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Operating Instructions MA 53

1. MAICO Diagnostic GmbH MAICO Operating Instructions MAICO MA 53 MAICO Diagnostic GmbH Salzufer 13 14 D 10587 BERLIN Tel 49 30 70714650 Fax 49 30 70714699 M Operating Instructions MA 53 MAICO Table of Contents Page IBinsoeeds 4 2 Description 5 3 Getting started 0 cece cece cece cence ee riteni I III II In e nnn rrr errr rreren rnnr enn 7 3 1 Unpacking your INSTTUMENL occ cece cece ecee eee ee eeee ceed e 3 2 Preparing the MA 53 for use Hee 8 3 3 Getting familiar with the MA 53 9 3 3 1 Using the keyboard of the MA 53 sssssssHH e 10 3 3 2 The display of the MA 53 mens 12 4 P re tone SUQIOMNC ty NER banter steseecses 13 4 1 Air Conduction AC Testing cccccccccc cece eceee mnn 13 4 2 Uncomfortable Hearing Level UCL Testing 14 4 3 Bone Conduction BC Testing ssssssssssee en 15 4 4 Masking of the opposite ear sssssssssRRR me 16 mq 16 4 4 2 MASKING theory sssssssssss HIR 16 4 4 3 Manual Masking accesses erstttumuttbartokenutuE nia pio E TR Pa reU CERE UU uence 16 4 4 4 Automatic masking ssssssssssssss mns 17 4 5 Diagnostic tests essssssssssssssssem II Inm nme nennen iis 18 4 5 1 Suprathreshold tests sssssssssss 18 4 5 2 The Stenger Test sssssssssssssss Henne 22 4 5 3 The Threshold Decay Carhart Test sssssssseemRRR
2. AC BC FF INSERT The display shows the selected receiver below the levels Not available receivers will be skipped It is not possible to select bone on both channels simultaneously After a new selection the level will be reset to 30dBy 6 3 Signal selection Press either the right or left SIGNAL key to select the signal The kind of NOISE signal depends on the signal of the opposite channel Speech masking noise is used if on the opposite channel the speech signal is selected see 6 4 below The display shows the selected signal below the receiver text The 5 Position is signal off The light at the signal key or and the STIM LED or is off and the level in the display is erased 6 4 Select tone or speech audiometry mode Tone audiometry shows level and frequency on the display Speech audiometry shows level correct and incorrect words and speech discrimination in percentage on the display Signal left Signal right Mode Geba MAB53 Fe 11a doc 30 851 430 3 11 11 Operating Instructions MA 53 6 5 Frequency selection Use one of the two sets of frequency keys or to select the frequency The maximum and minimum frequency depends on the receiver you have selected 6 6 Warble tone FM Press the FM key to activate the warble tone Warble is shown in the display Press the FM key again to switch back to pure tone 6 7 Pulse tone Press the PULSE key to activate th
3. B G V or S has been checked please inform your service center f conduction test signals are also audible in the non test ear please inform your service center Air EUG mM with test E T Ear kHz p25p5 n Pp p opum 25 f p B gp b B km LIE dBHL Left EH ctual Left piece o en Earpiece Right Right Earpiece dBHL Earpiece Target value is the value measured in the last audiogram of the test person Repeat the measurement with headphones the wrong way around If the difference between target and actual value at a particular frequency or between right and left headphones is more than 10 dB please inform your service center Bone Conduction Audiogram ni ight Ear E kHz 0 2505 1 2 B HM 6 02505 2 B H p g8 kHz dBHL dBHL If the difference between target and actual value at a particular frequency or between right and left headphones is more than 10 dB please inform your service center Geba MA53 Fe 11a doc 53 851 430 3 11 11 Operating Instructions MA 53 Specifications are subject to change MAICO Diagnostic GmbH Salzufer 13 14 1058 Berlin Telefon 49 3070 71 46 50 Telefax 49 30 70 71 46 99 Email export maico biz Internet www maico biz Geba MAB53 Fe 11a doc 54 851 430 3 11 11
4. Display of the MA 53 shows all actual settings and test results The display area is Eris l Talk Over split with a line into an upper or main area 70 db and a lower or advanced area see picture Picture 9 MA 53 display for BC test 9 The main area shows the individual settings for the left channel on the left and the right channel on the right General settings which affect both channels are displayed in the middle The example picture 9 shows a typical setting for a BC threshold test The left channel is bone conduction with 70 dBy tone and tracking function enabled The right channel is set to 90 dBy narrow band noise with air conduction for masking The test frequency is 1500 Hz and the test signal is a warble tone The lower section of the display shows that the talk over microphone button or is pressed and the audiologist talks to the patient with 70 dBHL The HL in the upper row before 1500 Hz indicates that the current measurement is stored as Hearing Level threshold test Z0 L m 1500 R 90 se NB Noise Picture 10 shows the display for a speech test with speech test material from tape 60 a Ms wy 7o R 605 Tape CD rong Speech Noise or CD of the left ear and masking of the opposite ear The left part of the LCD ISP 9y M shows the settings for the left Picture 10 MA 53 display for speech test channel level 60 dBHL receiver AC signal tape CD The middle of the LCD display sh
5. 5 dB SISI test 5 dB 3 dB 2 dB conditioning 1 dB test Modulation time 4 8 0 2s Carhart decay test built in stop watch Stenger test Tone presenter interrupter Interlock tone presentation of both channels simultaneously Channel swap Tracking fixed level difference between both channels Mixing ipsilateral presentation of both channels Talk forward Talk back Monitor phone Assistant phone less than 10 min after power on Continuous 44 851 430 3 11 11 AA Operating Instructions MA 53 MAICO Environment conditions Dimensions Weight Power Supply Power Consumption Device Fuses Geba MAB53 Fe 11a doc 15 4357 4 59 95 F operation 5 4 50 4 41 122 F storage Maximum humidity 90 storage and operation According to water ordinary equipment According to sterilization not applicable WxDxH 36x 46x 15cm 14 2 x 18 1 x 5 9 4 6 kg 10 1 Ibs with accessories 5 8 kg 12 8 Ibs 100 240 V 50 60 Hz 10 app 25 VA 2x 1A slow blow 45 851 430 3 11 11 Operating Instructions MA 53 Connection plugs Specification A power socket left right2power 100 240 V 50 60 Hz middle2prot GND B power fuses J S 1Asowbow C serial PC interface 12GND 2 RX 3 TX 52 GND RS 232 C 6 DTR ZA 4 UA 8 Vett Zl 47k Ul 0 04 5 Vett Zl 47 k Ul 0 04 5 Veff K masking phone for BC option sleeve GND tip out ZA 10 UA 1 V
6. Select Presenter 1 5s Invers Dials Interru Present Bone Mask System Enable disable switch off position of signal selector key and Default setting of INSERT instead of AC Initial masking setting of right channel on off Submenu to select language The signal will only 1 5 s presented when the STIM bar is pressed Changes direction of level control dials and Default setting of STIM MODE Presenter or Interrupter Activates the special MAICO Bone Masking headset not available in the USA only accessible if option is purchased Geba MA53 Fe 11a doc 35 851 430 3 11 11 Operating Instructions MA 53 M MAICO 7 Advanced features 7 1 Complex mixing The complex mixing feature of the MA 53 allows the operator to route two different test signals to the same ear The test signals and the test levels are independently adjustable but will be presented to one ear ipsilateral This feature could be used to test with speech in noise competing message tests tone on noise or several other combinations 30 FT Tone Mixin IL L4R off R R L off Picture 38 MA 53 display with mixing selection screen 100012 R 30 a To enter the complex mixing press the swap key longer than 2 seconds The LCD display shows the mixing selections see picture 38 Use the left frequency up key to switch on the mixing for the left ear and the right frequency up key for the right ear Picture 39 shows
7. conduction chapter 4 1 and bone conduction are the same In this case a hearing loss of the middle ear can be eliminated Place the bone conduction receiver so that the flat circular side of the transducer Y is placed on the mastoid at the noticeable ledge of the cranial bone behind the auricle The other side of the headband is placed in front of the opposite ear Set the receiver selector or to BC and the signal selector or to TONE Perform the test the same way as for air conduction see 4 1 Enter the measurements for all frequencies on the form connect all points with dotted lines marked on the audiogram form as follows gt right and left For hygienic reasons it is important to clean the bone conductor see chapter 10 Geba MAB53 Fe 11a doc 15 851 430 3 11 11 M Operating Instructions MA 53 MAICO 4 4 Masking of the opposite ear The basics of masking are explained below To begin testing immediately please go directly to 4 4 3 Manual masking 4 4 1 Crossover When measuring a pure tone audiogram you assume that the measured hearing threshold is correct But if you recognize that sound is also transmitted through bone conduction over the entire skull it is probable that the opposite ear has also received sound This is called crossover Crossover can also occur when measuring air conduction because a small amount of air conducted sound is received by the skull and transmitted by bone Wh
