Home

MADSEN Itera II User Manual

1. 26 3 2 1 5 Vhe TE xz Rb utton nh ets wd tede e i DR 27 32 16 The SETUP Button xac uos cebat axem ruv te u uyu i 27 3 Table of Contents MADSEN Itera Il e User Manual 3 2 17 The TALK BACK button asa EA OPES EXPE RR Es 28 3 2 18 The MASK c l mn or EE O W AE eed Ee DE eoo C dob 28 3 2 19 The dB STEP column atak oz KE Sab races dde 29 3 220 The FREQUENCY knob 2 propias aod i poa su gua us suq tenes 29 3 521 dB e PE VE LSI eia Cows CEA exta ie dicite ete date mi 30 022 B LEVEL Rights eka qa a ERO MERE ER VES 30 3 9 23 Left INT button RAIL iu wia uyu dudni woes eds boss etis 31 3224 Right INT button PASS 31 3 3 Socket connections rear panel S aca o ea E EDO ORE SO Eds 31 293 1 Description vios sept res ES ee Rare d 22 54 Side panel ux ders e ug tA bs Wah i ta EAN zad ERE I sa Rob Poe ae e ES 34 Navigating in the OTOsuite Audiometry Module 35 4 1 Audiometry Module features op aider c dor EX RR CR IU ee epa awa 35 4 2 The Audiometry Module menu system and toolbar 36 4 3 he Audiometry Module Control Panel Dra PAW 39 4 3 1 The MADSEN tera II Control Panel 40 PRE stimulus DAE a Pepe EA tb do dd ten Aa alg 42 4 4 1 The Tone stimulus bar a Eat O 44 4 4 2 The Speech stimulus bar
2. 139 ADD 139 App 3 2 Technical Specifications u 025 ac P der seh ERO DR eed 139 App 4 Standards and safety MADSEN Itera II and the Audiometry Module 145 App 4 amp 1 MADSEN Merl ines etenim eie n ta Dco eth e anaes eed 145 App 4 Ll Symbols ised rns aura doti es pella E pa 145 App 4 1 2 Warning notes o422 SWR Ferte s cp Eas 145 App 4 2 The OTOsuit Audiometry Module 147 App 4 2 1 Manufacturer oua deo ee Radares eva Sabes de Satur Va Medos 147 App 4 2 2 Responsibility of the manufacturer 147 Index roiv a eb OO S An destaca ew os Sta kaa ua 149 Table of Contents MADSEN Itera Il e User Manual 8 Otometrics 1 Introduction to MADSEN Itera II and the OTOsuite Audiometry Module 1 1 MADSEN Itera II LL Otometrics MADSEN Itera II is capable of performing all standard audiometer tests speech audiometry and depending on the configuration various special tests such as SISI Stenger ABLB Fowler and HIS Itera II can be used as a portable instrument or as a desktop unit fixed installation Itera II connects to PCs running theOTOsuite Audiometry Module for online mon itoring of test results data export and storage printing and NOAH compatibility Operation Operation is simple and intuitive The front panel buttons have indicator ligh
3. Audiometers Connect to the 1 Click on the device you wish to use device you wish to Ifthe device is not listed check the box My device use for testing is turned on and ready to be found and click on Search 2 The first time you select a device you will be prompted to enter the Audiometer license key 3 Enter the license key 4 Select the device and click on Next or Close Test type Show SISI test type e Click to enable viewing either of these test types as a test tab selection on the Audiometry test screens and SNOW AALE to access their settings in Tools gt Options type If a User Test is set up to include either of these tests Show MLD test type and they have been disabled in this screen you will be prompted to enable them here 116 Otometrics Configuring OTOsuite Audiometry Otometrics 117 Configuring OTOsuite Audiometry 118 Otometrics Configuring OTOsuite Audiometry Otometrics 119 Configuring OTOsuite Audiometry 120 Otometrics Configuring OTOsuite Audiometry Otometrics 121 Configuring OTOsuite Audiometry 122 Otometrics 12 12 1 12 2 12 2 1 Otometrics MADSEN Itera II Maintenance and Safety Service and repair It is recommended that you keep the packing material in which the Itera II was deliv ered If you need to send it in for service the original packing material will ensure protection against damage during transport etc On req
4. at the same time For a description of the Patient Response Switch see 5 2 2 The patient response switch 60 3 2 12 The START STOP button weer Press to Start Stop or Pause the counter timer function in different tests as required SISI Press to Start Stop and Pause HIS Press to activate the filters Otometrics 25 Overview of MADSEN Itera II FRONT panel controls 26 3 2 13 The STORE button STORE a Stores a threshold in the internal memory This button is not applicable in Speech testing Ifyou press and hold STORE it toggles the threshold status and symbol shown on the display between threshold value No response or no symbol Release the button when it shows the wanted status You can overwrite a stored threshold value with a new value You can delete an accidentally stored threshold Press and hold STORE until no symbol is shown Note In UCL and MCL testing No response is not applicable fa previously stored threshold is present it will be replaced by the new thresh old when you press STORE Change frequency after STORE You can set up the STORE button to automatically change the stimulus to the next test frequency See SETUP 13 FREQ CH AT STORE 104 When you select a frequency and intensity at which a threshold value has previously been found this value is shown in the display by means of an symbol beside the frequency indication and the applic
5. continues at 30 1500 Press STORE continues at 20 2000 Press STORE 107 Setup of MADSEN Itera II Parameters SETUP items dB Hz Continues at 10 3000 Press STORE continues at 0 4000 Press STORE continues at 10 6000 Press STORE continues at 10 8000 Press STORE continues at 10 12500 Press STORE continues at 10 125 Press STORE continues at 10 250 Press STORE continues at 10 500 Press STORE continues at 10 750 Press STORE continues at 10 1000 With masking dB Hz Masking level 40 1000 30 Press STORE continues at 30 1500 20 Press STORE continues at 20 2000 10 Press STORE Pulse frequency 16 PULSE FREQUENCY Choice of pulse frequency 0 25 to 2 50 Hz Impulse length 17 IMPULSE LENGTH Selection of the fixed period of time during which the signal will be presented when IMPULSE mode is selected 0 25 to 2 50 sec Warble modulation size 18 WARBLE MOD SIZE Set modulation size as a 96 1 to 25 e g At 5 the signal modulates 5 in relation to default frequency 108 Otometrics Setup of MADSEN Itera Il Parameters SETUP items Warble frequency 19 WARBLE FREQUENCY 1 Hz to 20 Hz Select manual frequency 20 SELECT AC FREQ Here you can select ON or cancel OFF the frequencies to be included for automatically changing frequencies when you store AC thresholds The frequencies
6. poe RO RO Robe a e 44 4 5 The Test dace b OC ERE eon ala ue EODEM E OP ERES 45 4 5 1 The work area in the Tone screen the audiogram 45 4 0 U REMIOWOBUO E iau ccs van eee able et ace yo d Ace Hes aaa 46 BOD TheLegend box oi sedo io eto hoe Iob ante 48 4 0 The Speech t65E screen aaa Sitios pase cote pod ooo decies ege a 48 4 6 1 The work area in the Speech screen 48 40 Whe Legend box A suy ys oai baw ees pot ics wa iu ah 50 4 6 3 Terms and abbreviations used in Speech testing 50 4 7 The Aided Speech test screeni cauce d Pe RUE ee EUER usa 51 4 8 The Patient Responder indicator 51 4 9 Curves and symbols selection 52 4 9 1 Selecting a symbol or curve ao O CY a 52 2 9 25 Creating new symbols Loves adopted sas oboli RO pol RUP RO opel Cn pon 53 4 10 The Masking Assistant 54 Preparing MADSEN Itera II for the test 59 5 1 Preparing the test environment 44 35 290399 REPLIES LE AAA 59 Sil gli Hygienic precautions v oves Ve Exe be RE DURER RES 59 5 2 Preparing the test equipment oos DEA PR peus cent a bt pra ait ed utr 59 5 2 1 Connecting the cables of the test equipment 59 5 2 2 The patient response switch 440 ob
7. To prevent cross infection use a clean eartip when you test the next patient 5 2 Preparing the test equipment 1 Make sure that you have connected the required accessories headphones To connect see 13 2 2 Air conduction 128 insert phone s To connect see 13 2 2 Air conduction P gt 128 bone conductor To connect see 13 2 3 Bone conduction P gt 128 external microphone To connect see 13 2 4 External microphone P gt 129 free field equipment To connect see 13 2 5 Free Field P gt 130 patient response switch 3 3 Socket connections rear panel 31 5 2 1 Connecting the cables of the test equipment Connect the cabling of the computer and various accessories as shown in the follow ing illustrations Otometrics 59 Preparing MADSEN Itera II for the test Preparing the test equipment Patient response switch Fig 11 USB RS232 connection for PC or Laptop with USB port or RS232 cable for PC or Laptop with serial port 5 2 2 The patient response switch Place the patient facing away from the Itera II in a sound booth if one is availa ble Instruct the patient in how to use the Patient Response switch Instruct the patient in pressing the button even if only weak signals are heard Note During automatic testing if the patient presses the switch repeatedly during a stimulus presentation the response is ignored Note During automatic testing if the patient does not release the s
