 Auto Sweep speed Setup 58 Scaling Threshold 59 Auto Sweep Setup 56 Scaling Tym
95. lected pressing Threshold displays the Threshold Fast Screening test illustrated in Fig 4 20 unless programmed otherwise by means of ZODICON If the factory default settings have been modified using the ZODICON software the following defaults may differ from those indicated below threshold level increment threshold fast screening maximum number of 46 Operation Manual GN Otometrics MANUALMODE Chap 4 ZODIAC 901 Middle Ear Analyzer THRESHOLD TESTING 4 3 measurements x axis pre stimulation delay stimulation duration and post stimulation delay Threshold Left IPSI Operator Patient Select Reflex A The Threshold Detect Delta Volume and Threshold Detection Time du ration of delta compliance after the onset of a stimulus are set at the fac tory to 20 ul and 500 msec respectively Smaller changes in volume or changes occurring after this time will be registered as N R No Reflex These measurement parameters may also be altered using the ZODI CON software In Version 3 x and later threshold detection may also be programmed to only accept negative reflexes by means of ZODICON Two markers fixed cursors may be applied to all reflex threshold records For a de scription of the marker function see 84 2 5 4 3 1 THRESHOLD REFLEX This test mode permits automatic Threshold Reflex search at six different levels Once a reflex has been found the test stops It may be con
96. lowed by printout Print All Auto Test Softkey 1 Operation Manual 63 AUTO MODE Chap 6 GN Otometrics USER PROGRAMMABLE TESTS 6 2 ZODIAC 901 Middle Ear Analyzer Softkey 2 T amp R performs a Tymp Sweep and then Reflex Threshold Ipsi with 500 Hz 1000 Hz 2000 Hz and 4000 Hz stimuli in turn followed by printout Print All Softkey 3 T amp Decay performs a Tymp Sweep Reflex Threshold Ipsi at 1000 Hz followed by Ipsi Reflex Decay at 1000 Hz Level 410 dB and finally printout Print All Softkey 4 T amp Fscr Ipsi performs a Tymp Sweep and Ipsi Reflex Threshold Fast Screening at 500 Hz 1000 Hz 2000 Hz and 4000 Hz followed by print out Print All Softkey 5 T Fscr Contra performs a Tymp Sweep and Contra Reflex Threshold Fast Screening at 500 Hz 1000 Hz 2000 Hz and 4000 Hz followed by printout Print All Madsen Electronics reserves the right to alter the contents and definition of these Preset Tests at any time without notice 6 2 USER PROGRAMMABLE TESTS User Programmable Tests Auto Test ZODIAC 901 is supplied with four user programmable tests User 1 User 2 User 3 and User 4 These tests may be uploaded to a PC or down loaded from a PC by means of ZODICON By user programmable or user tests we mean that the user can select the default parameters of a particular test the user ca
97. m the Main Menu Press the Main Menu key NOTE Changing Patient I D erases all data on previous patient Press Softkey 2 I D and the Identification menu shown in Fig 3 3 ap pears without name and number Identification Risht reratar Patient 412345367189 POR e reration Erase Select Cursor Curzor Line fers pss Press Softkey 1 Erase Line to clear any previous data on selected line Pressing Softkey 3 Select Line toggles between Operator and Patient To enter I D data press Softkey 3 if necessary to select the required line turn the Rotary Knob until you find the desired character and press the Tone Switch to enter the character Pressing the Cursor arrow buttons Softkeys 4 and 5 moves the cursor to the right or left on each line max 21 characters If you make a mistake return to the incorrect char acter s by means of the Cursor arrow buttons and overwrite the incor rect character s The following characters are available hyphen 0 9 space A Z Return to the Main Menu by pressing Main Menu 22 Operation Manual GN Otometrics GENERAL DESCRIPTION Chap 3 ZODIAC 901 Middle Ear Analyzer MAINMENU 34 3 4 3 DAILY CALIBRATION Your ZODIAC 901 is delivered to you fully calibrated and should be re Annual calibrated annually by suitably qualified personnel using the appropri Recalibration ate equipment Your instrument may have been configured by m
98. n also select a combi nation of tests to form a battery of preset tests The user programmable tests may be configured as a power up option see 87 1 Toggle Auto Test to enter the User Test Menu The bottom line of the display will contain the names of any User Tests which have been pro grammed otherwise there will only be dashes 64 Operation Manual GN Otometrics POWER ON OPTIONS Chap 7 ZODIAC 901 Middle Ear Analyzer USER TEST PROGRAMMING 7 1 7 POWER ON OPTIONS Two of the function keys Auto Test and Setup may be used to initiate extra facilities This is achieved by holding down the chosen function key while powering the instrument on These facilities are used if re quired not during patient testing but in the course of preparations for testing and this method of access protects the user against their acciden tal alteration or misuse There are two different facilities that may be ac cessed in this way User Test Programming and ZODIAC 901 System Setup User Test Programs and changes made to parameters using Sys tem Setup will be preserved in the non volatile memory of the ZODIAC 901 when the power is switched off and will remain in effect unless al tered again subsequently using the Power On facility 7 1 USER TEST PROGRAMMING The purpose of the User Test Programming Mode is to permit the user to program his own tests Tests 1 4 in the User Test Menu accessed from Auto Test By user programmable or u
99. nctioning of the Eustachian Tube in the presence of a perforated eardrum for example in cases where a pressure differen tial has been relieved by surgical perforation of the eardrum Operation Manual MANUAL MODE Chap 4 TYMPANOMETRY 4 1 GN Otometrics ZODIAC 901 Middle Ear Analyzer Softkey 5 Fig 4 11 Eustachian Tube Function 208 Perforated Eardrum Softkey 4 Rotary Knob Softkey 2 Y Axis Softkey 1 Ext Range Staircase Curve ETF P is included on the Tymp intermediate menu Press Tymp to ob tain this menu and then press Softkey 5 to access the ETF P display Fig 4 11 If the default settings have been altered using the ZODICON software the scale of the x axis baseline may differ from the 45 s illustrated and the y axis may be Pos only or Neg only instead of Pos and Neg as shown in Fig 4 11 Tame ETF F Fiaht daF 266 Y Axis Pos Hea Operation Start Pres ure Pumnr Pume SS tor 18 daF z Use Softkey 4 or Softkey 5 to decrease or increase the pump pressure respectively The Status lamp will light while this is being done While using the pump a scale at the top of the display indicates the cur rent pump position graphically i e what proportion of the pump s ca pacity is used to obtain the static pressure used for the measurement Alternatively turn the Rotary Knob The pum