8. i e the LCD display for enabled mixing on the left ear 30 L 1000 Tone Store the selection by pressing the STIM bar 9 or G3 Mising R R L off Picture 39 MA 53 display with The LCD display now shows the actual setting for mixing In the example picture 40 is a pure tone with a level of 30 dBHL and a narrow band noise with a level of 30 dBHL both with a frequency of 1000 Hz presented to the left ear Adjust hearing level and the test signal independently for both channels Both mixing selection for the left ear 30s L 1000 R 30 Mising R R L off L L K on Picture 40 MA 53 display with selected mixing for the left ear signals will be mixed and presented to the left ear You can also select other receivers like BC FF or insert phone for the left ear with the left receiver selector key Other possible selections are mixing with presentation to the right ear or to both ears To exit the complex mixing press the swap key longer than 2 seconds and switch the mixing for the left and the right ear to the off position Geba MAB53 Fe 11a doc 36 851 430 3 11 11 Operating Instructions MA 53 7 2 Advanced Noise Selection The MA 53 offers for advanced masking or testing the selection of narrow band noise speech masking noise and white noise as test signal Enable this feature from the user setup menu The additional signals are now available as test signals Select the required si
9. material simultaneously This helps in determining if the test word was understood by the patient If the talk back option of the MA 53 is installed the communication from the patient to audiologist will be heard with the monitor phone 5 3 2 Adjustment of the monitor phone To adjust the output level of the monitor phone press the right SIGNAL key longer than 2 seconds In the lower right area of the display the text Monitor appears Below that you see the actual settings in 96 of the maximum output level see picture 35 00006000 Tah fico O0G000 eoo OJ Picture 34 MA 53 rear panel with MONITOR phone output 0 R 305 ong ros 30 dB Air o Mind Tape CD Monitor 95 Talk Back Level 0 Picture 35 MA 53 display with adjustment of the monitor phone Perform a test signal with Tape CD or the talk back microphone if installed Use the right knob and adjust the output level that is comfortable for you Store the adjustment by pressing the STIM bar or Geba MAB53 Fe 11a doc 27 851 430 3 11 11 M Operating Instructions MA 53 MAICO 5 4 Speech Audiometry The speech recognition threshold SRT is the hearing threshold for speech It is the lowest level at which the patient correctly recognizes the stimuli 5096 of the time Usually recognition is indicated by repetition of the speech stimulus item The speech test can be done with recorded speech test material from CD or tape o
10. modulation time in the suprathreshold menu as described before under 4 5 and press the STIM bar or On the LCD display is ABL with the chosen modulation time shown see picture 17 Adjust the desired hearing levels for both the normal ear and the impaired ear using 20 L m 2000 R 505 the level control knobs and amp mE AB 0 5 s fens Press the STIM MODE button to present the signal continuously Picture 17 MA 53 display with ABLB test Now change the level for the hearing impaired ear with the level control knob or until the patient indicates that the loudness in both ears is equal Note the levels and proceed with other levels and frequencies as required To exit the test briefly press the PULSE button Geba MA53 Fe 11a doc 18 851 430 3 11 11 Operating Instructions MA 53 4 5 1 2 The DLI L scher Test The Intensity Difference Llmen for loudness test or Just Noticeable Difference JND is another recruitment test A pure tone is amplitude modulated at a rate of 2 second The patient has to determine whether this signal was steady or undulating beating To start the test select a modulation 50a L m 2000m R 50 5 amplitude from 0 5 dB to 4 0 dB in the ene DLI 1 5 dB Tone suprathreshold menu as decribed before under 4 5 1 and press the STIM bar Q or Q3 The LCD display shows DLI along with the chosen modulation amplitude see picture 18 Picture 18 MA 53 display with DLI te
11. printers and network special precautions must be taken in order to maintain medical safety Connecting this device to other devices in order to make a system may cause the safety specifications to be invalid It is therefore recommended to insert a galvanic separation between the device and the host computer unless the computer is battery operated or supplied by a medical approved power supply Galvanic separation must fulfill the EN 60 601 1 Geba MAB53 Fe 11a doc 52 851 430 3 11 11 Operating Instructions MA 53 Checklist for Subjective Audiometer Testing Clean the ear and head cushion Untangle all lines when necessary Instrument Are the headphone cushions in good condition Manufacturer If not gt replace Are plugs and leads in good condition undamaged Serial No Are all controls working properly Is the Patient Response Key working properly if available Exam Iner Check batteries and renew if necessary Test Signal Quality All the test frequencies in the below table indicate typical hearing level and can be changed when necessary Test these frequencies and enter the following abbreviations if necessary B for Buzz tone G for Noise V for signal distortion S for switching masking noise Righttar evd Left Ear kHz 0 250 5 1 p B M 6 B 0259550 p pap B c Bogei j a 1 Ll il pL ee ee j et ee TCI TEETS When noise
12. re20 uPa dB s 0 5 J 250 1080 J160 6 5 28 5 32 0 ee 0 0 Geba MAB53 Fe 11a doc 48 851 430 3 11 11 Operating Instructions MA 53 Calibration values FF Free sound field 0 degree incidence Reference equivalent threshold sound pressure level pega ANSI 53 6 1996 dB re 20 uPa dB re 20 uPa ISO 389 2 ANSI 3 6 1 with Coupler IEC 126 with Coupler HA 2 Reference equivalent threshold Frequency Hz sound pressure level sound damping dB re 20 uPa dB re 20 uPa dB Geba MAB53 Fe 11a doc 49 851 430 3 11 11 M Operating Instructions MA 53 MAICO Standard accessories 1 air conduction receiver DD 45 1 bone conduction receiver Radio Ear B 71 1 microphone for live speech 1 patient response switch 1 power cord 1 pad of audiogram paper 50 sheets Optional accessories Loudspeaker Canton single unit Part No 801165 Portable Loudspeaker SBC pair Part No 802092 not available in the USA Insert phone Part No 4790 Talk back microphone Part No 6619 Monitor phone Part No 705209 Audiogram paper 50 sheets Part No 1162 417 Options High Frequency Audiometry with HDA 200 Headphone Part No 801110 1 Geba MA53 Fe 11a doc 50 851 430 3 11 11 Operating Instructions MA 53 13 Warranty Maintenance and After Sales Service The MAICO MA 53 is guaranteed for 1 year This warranty is extended to the original purchaser of the inst
13. the test level to 45 dB the masking level is automatically Picture 15 MA 53 display for bone conduction with masking and enabled adjusted to 65 dB tracking function NB Noise Geba MAB53 Fe 11a doc 17 851 430 3 11 11 Operating Instructions MA 53 4 5 Diagnostic tests 4 5 1 Suprathreshold tests The MA 53 offers additional suprathreshold tests which can offer more information about the kind of the hearing loss To access suprathreshold tests press the 1000 R 25 PULSE button longer than two seconds Air The suprathreshold test menu is now u displayed on the lower part of the LCD E ao 0 10 s UN DE D display see picture 16 The actual tem eM menu o ay with choice is displayed inversely You can toggle through the different options by briefly pressing the PULSE button Start the chosen option by pressing the STIM bar or To exit the Supratreshold test menu briefly press the FM button Tone 4 5 1 1 The ABLB Fowler Test The Alternate Binaural Loudness Balance test is a recruitment test which uses the presentation of alternating tones between the two ears with headphones The intensity of the tone in the hearing impaired ear is varied until the loudness of the tone is judged by the patient to be equivalent to a tone at a constant intensity in the normal ear This is called loudness balance The test is done for various intensity levels in the normal ear To start the test select 0 5 sec or 1 sec
14. threshold If the loss in the poorer ear is real the patient will be unaware of the signal in that ear and will respond only to the tone in the good ear If the patient does not respond at all it is likely the admitted threshold is incorrect and you have a positive Stenger 4 5 3 The Threshold Decay Carhart Test This examination is conducted as a fatigue test in cases of sensitivity loss Select the desired frequency with the frequency keys or Adjust the sound level to a value about 5 dB above their hearing threshold with the level control knob or Instruct the patient to start pressing the patient response switch when he hears a tone and to release the switch when he doesn t hear the tone anymore Enter continuous tone presentation by pressing the STIM MODE button to present the test signal or press the corresponding STIM bar or B9 L a 500r R 10 xe The PAT response LED lights and after d two seconds a bar stop watch with a scale from O to 60 seconds appears on the lower picture 24 MA 53 display with area of the LCD display see picture 24 X initial tone decay test Geba MAB53 Fe 11a doc 22 851 430 3 11 11 AA Operating Instructions MA 53 MAICO When the patient releases the switch the bar of the stop watch stops and you can 35a L m 500m R 10 see the time the patient heard the tone see Tene Tene aiia sec If the time was less than 60 seconds Picture25 MA 53 displ
15. 1 11 Operating Instructions MA 53 swap function exchanges the outputs for both ears i e the right controls now affect the left ear tracking function enables the automatic tracking see chapter 4 4 masking 2nd Level enters level step selection menu The actual level step Is displayed at the lower center of the LCD display Choose the level steps with the frequency up down buttons and 2 right red channel signal selector key changes the test signal from pure tone to tape CD or e microphone or noise or Picture MA 53 keyboard switches the channel off 2nd Level adjustment of talkback microphone and monitor phone right red channel receiver selector changes the receiver from AC to BC or FF or INSERT if option assembled The lighted LED above shows the current selection 2nd level selects test mode HL UCL MCL for selected receiver right red channel talk over microphone switches on talk over microphone as long as the button is pressed The level can be adjusted with the knobs or The actual value is displayed in dBHL at the lower center of the LCD display 9 right red frequency down change to next lower frequency right red frequency up change to next higher frequency 5 oS ay os aa H w d 5 T e g Geba MAB53 Fe 11a doc 11 851 430 3 11 11 AA Operating Instructions MA 53 MAICO 3 3 2 The display of the MA 53 The large backlighted graphical LCD