8. 3000 56 Munro amp Agnew BJA 1999 4000 50 Munro amp Agnew BJA 1999 6000 44 Munro amp Agnew BJA 1999 8000 42 Munro amp Agnew BJA 1999 Otometrics 71 Tone Testing with MADSEN Itera II Testing with masking r2 6 3 2 Air conduction with masking Suggested procedure Prerequisites The unmasked hearing thresholds have first been determined as described in 6 1 Air Conduction threshold test 65 Prerequisites as in 6 1 Air Conduction threshold test 65 Prepare the patient for testing with masking See 5 2 5 Preparing for testing with masking gt 62 tis recommended to use the default setup used in connection with selecting MASK ON for presenting the masking signal as continuous presentation This means that you will not be using the INT button to control the masking sig nal Testing 1 Press MASK ON to activate contralateral masking 2 Set the masking level at the threshold of the masking ear and make sure that it is heard by the patient If it is not increase the masking level 3 Present the tone to the test ear at the unmasked threshold level If the tone is not heard increase the level in 5 dB steps until the patient responds 4 When the patient responds increase the masking level in 5 dB steps After each increase present the tone no more than twice The tone is considered heard if the patient responds at least once If the tone is heard when the masking level ha
9. 60 VA Fuses T1AL 250V Standards Audiometer EN60645 1 EN60645 2 EN60645 4 and ANSI 53 6 Patient Safety Complies with EN 60601 1 Class 1 Type B U2601 1 CAN CSA C22 2 NO 601 1 90 EMC EN 60601 1 2 Miscellaneous Internal power supply to CD player 1 5 10 V 0 5 V steps Software adjustable contrast brightness on display and LED s Integral Talk Over microphone Digital Aux 5 pole DIN 143 App 3Technical Specifications MADSEN Itera Il Technical Specifications 144 Otometrics App 4 Standards and safety MADSEN Itera II and the Audiometry Module App 4 1 MADSEN Itera II App 4 1 1 Symbols used MADSEN Itera II is marked with this symbol to indicate compli R ance with Type B requirements of EN60601 1 The MADSEN Itera II audiometer and this manual are XXXX marked according to the Medical Devices Directive 93 42 EEC Warning MADSEN Itera II is marked with this symbol when it N is important that the user refers to associated warnings given in this manual Please pay special attention to these warnings ROCA Classified with respect to electrical shock fire mechanical and other specified hazards only in accordance with 2601 1 and CAN CSA C22 2 NO 601 1 90 The power supply to the device has been interrupted The instrument is marked with this symbol to indicate that it is x electronic equipment covered by the Directive 2002 96 EC on waste electrical and el
10. AC 10 to 120 dB HL at mid frequencies BC 10 to 70 dB HL at mid frequencies HIS function Low pass frequencies 250 Hz 500 Hz 1 kHz or 2 kHz High pass frequencies 1 kHz 2 kHz 3 kHz or 4 kHz Amplification options 0 5 10 15 20 25 dB SPL Max output 130 dB SPL for TDH39 Max gain 50 dB SPL Masking Narrow band noise Speech noise and White noise Wide band noise Total harmonic distortion Air 2 5 96 Otometrics Bone lt 5 Selectable transducers AC BC SF App 3Technical Specifications MADSEN Itera Il Technical Specifications TDH39 HDA200 and E A RTONE 3A B71 Mastoid Forehead TDH39 HDA200 E A RTONE 3A Free Field amplifier loudspeaker Transducer options depend on how the MADSEN tera II is calibrated Outputs AC BC SF External inputs CD Tape Microphone Talk Back 2 x mono jack 1 4 1 x mono jack 1 4 2 x mono jack 1 4 0 2 to 2 0 Vrms 10 k 2 x RCA phone 0 002 to 0 02 Vrms 2 x 8 pole DIN 0 002 to 0 02 Vrms 5 pole DIN for all microphones DC bias for electric Mic Optional input resistance between 10 k and 6000 Interrupter Normal Reverse Pulse Impulse Otometrics The signal is presented when the INT button is pressed The signal ceases when the INT button is pressed The signal is pulses The pulse frequency can be adjusted in the range 0 25 to 2 5 Hz in 0 25 Hz steps The signal is presented for a preset period of t
11. INTERN MIC The display then shows the selected microphone input for the current ear Otometrics 75 Speech Audiometry with MADSEN Itera II Monaural Speech Test 76 MICI default or MIC2 You can set the sensitivity independently for MICI and MIC2 Adjusting input sensitivity P gt 77 regardless of whether both MIC input channels are routed from a single microphone the internal microphone an external table top microphone or an external monitor headset or from two different external microphones gooseneck microphones If you are using an Itera II with two built in gooseneck microphones the follow ing selections apply gooseneck microphones are external microphones MICI left gooseneck microphone MIC2 right gooseneck microphone Note Ifyou connect an external microphone which can be the monitor headset or the gooseneck microphones to EXTERN MIC this automatically disables the internal micro phone INTERN MIC If no external microphone is connected the corresponding inter nal microphone will automatically be selected CD If you press CD CD_1 or CD_2 is shown briefly in the display The CD 1 input is Channel 1 left on the recording The CD 2 input is Channel 2 right on the recording Switching between input signals You can switch between input channels Press and hold MIC or CD and simultaneously press L lt gt R The display will show the input channel you have selected and
12. MADSEN Itera II 17 for a full description of unpacking instructions controls and socket connections Safety This User Manual contains information and warnings which must be followed to ensure the safe performance of Itera II Warning Local government rules and regulations if applicable should be followed at all times 11 Introduction to MADSEN Itera Il and the OTOsuite Audiometry Module Typographical conventions 1 5 1 5 1 12 App 4 Standards and safety MADSEN Itera II and the Audiometry Module 145 gives you an overview of device labelling and standards App 4 1 2 Warning notes gt 145 contains relevant warning notes Training It is recommended that you read this manual and the OTOsuite Platform User Man ual and make yourself familiar with Itera II before you begin testing a patient Note Ifyou are using the OTOsuite Audiometry Module with NOAH 3 we recom mend that you are familiar witb the screens and functions provided in NOAH 3 Terminology The correct term for the person being tested evaluated serviced may depend on the setting in which the system is being used For this manual the term Patient was cho sen but when you use Itera II with OTOsuite you can configure OTOsuite to use another term Typographical conventions The use of WARNING CAUTION and NOTE For safety reasons and appropriate use of the OTOsuite Audiometry Module the manual contains WARNINGS CAUTIONS and
13. Z Monaural Speech Testes ad RB ARG AE AAAA Ee ita 75 ZL Selecting input baa tad 75 7 1 2 Selecting masking for speech audiometry TT 7 1 3 The counter function in speech audiometry 78 7 1 4 Interrupting the speech signal 78 7 2 Binaural Speech sy Aa El O P o 78 7 2 1 One channel or two channel Speech testing 79 7 2 2 Adjusting input sensitivity wc eed ida SKA EP GK pW 79 7 3 Special Speech routing dw ola eae aka td EE be MESS 80 7 9 4 Mixing input signals for two channel monaural Speech 80 Lor Speechin Noise aea di EO dea SES Oe RO HUE AU A drca 80 7 3 3 Binaural Speech with masking 81 7 3 4 Masking level for Binaural Speech 82 Special tests with MADSEN Itera II 83 81 MCLtone testing 00 lasa s e e 83 8 2 UC E1one tesung 4 xe euet C ERA CREDE IRE C PRSE dA 83 8 9 ISI Lese asso eben yk die aur ey anes aec e p RE Fore eeu o qua Muda aia btts d 83 8 3 1 Masking during SISI Bi 85 8 3 2 Using STORE in the SISI test M eR ra p 85 8 4 ABEBAEONIGDA nie AO eben edt on bot hk iot es OAK 86 8 4 1 Using STORE in the ABLB Fowler test 87 8 5 STENGER a notes CES a katu n odo