100. ndon The middle ear is an air filled cavity the tympanic cavity connected to the throat and thence to the atmosphere by a fine channel the Eusta chian Tube which serves to prevent the build up of a pressure differen tial across the ear drum The healthy Eustachian Tube is normally obstructed except during swallowing In the middle ear cavity is a structure of three tiny bones hammer mal leus anvil incus and stirrup stapes called the auditory ossicular chain which links the ear drum to another membrane the oval window fenestra vestibulii ovalis Among the attachments between the auditory ossicular chain and the walls of the middle ear is a tendon connecting the stirrup to a tiny muscle the stapedius muscle The hammer is also subject to the action of a muscle the tensor tympani When either or both of these two muscles contract the ear drum to becomes tensioned and the impedance of the system will be increased The oval window is the component by which sound waves enter the in ner ear in the form of mechanical vibrations The inner ear labyrinth is filled with fluid and consists of the cochlea which converts the vibra tions into nerve impulses and the semi circular canals which form part of the body s balancing mechanism The auditory ossicular chain serves as a broad band impedance matching transformer 8 6 THE EFFECT OF LOUD SOUNDS The normal condition of the ear drum is that of a highly compliant
101. nt volume from the default has been programmed using ZODI CON Softkey 1 may be used to toggle between the two cavities The volume of the cavity selected is shown in the small box on the left of the display Insert the probe into the 2 0 cc 2 0 ml Madsen Electronics Precision Softkey 2 Cavity located in the left side of the ZODIAC 901 s cabinet Do not in sert it into the Madsen Electronics Ear Simulator Press Softkey 2 or the Start Stop Button on the Probe to start the calibration The Status lamps on the Front Panel and the Probe light steadily green during cali Operation Manual 23 GENERAL DESCRIPTION Chap 3 GN Otometrics MAINMENU 34 ZODIAC 901 Middle Ear Analyzer Softkey 5 Softkey 4 In Advanced Mode Fig 3 5 bration After a few seconds an X appears under the cavity volume in the box on the left of the display indicating that the procedure has been completed If the Status lamps flash green slowly check that the Probe is not blocked with cerumen wax or has not been inserted into the Ear Simulator by mistake To re calibrate without powering off the instrument press Softkey 5 to erase the existing calibration and repeat the procedure described above 3 44 DEFAULT CONFIGURATION Pressing Softkey 4 invokes a menu called Select Default Configura tion This allows changes made using Setup see 85 2 to be cancelled in favour of the default Press Softke
102. nts whose Stapedius muscle is unable to maintain a response to sustained loud sounds User 1 and User 2 are special versions of Reflex Decay tests in which many of the measurement parameters may be pre programmed to suit the requirements of the user If Easy Mode has been selected pressing Reflex displays the Manual Re flex screen illustrated in Fig 4 15 unless this has been altered using the ZODICON software If the default has been modified using the ZODICON software the fol lowing default settings may differ from those shown in the Reflex screens illustrated or referred to in the explanations y axis scaling and origin position Pressure Control MED attenuator increment use of threshold level in decay Reflex fast slow mode threshold level incre ment threshold fast screening maximum measure and use of pump in threshold air conduction Two markers fixed cursors may be applied to all reflex records For a description of the marker function see 84 2 5 4 21 MANUAL REFLEX Press Reflex and then Softkey 1 if Advanced Mode has been selected to access the Manual Reflex screen for manual testing Fig 4 15 The manual test mode permits the duration of the stimulus presentation to be manually controlled via the Tone Switch 40 Operation Manual GN Otometrics ZODIAC 901 Middle Ear Analyzer MANUAL MODE Chap 4 REFLEK TESTING 4 2 In Version 4 x a new feature has been added as default called Multi
103. odified us ing the ZODICON software The Stimulus lamp on the front panel will light while the stimulus is being applied The Status lamp will light throughout the measurement period Alternatively press the Tone Switch to start the test and only one reflex measurement will be made If required change frequency or intensity and press the Tone Switch again another reflex measurement will be made 42 Operation Manual GN Otometrics MANUAL MODE Chap 4 ZODIAC 901 Middle Ear Analyzer REFLEK TESTING 4 2 After the measurements the screen will look like the one shown in Fig 4 16 Fig 4 16 Reflex Screenins Left IPSI pm 166dE shu 1 6dE Reflex Screening 225 ml Stimulus Start Penati H SIPSI T 1666 Hz gt S toF inm dB CONTRA daF The Softkeys and the Ext Range button function just as described above Softkey 2 in 4 2 1 with the exception of Softkey 2 which is used for starting and stopping the test there is no meter display in this operation mode The test may also be started by the pushbutton on the probe When starting to test the patient s other ear remember to register the L R Shift change over on the ZODIAC 901 otherwise the data for the first ear will be overwritten To change to the other ear press Alt Select and then Softkey 4 Setup parameters available in Screening Reflex Mode see also 85 2 2 Setup Parameters are Stimulus SPL HL increment 1 2 5 or
104. oftkey 4 Softkey 5 Operation Manual 61 SUPPLEMENTARY FUNCTIONS Chap 5 GN Otometrics PRINTER 5 3 ZODIAC 901 Middle Ear Analyzer Printer Softkey 4 Softkey 1 Softkey 2 Softkey 3 Version 4 x Only 5 3 2 PRINTOUT Four different kinds of printout may be made screen dump print data on screen only print all data or print all new data All data means all data available for both ears and for all tests made for that patient From Version 4 x printout may be interrupted To stop printout when in progress press and hold down the Printer pushbutton until Cancel ap pears over Softkey 4 Press Softkey 4 until printout stops 5 3 2 1 SCREEN DUMP Pressing Softkey 1 Screen Dump prints ALL data and test results shown on the screen including the operation commands etc in the bot tom two lines of the display 5 3 2 2 PRINT DATA Pressing Softkey 2 Print Data only the data and test results for that test are printed out plus setup parameters not shown on the screen This means that in Reflex Decay and Reflex Threshold all curves for all fre quencies are printed out For convenience this choice of printout is distinguished visually from the Screen Dump by the presence of a frame printed around the test title and ear selection left or right If there is no test data to print out the panel offering this function is b