16. G psu PrERESUm eI ee DEM P SM D ALLE 31 6 8 SUpratniresnold DOSES esteem rrt ttn tad ite kso va op DROP eee ere 31 6 8 1 SISI Test ao en a ee ee ee ee 31 6 8 2 Decay test Carhart ssssssssesesse emnes 32 6 9 Swap function esssssssssssse I emm nnm e nennen nnne nn nn rn nnne 32 6 10 Tracking function ssssssssssssssse emm mme nnnm 32 6 11 STIM Mode selection sssssm RII 32 6 12 Interlock function ssssssssssss Hem mmn 33 6 13 Talk over microphone sssssssssseeRH mmm 33 Geba MA53 Fe 11a doc 2 851 430 3 11 11 M Operating Instructions MA 53 MAICO 6 14 Talkback microphone and Monitor volume control 33 6 15 Speech audiometry sessssssssssse Ime ener 33 6 16 Speech calibration ssssssssssssm mmm 33 6 1 User menu sssssssssssssssssssesseseneneenneen nnne nnn ense setse sese sese sa seen 34 7 Advanced features Hee eee nennen nen nennen 36 7 1 Complex mixing ssssssssssssee Imm enm emere nnns 36 7 2 Advanced Noise Selection sssssssssse eene 37 7 3 Talk back microphone ssssssssss Ie 37 7 3 1 Connection of the talk back microphone ssesssessseseeses 37 7 3 2 Adjustment of the talk back MICrOPNONE cece cc eee cece eeeeeeeeeeeeees 37 7 4 Assistant phone 0 0 cece cc eccc cece ecce HH e mm nme nme nnn nne nennen 38 7 4 1 Connection of the assista
17. He 22 4 6 Dual Frequency Mode ssssssssssssm IH Imm mmn nnne 23 4 7 Free tunable frequencies in 1 Hz Steps FTF 24 4 8 High Frequency Audiometry optional 24 CCG eletti MERE ETE 25 Geba MAB53 Fe 11a doc 1 851 430 3 11 11 M Operating Instructions MA 53 MAICO 5 1 Connecting the speech source 2 0 cece cece cece cece cece eect ee eece een 25 5 1 1 Connecting a CD player sssssssss Im 25 5 1 2 Connecting a Microphone sssssssse Ree 25 5 2 Speech calibration 2 0 cece e cece cece ce eee eee ee eeeeeeee Imm nnne 26 5 2 1 Calibration of the CD with speech test material sssss 26 5 2 2 Calibration of the microphone for live speech test 26 5 3 Connection and calibration of the monitor phone sssssessess 27 5 3 1 Connection of the monitor phone sssssssssR 27 5 3 2 Adjustment of the monitor phone ssssssssm 27 misere ieu RT m TT 28 5 6 Masking RR RR 29 6 Quick reference guide ssssssssssssss memes 30 6 1 Startup settings ass sce E 30 6 2 Receiver selection sssssssssssssssse m II e Ime emnes 30 6 3 Signal selection ssssssssssssssssssse I Ime emet nnne nnne 30 6 4 Select tone or speech audiometry mode sssssssee 30 6 5 Frequency selection sssssssssssse Immer 31 6 6 Warble tone FM cccccccececcccececececcccececceuecsecaeeeeceeeeeueacecsetetavaveueeeenanes 31 D POLE TON
18. If you are sure that the result of the test is 8000 Lm 1500 R 105 Picture 22 MA 53 display with SISI result consistent you can abort the test at any time ene idi by pressing the PULSE button The result is 50 Presented 10 Detected 5 then indicated accordingly picture 23 Picture 23 MA 53 display with aborted SISI l l test Retrocochlear hearing impairment is represented by low scores lt 25 cochlear defects by high scores gt 70 Press any button leave the SISI test Geba MA53 Fe 11a doc 21 851 430 3 11 11 M Operating Instructions MA 53 MAICO 4 5 2 The Stenger Test The Stenger test is conducted as a malingering test in cases of alleged hearing loss or unilateral deafness It is based on the premise that when two tones of the same frequency are presented simultaneously into both ears only the louder tone will be perceived The patient with a feigned hearing loss will not be able to hear the quiet tone but will also not admit being able to hear the loud tone Select the desired frequency with the frequency keys or and adjust the sound intensities with the level control knobs and amp Present the tone with the STIM bars and The easiest procedure is to present the desired frequency into the better ear at a level of 10 dB above the threshold At the same time present the signal into the poorer ear the one with the possible feigned loss at a level 10 dB below the admitted
19. Press STIM bar or When the diode illuminate and the tone is available the device works in presenter mode Green STIM LED or does glow Is level control or set to an audible level position Are the acoustic receivers connected to the correct socket Is the required receiver with button or selected is the correct LED illuminated Is the lead connecting the headphones bone conductor or loudspeaker loose or defective If your instrument still does not work properly after this short check please consult your dealer or service center Geba MAB53 Fe 11a doc 42 851 430 3 11 11 Operating Instructions MA 53 12 Technical Data The MA 53 audiometer is an active diagnostic medical product according to the class lla of the EU medical directive 0122 93 42 EEC Standards IEC 601 1class Il protection class BF IEC 645 1 EN 60 645 1 Type 2 IEC 645 2 Type A ANSI 3 6 1996 Type 1 HF A Test Frequencies 125 Hz 250 Hz 500 Hz 750 Hz 1 kHz 1 5 individual selectable for kHz 2 kHz 3 kHz 4 kHz 6 kHz 8 kHz each channel 9 kHz 10kHz 11 2 kHz 12 5 kHz 14 kHz 16 kHz with optional HDA 200 Level step 5 dB 2 dB or 1 GB level steps user selectable Sound Pressure Level AC with earphone DD45 10 dBHL 120 dBHL 500 Hz 4 kHz 10 dBHL 115 dBHL 250 Hz 8 kHz 10 dBHL 100 dBHL 6 kHz 10 dBHL 110 dBHL 125 Hz 10 dBHL 80 dBHL BC with bone conduction recei
20. REQUENCY keys or 9 8 To confirm the changed setting press one of the STIM bars Q or To return without change press the FM key 9 To return to the standard operation press the FM key at the user menu Following menu items are available FF Set 1 2 Select the calibration for the first or the second loudspeaker set Bin Monaural Select the signal source channel for CD TAPE Bin Left Right User Setup Setup of special functions User Preference Customization of the instrument only accessable if option is purchased The User Setup Menu has the following selections Frequence Roll Setting of frequency control function stop at highest and lowest frequency or continuous change Default Levelset Initial level signal or receiver change is 30 dBHL or not altered Return to 1 kHz After the transducer has been changed the test frequency of 1 kHz is automatically selected Monitor with STIM Monitor phone active only with speech or presentation of actual test signal SRT Test Enable disable Speech Reception Threshhold test Adv Noise Select Enable disable additional masking test signals NB noise speech noise white noise el Output FF Electric output off or active when FF selected Decay Enable disable decay test Geba MA53 Fe 11a doc 34 851 430 3 11 11 AA Operating Instructions MA 53 MAICO The User Preference Menu has the following selections Off Signal Start with IP Start Tone NBN Language
21. annel 10 dBHL noise for the right All these 302 a settings are also shown on the display Tone see picture 5 The hearing level can be easily adjusted independently for each channel with a knob and on each side of the instrument For optimal convenience these level control knobs are usable from the top or the side of the instrument They are detented in 5 dB steps adjustable to 2 dB or 1 dB The signal STIM bars and are located beside the level control knobs amp The signal LEDs and light up when the signal is presented You can change trom presenter to interrupter function with the STIM MODE button The corresponding 2 m o LED lights when the interrupter is Picture6 MA 53 level and frequency control Geba MAB53 Fe 11a doc 9 851 430 3 11 11 AA Operating Instructions MA 53 MAICO selected The frequency is changed with up and down buttons for both channels together The design of the MA 53 makes it easy to control level signal presentation and frequency with one hand 3 3 1 Using the keyboard of the MA 53 All main functions of the MA 53 are directly accessable by pressing a single button Not frequently used procedures like the calibration of the speech source or the level step selection are hidden as a second level function To select this function just press the addressed button more than two seconds A user menu for the customization of the MA 53 is available f
22. ay with increase the level with the level control example tone decay test knob or by 5 dB Press any button to erase the stop watch on the display and start the test again Continue this procedure until the patient can hear the tone at least for 60 seconds The threshold shift can be entered on the tone audiogram pad by drawing a wavy line under the selected frequency 4 6 Dual Frequency Mode The MA 53 offers the dual frequency mode to the right and the left ear with different frequencies This true two channel feature can be used to detect frequency disorders To enable the dual frequency mode press the left frequency up key and frequency down key simultaneously The LCD display shows the test apa L 1000 zo R 20 ys Tone Tone frequency of the left channel on the left 1000 Hz and the test frequency of the right channel on the right 2000 Hz of the picture 26 MA 53 display with dual center Picture 26 frequency mode Use the frequency up key to select the higher frequencies and the frequency down key to select the lower frequencies for the left channel The frequencies of the right channel could be selected independent from the left with the frequency up key and the frequency down key To exit the dual frequency mode press the left frequency up key and frequency down key simultaneously again The LCD display now shows the test frequency example 1500 Hz for both channels i