14. microphone on the monitor headset 3 2 10 The TALK OVER button xw Enables communication with the patient who may be sitting in a sound booth The signal from the internal microphone or the right Speech microphone is sent to the patient s headset while the button is pressed 24 Otometrics Overview of MADSEN Itera II FRONT panel controls The test signal and any masking signal is interrupted during this period When you release the button the test signal returns Shortcut functions When you press and hold TALK OVER see 25 TALK OVER 110 you can adjust the following Talk over shortcut functions Output level head Left LEVEL selector phone Adjusts the output level in the headphone dB HL Fixed dB level talko Frequency selector ver level Switches between the fixed dB level FIX displayed and a talkover level related to a mean of the saved thresholds THR for the following frequencies 250 500 1000 2000 and 4000 Hz MIC sensitivity Right LEVEL selector Sets Mic sensitivity Talkover signal to Left Right arrow button headphone Controls the Talk Over signal to the right or left head phone Press twice to transmit the signal to both ears The change over from INTERN to EXTERN occurs automatically if an exter nal microphone is connected see Fig 3 32 3 2 11 The RESPONSE indicator www Lights up when the patient presses the Patient Response switch You will hear a
15. 2 1 Front panel layout Tests Transducers Signal The Itera II buttons and controls are grouped according to their function and how frequently they are used The layout is shown in Fig 2 20 The buttons and knobs most frequently used are placed directly below the display Ext range LR Signal indicators Setup Masking dB 20 10 3 10 TALK OVER RESPONSE START STOP Press Twice Erase 20 gt LEVI F FREQ Y o 8 UR alga v 6 Start Pause Frequency selection knob Store toggle status of thresholds Present interrupt signal word count buttons Stimulus masking intensity knobs Fig 2 The Itera Il controls and display If you try to use a button which is not enabled you will hear two short beeps Itera II also beeps when the SISI test is completed Otometrics 3 2 2 3 2 3 Otometrics Overview of MADSEN Itera II FRONT panel controls The TEST column Press to select the test TONE Press TONE to select the Tone Threshold test SPEECH Press SPEECH to select the Speech test SPECIAL Press SPECIAL to see the optional test types Press the appropriate function key to select On versions of Itera II supplied with more than three special tests press SPECIAL again while its LED is flashing This will display the names of more Special tests The most recently used Special test always appears in the first row the next time y
16. Il rear panel SF AC To the SF Transducer output Here you can connect any headphone or free field system Connect the blue 1 4 jack plug for left SF Left and the red 1 4 jack plug for right SF Right AC Connection for the AC transducer to the enclosed headphone Blue 1 4 jack plug for left AC Left and red 1 4 jack plug for right AC Right BC Connect the black 1 4 jack plug from the bone conductor CD TAPE Connection of CD or tape recorder Left 1 and Right 2 Caution When you connect other electrical equipment to Itera remember that equipment that does not comply with the same safety standards as Itera II can lead to a general reduction in the system s safety level Note Jt is recommended that the Itera II supplies power to the CD Tape player EXTERNAL MIC MONITOR HEADSET Connection for the gooseneck microphones for speech audiometry or monitor head set with internal microphone MONITOR Connection for the monitor head set without internal microphone Can be used if a stereo microphone is connected to EXT MIC MONITOR HEADSET TALK BACK Connection for the Talk Back microphone for communication from patient to oper ator Set the switch on the Talk Back microphone to ON Otometrics Otometrics N gt P Overview of MADSEN Itera II Socket connections rear panel DIGITAL AUX N A PATIENT RESPONSE Connect the black 1 4 jack plug from the Patient Response swi
17. Shades the area which is outside the patient s dynamic range of hearing Default Returns the overlay options back to whatever has been set as default 47 Navigating in the OTOsuite Audiometry Module The Speech test screen 4 5 3 The Legend box The Legend box shows the audiogram symbols used in the graphs 4 6 The Speech test screen During online testing the screen reflects the test done by the audiometer as it progresses Edt Vem Mewurenent Tools Reports Stimulus bar Bus 9 p Tabular view Work area K W u 0 10 PTA AC 30 dB SRT MEL 0 PTA BC 28 dB E Sk x aun 30 sm Level Msk Level Level Msk 40 KM SDT D SDT SDT I n 0 Test Opticon 48 Step uct E uva ua 110 WRS SRS 125 250500 1k 2k 4k 8 Score Level Msk SNR Izd WRS SRS Score Level Msk SNR AEK Audiogram Ready 2092000 QN Otormetncs 4 6 1 The work area in the Speech screen The speech test results of the selected Client are shown automatically in the stimulus bar You can choose between tabular view See Fig 9 49 graph view See Fig 10 gt 50 48 Otometrics Speech testing tabular view Navigating in the OTOsuite Audiometry Module The Speech test screen Level Msk Level sor P 1 85 50 SRT 85 wu uc PTA PTA WRS SRS WRS SRS WRS SRS Sc
18. Speech testing SDT Speech Detection Threshold SRT Speech Recognition Threshold MCL Most Comfortable Level speech UCL UnComfortable Level speech WRS SRS Word Recognition Score Sentence Recognition Score Can store up to lines of WRS SRS scores An additional line appears max 4 when you change settings level speech material etc Score Percentage of correct incorrect words Otometrics 4 7 4 8 Otometrics Navigating in the OTOsuite Audiometry Module The Aided Speech test screen Level dB level at which the words were presented Noise dB level of masking The masking stimulus is considered noise if it is presented into the contralateral opposite ear in relation to the stimulus ear SNR Signal to Noise Ratio calculated as the difference between the dB of the stimulus and the dB of the masking The SNR is only calculated if the masking signal is in the ipsilateral same ear in relation to the stimulus ear PTA Pure Tone Average The Aided Speech test screen This screen is for testing clients with hearing instruments For a description of the screen and its functionalities see 4 6 The Speech test screen gt 48 The Patient Responder indicator When the patient presses the Patient Responder this is shown on the Stimulus bar and a beep from the PC is heard through the Monitor Speaker or Operator Head set Single Responder setup Amber Indicates that the patient is pressing the re
19. for each ear The stimulus levels can be adjusted independently Masking is available on the audiometer 7 2 2 Adjusting input sensitivity You can adjust the strength of the input signal Otometrics 79 Speech Audiometry with MADSEN Itera II Special Speech routing 1 Press and hold the selected input button and use the right LEVEL selector to adjust the strength of the input signal in the channel which is flashing on the dis play 2 Press L lt gt R to toggle to the opposite input channel to be able to adjust its sen sitivity To calibrate the speech signal the VU meters must move into line with 0 dB on the VU meter scale 7 3 Special Speech routing 7 3 1 Mixing input signals for two channel monaural Speech Note Jf masking noise is switched on the input signals cannot be mixed see 7 3 3 Binaural Speech with masking P 81 If you press and hold CD or MIC and then press L lt gt R the selected test input source is sent to the left ear indicated by an arrow from right to left SBS MIC2 Press once more to send the input to the right ear CD 1 2 Press once more to send the input to each ear in the normal way The arrow dis appears 7 3 2 Speech in Noise Adjusting the masking dB level To adjust the masking dB level use the LEVEL knob on the masking side to select 80 Otometrics Speech Audiometry with MADSEN ltera II Special Speech routing L f5
20. functions Warble modulation Select the warble frequency Signal type SISI The signal type for the SISI test Master volume HIS The master volume value to be changed in HIS Parameter selection Parameter selection in SETUP SETUP Right Intensity change Changes the intensity of the masking signal in the selected dB steps To change this setting select SETUP 37 STIMULI KNOB 112 When you turn the knob clockwise the intensity is increased and when you turn the knob counter clockwise the intensity is decreased Shortcut functions You can also use the right LEVEL selector to dB LEVEL right shortcut functions Talkback level Set the level of Talk Back Warble modulation ampli Warble frequency in SETUP and amplitude tude Pulse frequency Pulse frequency Impulse time Impulse time Otometrics Overview of MADSEN Itera II Socket connections rear panel dB LEVEL right shortcut functions Input sensitivity speech Input sensitivity for speech testing Word counting method Choice of word counting method for speech test speech ing Alternating Fowler frequency Alternating Fowler frequency Master volume HIS Master volume value selection in HIS Parameter selection SETUP Parameter selection in SETUP Power out voltage DC POWER OUT voltage 3 2 23 Left INT button FAIL Presentation of test signal This function depe