105. on delay stimulus duration and post stimulation record dura tion to be separately pre programmed 4 2 5 MARKER FUNCTION All reflex and reflex threshold testing modes have a marker function for Acoustic Reflex the purpose of accurately measuring the duration and degree of an elic Latency ited reflex The marker function may be used to measure Acoustic Reflex Latency which is the delay of the onset of the reflex from the instant when the stimulus is initiated This function also enables the deletion of a single curve also when multiple reflex curves have been obtained at Delete Curves in different levels in Manual Reflex each reflex curve can be individually Manual Reflex erased see 85 1 6 The marker is accessed by pressing the Alt Select button from any re Softkey 2 flex test mode and then Softkey 2 to activate the Marker Mode Pressing Softkey 2 then toggles between Track Marker 1 and Marker 2 Softkey 2 where Track means that both markers move simultaneously The screen in Fig 4 18 shows Marker 1 and Marker 2 set The markers are moved by turning the rotary knob When the Marker Mode is selected the following data is displayed be tween the graphics and the sub menu lines Operation Manual 45 MANUAL MODE Chap 4 THRESHOLD TESTING 4 3 GN Otometrics ZODIAC 901 Middle Ear Analyzer Fig 4 1 Softkey 4 Softkey 1 Softkey 5 T1 time elapsed from measur
106. or NOAH Softkey 4 To Adjust Contrast Softkey 5 installed with suitable software For this purpose Madsen Electronics supplies the MateBaseI dedicated software for the transfer and storage of audiological test results and patient data supplied as standard with the ZODIAC 901 and MIDIMATE 622 Zodi Link software is also available for transferring data to NOAH DataXmit implements an internal flag which can be read by an external application program and data transfer can then be executed 5 1 4 LEFT RIGHT SHIFT Pressing Softkey 4 L R switches from one ear to the other all data on the other ear are already stored in memory 5 1 5 CONTRAST The contrast on ZODIAC s Liquid Crystal Display LCD may be ad justed either from Setup see 87 2 or from the Alt Select Menu After accessing the Alt Select Menu note that there is a number dis played on the lower line under the word Contrast Hold down Softkey 5 and turn the Rotary Knob turning it clockwise increases the number and the contrast while turning it anti clockwise reduces the number and the contrast Adjust the contrast according to personal preference or lighting condi tions Your contrast adjustment is stored in the instrument s non volatile memory which means that it will retain this setting after power off and until the next adjustment 5 1 6 MARKER In the different test modes the marker function is ava
107. p is duplicated on the probe 3 2 7 LIQUID CRYSTAL DISPLAY The Liquid Crystal Display LCD can show both textual and graphical information about the functions of the ZODIAC 901 and the results of tests It can display tympanograms and other Cartesian graphs during measurement For Tympanometry and Reflex measurements the dis play can also emulate accurately the panels of a pair of moving coil me ters see for example Fig 4 3 and Fig 4 4 Each test mode and supplementary function has its own screen display layout which has been optimized to convey information relevant to the function The contrast of the LCD may be altered using Alt Select 85 1 5 or in System Setup 87 2 This value is saved to NOVRAM i e the LCD will have the new value next time the instrument is powered on Every display layout however contains a lower sector consisting of a menu with five panels Each panel shows the function of the Softkey im mediately below it At the top of each menu in the centre is a descriptive title such as Operation which identifies the current operating mode The operating modes are Select Operation New Patient Erase Data Select Default Configuration Alt Select Setup Printer and Marker The second line of the main upper part of every display layout also contains a descriptive title with several components as follows Mode Activity Ear Earphone 18 Operation Manual GN Otometrics GENERAL DESCRIPTIO
108. p position scale will ap pear temporarily at the top of the display to indicate the pump position graphically Press Softkey 2 or the Start Stop Button on the Probe to start the test The screen displays the pressure in the ear canal over a 45 second time base The patient should be instructed to swallow at regular intervals during the measurement period if necessary with the help of a glass of water Negative positive or positive negative y axis may be selected by means of Softkey 1 Note that the pressure range of 200 daPa may be expanded to 400 daPa by pressing Ext Range Each time the patient swallows a perforated eardrum and a healthy Eustachian Tube will result in a fall in pressure indicated on the display creating a so called staircase curve after a number of swallows illus trated in Fig 4 12 This is because the pressure in the ear canal is re lieved gradually via the perforation and the Eustachian Tube Neither a blocked Eustachian Tube nor an intact eardrum allow relief from the 38 Operation Manual GN Otometrics MANUALMODE Chap 4 REFLEX TESTING 4 2 ZODIAC 901 Middle Ear Analyzer artificially created pressure differential and this will be indicated by the absence of a staircase 2B 455 Oreratior Y Axis Start Pressure Pume Pume Pos Sto 43 daP 5 Steady pressure on the other hand indicates a blockage in the Eusta chian Tube Impaired Eustachian
109. panometry 57 Ear canal volume 19 Easy Mode Ce eee was Z Manual Mode 13 15 21 29 30 Manual Sweep 31 ZODIAC 901 Setup Manual sweep 4 15 24 See System Setup Manual sweep setup 57 ZODICON 1 2 5 20 21 23 24 45 60 85 88 menu 14 Zodi Link 54 mode 19 principles 76 Reflex wa 24 Scaling Setup 57 Setup Ny Warn patient 28 Tympanum s 73 U Unpacking the ZODIAC 901 7 Use MEP Setup 2 2 59 60 Use MEP Setup 58 User1 3 15 24 45 User 1 amp User 2 co 40 User 2 15 24 45 User interface 1 User Test R deut n 15 menu 13 19 64 Programming 65 68 User Tests Operation Manual 93 94 Operation Manual