23. ct speech audiometry switch both channels to TAPE CD or MIC by using the SIGNAL selector keys amp and In speech mode the display shows the percentage of correct repeated words Below this percentage the number of correct and wrong receipted words is shown To count the correct words press one of the frequency up keys or To count the wrong words press one of the frequency down keys or To clear the counter press the FM key 6 16 Speech calibration To calibrate the speech inputs Tape CD or MIC select the signal you d like to calibrate with the left SIGNAL selector key Press the left SIGNAL key longer than 2 seconds In the lower area of the display the text Calibration appears Perform the reference signal with Tape CD or microphone Use the left knob for the left channel and the Geba MAB53 Fe 11a doc 33 851 430 3 11 11 AA Operating Instructions MA 53 AIC z right knob for the right channel and adjust the levels until both VU meters and show all yellow and one green light If one or more red lights are on reduce the level using the corresponding knobs or Store the calibration by pressing the STIM bar G or 6 17 User menu To enter the User Menu you have to press the FM key during instrument switch on To choose an item from the menu use the FREQUENCY keys amp 6 or 9 8 To select the chosen item press one of the STIM bars or Change the actual setting with the F
24. d show all yellow and one green light If one or more red lights are on reduce the level using the corresponding knobs or Store the calibration by pressing the STIM bar G or 5 2 2 Calibration of the microphone for live speech test To calibrate the SPEECH MIC input select MIC with the left SIGNAL selector key 20 L Mr Do R 305 Microphone r rong Microphone Press the left SIGNAL key longer than 2 Calibration seconds Picture 33 MA 53 display with In the lower area of the display the text speech calibration of the microphone Calibration appears You also see the actual Geba MA53 Fe 11a doc 26 851 430 3 11 11 M MAICO Operating Instructions MA 53 settings in of the maximum calibration for both channels Position yourself the customary distance from the microphone and speak test words Use the left knob to adjust the level until both VU meters and show all yellow and one green light If one or more red lights are on reduce the level using the knob Store the calibration by pressing the STIM bar or G3 5 3 Connection and calibration of the monitor phone 5 3 1 Connection of the monitor phone Connect the monitor phone plug E to the MONITOR connector at the rear panel of the MA 53 see picture 34 To avoid pinching the cables when closing the cover lay the cables in the slots provided The monitor phone allows you and the patient to hear the speech test
25. e pulse tone Pulse is shown in the display and the light above the PULSE key is on Press the PULSE key again to deactivate pulsing 6 8 Suprathreshold tests Press the PULSE key longer than 2 seconds In the lower area of the display the parameters of the ABLB DLI and SISI test are shown Using the PULSE key select the test and parameter Press one of the STIM bars or to select your choice The lower area of the display is cleared and the selected test is shown on the display 9 The light above the PULSE key is on To change to another parameter press the PULSE key again and hold longer than 2 seconds To end the selected test press the PULSE key briefly 6 8 1 SISI Test Once SISI is selected the test begins immediately by conditioning in 5dB increments Press the PULSE key again to enter the next levels of SISI conditioning 3 dB then 2 dB and to start the SISI test 1dB During the test the display shows the increment level the number of presented increments and the number of correct answers given by the patient In addition Tone Now is displayed when an increment is presented and Answer Now is displayed during the answer acceptance time During SISI conditioning it is possible to clear the counters by pressing the FM key Q9 Geba MA53 Fe 11a doc 31 851 430 3 11 11 M Operating Instructions MA 53 MAICO To cancel the conditioning and the SISI test and to return to standa
26. ect words by pressing the 40s L 20 R 10 4s frequency up key or Tape CD er ong Tape A Tally the incorrect words by pressing the frequency down key or Picture 37 MA 53 display with typical result for speech audiometry When you finish a word list note the percentage of the speech discrimination score Geba MA53 Fe 11a doc 28 851 430 3 11 11 M Operating Instructions MA 53 MAICO If you are working online with a PC press the STIM bar or 3 to transfer the test result to the PC see also chapter 9 To clear the counter for the next test press the FM key It is also possible to perform the speech test with loudspeakers e g for the verification of hearing aid fitting or bone conduction Select the required transducer with the RECEIVER selection button or and proceed as described before 5 6 Masking Speech audiometry has similar masking rules to those described in chapter 4 4 for pure tone audiometry When TAPE CD or MIC is selected on one channel and NOISE masking on the opposite channel the MA 53 automatically performs speech masking noise Geba MAB53 Fe 11a doc 29 851 430 3 11 11 AA Operating Instructions MA 53 AIC z s 6 Quick reference guide 6 1 Startup settings Air conduction on both channels Pure tone on both channels 30dBHL on both channels Presenter mode 6 2 Receiver selection Press either the right or left amp RECEIVER key to select the receiver
27. eff Zi 47 k Ul 0 04 5 Veff Zi 47 k Ul 0 04 5 Veff V AC headphone left channel E MAE B WSEETI ALAR EN c ole lO 00000000 00 J L N d P UR S f p Vv Picture 55 rear of M 53 with connection plugs Qu uds JP P F Fi Fa F l L E L J a L F l F F A LOLOL OLM O B 4 d H Fam rp Geba MAB53 Fe 11a doc 46 851 430 3 11 11 Operating Instructions MA 53 Calibration values AC Receiver DD 45 Force 4 Reference Ed threshold Frequency Hz sound pressure level sound damping ISO 389 1 ANSI S3 6 1 with Coupler IEC 318 2 with Coupler NBS 9A dB re 20 uPa dB re 20 uPa E 47 5 Calibration values BC Receiver Radioear B 71 Force 4 9 Frequency Hz force level air radiation ISO 389 3 ANSI 3 6 1996 RE EMEN dB re 1uN re DOE I C 00 8 RE T5008 5B 1000 425 J J425 J 1500 hes oS 2000 j 31 J 3l1 pj 4000 j355 355 J 6000 140 10 5 31 Geba MAB53 Fe 11a doc 47 851 430 3 11 11 Operating Instructions MA 53 Calibration values AC High Frequency Receiver Sennheiser HDA 200 Force 9 10N Reference equivalent threshold Frequency Hz sound pressure level Sound damping ISO 389 5 ANSI S3 6 1 with Coupler IEC 318 with Coupler IEC 318 and Type 1 Adapter and Type 1 Adapter dB re 20 uPa dB
28. er of the MA 9066009 C On O 53 The microphone can be used for live speech audiometry and communication with the patient If your instrument is supplied with a monitor mic headset Picture30 MA 53 rear panel connect the phone plug labeled M with the With SPEECH MIC input SPEECH MIC connector O U m Geba MAB53 Fe 11a doc 25 851 430 3 11 11 Operating Instructions MA 53 5 2 Speech calibration 5 2 1 Calibration of the CD with speech test material The MA 53 must be calibrated to the particular speech test material in use to ensure valid test levels That means every time you change the CD or tape you must recalibrate the instrument To calibrate the Tape CD speech input select TAPE CD with the left SIGNAL selector key Press the left SIGNAL key longer than 2 seconds In the lower area of the display the text Picture 31 MA 53 controls and displays Calibration appears You also see the for speech calibration actual settings in 96 of the maximum calibration for both channels see picture 32 L Mad De R 305g ong A On every CD or tape with speech test material you have a reference signal such as a reference tone or speech simulating Picture 32 MA 53 display with noise speech calibration of CD player or tape Calibration Perform the reference signal with CD Use the left knob for the left channel and the right knob for the right channel and adjust the levels until both VU meters an
29. ether the crossover signal can heard by the opposite ear depends on its inner ear function Relevant to crossover is the sound level which is received by the opposite ear The difference between the original test signal at the test ear and the received signal at the opposite ear is called interaural attenuation For bone conduction measurement the interaural attenuation is O to 15 dB Bone conduction crossover is therefore possible even with a slight difference in hearing loss between ears Important Please advise the patient to tell you in which ear he hears the test signal It is thereby easier to detect crossover 4 4 2 Masking theory To ensure that the patient will not experience crossover you must mask the opposite ear Masking increases the hearing threshold of the opposite ear The masking is done with a noise signal which is transmitted by the headphone For pure tone audiometry a narrowband noise is used This noise changes its center frequency according to the frequency of the test signal 4 4 3 Manual masking If you have to mask use the common masking rules See chapter 7 for recommend literature Masking is an important part of practical audiometry It is necessary to be familiar with this topic to avoid errors which would lead to a wrong diagnosis For the opposite ear set the receiver selector amp or to AC and the signal selector or to NOISE Adjust the required masking level with the level control k