21. gt 31 The sound is then routed out through sound field speakers XX ar Dae Fig 20 Free Field without Power Amplifier With Power Amplifier Plug the Power Amplifier cables into the two center sockets in the back panel of Itera II 130 Otometrics Unpacking and Installing MADSEN Itera II Installation FF cables PA cables 31 du I w a d 194 Fig 21 Free Field with Power Amplifier 13 2 6 Powering 1 Plug the power cord into the power socket on the back of the instrument 7 019 2 Plug the other end of the power cord directly into an AC power outlet with a three wire protective ground 13 2 7 Connecting to a PC See RS 232 INTERFACE P 33 for a description of how to connect the RS 232 cable to Itera II If required use a USB converter for your RS232 cable See your accessories list to order 13 2 8 Firmware update audiometers If your OTOsuite version contains a more recent firmware for your audiometer a message will appear when next you switch on your device It is recommended that you update your audiometer firmware to make sure that your audiometer and OTOsuite perform correctly Follow the on screen instructions Otometrics 131 Unpacking and Installing MADSEN ltera II Installation 132 Otometrics App 1 App 1 1 App 1 2 Otometrics Input and output sockets Maximum n
22. headphones 102 accessories connections 31 specifications 139 Aided Speech test the Aided Speech screen 51 Air conduction testing 65 with masking 69 air conductor 21 AC connection 32 alternating frequency Fowler 30 amplitude 30 annual calibration 124 attenuator specifications 140 steps 29 Audiogram combined enabling disabling 38 show combined view Audiogram Module 38 show split view Audiogram Module 38 viewing frequency range 38 viewing left right 38 viewing legend box 38 viewing right left 38 work area in screen 48 work area in screen Audiogram Module 45 Audiogram symbols Audiogram module 48 50 Audiogram symbols Itera II 18 Audiometry basic functions 35 menu bar 36 OTOsuite toolbar 36 user interface 35 Audiometry module main window 35 L M P Q R S T U V W X Y z B baud rate setting 111 BC connection 32 BC key 21 BC masking select transducer 103 BC transducer select bone conductors 102 beep function 20 ON OFF setting 110 binaural speech test input selection 79 input sensitivity 79 masking 81 masking level 82 mixing input signals 80 Bone conduction testing 67 bone conduction BC transducer 102 bone conductor 21 BC connection 32 calibration 124 butterfly 105 c Cables connecting test equipment 59 calibration 124 annual 124 certificate 125 CD power supply voltage setting 111 selection 23 CD key 23 CD tape connection 32 power supply 33 select input sensitivity 109 cleaning 123 accessori
23. mixed signals 27 select number of words 104 test signal in both ears 27 unheard words 31 speech testing 75 interrupting speech signal 78 monaural 75 word count 78 SPL selection 109 standards 145 start counter timer 25 START STOP key 25 Stenger 87 stimuli knob setting 112 Otometrics Index A B C D E F G H I J K L M N P Q R S T U V W X Y z Otometrics stimulus impulse 22 pulse 22 selection 22 warble 22 stop counter timer 25 STORE key 26 storing results Fowler 87 SISI 85 supply voltage connection 33 symbols 145 Symbols and curves selecting 39 Symbols audiogram module 48 50 Symbols audiogram in Itera 18 T talk back level 30 microphone sensitivity 110 volume 28 TALK BACK connection 32 TALK BACK key 28 talk over settings 110 TALK OVER key 24 technical specifications 139 Test devices Audiometry firmware update 131 Test equipment connecting cables Audiometry 59 test frequency change 26 test parameters changing 27 set default 102 test report 125 test setup save 102 test signals 31 monaural binaural and masking 96 test types 21 Testing air conduction 65 bone conduction 67 testing 65 ABLB 86 Fowler 86 Hearing Instrument Simulation HIS 88 monaural speech t 75 SISI 83 special tests 83 speech t 75 Stenger 87 Tests Aided Speech screen 51 controlling from Control Panel 39 Speech screen 48 Tone screen Audiogram Module 45 thresholds deleting 23 store 26 timer start or stop 25
24. noise exposure it may not be possible to determine the normal hear ing threshold It is recommended that a minimum of 16 hours should pass between exposure and testing Explaining the test procedure Explain how the test will be done including which ear will be tested first Describe what the presented signals may sound like Explain what the patient will be expected to do This includes using the Patient Response Switch and responding to the presented signals speech Otometrics 63 Preparing MADSEN Itera II for the test Preparing the patient for testing 64 Otometrics 6 6 1 6 1 1 6 1 2 Otometrics Tone Testing with MADSEN Itera II Air Conduction threshold test Modified ascending Hughson Westlake Prerequisites Testing Press TONE Press AC If required select another stimulus type WARBLE or PULSE an advantage when you test children If you want to use a predefined duration of the signal presentation when you press the INT button press IMPULSE If masking is required select the appropriate masking type Press MASK ON See also 6 3 Testing with masking 69 If required turn the FREQUENCY knob to set the starting frequency Typical starting frequency 1000 Hz The signal is usually presented for each tone in the following order 1000 Hz and increasing frequencies followed by 1000 Hz cross check and decreasing frequencies Set the initial level of the presented signal
25. normal REVERSE follows the normal rules see 3 2 23 Left INT button FAIL gt 31 Changing stimulus 7 You can change the stimulus type from pure tone to Warble WRB or Narrow Band Noise NBN When you deactivate these stimulus types the stimuli return to pure tone TON Press WARBLE to activate or deactivate see 3 2 4 The SIGNAL column 22 Activate Narrow Band Noise to activate press MASK ON or MASK LOCK to deactivate press MASK OFF See 3 2 18 The MASK column 28 If you use the MASK LOCK function to select Narrow Band Noise you lock together the L and R levels 8 6 Hearing Instrument Simulation HIS You can use this function to demonstrate how a hearing instrument will sound Follow the steps described in 8 6 1 The HIS procedure 89 88 Otometrics 8 6 1 Otometrics Special tests with MADSEN Itera II Hearing Instrument Simulation HIS A brief description Itera II provides an immediate way to demonstrate what big help amplification can be For this purpose the basic simulation described below is quite sufficient in most Cases The filter caracteristics are applied automatically in HIS depending on the shape of the audiogram T he following is a description of the HIS approach 1 High and low frequency filters are applied to match the slope of the audiogram 2 The steepness of the audiogram slope in dB octave is calculated and the HIS is set to about half this approximated slop
26. packing list correspond to those delivered Installation Location Before you install Itera II Before you start using the device it is recommended that you leave it at room temperature for 30 minutes particularly if it has been stored in very cold or warm temperatures e g if it has been in a car Read the User Manual before you connect or use Itera II for the first time Connect required accessories such as the headset the bone conductor and the Patient Response Switch to their respective connectors on the back panel accord ing to the instructions in 13 2 2 Air conduction gt 128 13 2 3 Bone conduction 128 13 2 4 External microphone 129 13 2 4 External microphone 129 and the locations described in 3 3 Socket connections rear panel 31 Note that the headphone AC transducer and SP SF transducer connectors and the CD Tape sockets are color coded as described in 3 3 Socket connections rear panel 31 Place the instrument in a well ventilated location away from sources of heat 127 Unpacking and Installing MADSEN ltera II Installation 13 2 2 Air conduction Headphones Connect the right and left wires red and blue from the transducers to the right and left AC sockets in the back panel of Itera II 3 3 Socket connections rear panel gt 31 Y I can Fig 15 Headset Insert phones Connect the Insert phones to the right and left AC socket o
27. step 8 Keep the established masking level and confirm the masked hearing threshold level To do so Decrease the test tone level by 10 dB and increase in 5 dB steps The patient should respond within 5 dB from the previously determined masked threshold level If not repeat from 3 If required test the remaining frequencies in the same way and switch to the other ear 6 4 Storing thresholds 74 To use the store button see 3 2 13 The STORE button gt 26 Results can be stored on a PC when Itera II is used with the OTOsuite Audiometry Module Otometrics 7 Speech Audiometry with MADSEN Itera II 1 Prepare the patient for testing as described in 5 Preparing MADSEN Itera II for the test 59 2 To select Speech testing press SPEECH 3 You can now proceed with 7 1 Monaural Speech Test 75 or 7 2 Binaural Speech Test gt 78 7 1 Monaural Speech Test 11 BAS 1 When you select Speech Test the display shows the following the top line displays the VU meter for the test signal aspeech counter to count the number of words heard by the patient correctly or incorrectly and indication of any masking signal The intensity for left and right ear is shown on the bottom line 7 1 1 Selecting input Select Microphone or CD input by pressing the MIC or CD button MIC If you press MIC the microphone selection is shown briefly in the display as fol lows EXTERN MIC or