110. pause into a user test when required while it is being programmed see 87 1 3 23 SELECT The functions of Softkey 1 2 3 4 and 5 are determined at any time en tirely by whichever menu which is displayed on the LCD Every menu contains five panels each of which identifies the current function of the key below it In some menus not every key has a function assigned to it 3 2 4 ALT SELECT AND SETUP The Alt Select pushbutton accesses L R shift from left to right ear or vice versa plus the following other functions at any time except when a test is in progress Erase Data but only if there is data to be erased Tymp Smooth not applicable in versions of the ZODIAC 901 lower than 3 x Reflex Marker Data Xmit Transmit and Contrast for adjusting the display s contrast using the Rotary Knob Press Alt Select again to return to the function currently selected except where this happens automatically See 85 1 NOTE To select the alternate ear press Alt Select and then Softkey 4 The Setup pushbutton offers different sub menus depending on which function or mode you are in at any given time For example if you are making a Reflex Decay measurement pressing Setup will access the Re flex Decay Setup sub menu enabling you to alter the following Reflex Decay parameters attenuation step optional use of a selection of meas urement levels relative to the stored level of Reflex Threshold THL which has previously been m
111. puter PC to their respective connectors in the Connection Panel located on the rear of the instrument see Figs 2 1 and 2 2 Before connecting the power cord please make sure that the voltage from the electrical outlet matches the voltage shown on the identification label stuck over the power inlet CAUTION Operating at the wrong voltage may blow the fuses Plug one end of the power cord supplied into the power inlet on the back of the ZODIAC 901 and plug the other end directly into a three wire protective ground AC power outlet If an extension cord is re quired only use a cord with a three prong connector 200 240 V 50 60Hz Data Interface Printer Headset Fig 2 1 Power Inlet ZODIAC 901 Connection Panel Operation Manual GN Otometrics INSTALLING THE ZODIAC 901 Chap 2 ZODIAC 901 Middle Ear Analyzer INSTALLATION 2 3 200 240V v Headset El EE lt MM 622 Printer Fig 2 2 ZODIAC 901 Connections Operation Manual INSTALLING THE ZODIAC 901 Chap 2 GN Otometrics CARE AND MAINTENANCE 24 ZODIAC 901 Middle Ear Analyzer 2 4
112. r chain D See Ossicular chain Auditory reflex Daily Calibration See Reflex Stapedius See Calibration Auto Mode 5 13 15 638 64 Data Erase Auto Sweep See Erase Data See ze Auto bci Data Interface a ats 69 Auto Test 13 15 Data Transmit ban eh me odes 16 53 54 toanterrupl has ase 5 x 4 07 Date ux 03h SUS S Q Ate s acum ce dX Automatic Sweep Decay See Tympanometry Auto Sweep See Reflex Decay Automatic tympanometry Default configuration 1 15 18 21 See Tympanometry Auto sweep Delta Volume 47 78 Averaging 33 57 Diagnosis of auditory disorders 81 82 Disruption of the ossicular chain 81 B Distress to patient TE i 27 29 Dried ear wax 8 Barometric pressure s lt o 23 DustCover 10 Baud Rates 4 o9 es e e ovo 69 Beeper AA woo ch cuu d B Bone conductor e adla a VR um Ede E na IO Boyle s Law s s a soe coa tos 34 4 os 7D Ear canal 18 19 26 27 29 C canal structure Sw oe ck a vow disorder distress to patient E Gn ht tie ze 29 Calibration 1 15 19 21 23 25 problems xxx 4 A068 wa ss a yaw w 27 Daily during power up TERETERE Simulator so Bone 3 23 data in probe Sa 3 25 Otr ct re x ew W Q Q G s ala x a 79 Warning 4 ko ek eom Um E s xo 20 Wa m Calibration data sono 19 wax dried 8 amp Care amp Maintenance si ZODIAC 901 Sox woss TO Ear to change Cartesian graphs 1 18 53 S
113. raphics on blue background Thermal 112 mm 4 5 Any conventional Centronics printer inkjet laser etc may be connected via parallel port The HP Deskjet 500 generic series is the standard driver HP 510 520 etc Measuring results setup and I D data etc may be communi cated to and from ZODIAC 901 via this port AC 50 60 Hz 100 120 V 10 or 200 240 V 10 Approx 50 VA 370 x 385 x 120 mm W x D x H 14 8 x 15 4 x 4 8 7 6 kg Built in beeper and clock calendar sockets for 2 cc cavity and ear simulator in cabinet Also available without built in printer 84 Operation Manual GN Otometrics ZODIAC 901 Middle Ear Analyzer B APPENDIX ZODICON PARAMETERS B APPENDIX ZODICON PARAMETERS The ZODICON software running on a PC allows each of the ZO DIAC 901 parameters below to be set to any of the corresponding set tings listed Each of the following lists of settings begins with the factory default setting Institution s Name Line 1 Line 2 General System Parameters Default Ear Default Transducer Default IPSI Freq Default IPSI Level Default CONTRA Freq Default CONTRA Level Default Air Cond Freq Default Air Cond Level Default Meter Mode Default Printer Calibration Period Warning Date Format Daily Calibration Power up in Daily Calibration Cavity 1 Cavity 2 Easy Mode HOT Keys Tymp Key Reflex Key Threshold Key
114. rated eardrum Version 3 x of the ZODIAC 901 includes another ETF test Intact Eardrum which is not included in Version 2 x and is used to test the Eustachian Tube Function in patients where the eardrum is intact If the default has been altered using the ZODICON software the follow ing Tymp defaults may differ from the settings shown in the illustrations compliance scaling absolute volume scaling sweep pump speed sweep measurement direction manual measure direction leak detect minimum sweep pressure and maximum sweep pressure From Version 4 x of the ZODIAC 901 including the Limited Version a Middle Ear Pressure MEP marker has been implemented in Tymp Auto Sweep and ETF I testing Softkeys 4 and 5 no longer are used for moving the pump but for moving the marker instead When moving the MEP marker the current values for MEP SC Gradient and TW are dis played in real time on the left of the screen An asterisk appears to the right of the MEP value to indicate that the marker has been moved 30 Operation Manual GN Otometrics ZODIAC 901 Middle Ear Analyzer MANUAL MODE Chap 4 TYMPANOMETRY 4 1 4 1 1 MANUAL This test permits the user to operate the instrument manually Both Compliance and Volume tympanograms may be generated Pressure may be altered and volume adjusted to zero at any point in the test Press Main Menu and use Softkey 5 to select Advanced Mode unless this requirement has been changed u