30. functions are software controlled upgrading later to new extended measurement functions will be simple and inexpensive That means that you have invested in a device that will adjust to your future needs This user manual should make it as easy as possible for you to become familiar with the functions of the MA 53 Please open out the flap of illustrations on the last page The description of the position e g of controls displays and connections found again in the text will make it easier for you to learn how to operate the MA 53 If you have problems or have ideas for further improvements please get in touch with us Simply call Your MAICO team Geba MAB53 Fe 11a doc 4 851 430 3 11 11 Operating Instructions MA 53 2 Description The MA 53 is a two channel audiometer for pure tone and speech audiometric tests It can be used for ENT diagnostics and hearing aid fittings in the office and for mobile audiometry in clinics homes and abroad Tests can be performed using the DD45 headphones AC the optional high frequency headphones HDA 200 B 71 bone conduction receiver BC or optional insert phones and loudspeakers FF Built in test signals are pure tone pulse tone warble tone narrow band and broadband noise The MA 53 has stereophonic microphone inputs for live speech audiometry an input for an optional tape CD player with speech test material and an additional input for a second tape CD player i e for external mas
31. g the MA 53 for use The MA 53 with its integrated compartment for the accessories is perfect for portable use The rugged housing light weight and the comfortable handle make it easy and convenient to transport the instrument Carry it as shown with the bottom away from the leg That helps protect the front cover from damage and due to the asymmetrical handle position it provides more space for your leg To get started first move the handle under the housing Unlatch the cover by pressing in the two black locks located on the left and right sides near the front of the instrument Open the front cover and rest it on the back cover of the accessory compartment To open the compartment press the two black locks in the upper middle of the instrument Open the compartment cover as seen in picture 2 Take the headphone the bone conduction receiver the patient response switch and the microphone out of the compartment and connect the power cable to power The MA 53 operates with voltages from 100 to 240 V AC 50 60 Hz To avoid pinching the cables when closing the cover lay the cables in the slots provided Close the back cover and latch it with slight pressure You can place the microphone or a tape or CD player on top of the cover see picture 3 Picture 1 Transport of MA 53 The MA 53 should be operated in a quiet room so that the audiometric examinations are not influenced by outside noises For use in noisier environments
32. gnal by pressing the signal selector key for the left channel and key for the right channel If the noise LED is illuminated you can choose between NB Noise Speech Noise and White Noise by pressing the signal selector key 7 3 Talk back microphone The optional talk back microphone allows the patient to speak to the operator This feature is used if the patient sits in a sound excluding booth The communication from the patient to the oper will be heard with the monitor phone 7 3 1 Connection of the talk back MOO microphone E M Connect the talk back microphone plug O O O OOOOO to the TB MIC connector at the rear peja AE DAE a ae panel of the MA 53 see picture 41 To O060000 M00 avoid pinching the cables when closing the cover lays the cables in the slots provided Picture 41 MA 53 rear panel TALK BACK MICROPHONE and ASSISTANT PHONE 7 3 2 Adjustment of the talk back ne microphone To adjust the level of the talk back me microphone press the right SIGNAL key pOw L dimer ro R 30 gB longer than 2 seconds hik Tape Talk Back Level Monitor In the lower left area of the display the As amm text Talk Back Level appears Below that Picture 42 MA 53 display with adjustment of the talk back microphone you see the actual settings in of the maximum output level see picture 42 Let the patient say some test words with the talk back microphone Use the right knob and adjus
33. he next frequency increase the level again and proceed with presenting the test signal as described before Once all frequencies are tested choose the poorer ear and repeat the hearing threshold test You can do this with the corresponding controls on the other side or just by pressing the SWAP button 4 The SWAP function enabled means that you measure the right ear using the controls on the left side The ouput to the left and right earphones are changed picture 13 MASS display for AC test with Also the left and right display text ig enabled SWAP function Pulse and Warble tone changed see picture 13 The correct marks in an audiogram are O red right and X blue left Pulse tone If required the test can also be performed with a pulsed tone Press the PULSE button and the pure tone will be switched 0 25s on and 0 25s off Warble tone If required the test can also be performed with a warble tone Press the FM button and the pure tone will frequency modulate The warble tone can also be pulsed as described before For hygienic reasons it is important to clean the ear cushions of the headphone see chapter 1 1 4 2 Uncomfortable Hearing Level UCL Testing Testing of UCL can be measured using pure tone stimuli or speech live voice or tape CD The purpose is to determine the dB level at which the stimuli becomes uncomfortable to the patient This information is valuable for determining the patients upper dynamic ra
34. headphones with optional sound insulation muffs are available Electro medical instruments which emit strong electromagnetic fields e g microwaves radiotherapy devices can influence the function of the audiometer Therefore the use of these instruments is not allowed in close proximity to the audiometer Picture 3 MA 53 In operation Geba MAB53 Fe 11a doc 8 851 430 3 11 11 AA Operating Instructions MA 53 MAICO The test room must be at normal temperature usually 15 C 59 F to 35 C 95 F and the instrument should be switched on about 10 minutes before the first measurement to guarantee precise measuring results If the device has been cooled down e g during transport please wait until it has warmed up to room temperature 3 3 Getting familiar with the MA 53 Turn on the instrument with the power switch which is located at the right side of the MA 53 The device performs its initial test and autocalibration If an error is detected the test is stopped and a description of the error is shown on the LCD display In this case please contact your local dealer or service If the test is passed the instrument is setup to air conduction and pure tone The corresponding LEDs above the receiver selectors and and the signal picture 4 MA 53 power switch display and selectors and are lighted The selection buttons for left and right channel frequency is set to 1 kHz and the level to 30 dBHL for the left ch
35. ill assure that a proper claim is made Save all packing material so the claim adjuster can inspect it as well Notify your dealer or MAICO when the adjuster has completed the inspection SAVE ALL THE ORIGINAL PACKING MATERIAL AND THE SHIPPING CONTAINER SO THE INSTRUMENT CAN BE PROPERLY PACKED IF IT NEEDS TO BE RETURNED FOR SERVICE OR CALIBRATION All accessories are already packaged in the compartment connected with the MA 53 Please check that all accessories listed below are received in good condition If any accessories are missing or damaged immediately notify your dealer or MAICO Standard accessories 1 Headphone DD 45 1 Bone conduction receiver B 71 with headband 1 Patient response switch 1 power cable 1 microphone with stand only for export outside USA 1 audiogram form 50 sheets 1 monitor headset with microphone USA only 5 sound room cords USA only Calibration of the device The instrument headphones bone conduction receiver as well as the optional insert phone and loudspeaker match one another and have the same serial number e g 6631520 Because they have been calibrated with this particular instrument use of other transducers is not allowed If one of the acoustic transducers is replaced the instrument must be recalibrated The use of non calibrated audiometers leads to incorrect measurements Geba MAB53 Fe 11a doc 7 851 430 3 11 11 AA Operating Instructions MA 53 MAICO 3 2 Preparin
36. ions MA 53 10 Care and maintenance of the instrument Disconnect the power plug before cleaning To clean the instrument headphones bone conduction receiver loudspeaker and other accessories use a soft cloth dampened with a little warm soapy water or washing up liquid no alcohol or spirits should be used The ear cushions of the headphone can be detached for cleaning To remove the ear cushion pull it gently trom the earphone To assemble the cleaned or changed ear cushion press it on the earphone and make sure that it sits properly The sound outlet hole must be exactly in the middle of the earphone During cleaning please ensure that no liquid runs into the switches level control headphone capsules or loudspeaker openings Geba MAB53 Fe 11a doc 41 851 430 3 11 11 Operating Instructions MA 53 11 Trouble shooting If you should find that your instrument is no longer working properly during a test run please check the following points TELE Diodes in the buttons do not light up and there is nothing to see on the LCD display Is the power cord plugged in correctly ED n a Check the power fuses Ez Disconnect the power plug unscrew the fuses alongside the power cord socket and check the A B fuses If the wire in the glass vial is broken please Picture 47 power socket and fuses insert new fuses 1 A slow blow Diodes light up but test tone is absent Green STIM LED or does not glow
37. king signals The MA 53 audiometer with the standard DD 45 delivers 11 air conduction AC test frequencies from 125 Hz to 8 kHz with levels from 10 dBHL to 120 dBHL With the optional high frequency HDA 200 it delivers 17 air conduction AC HF test frequencies from 125 Hz to 16 kHz with levels from 20 dBHL to 120 dBHL Bone conduction BC can be tested with 11 test frequencies from 125 Hz to 8 kHz with levels from 10 dBHL to 70 dB HL with the standard bone conductor B 71 the frequency range is limited from 250 Hz to 6 kHz The optional insert phones EAR 3A submit levels from 10 dBHL to 120 dBHL with 11 test frequencies from 125 Hz to 8 kHz Optional loudspeakers are available for free sound field measurements FF The new portable loudspeakers MAICO SBC have a dynamic range from 10 dBHL to 80 dBHL at 1m distance for nine test frequencies from 500 Hz to 8 kHz The frequency range for speech is 500 Hz to 8 kHz with levels up to 80 dBSPL The Canton loudspeakers not available in the USA deliver levels up to 90 dBHL at 1m distance over the entire frequency range from 125 Hz to 8 kHz The MA 53 has also separate line level outputs for an external amplifier The hearing level is controlled independently for each channel by two detented dials on the left and right of the instrument which can be operated from the side or the top The level steps are 5 dB and can be changed to 2 dB or 1 dB The signal STIM bar and the frequenc