28. to an audible level Turn the LEVEL knob to 40 dB HL This is to familiarize the patient with the test signal Other familiarization proce dures may be preferred Test the better ear first If this is unknown start with the right ear Press L lt gt R to select the ear you wish to test Give the Patient Response switch to the patient and explain how it should be operated see 5 2 2 The patient response switch P gt 60 Press the INT button right or left to present the tone to the patient for 1 to 1 5 seconds 65 Tone Testing with MADSEN Itera II Air Conduction threshold test 66 Use the corresponding LEVEL knob to set the intensity to approx 20 dB above the patient s presumed threshold If the patient does not respond to the presented signal turn the LEVEL knob to increase the signal level in steps of 10 dB until the patient responds Reduce the signal level by 20 dB until the patient does not respond to the signal Increase the signal level in steps of 5 dB and present the signal to the patient at each level until the patient responds to the signal Reduce the signal level by 10 dB and present signals at levels increased by 5 dB until the patient responds Repeat item 5 1 to 3 times until the patient has responded 3 times at the same level This level represents the hearing threshold at 1000 Hz based on 3 5 ascending series In some situations it may be satisfactory with two responses at
29. two CD Tape input sensitivity 24 CD INPUT SENSE Selection of CD Tape input sensitivity CD LED is lit Otometrics 109 Setup of MADSEN Itera II Parameters SETUP items 110 Talk over Talk back micropbone Monitor ON OFF Monitor left Monitor right Light intensity in LEDs Internal beep If you press and hold CD you can adjust the left input with the left LEVEL selec tor and the right input with the right LEVEL selector If you turn the right LEVEL selector without pressing CD both right and left inputs are adjusted and the display shows an average value 25 TALK OVER EXTERN if external microphones connected otherwise INTERN Possible settings Frequency selector Switches between dB level fixed FIX or dB level relative to any saved threshold value THR for frequencies 250 500 1000 2000 4000 Hz L lt gt R button Sends the Talk Over signal to the right or left headphone Press twice to transmit the signal to both ears When you press and hold TALK OVER the following adjustments can be made Left LEVEL selector Output level in headphone dB HL Right LEVEL selector Microphone sensitivity for Talk Over 26 TALK BACK MIC Selection of sensitivity for Talk Back microphone 27 MONITOR ON OFF Switches the monitor ON or OFE Tone Speech Masking Choose the stimulus using the FREQUENCY selector On Off Enable disable monitoring of the chosen stimulus using the right Level selector 28
30. volume Adjusting HIS Master Volume Note The system automatically sets the Master Volume Increasing the output level manually You can manually increase the output level by adding to the Reference Level Use the right and left LEVEL knobs to change the Master Volume as follows The Master Volume for left and right ears are locked together as default MASK LOCK is lit Use the left or right LEVEL knob to control the Master Volume for both ears together If you wish to control the Master Volume for the two ears individually press MASK LOCK to deactivate the locked function Example L 10 HIS 10 n Sound level Ref level 10 65 10 75 dB SPL in both ears None of the filters is active 8 6 2 Viewing thresholds and filters 1 You can use the FREQUENCY knob to view stored thresholds and resulting fil ters graphically 92 Otometrics 8 6 3 Otometrics Special tests with MADSEN Itera II Hearing Instrument Simulation HIS TONE 10 Right 55 Note The aspect ratio displayed is scaled based on the audiogram thresholds listed at the beginning of this example TONE denotes AC BONE denotes BC HISF denotes Hearing Instrument Simulator Filter 2 If the simulation is not satisfactory use the manual procedure described in 8 6 3 Manually adjusting the HIS filters P gt 93 to further adjust Manually adjusting the HIS filters The filters are in series but could theore
31. you replace a fuse first switch off the instrument and disconnect it 3 from the mains power supply See 12 2 3 Replacing fuses P 124 3 4 Side panel Power ON OFF 34 Otometrics 4 Navigating in the OTOsuite Audiometry Module The general functions for navigating in the main window are described in the OTO suite manual Audiometry elements f X v Pese l k us x 43 Y tow FR A T n F Audiometry toolbar 1000 w Control Panel Work area Stimulus bar Stimulus marker Masking level indicator ORENSE 629 Screen descriptions You will find descriptions of the actual screens and how to use and view them in 4 5 The Tone test screen p gt 45 4 6 The Speech test screen p gt 48 4 7 The Aided Speech test screen P gt 51 4 1 Audiometry Module features Note Some of the features below are device dependent With the Audiometry Module you can perform testing using the Audiometry Module as a handy control panel while you follow stimulus settings and test progress on your PC display Otometrics 35 Navigating in the OTOsuite Audiometry Module The Audiometry Module menu system and toolbar view and print test results view historic audiometry results from NOAH or XML view online audiometry results during testing Tone testing Speech testing use the Masking Assistant to prompt when masking is recommended view the masking level indicator in audiogram view audiogram overl
32. 2 Press SETUP again to implement the new setting 3 You can present the signal in two ways present the signal to the patient by pressing the INT button or press the REVERSE button to present the signal continuously You can then interrupt the test signal by pressing the INT button Otometrics 8 4 1 8 5 Special tests with MADSEN Itera II STENGER Test Signal presentation normal REVERSE follows the normal rules see 3 2 23 Left INT button FAIL gt 31 Using STORE in the ABLB Fowler test Storing equal volume values Press STORE to store values of equal volume You can store up to five sets of measurements for each test frequency If you try to save more than five sets of measurements for a given frequency Itera II displays the message No more STORE You can store a maximum of four test frequencies which you can select If you have stored two or more measurements at the same frequency you can turn the frequency knob to step through each of these measurements in turn before changing to the next frequency Deleting individual measurements To delete an individual measurement press ERASE once while the measurement is displayed Other measurements at the same frequency and at other frequencies remain unaffected If you change the signal type If you start a test and data are stored you cannot just change the signal type If you do so the system will refuse to save data The message Not allowed
33. 21 BC 21 beep 20 CD 23 dB STEP 29 ERASE 23 EXT RANGE 26 FREQUENCY 29 Otometrics Index A B C D E F GH J K Otometrics IMPULSE 22 input signal 23 INT left 31 INT right 31 LEVEL left 30 LEVEL right 30 LR 27 MASK 28 MASK LOCK 28 MASK OFF 28 MASK ON 28 MIC 23 MIC 24 PULSE 22 RESPONSE 23 25 REVERSE 23 SETUP 27 SF 21 SIGNAL 22 SPECIAL 21 SPEECH 21 START STOP 25 STORE 26 TALK BACK 28 TALK OVER 24 TONE 21 TRANSD 21 WARBLE 22 XMIT 24 fuses fuse types 124 replacement 124 G gooseneck microphones connection 32 H headphones calibration 124 Hearing Instrument Simulation 88 Hearing Instrument Simulator filter 93 master volume regulation 92 reference level 91 L M O P Q R S T U V W X Y z specifications 140 value selection 30 HIS 88 HL range specifications 140 selection 109 Icons combined view Audiogram Module 38 split view Audiogram Module 38 impulse length 108 time 30 IMPULSE key 22 input sensitivity 30 binaural 79 CD tape 109 microphone 109 monaural 77 input signals binaural 80 CD 23 microphone 23 REVERSE 23 selection 23 installation connections 31 location 127 powering 131 instrument overview 17 INT left key 31 INT right key 31 intended use 11 interface cable connection 33 Interfacing OTOsuite modules audiological test equipment 11 internal microphone 24 interrupter specifications 141 151 Index A B C D E G H J interrupting speech signal 7