115. rds for audiometers EN 60645 1 2 ANSI 3 6 EN 55022 1998 The ZODIAC 901 and this manual are CE marked according to the Medical Devices Directive 93 42 EEC Operation Manual 5 INTRODUCTION Chap 1 GN Otometrics SAFETY 1 5 C 0459 e X pst 1 5 SAFETY A ZODIAC 901 Middle Ear Analyzer The ZODIAC 901 is marked with this symbol to indicate compliance with Type B requirements of EN60601 1 The device is marked with this symbol to indicate that it is electronic equipment covered by the Directive 2002 96 EC on waste electrical and electronic equipment WEEE In European countries the crossed out wheeled bin WEEE symbol reminds you that all the electrical and electronic products batteries and accumulators must be taken to separate collection at the end of their working life This requirement applies in the European Union Do not dispose of these products as unsorted municipal waste You can return your device and accessories to Otometrics or to any Otometrics supplier You can also contact your local authorities for advice on disposal This operation manual contains information and warnings which must be followed to ensure the safe performance of the ZODIAC901 Local government rules and regulations if applicable should also be followed at all times Special note should be made of the following ZODIAC 901 is marked with this symbol when it is important that the user refers to associated warnings gi
116. ressure This may be compared with the RMS root means square sound pressure of the threshold of pain which is around 100 Pa at the entrance to the ear canal Notice that a static pressure of this magnitude will not cause any pain or discomfort in the healthy ear unlike an acoustic pressure of the same magnitude The ear drum may also be tensioned by the application of a loud sound to either ear resulting in the contraction of the middle ear muscles of both ears The term audiological reflex or simply reflex is com monly taken to refer to the measurement of mechanical impedance dur ing the application and removal of a loud sound either to the same ear ipsi or to the other ear contra This phenomenon may be ob served and measured at a sound pressure level considerably below the threshold of pain 89 THE PRINCIPLE OF TYMPANOMETRY Audiological reflex The method used by the ZODIAC 901 for measuring the impedance of the ear canal is sometimes referred to as acoustic flow tympanometry The entry to the ear canal is sealed using a suitably dimensioned eartip and a probe inserted through the eartip The probe contains three fine air channels One is connected to a pump which can raise or depress the static pressure in the ear canal A second carries a source of sound of known amplitude referred to as the probe tone The third gives access to a calibrated measuring microphone which is used to measure the result ing soun
117. s are plotted on a Cartesian graph with time along the x axis The difference between the tympanometric graphs generated from measurements on healthy ears and those obtained in cases of hearing disorders allow reliable diagnosis to be made of the nature of the disor ders The real time computing power of the ZODIAC 901 enables these informative graphs to be generated quickly repeatedly and accurately 8 10 PRACTICAL CONSIDERATIONS Calibration for tympanometry Ordinary environment for tympanometry The volume of air measured using acoustic flow tympanometry can be expected to be influenced by such variable factors as barometric pres sure The ZODIAC 901 provides for the elimination of the influence of these factors by means of an automatic daily calibration procedure us ing a Madsen Electronics Precision Cavity with a known volume of 2 0 cc 2 0 mil Because the absolute values of acoustic impedance are influenced by barometric pressure and other variable factors practical tympanometry concentrates on relative volume measurements which are used as ana logs of impedance The probe tone used to measure the ear canal volume in the ZODIAC 901 is a 226 Hz tone which is the frequency prescribed by the Standards CEI IEC 1027 1991 and ANSI S3 39 1987 The electronic circuitry used to measure the sound level in the ear cavity incorporates a highly selective filter which attenuates sound energy at other frequencies than 226 Hz Th
118. s used to obtain the static pressure used for the measurement The pump pressure may also be reduced or increased by pressing Soft key 4 or Softkey 5 respectively The Status lamp will light while this is being done Holding either key down causes the pressure to change con tinuously in the direction of the arrow shown in the window above the key To restore the static pressure to zero quickly press Air Release which automatically resets the pump position Before testing the patient s other ear remember to register the change over on the ZODIAC 901 otherwise the data for the first ear will be overwritten Press Alt Select and then Softkey 4 Note that the pressure range of 400 to 200 daPa may be expanded to 600 to 4400 daPa by pressing Ext Range 32 Operation Manual GN Otometrics MANUALMODE Chap 4 TYMPANOMETRY 4 1 ZODIAC 901 Middle Ear Analyzer Setup parameters available in Manual Tymp Mode are Measuring Direction positive negative pos or neg Y axis Scaling Compliance Auto 0 3 ml 0 6 ml 0 9 ml 1 5 ml 3 0 ml 4 5 ml Averaging On Off not Version 2 x The Alt Select pushkey allows you to use the Smooth feature to opti mize the curves see Fig 4 10 and refer to 84 1 35 1 2 for further details re this function Just press Softkey 2 from the Alt Select sub menu 4 1 2 AUTO SWEEP In this test a sweep is automatically performed and a Compliance tym panogram generated when a volume
119. sas Q S S aw dee ZA See Reflex Threshold Fast Screening Lamps indicator 18 Features of the ZODIAC 901 12 Latency Acoustic Reflex Fenestra vestibulii ovalis 74 See Reflex Latency Flabby tympanic membrane 82 LCD Front panel layout 13 18 See Liquid ge dn BEDAE Fuse replacement 10 Leak Ete A Wa 42 Fuses 11 Leak Detect 33 40 42 58 60 Leak Detect On Off 95 40 43 45 48 50 G Leak lamp noa 14 18 25 27 Line Connection s s 98 Gelle s test 4 52 Liquid Crystal Display 1 17 18 29 Cleaning ede 2 amp eee ou X0 H See also Contrast Logo on printout s lt e x e 17 Hammer 74 Loud sounds effect 74 Hard copy output 2 Header Printout gt s EE d7 M Headset zs E 3 19 20 25 28 Hearing disorders diagnosis 81 82 Madsen Electronics Ear Simulator Hearing loss cochlear 82 See Ear Simulator Hysteresis 73 Madsen Electronics Precision Cavity See Precision Cavity I Madsen Electronics Preset Tests See Preset Tests Identification 22 Main Display Identification details 15 17 1924 See Liquid a Display entry 22 Main Menu ws 13 15 19 24 28 29 Identification menu 22 Mains Connection 8 Immittance 27 Malleus tee tese y SUR E RURSUS MA 90 Operation Manual Manual Acoustic Refler Packing Specification 2 7 See Reflex Paper Feed 61 Manual conventions Paper Loading 61 Se