38. n the center picture 27 500 L 15005 R 505 Tone Tone Picture 27 MA 53 display with single frequency mode Geba MAB53 Fe 11a doc 23 851 430 3 11 11 M Operating Instructions MA 53 MAICO 4 7 Free tunable frequencies in 1 Hz Steps FTF This feature is activated by pressing the right frequency button simultaneously This feature is just a gimmick to show the possibilities of the instruments 4 8 High Frequency Audiometry optional The optional High Frequency Audiometry offers tone audiometry with the additional test frequencies 9000 Hz 10000 Hz 11200 Hz 12500 Hz 14000 Hz and 16000 Hz Tests using this advanced frequencies give additional information of the individual hearing performance They are especially useful for the early detection of hearing damages of younger persons The headphone Sennheiser HDA 200 is l designed for high frequency audiometry 304s L 16000 R 20 gp The HDA 200 works over the full Tene Tone frequency range from 125 Hz to 16000 Hz Picture 28 MA 53 display for It is possible to use the HDA 200 as high frequency audiometry Standard AC receivers for all AC tests or to use two AC receivers with the MA 53 In this case the normal AC receiver DD45 goes up to 8000 Hz The HDA 200 is selected with the receiver selector key or as insert phone The tests with high frequencies are done as described before in chapter 4 The minimum hearing level starts for frequencies f
39. nge limit for proper hearing aid fittings and for determining symptoms of recruitment Warning Because this test uses high sound pressure levels it is extremly important to perform this test using the utmost caution to avoid damaging the ear To prevent the possibility of extreme Geba MA53 Fe 11a doc 14 851 430 3 11 11 AA Operating Instructions MA 53 MAICO discomfort by the patient it is important to start the test with levels near the patients MCL Most Comfortable Level The UCL level is described as the level between very loud and loud perception of the test signal Press the receiver selector button or longer than 2 seconds The LCD 60 L u 1000 L 305 display in the upper row changes from Tene Tone hoes Start as described in chapter 4 1 with a Picture 14 MA 53 display for UCL test left test level of 60 dBi Present the tone briefly max 1s If the signal was recognized by the patient as not uncomfortable increase the level and proceed as described before If the signal was uncomfortable for the patient note the values Proceed accordingly with other test frequencies For hygienic reasons it is important to clean the ear cushions of the headphone see chapter 10 4 3 Bone Conduction BC Testing Bone conduction i e the transmission of sound waves through the skull directly to the inner ear conways information about the function of the inner ear For a neural hearing loss the values of air
40. nob or 65 Geba MA53 Fe 11a doc 16 851 430 3 11 11 M Operating Instructions MA 53 MAICO Notice that the masking sound is continuously presented for effective masking You can interrupt the masking signal by pressing the corresponding interrupter key or To mask when performing bone conduction testing place the headphone on the opposite ear so that the receiver is at the correct height the sound output grid exactly faces the ear canal Adjust the headband of the headphones The receiver on the side where the bone conductor Is placed should sit directly on the cheek bone The marking for air conduction with masking should be done with the symbols A the right side and E the left side on the audiogram form The marking for bone conduction with masking should be done with the symbols the right side and the left side on the audiogram form 4 4 4 Automatic masking With the manual masking as described before you have to readjust the masking level every time you change the test signal level The MA 53 has a tracking feature for easy masking Adjust for the test signal using the level control knob or then with the opposite level control knob or adjust for the corresponding masking level Now press the TRACK button The masking level is automatically changed if you adjust the test signal level e g if the 45 L 4 1000 R 65g test level was 30 dB and the masking level 50 dB and you change
41. nsferred as hearing threshold data You can see the letters HL meaning threshold measurement in the BEEN upper middle of the LCD display see Picture 45 MA 53 display with picture 45 pure tone threshold setting To test the uncomfortable level UCL press the receiver selector button or D longer than 2 seconds and the LCD display in the upper row changes from HL to UL All measured data is now transferred as UCL data To test the most comfortable level MCL press the receiver selector button or longer than 2 seconds and the LCD display in the upper row changes from UL to ML All measured data is now transferred as MCL data In speech audiometry initially all measured data is transferred as multisyllable test data 30 L ys 070 R 30g 0 I Tape CD Air You can see the indication MS in the upper PS Wrong middle of the LCD display see picture 46 To test with single syllables press the receiver selector button or longer than 2 seconds and the LCD display in the upper row changes from MS to SS All measured data is now transferred as single syllable test data Picture 46 MA 53 display with speech setting To test the uncomfortable level UCL for speech press the receiver selector button or longer than 2 seconds and the LCD display in the upper row changes from SS to UL All measured data is now transferred as UCL speech data Geba MAB53 Fe 11a doc 40 851 430 3 11 11 Operating Instruct
42. nswer will not be he MA 53 nd Lipa eU 5 L 2000 R 105 The number of detected increments is rone SISI Conditioning Tone counted and shown on lower right area of the display Furthermore the number of presented increments is shown see picture 20 db Presented 4 Detected 2 Picture 20 MA 53 display with SISI conditioning 5dB and presented increment When you are sure that the patient has understood the object of the test press the PULSE button t The modulation level will be changed to 3 dB If the patient has understood this part of the test also press the PULSE button again The modulation level will be reduced to 2 dB 4 5 1 3 3 SISI Test If the patient has understood the test up to here press the PULSE button again to 65 L 4 2000 R 10 xe start the SISI test Tone aid Midi The LCD display indicates SISI test see Top Presented O Detected O picture 21 and the modulation level is Picture 21 MA 53 display with SISI test adjusted to 1 dB Now 20 increments will be presented to the patient You can delay the test for the time you press STIM bar or This could be helpful in determining if the patient maiingers 65 L m 20004 R 105 The test will end automatically after 20 J e Sal Result Tone presented increments The number of 20 Presented Z0 Detected 4 detected increments is counted and indicated as percentage of the presented increments see picture 22
43. nt phone ssssssseRRRHel 38 7 4 2 Adjustment of the assistant phone ssssssmel 38 8 Recommended literature sssssssssss mnn 39 9 Computer interface ssssssssssssse m mme nnnm 40 10 Care and maintenance of the instrument ssssssssm 41 11 Trouble shooting sssssssssssemR IIR 42 12 Technical Data sssssssssssss mmm nm nme nnne 43 13 Warranty Maintenance and After Sales Service ssssssss 51 14 Safety Regulations ssssssssssss Hmmm nnnm nnne 52 14 2 Measuring security leesseesssssssssssnn III nnne 52 14 3 Device control esses mmm nm nmm nnne 52 14 4 Operation ssssssssssse HH I III III nm mmm nre 52 14 5 Patient Safety isssssssssssssssse He mm m mm n nnne nnne nennen 52 Geba MAB53 Fe 11a doc 3 851 430 3 11 11 Operating Instructions MA 53 1 Introduction Thank you very much for purchasing a quality product trom the MAICO family This MA 53 audiometer is manufactured to meet all quality and safety requirements and has been certified with the CE symbol according to Medical Directive 93 42 EEC In designing the MA 53 we placed particular importance in making it a user friendly device meaning its operation is simple and easy to understand All built in test signals are generated by a digital signal processor DSP which allows implementing new test signals just with a software upgrade And because MA 53
44. ollowing example we assume that the left is the better ear Set the receiver selector to AC and the signal selector to TONE Set the left level control knob to a value just below expected hearing loss Explain to the patient that he should press the button of the patient response switch if he just hears the test tone Press the STIM bar for a certain time to present the test tone The STIM LED should light on If the patient hears the test tone the patient response display lights red In this case decrease the level with the level control knob 5 9iUCO o d Proceed with presenting the test zi ph nei signal as described before 0 Me 0 OO Q If the patient doesn t hear the test tone increase the level with the level control knob Proceed with 44 P presenting the test signal as 2 wp l Picture 12 MA 53 controls and display for air conduction described before threshold test of the left ear MMAICO MAS53 Geba MA53 Fe 11a doc 13 851 430 3 11 11 AA Operating Instructions MA 53 MAICO When you find a stable threshold value note the level and frequency If the MA 53 is connected to a PC the value was stored with your last STIM presentation Test through the frequencies Starting at 1 kHz set the higher frequencies first then the lower frequencies Use the frequency up key or to select the higher frequencies and use the frequency down or to select the lower frequencies Select t