34. 3 The permitted signal source depends on the TEST selected see 3 1 Display 17 Speech and HIS Press REVERSE to toggle the signal 3 2 6 The OUTPUT test signal indicators The OUTPUT indicators are located on either side of the display They light up when the selected test signal is present in the corresponding ear 3 2 7 The ERASE button This button has several functions Otometrics 23 Overview of MADSEN Itera II FRONT panel controls ERASE Deleting all audiogram data You must delete all data before you start testing on a new patient Press ERASE to clear all data The following dialog appears Erase all data YesNo To delete all data press the function key below YES To cancel the ERASE command press the function key below NO Note Switching off the power does not erase stored thresholds from the memory Additional functions Speech Audiometry and many special tests Various counter values Press to reset to zero See the description of e SPECIAL gt 21 and 8 Special tests with MADSEN Itera II gt 83 SISI Press to stop test completely during the pause Press to delete data at a specific frequency if it is activated during a test see 8 3 SISI Test gt 83 3 2 8 The XMIT button This button is not active 3 2 9 The MIC microphone ME The internal microphone for Talk Over and Speech testing m Use this microphone as an alternative to the gooseneck microphone or the boom
35. 8 K keys 19 AC 21 BC 21 CD 23 dB STEP 29 ERASE 23 EXT RANGE 26 FREQUENCY 29 IMPULSE 22 input signal 23 INT left 31 INT right 31 LEVEL left 30 LEVEL right 30 LR 27 MASK 28 MASK LOCK 28 MASK OFF 28 MASK ON 28 MIC 23 PULSE 22 RESPONSE 23 25 REVERSE 23 SETUP 27 SF 21 SIGNAL 22 SPECIAL 21 SPEECH 21 START STOP 25 STORE 26 TALK BACK 28 TALK OVER 24 TONE 21 TRANSD 21 WARBLE 22 XMIT 24 L LEDs light setting 110 Left Right audiogram viewing 38 152 K L M O P Q R S T U V W X Y z Legend Audiometry 48 50 Speech Mapping 50 Legend box audiogram viewing 38 LEVEL left key 30 LEVEL right key 30 location of instrument 127 LR key 27 Main window Audiometry module 35 maintenance 123 replacing fuses 124 manufacturer 147 MASK key 28 MASK LOCK key 28 MASK OFF key 28 MASK ON key 28 Masking air conduction 69 masking binaural 81 level binaural 82 monaural 77 on off lock 28 select AC transducer 103 select BC transducer 103 select presentation 103 select SF transducer 103 select stimulus for speech test 104 select stimulus for tone test 104 selecting m transducer 29 signal 31 SISI 85 with monaural binaural test signals 96 Masking Assistant 54 Masking assistant enabling disabling 37 master volume regulation HIS 92 MCL Itera II 83 measuring points deleting 23 Otometrics Index A B C D E F GH J K Otometrics Menu bar Audiometry 36 microphone internal 24 select input
36. 9 25 TALK OVER P 110 26 TALK BACK MIC gt 110 101 Setup of MADSEN Itera II Parameters SETUP items Save test setup Set default test parameters 102 AC transducer BC transducer 27 MONITOR ON OFF P 110 28 MONITOR LEFT P 110 29 MONITOR RIGHT P 110 30 LIGHT INTENSITY p 110 31 INTERNAL gt 110 32 EXT RANGE P 111 33 EXT R dB SPACE p 111 34 BAUDRATE P 111 35 CD POWER SUPPLY P 111 36 DISPLAY p 111 37 STIMULI KNOB P 112 38 DEFAULT SETTING P 112 1 SAVE TEST SETUP Here you can save a test setup e g masking ON signal type WARBLE and pres entation REVERSE so that this setup is used next time the device is switched on This can be saved and when the device is next switched on these settings will be selected automatically To use this item press STORE Note When Itera II is switched on and you choose between various tests the Itera II will always revert to the setup last used for a given test 2 SET DEF TEST P Activates Itera II s default setting for the relevant test All settings are set to the default values for example for the THR test the setting will be as follows sig nal TONE mask OFF dB 5 etc If this setting is to apply next time Itera II is switched on go to 38 DEFAULT SETTING P 112 afterwards To use this item press STORE 3 AC TRANSDUCER Choose between calibrated headphones None HDA 200 TDH 39 EAR T E A R TONE 3A Note Ifthe wrong headp
37. 9E headphones B 71 bone conductor Patient Response switch Mains cable Audiogram pad This User Manual HDA 200 headphones for high frequency audiometry Insert phones E A RTONE 3 Monitor headphones with microphone Gooseneck microphones one right and one left Microphone for speech audiometry and Hearing Instrument Simulation Free field loudspeaker Power supply cable from the MADSEN Itera II to CD player PA 210 power amplifier for free field testing App 3 2 Technical Specifications Channels 2 separate and identical channels Pure tone frequencies AC and SF 12 standard 125 8000 and 12500 Hz BC 250 8000 Hz standard frequencies Insert phones 125 6000 Hz standard frequencies Accuracy Better than 1 1 Which accessories are standard and which are optional varies from country to country please consult your local supplier Otometrics 139 App 3Technical Specifications MADSEN Itera Il Technical Specifications 140 Modulation FM Warble 1 20 Hz in 1 Hz steps Mod width 1 25 in 1 steps AM for SISI 5 4 3 1 0 75 0 50 0 25 dB HL steps Attenuator 1 dB HL 2 5 dB HL 5 dB HL step resolution over the entire range Attenuator accuracy In whole range better than 3 dB HL Between two consecutive attenuator positions 5 dB HL step better than 1 dB HL 2 5 dB HL step better than 0 75 dB HL 1 dB HL step better than 0 3 dB HL HL Range Maximum output will be limited by the transducer
38. ART STOP once more Otometrics 8 3 1 8 3 2 Otometrics Special tests with MADSEN Itera II SISI Test Aborting the test During pause you can stop the test completely by pressing ERASE Select Yes to erase all SISI data and stop the test completely or No to retain SISI data and resume the test Restarting the test Ifyou press ERASE when the test is in progress Select Yes to erase data The counter is reset to zero and the test will start again from the beginning Changing the dB level To change the dB level use the left LEVEL knob Changing the dB increments To change the dB increments use the right LEVEL knob 0 25 5dB If you do so while the test is in progress the counters are reset to zero and the test starts again from the beginning Changing number of increments To change the preset number of SISI dB increments transmitted during a test 10 50 press SETUP once and use the right LEVEL knob Then press SETUP again to implement the new setting While the SISI test is in progress it is not possible to change the frequency or the number of dB increments Masking during SISI Masking To perform masking press MASK ON or LOCK When you hold down the button the masking intensity instead of 96 score and signal type are displayed Intensity To change the intensity press and hold the button and turn the right LEVEL knob Signal type To change the signal type press and hold the button and t
39. Cod 123 12 2 Cleaning and maintenance Leta oO be o ea Rer 123 122 1 Cleaning the device 222 Ad APE OC e a MES 123 12 22 Cleaning accessories e ua war wt alone ai ls 124 12 23 Repla n NSE b dal O eQ Monika Mert A 124 12 3 Calibratiom WA O O dedita Ua AA 124 13 Unpacking and Installing MADSEN Itera Il 127 13 1 Unpacking Itera TE opes htt inertes neg aeter a KO rend 127 15 2 Installation Sedes ee erbe e ORE PERS eR eed s 127 WBZ Location woke eres RM v etes dew ege e R usq 127 13 242 Ait conduction boe reste en p epe MUERE CR ep doa 128 13 2 3 Bone conduction a ULM ue Rn Coa uon Proh at m ET 128 13 2 4 External microphone gt 6 24034 oer ERR poi E A REG PRODR CY 129 1520 Free Field dor dau apiu aes oos vei AG ipto id 130 13 256 Ao ue dae Mee ea MUR PCI ERR OU UR TRUE DA EE 131 13 2 7 Connecting toaPC gt 131 13 2 8 Firmware update audiometers 131 App 1 Maximum Non Destructive Voltage MADSEN litera II 133 App 1 1 Input and output sockets iu a ed Fiki ye Gia wi ole OPE SEA 133 App 1 2 R3237 interface sockets adu op ROA US ROA ONE SOR PY ZA 133 6 Otometrics Otometrics Table of Contents MADSEN Itera Il e User Manual App 2 MADSEN Itera II Abbreviations aha eb ts dts dra t 135 App 3 Technical Specifications MADSEN Itera Il