120. sed static compliance and increased gradi ent or in some cases multiple humps If an ipsilateral reflex is detected then the disruption is likely to be downstream of the hammer Otherwise the reflex may be absent 9 1 3 OTOSCLEROSIS Otosclerosis and relative fixation of the footplate of the stapes tend to re sult in reduced static compliance 0 2 to 0 4 reduced gradient and in creased tympanogram width Reflex may be reduced or absent 9 1 4 PERFORATED EARDRUM The eardrum may be perforated as a result of trauma or because it has atrophied The tympanogram will be almost completely flat 9 1 5 OCCLUDED EUSTACHIAN TUBE If the Eustachian Tube is occluded blocked or fails to open regularly dysfunction the pressure in the middle ear will usually become less than atmospheric pressure The effect will be to shift the tympanogram to the left The reflex is normally unaffected If the eardrum is not perfo rated this condition may be investigated using the Intact Eardrum test Operation Manual 81 DIAGNOSIS OF AUDITORY DISORDERS Chap 9 GN Otometrics DISORDERS AND THEIR SYMPTOMS 9 1 ZODIAC 901 Middle Ear Analyzer available in Tymp Advanced Mode not Version 2 x of the ZODIAC 901 9 1 6 FLABBY TYMPANIC MEMBRANE A flabby flaccid tympanic membrane may be due to aging healed per forations or surgery It will result in a static compliance which is greater than normal Reflexes are usually absent 9
121. ser tests we mean that the user can select the default parameters of a particular test the user can also select a combi nation of tests to form a battery of preset tests To enter User Test Programming Mode switch off the instrument and power it on again with Auto Test held down Keep it held down until the message Programming Mode Enabled appears on the display then release it The ZODIAC 901 carries out the normal self test procedure When this has finished the Main Menu appears To continue with user programming press Auto Test again The User Test Menu screen shown in Fig 7 1 ap pears here Test 1 has previously been saved as PEN User Test Menu Lett Time 10 36 Date Dec 14 139 6 reratar Patient 1 Prosr ndFr a Auto test User Programmable Tests Defined Auto Test Auto Test Fig 7 1 User Test Menu Programming Mode Enabled Operation Manual 65 POWER ON OPTIONS Chap 7 USER TEST PROGRAMMING 7 1 GN Otometrics ZODIAC 901 Middle Ear Analyzer Softkey 5 able Fig 7 2 Program Mode Select menu before programming Press Softkey 5 to start programming to enter the Program Menu Fig 7 2 The top line of this menu indicates how many steps are avail PROGRAM MODE SH Steps available Tt User Test Menu Le Time Date if 37 Dec 14 127358 Softkeys 1 to 4 Fig 7 3 Program Mode Select menu
122. shold Reflex Threshold 3 5 HEADSET AND PROBE Easy Mode One of the unique features of the ZODIAC 901 Middle Ear Analyzer is the novel headset with detachable probe and integrated cable which permits patients to be tested with or without headset depending on whether they are being screened or subjected to a clinical examination The probe assembly consists of 3 parts the probe itself on to which the eartip is mounted the transducer or probe handle and 3 small plastic tubes connecting the probe and transducer Fig 3 6 illustrates the headset with probe attached The headset may be adjusted to suit the geometry of the patient s head by sliding the buckles which fasten the leather strap to the headset up or down the stainless steel spring band The pushbutton on the transducer duplicates the function of Softkey 2 in the measurement modes which have a start stop function i e as a start stop button The two LED s indicate duplicate the functions of the Status and Leak LED s on the top right of the front panel The Status lamp lights steadily green when a measurement is in progress It flashes green if the ZODIAC 901 is waiting to make a measurement when no cavity is detected It lights red when a measurement has been inter rupted by a leak Remote Control From Fig 3 6 Probe and Headset Probe Operation Manual 25 GENERAL DESCRIPTION Chap 3 GN Otometrics HEADSET AND PROBE 3 5 ZODIAC 901 Middle Ear Anal
123. sing the ZODICON software Press Tymp and then Softkey 1 to access the screen shown in Fig 4 2 s Manual Left Fig 4 2 Manual Softkey 1 2 8 Tymp sub menu displayed when ml daP S B ml dap 8 Tymp is selected in Advanced ModeTymp Manual before measurement B 14 Operation Meter Come Mila lg k Pune Gr arh Lol Lime m Vol shows the cavity volume measured at the pressure shown in the center panel ECV Ear Canal Volume Comp Compliance i e the volume change relative to the ECV Thus Vol ECV 4 Comp ECV is shown only when Comp is selected The vertical scales are in millili ters 1 ml 1 cc ml NOTE The Tymp screens of software versions lower than 3 x do not include fields displaying calculated values for MEP SC Grad TW nor Dir After a satisfactory Tymp measurement has been made and Comp is selected a screen similar to that shown in Fig 4 3 containing the meas ured tympanogram will be seen Software Version 3 x and Higher Only Tame Manual Left ml daP 4 6 ml a a E 4na rFeration DomF ES De aval 365 daP Meter Gr arh Fig 4 3 Tymp Manual after measurement Operation Manual 31 MANUAL MODE Chap 4 TYMPANOMETRY 4 1 GN Otometrics ZODIAC 901 Middle Ear Analyzer Softkey 1 Fig 4 4 Tymp Manual analog meter display Softkey 1 Softkey
124. ssure which are significantly greater than those produced by the normal range of sounds the deflection of the ear drum is non linear Its impedance is no longer independent of the ap plied pressure The greater the pressure or depression the stiffer it becomes If the ear drum becomes tensioned for any reason most of the acoustic energy arriving at it will be reflected and the mechanical impedance measured will be determined predominantly by the volume of the outer ear alone The nonlinearity of the eardrum is what makes tympanometry possible Tensioning of the ear drum may be achieved by applying a positive or negative standing air pressure to the outer ear The inner ear normally remains at or close to atmospheric pressure provided the ear is healthy i e the Eustachian Tube is functioning correctly The term tympanome try is commonly understood to mean the measurement of mechanical impedance while varying the static standing pressure in the outer ear The resulting mechanical impedance characteristic the tymapanogram is a very effective indicator of conditions of disorder in the middle ear 76 Operation Manual GN Otometrics PRINCIPLES OF MIDDLE EAR ANALYSIS Chap 8 ZODIAC 901 Middle Ear Analyzer THE PRINCIPLE OF TYMPANOMETRY 8 9 The static pressure or depression typically required to tension the ear drum sufficiently to reflect half of the sound power impinging on it is 300 Pa i e 0 3 of atmospheric p