45. or advanced users see chapter 8 Following is the description of the main and second eve functions of each button left blue channel frequency up change to next higher frequency lett blue channel frequency down change to next lower frequency lett blue talk over microphone switches on the talk over microphone as long as the button Is pressed The level can be adjusted with the knobs or The actual value is displayed in dB at the lower center of the LCD display left blue channel receiver selector changes the receiver from AC to BC or FF or INSERT if option assembled The lighted LED above shows the current selection 2nd level selects test mode HL UCL MCL for selected receiver 9 FM modulation warble tone changes test signal from pure tone to warble tone 2nd Level to enter the user menu press button during power on left blue channel signal selector changes the test signal from pure tone to tape CD or microphone or noise or switches the channel off 2nd Level Calibration of tape CD or live voice microphone pulse tone enables pulsing of pure tone or warble tone 2nd Level enter pulse tone menu ABLB DLI and SISI Test stim mode changes the signal presentation from presenter to interrupter mode 2nd Level enables interlock function Pressing left or right signal presentation bar affects both channels Picture 7 MA 53 keyboard Geba MA53 Fe 11a doc 10 851 430 3 1
46. ows the actual test and the result MS stands for multi syllable speech test speech discrimination 60 correct words 6 wrong words 4 The right part of the LCD display shows the setting for the right channel level 60 dBHL receiver AC signal speech noise masking The LCD display has an energy saver function the backlight of the display is automatically switched out after approximately three minutes Any action with the MA 53 such as pressing a button or turning the knobs switches the backlight immediately on again Geba MAB53 Fe 11a doc 12 851 430 3 11 11 Operating Instructions MA 53 4 Pure tone audiometry 4 1 Air Conduction AC Testing In the hearing threshold test the hearing threshold of the patient is measured in comparison with the normal hearing threshold for air conduction The test is started on the ear with better hearing The patient should sit at a distance of at least 1 m from the device Eliminate any obstructions which will interfere with the placement of the earphone cushions on the ear i e hair Picture 11 Headphone eyeglasses Ensure the headphones are put on correctly Red side on the right blue side on the left Adjust the headband of the headphones so that the receivers are at the correct height the sound output grid exactly facing the ear canal Start with the better indicated ear at 1 kHz After switching on the frequency is automatically set to 1 kHz In the f
47. picture Picture 19 MA 53 display with 9 SISI conditioning 5dB Select the test frequency with the frequency keys or For the test you should choose the frequency where the maximum bone conduction hearing loss is measured as described in chapter 4 3 5 dB Presented 0 Detected 0 Adjust test level with the level control knob or The level should be set to a value 20 dB above the individual hearing threshold measured under chapter 4 1 It must reach at least 60 dBu Recognize that in the SISI mode the test signal is presented continuously You can interrupt the test by pressing the STIM bar or for however long you hold it down The patient must be instructed You will now hear a continuous tone Every time it becomes louder immediately push the switch 4 5 1 3 2 Training of the Patient Only with careful training during the following conditioning phase can a valid test result be achieved The training starts with a modulation level of 5 dB That means a continuous tone e g 65 dBu is briefly increased every 4 8 seconds for 0 2 seconds by 5 dB e g to 70 dBu During the increment time the text Tone Now is shown Geba MAB53 Fe 11a doc 20 851 430 3 11 11 AA Operating Instructions MA 53 MAICO on the lower area of the LCD display 9 see picture 20 The text Answer now appears for approx 1 5 seconds During this period the patient may respond If he she answers too early or too late the a
48. ponsibility for the proper collection and treatment according legal regulations to our customers Geba MAB53 Fe 11a doc 51 851 430 3 11 11 Operating Instructions MA 53 14 Safety Regulations 14 1 Electrical Safety The MA 52 audiometer is constructed to comply with protection class Il of the international standard IEC 601 1 EN 60601 1 4 Protection from an electric shock is ensured even without the system earth connection The instruments are not intended for operation in areas with an explosion hazard 14 2 Measuring security To guarantee that the audiometer works properly the instrument has to be checked and calibrated at least once a year The service and calibration must be performed by an authorized service center In accordance with the regulations of the EU medical directive we will drop our liability if these checks are not done The use of non calibrated audiometers is not allowed 14 3 Device control The user of the instrument should perform a subjective instrument check once a week This check can be done following the list for subjective instrument check see next page For your own security you should copy the enclosed list fill itin once a week and store it in your files 14 4 Operation Only skilled personnel Audiologists ENT professionals or other with equivalent knowledge should operate the instrument 14 5 Patient Safety Please note that if connection is made to standard equipment like
49. r with the microphone and live voice using standardized word lists Different methods for speech tests are standardized worldwide such as the ASHA guidelines for determining the threshold level for speech Asha 21 page 353 356 Explain to the patient that he should repeat each word he hears The patient should sit at a distance of at least 1 m from the device Eliminate any obstructions which will interfere with the placement of the earphone cushions on the ear i e hair eyeglasses Ensure the headphones are put on correctly Red side on the right blue side on the left Adjust the headband of the headphones so that the receivers are at the correct height the sound output grid exactly facing the ear canal Set the receiver selectors and to AC and the signal selectors and both to TAPE CD if you are using recorded speech test material or to MIC if you wish to perform a speech test with live speech MEM R 30 On the LCD display the initial setting for Tape CD speech audiometry see picture 36 appears The percent speech discrimination score is displayed in the middle Below this Picture 36 MA 53 display with the number of correct and incorrect words it settings for speech audiometry Is shown If you are using CD or tape put the monitor phone on to hear the test words Depending on your test method use the level control knob or amp to set the start level Perform the test words Tally the corr
50. rd operation press the SWAP key 4 After 20 increments the SISI test is finished The text SISI Result with the result in percentage Is shown You can stop the SISI test with the PULSE key The text SISI aborted and the actual result in percentage is shown Press the PULSE key to quit the SISI test 6 8 2 Decay test Carhart If the patient presses the patient response switch longer than 3 seconds in the lower area of the display a decay bar appears and shows the counted time until the patient releases the patient response switch To clear the display and reset the decay function press one of the STIM bars or 6 9 Swap function Press the SWAP key to exchange the left and right channel The big letters R and L will be swapped in the display and the light above the SWAP key IS On Press the SWAP key again to deactivate swapping 6 10 Tracking function Press the TRACK key 9 to activate tracking Both the left and right sides of the display amp will say TRACKED meaning that both channels are tracking each other If NOISE is selected on one channel the text TRACKED is erased because a noise channel is not allowed to track a signal channel Press the TRACK key 9 again to deactivate tracking 6 11 STIM Mode selection Press STIM MODE key to switch between continuous presentation and presentation by pressing the STIM bar or When in continuous presentation mode the STIM bars Gand f
51. rom 9000 Hz to 16000 Hz at 20 dBu Geba MA53 Fe 11a doc 24 851 430 3 11 11 Operating Instructions MA 53 5 Speech audiometry 5 1 Connecting the speech source 5 1 1 Connecting a CD player To conduct speech tests using speech test material you can connect a CD player to the MA 53 Use a standard phono plug cable to IM connect the right and left outputs of the O Q O O O O device with the corresponding inputs and b SAPE Vel Cy O on the rear panel of the MA 53 To avoid OOE pinching the cables when closing the cover lay the cables in the slots provided OM Picture 29 MA 53 rear panel If you are using a small portable CD player with TAPE CD input or tape you can place it on top of the cover of the MA 53 This saves space and makes the usage of the CD player or tape very convenient Caution If you are using a CD or tape player powered by electrical current the player must meet electrical safety requirements such as IEC 601 1 or UL This is to avoid electrical shock of either the patient or you If you are not sure if your player meets these requirements it is safer to use battery power 5 1 2 Connecting a Microphone Connect the microphone to the SPEECH MIC connector on the rear panel of the MA 53 see picture 30 To avoid pinching the cables when closing the cover lay the cables in the slots provided Place the O 6 O O T BE BE Tat ch GW TOR TB microphone on top of the cov