40. H III Munro amp Agnew BJA 1999 8000 42 Katz J Munro amp Agnew BJA 1999 Min IA Insert Phone EAR 3A Hz EAR 3A 125 60 N A traditional value 250 72 Munro amp Agnew BJA 1999 500 64 Munro amp Agnew BJA 1999 750 60 N A traditional value 1000 58 Munro amp Agnew BJA 1999 1500 60 N A traditional value 2000 56 Munro amp Agnew BJA 1999 3000 58 Munro amp Agnew BJA 1999 4000 72 Munro amp Agnew BJA 1999 6000 54 Munro amp Agnew BJA 1999 8000 62 Munro amp Agnew BJA 1999 56 Otometrics Navigating in the OTOsuite Audiometry Module The Masking Assistant Otometrics 57 Navigating in the OTOsuite Audiometry Module The Masking Assistant 58 Otometrics Preparing MADSEN Itera II for the test To save time it is recommended that you have set up the test environment and equip ment before you prepare the patient 5 1 Preparing the test environment It is recommended that you carry out testing in a test environment such as a sound booth protected from excessive noise produced for instance by office machinery and conversation 5 1 1 Hygienic precautions Be sure to follow any established infection control procedures for the setting in which you are working Always use clean eartips Swab the probe tip with disinfectant between ears If one ear is infected test the healthy ear first and change eartips between ears
41. I and the Audiometry Module The OTOsuite Audiometry Module App 4 2 The OTOsuite Audiometry Module C The Audiometry Module and this documentation are CE marked according to the Medical Devices Directive 93 42 EEC XXXX box Used in error messages if program fails See the detailed information the dialog App 4 2 1 Manufacturer GN Otometrics A S 2 Dybendalsvaenget DK 2630 Taastrup Denmark T 45 45 75 55 55 F 45 45 75 55 59 www otometrics com App 4 2 2 Responsibility of the manufacturer The manufacturer is to be considered responsible for the effects on safety reliability and performance of the equipment ONLY IF All assembly operations extensions re adjustments modifications or repairs are carried out by personnel authorised by the manufacturer The electrical installation to which the equipment is connected is earthed and complies with IEC requirements And the equipment is used in accordance with the instructions for use The manufacturer reserves the right to disclaim all responsibility for the operating safety reliability and performance of equipment serviced or repaired by other parties Otometrics 147 App 4Standards and safety MADSEN Itera II and the Audiometry Module The OTOsuite Audiometry Module 148 Otometrics Index A B C D E F GH J K Otometrics A abbreviations 135 ABLB 86 AC connection 32 AC key 21 AC masking select transducer 103 AC transducer select
42. IL WORDS 20 13 FREQ CH AT STORE WARP 14 DB LEV NEW TRA 20 dB 15 DB LEV NEW FREQ No change 16 PULSE FREQUENCY 1 50 Hz Otometrics Otometrics Setup of MADSEN Itera Il Parameters SETUP items 17 IMPULSE LENGTH 1 50 Sec 18 WARBLE MOD SIZE 596 19 WARBLE FREQUENCY 5Hz 20 SELECT MANU FREQ All frequencies on 21 SELECT AUTO FREQ All frequencies on 22 SIGNAL UNIT HL 23 26 Half gain 27 MONITOR ON OFF Tone On Speech On Masking Off 28 30 Half gain 31 INTERNAL BEEP ON 32 EXT R TIMEOUT Off 33 EXT R dB SPACE 30 dB below max 34 BAUDRATE 36 DISPLAY 19200 Baud Fix signal on Left 37 STIMULI KNOB Fix signal to Left 113 Setup of MADSEN Itera II Parameters SETUP items 114 Otometrics 11 Otometrics Configuring OTOsuite The Configuration Wizard guides you through the process of customizing the vari ous features and functions that apply to OTOsuite 1 Select Tools gt Configuration wizard Configuration Wizard Applications the applications you would like to use Immittance Audiometry Visible Speech For general OT Osuite configuration click Next 2 Ifyou wish to connect your test device to the specific module and set up mod ule specific functionalities click on Configure next to Audiometry 115 Configuring OTOsuite Audiometry 11 1 Audiometry
43. Itera II Testing with masking 70 If the appliance of masking is to be optimally administered without using unneces sary masking it is recommended in the literature not to use the one number fits all 40 dB criterion for circum aural and 55 to 60 dB criterion for insert phones This may cause errors and will increase the test time as well as increase the strain on the patient Instead the literature recommends the use of frequency specific criteria that would be taken from transducer specific inter aural attenuation tables available from clinical studies See also When to use masking for Bone Conduction testing If the difference between the air conducted threshold and the unmasked bone con duction threshold of the same ear is 15 dB or greater it is recommended that you retest bone conduction thresholds with masking applied to the contralateral ear See 6 3 Testing with masking 69 When to use an insert phone Masking via insert phone is recommended The insert phone gives less inter aural cross talk than the TDH39 headphones Use the insert phone instead of the TDH39 headphones for masking when you test the Bone Conduction threshold of patients with much more hearing loss in one ear than in the other This will reduce the risk of over masking caused by the high masking level required in the poorer ear In order to use the insert phone for masking bone conduction the EAR 3A must be included as a transducer for your audiomete
44. MADSEN Itera ll User Manual CE sss otometrics 0459 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 consent of GN Otometrics A S Copyright 2009 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 avail able at the time of publication GN Otometrics A S reserves the right to make changes at any time without no tice Technical support Please contact your supplier Table of Contents MADSEN Itera ll User Manual Otometrics Introduction to MADSEN Itera II and the OTOsuite Audiometry Module 9 1 3 MADSEN Itera rette ue aby e ere N eee 9 1 2 The Audiomety Module xd 2955044 PERRO PER ORF ZG RO SERERE RM ES 10 1 2 1 OTOsuite Audiometry Module interfacing to audiometers 11 Aide Iniendeu se vieri Cite h ZG POOR 11 13 1 MADSEN Itera II ies dme eem EE Mee RR Ren 11 1 3 2 The Audiometry Module tete b seen e pp t Dd 11 TR Ab utthis Manna seta a de ve AA dase RO re e 11 15 Typographical conventions waite bole trio et cil eh eo aes eet 12 15 1 Navigation in this manual ta daty bad 12 Get
45. MONITOR LEFT Selection of volume for left monitor 29 MONITOR RIGHT Selection of volume for right monitor 30 LIGHT INTENSITY Selection of brightness in LEDs All LEDs are lit 31 INTERNAL BEEP Switches the internal beeper in connection with the patient s response switch and under item change in SETUP ON or OFE Otometrics Setup of MADSEN Itera Il Parameters SETUP items Fault beeps are not removed Extended range timeout 32 EXT RANGE Selection of one of three modes see description in 3 2 14 The EXT RANGE button 26 Auto Manual Timeout Selection of the time interval that passes between the device standing untouched and the EXTended sound intensity RANGE is deactivated If OFF is selected this safety feature is disabled Selectings possibilities OFF 20 sec to 120 sec Default Auto Extended range dB space 33 EXT R dB SPACE Selection of the sound intensity range below the maximum value for which selec tion of EXTended RANGE is permitted 30 dB to 70 dB below max Baud rate 34 BAUDRATE Selection of baud rate for RS232 interface 9600 19200 default value 38400 57600 CD power supply 35 CD POWER SUPPLY Selection of voltage for CD power supply OFF and 1 5 V to 10 0 V set using the right LEVEL selector 2 Note Remember to use an adapter if necessary so that the CD has the correct polarity The centre pin is and the sheath is 0 V Display 36 DISPLAY Controls
46. NE MASK SIG Select masking stimulus for Tone Test NBN WBN Speech masking signal 11 SPEECH MASK SIG Select masking stimulus for Speech Test SPN WBN Speech count 12 SPEECH COUNT Select number of words in a list and select counting method For further details look under speech audiometry in 7 Speech Audiometry with MADSEN Itera H 75 OK amp FAIL WORDS FAIL WORDS 5 25 OK WORDS 5 25 Frequency change at 13 FREQ CH AT STORE STORE Method for frequency change when you press STORE NO CHANGE the frequency remains the same If this parameter is set to No change the setting will remain for instance at 40 dB at 1000 Hz when you press STORE See the following example continues at 1000 WRAPIf you press STORE at the highest possible frequency you switch to the lowest possible frequency At other frequencies pressing STORE advances the frequency See the following example 104 Otometrics Otometrics Setup of MADSEN Itera Il Parameters SETUP items dB Hz 40 1000 Press STORE Continues at 40 1500 Press STORE Continues at 40 2000 Press STORE continues at 40 3000 Press STORE Continues at 40 4000 Press STORE Continues at 40 6000 Press STORE Continues at 40 8000 Press STORE Continues at 40 12500 Press STORE Continues at 40 125 Press STORE Continues at 40 250 Press STORE Continues at 40 500 Press