125. tinued manually i e a further test at a higher or lower level may be made by pressing the Tone Switch If Additional Threshold has been selected under Setup 85 2 3 one additional measurement will automatically be run at the same level or 5 dB or 10 dB Data from all stimulus frequencies 500 1000 2000 4000Hz White Noise if Contra has already been selected is memorized Press Threshold or Softkey 1 from the Threshold Menu if Advanced Mode has been selected to access the screen shown in Fig 4 20 Note that in Easy Mode pressing Threshold might access one of the other Threshold measurement modes if the instrument has been programmed by means of the ZODICONTM software Press Softkey 1 to set the desired stimulus 500 1000 2000 4000 Hz or White Noise note that White Noise is only available if Contra has al ready been selected Softkey 2 starts or stops the test The pushkey on the probe may also be used to do this Fig 4 19 Threshold sub menu displayed NA 10 45 when Threshold is selected in Date dc Jun 1992 Advanced Mode Threshold Detection Reflex Add Threshold Version 4 x Softkey 1 Softkey 1 Softkey 2 Operation Manual 47 MANUALMODE Chap 4 GN Otometrics THRESHOLD TESTING 4 3 ZODIAC 901 Middle Ear Analyzer Tone Switch Fig 4 20 Threshold Reflex Softkey 3 Ext Range Softkey 4 So
126. tion Program Non Volatile Memory Operation Manual INTRODUCTION Chap 1 FEATURES OF THE ZODIAC 901 1 1 GN Otometrics ZODIAC 901 Middle Ear Analyzer Fig 1 1 ZODIAC 901 Middle Ear Analyzer Volatile Memory MateBase Software Hard Copy Output Unique Probe amp Headset preserved when the mains power is switched off The built in clock and calendar also continue without interruption The ZODIAC 901 Version 2 x can perform up to 36 different meas urement curves on a patient including both ears and remember all the results in volatile memory until a new patient is entered or the power switched off Version 3 x can perform store 62 curves and Version 4x can perform store 72 curves Connected via its RS232C serial interface to a personal computer run ning the MateBaseI software supplied the ZODIAC 901 can be used to store patient records in the form of a computer database The ZODIAC 901 can print out the contents of the current screen dis play the results of the current test or all the test results performed on the current patient on the instrument s own built in thermal printer and or an external printer connected via the ZODIAC 901 s Centronics parallel port Printouts can include the Madsen logo time and date the patient s I D data as well as the clinic s name and address It is espe cially beneficial to have the results of fast automatic screening with tympanogram reflex and al
127. to select between Pos itive Neg ative Pos Neg and Auto If Auto is selected the instrument will automatically select whichever Y axis displays the meas ured curve in the greatest detail Use MEP Selects whether automatic adjustment of MEP Press C middle ear pressure is on or off In Version 3 x and later Pressure Control includes Manual Auto MEP 5 10 15 20 25 25 20 15 10 5 daPa When Auto is selected an automatic offset to MEP is calculated on the basis of Gradient and TW Leak Detect On or Off Add Threshold None 0 5 10 dB Stimulus Increments Scaling Threshold Step Y Axis Use MEP Leak Detect On Off Add Threshold Operation Manual 59 SUPPLEMENTARY FUNCTIONS Chap 5 GN Otometrics PRINTER 5 3 ZODIAC 901 Middle Ear Analyzer Stimulus Increments Threshold Step MaxMeas Y Axis Use MEP Leak Detect On Off Stimulus Increments Pump On or Off 5 3 PRINTER 5 2 3 2 FAST SCREENING Stimulus The following settings are available 1 2 5 10 dB Increments Threshold Step The following settings are available 1 2 5 10 20 1 2 10 20 dB MaxMeas Selects the maximum number of measurements per frequency from 1 to 16 Y Axis it is possible to select between Pos itive Neg ative Pos Neg and Auto If Auto is selected the instrument will automatically select whichever Y axis displays the measured curve in the greatest detail
128. ustment of MEP middle ear pressure is on or off In Version 3 x Pressure Control includes Manual Auto MEP 5 110 15 20 25 25 20 15 10 5 daPa When Auto is selected an automatic offset to MEP is calculated on the basis of Gradient and TW In the setup for reflex decay pressing Softkey 2 enables you to select THL Threshold Level Off or to present stimulus at a level of 0 5 10 15 or 20 dB above the previously found reflex threshold at any given frequency If you have measured reflex thresholds using both Reflex Threshold and Fast Screening the value found 58 Operation Manual GN Otometrics SUPPLEMENTARY FUNCTIONS Chap 5 ZODIAC 901 Middle Ear Analyzer SETUP 5 2 in the former will be automatically used by Refler Decay Multi Curves In Manual Reflex select multiple curves or single Version 4 x Only curve 5 2 3 THRESHOLD 5 2 3 1 REFLEX Stimulus The following settings are available 1 2 5 10 dB Increments Attenuation Steps Y axis Scaling Together with the Y axis parameter it is possible to select numerous different reflex threshold configurations Here it is possible to select 75 150 225 300 375 ul of volume or Auto If Auto is selected the instrument will automatically select the volume which displays the meas ured curve in the greatest detail Threshold Step The following settings are available 1 2 5 10 20 1 2 5 10 20 dB Y Axis it is possible