52. rument by MAICO through the distributor from whom it was purchased and covers defects in material and workmanship for a period of one year from date of delivery of the instrument to the original purchaser The MA 53 may be repaired and serviced only by your dealer or by a service center recommended by your dealer We urgently advise you against attempting to rectify any faults yourself or commissioning non experts to do SO In the event of repair during the guarantee period please enclose evidence of purchase with the instrument In order to ensure that your instrument works properly the MA 53 should be checked and calibrated at least once a year This check has to be carried out by your dealer When returning the instrument for repairs it is essential to send the headphones as well Send the device to your dealer or to a service center authorized by your dealer Please include a detailed description of faults In order to prevent damage in transit please use the original packing if possible when returning the instrument Within the European Union it is illegal to dispose electric and electronic waste as unsorted municipal waste According to this all MAICO products sold after August 13 2005 are marked with a crossed out wheeled bin Within the limits of Article 9 of DIRECTIVE 2002 96 EC on waste electrical and electronic equipment WEEE MAICO has changed their sales policy To avoid additional distribution costs we assign the res
53. st Now adjust the required test level with the level control knob or and present the test signal by pressing the STIM bar or G3 To exit the test press the PULSE buttom longer than 2 seconds The suprathreshold tests menu is now displayed To exit the suprathreshold test menu briefly press the FM button Geba MA53 Fe 11a doc 19 851 430 3 11 11 Operating Instructions MA 53 4 5 1 3 The SISI Test The SISI Short Increment Sensitivity Index is guided by the principle that patients with cochlear impairment are hypersensitive to small intensity increments The continuous test tone is increased by 1 dB for a period of 0 2 seconds every 4 8 seconds Whenever the patient hears the increment he she presses the patient response switch The SISI test information and the test score are shown on the LCD display The test will end automatically after 20 presented increments The score is expressed as a percentage of ratio of the increments heard to the delivered increments all increments heard 100 no increments heard 0 A high score indicates a cochlear impairment A low score is related to normal hearing or conductive or retrocochlear pathology 4 5 1 3 1 Preparation of the SISI Test To start the test select SISI in the suprathreshold menu as decribed before 65a L m 2000m R 105 under 4 5 and press the STIM bar Q or Tene SISI Conditioning Tone The display changes to the SISI conditioning screen as shown in
54. t the output level that is comfortable for you Store the adjustment by pressing the STIM bar or 8 Geba MA53 Fe 11a doc 37 851 430 3 11 11 AA Operating Instructions MA 53 MAICO 7 4 Assistant phone The optional assistant phone allows the operator to speak directly to an assistant person in the sound excluding booth This could be a parent when measuring children The operator speaks to the assistant person via the talk forward microphone and the assistant phone This communication cannot be heard by the patient To talk to the patient press the left TALK OVER button To talk to the assistant person press the right TALK OVER button 7 4 1 Connection of the assistant phone JUUUU Connect the assistant phone with the attached connecting cable together with the Nc O O OO talk back microphone to the TB MIC 090d connector at the rear panel of the MA 53 005000 see picture 43 To avoid pinching the cables a when closing the cover lay the cables in the Picture 43 MA 53 rear panelwith TALK slots provided BACK MICROPHONE and ASSISTANT PHONE connector 7 4 2 Adjustment of the assistant phone Press the right TALK OVER key In the lower area of the display the volume level of the assistant phone is shown see picture 44 304 L T TR 30 Adjust the assistant volume with the left Tape co Wron Tape CD PCR Enn Release the TALK OVER key if you have Picture 44 MA 53 display with finished talking
55. to the patient adjustment of the assistant phone Geba MAB53 Fe 11a doc 38 851 430 3 11 11 M Operating Instructions MA 53 MAICO 8 Recommended literature Audiometric Interpretation A Manual of Basic Audiometry Lloyd Lyle L and Harriet Kaplan Baltimore University Park Press 1980 Auditory Disorders A Manual for Clinical Evaluation Jerger Susan and James Jerger Boston College Hill Press 1981 Handbook of Clinical Audiology Katz Jack Baltimore William amp Wilkins 1994 Roesers Audiology Desk Reference Roeser Ross J New York Stuttgart Thieme 1996 Auditory Diagnosis Silam Shlomo and Carol A Silvermann San Diego London Singular Publishing Group 1997 Geba MA53 Fe 11a doc 39 851 430 3 11 11 M Operating Instructions MA 53 MAICO 9 Computer interface The MA 53 has a built in serial RS 232 PC interface for data transfer to a connected PC The serial cable to connect the MA 53 with the PC should be a normal non twisted 9 pin extension cable It has a male and a female connector and all wires are direct 1 1 connected It is also sold as monitor extension cable Caution The computer you are using must meet electrical safety requirements such as IEC 601 1 or UL This is to avoid electrical shock of either the patient or you All test results are online transferred to the PC and stored in the database 30a Lm 1000 L 30 Tone Tone In pure tone audiometry initially all measured data is tra
56. unction as interrupters The light above the STIM MODE key is on if continuous presentation is selected Speech and noise are always in continuous presentation except when both channels are selected as noise Press the STIM MODE key again to deactivate continuous presentation Geba MA53 Fe 11a doc 32 851 430 3 11 11 M Operating Instructions MA 53 MAICO 6 12 Interlock function Press the STIM MODE key longer than 2 seconds to activate the interlock function The display shows the text Interlock Interlock works only if both channels have the same kind of signal Speech tone or noise In modes where no interlock is available the display amp shows No Interlock Press the STIM MODE key longer than 2 seconds to deactivate the interlock function 6 13 Talk over microphone Press one of the TALK OVER keys and In the lower area of the display the volume level of the talk over microphone is shown Adjust the talk forward volume with the left 9 or right knob Release the TALK OVER key or if you have finished talking to the patient 6 14 Talkback microphone and Monitor volume control Press the right SIGNAL key longer than 2 seconds and the volume control bars for TB and monitor are shown Adjust the monitor volume with the right knob Adjust the talkback microphone volume with the left knob To store the actual settings press one of the STIM bars or 6 15 Speech audiometry To sele
57. ver Radioear B 71 10 dBHL 80 dBHL 1000 Hz 10 dBHL 75 dBHL 500 Hz 750 Hz 4 kHz 6 kHz 10 dBHL 60 dBHL 250 Hz 10 dBHL 45 dBHL 125 Hz 8 kHz no output speech 10 dBHL 80 dBHL Insert earphone with 10 dBHL 115 dBHL optional EAR 3A 500 Hz 4 kHz 10 dBHL 110 dBHL 250 Hz 10 dBHL 105 dBHL 6kHz 10 dBHL 95 dBHL 125Hz 10 dBHL 90 dBHL 8kHz 10 dBHL 85 dBHL Geba MA53 Fe 11a doc 43 851 430 3 11 11 FF with optional loudspeaker type Canton FF with optional portable loudspeaker MAICO SBC Test Signal Modulation Tests Functions Warm up time Mode of operation Geba MAB53 Fe 11a doc Operating Instructions MA 53 10 dBHL 90 dBHL measurement in 1m distance 1 kHz 1 5 kHz 10 dBHL 85 dBHL 500 Hz 750 Hz 10 dBHL 80 dBHL 250 Hz 6 kHz 8 kHz 10 dBHL 75 dBHL 125Hz 10 dBHL 60 dBHL speech 10 dBHL 85 dBHL 10 dBHL 85 dBHL measurement in 1m distance 750 Hz 2 kHz 8 kHz dBHL 500 Hz 6 kHz 10 dBHL 80 10 dBHL 75 dBHL 125 Hz 250 Hz no output 2 kHz 6kHz 10 dBHL 90 dBHL 3 kHz 4 kHz 10 dBHL 100 dBHL Pure tone pulse tone warble tone narrowband noise broadband noise speech masking noise Pulse tone 0 5 s on off Warble tone triangular freq deviation 5 repetition rate 5 Hz ABLB Fowler 0 5sand1s DLI L scher 4 3 2 1 5 1 and 0
58. y up down keys are just beside the level control knobs for easy one handed control of level frequency and signal presentation Geba MAB53 Fe 11a doc 5 851 430 3 11 11 M Operating Instructions MA 53 MAICO The large backlighted LCD display shows level frequency transducer signal and other information for each channel As a result of modern microprocessor technology the MA 53 is easy to use and is extremely reliable The audiometer is designed to be extremely service friendly Automatic test programs make trouble shooting and the yearly calibration as easy as possible PC Interface A serial RS 232C interface for data transfer to a connected computer is built in The optional MAICO audiometry module for NOAH enables the automatic data transfer of all test results of the MA 53 like speech audiogram and ABLB DLI SISI tone decay etc For more information see chapter 9 Geba MAB53 Fe 11a doc 6 851 430 3 11 11 Operating Instructions MA 53 3 Getting started 3 1 Unpacking your instrument Your MA 53 was carefully inspected and packed for shipping However it is a good practice to thoroughly inspect the outside of the shipping box for signs of damage If any damage is noted please notify the carrier immediately Carefully remove the instrument from the shipping box Remove the plastic bag from the instrument and inspect the case for any damage Notify the carrier immediately if any mechanical damage is noted This w

Operating Instructions MA 53

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