129. velocity is equal to the characteristic mechanical impedance of the transmission medium If the vibration encounters an inhomogeneity in its passage i e a region where the mechanical impedance changes from one value to another then in general a part of the energy in the vibration will be reflected back towards the source and only a proportion of the energy will con tinue in the direction of the original wave past the inhomogeneity The impedances are said to be mismatched In a system whose purpose is to transmit vibrational energy such as the ear this is a functional disadvantage since some of the energy fails to ar rive at its intended destination An inhomogeneity in this kind of system is most likely to arise at a boundary between adjoining components of the system 83 MATCHING OF MECHANICAL IMPEDANCES Matching of impedances The ear collects as much as possible of the acoustic energy arriving at the ear lobe by means of two natural mechanisms which minimize reflec tions The structure of the outer ear is such as to effect a continuous transition from the relatively low mechanical impedance of the open air to the in termediate impedance of the eardrum e The middle ear incorporates a mechanical broad band impedance transformer A broad band transformer is a device whose structure is such that it presents differing impedances at its input and output 8 4 RESISTIVE LOSS OF VIBRATION ENERGY Resistive loss of
130. ven in this manual Any PC connected to the ZODIAC 901 must comply with the requirements of IEC 950 Safety of information technology equipment including electrical business equipment 1 6 SERVICE AND REPAIR Service and repair of electromedical equipment should only be carried out by the equipment manufacturer or by authorized representatives The manufacturer reserves the right to disclaim all responsibility for the operating safety reliability and performance of equipment serviced or repaired by other parties Operation Manual GN Otometrics INSTALLING THE ZODIAC 901 Chap 2 ZODIAC 901 Middle Ear Analyzer UNPACKING AND INSPECTION 2 1 2 INSTALLING THE ZODIAC 901 2 1 UNPACKING AND INSPECTION The ZODIAC 901 is shipped in its own custom made carton together with this Operation Manual a Packing Specification and standard acces sories Please do NOT dispose of this carton in case the instrument needs to be returned to your Madsen Electronics distributor for service or repair If the shipping carton is visibly damaged ask the carrier s agent to be present when the instrument is unpacked If the instrument is damaged or fails to operate please notify the carrier and your Madsen Electronics distributor immediately The Madsen Electronics distributor will ar range for the repair or replacement of the instrument without waiting for the claim against the carrier to be settled Please check that all accessories are complete
131. y 1 Yes to do this Note that your default configuration may have been programmed using ZODI CON software If cancelling changes which have been made using Setup is not what is required press Softkey 2 No 3 4 5 EASY AND ADVANCED MODES In Manual Mode tympanometry reflex and threshold testing are accessed by pressing the appropriate pushbutton on the left of the front panel How ever the screen that appears in either one of these three test modes de pends on whether Advanced or Easy Mode has first been selected in the Main Menu This selection is stored in NOVRAM i e the instrument will power on with the last selection active In Advanced Mode an intermediate sub menu appears at the bottom of the screen offering you the following choices for an example see the Re flex sub menu illustrated in Fig 3 5 Tymp Manual Sweep Auto Sweep ETF I ETF P Reflex Manual Screening Decay User 1 User 2 Threshold Reflex Fast Screening Air Conduction Reflex Left IPSI Operator Patient Select Manual pem n wa 1 m z 24 Operation Manual GN Otometrics GENERAL DESCRIPTION Chap 3 HEADSET ANDPROBE 3 5 ZODIAC 901 Middle Ear Analyzer In Easy Mode these sub menus are omitted and instead the following test modes are entered ready for immediate testing unless the selection has been previously modified using the ZODICON software Tymp Automatic Sweep Reflex Reflex Manual Thre
132. y are all listed under a subject in dex at the end of the manual All screen instructions are reproduced as far as possible as they appear Manual Conventions on the screen or are shown in screen dumps from ZODIAC 901 Push buttons on the instrument s front panel are printed in the text in bold script and shown in the margin inside a box For example Press Auto Test to access the User Test Menu Auto Test Note that default settings of various setup parameters etc specified in Default Settings this manual refer to those set at the factory if your Middle Ear Modified By Analyzer differs this is because the default settings have been changed ZODICON by your local distributor using ZODICON Another feature of ZODIAC 901 is that test parameters for all tests may Setup Parameters be changed at any time except when a test is actually in progress Since only those parameters valid for any particular test are displayed in the measurement setup sub menu when Setup is pressed the relevant pa rameters are listed in bold script at the end of the description of each test mode If you have any questions or suggestions with regard to the ZODIAC 901 or this manual please contact us at the following address GN Otometrics A S 9 Hoerskaetten DK 2630 Taastrup Denmark T 45 45 75 55 55 F 45 45 75 55 59 www otometrics com 14 STANDARDS The ZODIAC 901 Middle Ear Analyzer complies with the following standa
133. yzer Calibration Data In Probe Probe Replacement Avoid Detaching Transducer From Cable Eartips Sanitization Of Eartips It should be stressed that the calibration data for the probe are located in the transducer itself and are loaded from the probe into the instrument s memory immediately after power on Loading from headset This means that any replacement of probe assembly does not require any lengthy calibration procedure but simply a power on after the new transducer has been connected The probe assembly may easily be de tached from the instrument by detaching the connector from the rear panel However the practise of repeatedly detaching the transducer from the cable is not recommended since this could affect the integrity of the air pressure system WARNING ZODIAC 901 must be powered off BEFORE disconnecting either transducer or transducer cable 3 5 1 EARTIPS The ZODIAC 901 is supplied with a set of different sized soft plastic ear tips also called probe tips or probe cuffs which fit over the end of the probe and permit an airtight seal in the patient s ear canal Each tip should be used on only one patient and then sanitized by washing in warm soapy water Eartips should then be rinsed and al lowed to dry before reuse Each tip has a limited life and should be dis carded once it becomes difficult to achieve a reliable seal Probe tips from other manufacturers may fit the ZODIAC 901 probe

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