47. NOTES which you should read care fully The use of these headings is denoted as follows Warning Indicates that there is a risk of danger to persons and data Caution Indicates that there is a risk of damage to data Note ndicates that you should take special notice Navigation in this manual Menus icons and functions to select are shown in bold type as for instance in Click the Set options icon on the toolbar or select Tools gt Options Otometrics 2 Getting started with MADSEN Itera 11 and the OTOsuite Audiometry Module 2 1 Unpacking Itera II 1 2 Inspect the package and its contents for possible visual damage Check with the packing list to make sure that you have received all necessary parts and accessories If your package is incomplete contact your supplier 2 2 Getting started 1 If you are using OTOsuite install OTOsuite from the OTOsuite Installation CD See the OTOsuite User Manual Install Itera II as described in 13 Unpacking and Installing MADSEN Itera II 127 Connect the accessories 13 2 Installation 127 Connect the Patient Response Switch Connect headphones insert phones If bone conduction is required connect the bone conductor Connect external and Free Field microphones if required 3 3 Socket connections rear panel 31 shows the location of the sockets for the various accessories required Customize and prepare the test equ
48. Osuite The standard symbols are drawn within a centered inner frame of 1 5 x 1 5 cm 0 6 x 0 6 inches The area between the inner and outer frames is used for additions to the main symbol such as arrows for No Response or Response at Limit and designa tors for Aided Left or Aided Right 3 Before you store the new graphic make sure that the outer and inner frames are invisible select the frame and set the line color to No Line Repeat this for each frame 4 To save as an emf picture file select all elements in the drawing typically this includes the invisible outer frame as well as the symbol itself centered within the frame Right click and select Save as picture 5 Name the figure and select the file type emf Save it in C Program FilesiGN Otometrics OTOsuite AudSymbols 7 Launch the OTOsuite Audiometry Software Module and go to Tools gt Curves and Symbols The new symbol should appear on the list of symbol options In this dialog box you also have options for setting the color line type and hor izontal and vertical offsets that will apply when you use the new symbol The Masking Assistant If the Masking Assistant is enabled it will at all times check for frequencies that may require testing with masking This also applies to old audiograms imported from NOAH or XML as long as a supported transducer was stored with the data The Masking Assistant is a tool provided to you with an ind
49. STORE Continues at 40 750 Press STORE continues at 40 1000 BUTTERFLYIf you press the STORE button at the highest or the lowest possible frequency you change to 1000 Hz Itera II will automatically test frequencies above 1000 Hz in ascending order and frequencies below 1000 Hz in descending order See the following example dB Hz 40 1000 Press STORE Continues at 40 1500 Press STORE continues at 40 2000 Press STORE Continues at 40 3000 Press STORE Continues at 40 4000 Press STORE continues at 40 6000 Press STORE Continues at 40 8000 Press STORE Continues at 40 12500 Press STORE 105 Setup of MADSEN Itera II Parameters SETUP items dB level new transducer dB level new frequency 106 dB Hz continues at 40 1000 Press STORE Continues at 40 750 Press STORE Continues at 40 500 Press STORE Continues at 40 250 Press STORE Continues at 40 125 Press STORE Continues at 40 1000 Press STORE Continues at 40 1500 Press STORE 14 DB LEV NEW TRA Choice of initial volume level for a new transducer or change between different tests NO CHANGE or adjustable in the range 10 to 50 dB 15 DB LEV NEW FREQ Choice of initial intensity when changing frequency NO CHANGE the frequency remains the same or adjustable in the range 10 to 50 dB See the ex
50. Switching masking noise to other ear To toggle the masking noise to the other ear press L lt gt R This lets you switch the masking noise to the same side as the speech signal An arrow appears pointing to the ear to which the masking is to be presented Masking noise in both ears To transmit the masking signal to both ears press and hold MASK ON and then press twice on L lt gt R To disable this setting press twice on L lt gt R When the masking signal returns to normal contralateral masking i e when you press MASK OFF or press L lt gt R the arrow s disappears Note Binaural masking is not possible in BC testing 7 3 8 Binaural Speech with masking 1 To switch on masking noise press MASK ON MASK LOCK cannot be selected 2 By default masking noise is transmitted to both ears but you can select the masking ear press and hold MASK ON and press L lt gt R once to send the mask ing noise to the left ear only L 5 60 5 R Press L lt gt R once more to send the masking noise to the right ear only This is how you switch between left and right ear L 75 60 gt 75 R Press twice on L lt gt R to send the masking noise to both ears Otometrics 81 Speech Audiometry with MADSEN Itera II Special Speech routing Ea 100 27 7 3 4 Masking level for Binaural Speech Turn che FREQUENCY knob to set the masking dB level For a description of how to test a patient and rec
51. TONE key 21 Tone test the Tone screen Audiogram Module 45 Toolbar Audiometry 36 Tools menu Aud Curves and symbols 39 fetch test results from audiometer 39 TRANSD key 21 transducers AC 21 AC connection 32 AC headphones 102 BC 21 102 calibration 125 dB level for new t 106 selection 21 SF 21 103 SF connection 32 specifications 141 transmission data 24 155 Index A B C D E G H J K 156 U UCL Itera II 83 UnComfortable Level Itera II 83 User interface 35 V value selection HIS 30 View menu Aud audiogram legend 38 combined audiogram 38 frequency range 38 left right audiogram 38 masking assistant 37 Overlays 37 right left audiogram 38 voltage maximum non destructive 133 W warble frequency 109 modulation size 108 selection 30 setup selection 30 WARBLE key 22 warning notes 145 word count 30 78 failed word 31 heard word 31 select method 104 wrap 104 X XMIT key 24 L M N P Q R S T U V w X Y z Otometrics Index A B C D E G H J K L M N O P Q R S T U V W X Y z Otometrics 157 Index A B C D E G H J K L M N O P Q R S T U V W X Y z 158 Otometrics Index A B C D E G H J K L M N O P Q R S T U V W X Y z Otometrics 159 Index A B C D E G H J K L M N O P Q R S T U V W X Y z 160 Otometrics Index A B C D E G H J K L M N O P Q R S T U V W X Y z Otometrics 161 Index A B C D E G H J K L M N O P Q R S T U V W X Y z 162 Otome
52. You can choose between Tone testing combined view audiogram Click the Combined view icon to select Otometrics 45 Navigating in the OTOsuite Audiometry Module The Tone test screen 125 250 500 1k 2k 4k 8kHz Fig 7 Tone testing combined view audiogram Tone testing split view audiogram Eh Click the Split view icon to select dB HL 750 15k 3k 6k Right dB HL 750 15k 3k 6k Left 1 1 125 250 500 Ik 2k 4k BkHz Fig 8 Tone testing split view audiogram 4 5 2 Tone view options You can access a number of tone display options directly from the Tone main screen Overlays Select the overlay that will be displayed on the audiogram These overlays assist in the counseling process Select Tools Options Audiometry Tone Over lays to enable or disable displaying the overlays 46 Otometrics Otometrics Overlays Pictures Severity JUnusable Area Navigating in the OTOsuite Audiometry Module The Tone test screen Speech Banana Speech Letters Pictures Displays pictures representing common environmental sounds at their approximate dB level e g bird plane Severity Displays the audiometric severity levels normal mild moderate moderate to severe severe profound Speech Banana Displays the speech banana ofa listener with normal hearing Speech Letters Displays speech sounds at their approximate dB level Unusable area
53. able audiogram symbol beside the level indica tion depending on the selection of ear masking and transducer type 3 2 14 The EXT RANGE button Enables presentation of stimuli above the safety limit approx 100 dB The safety limit is set to 20 dB below the maximum dB HL for a given transducer and fre quency The exception is at 125 Hz where the limit is 30 dB below the maximum dB HL Extended Range has three modes to select see SETUP 32 EXT RANGE b 111 Auto levels at all frequencies are always accessible but the EXT RANGE button is lit when a level above the safety limit is reached Manual You must manually press the EXT RANGE button to test above the safety limit Timeout Selection of the time interval that passes between the device standing untouched and the EXTended sound intensity RANGE is deactivated EXT RANGE is automatically disabled Otometrics Overview of MADSEN Itera II FRONT panel controls when the intensity falls below the limit selected under SETUP 33 EX I R dB SPACE gt 111 when the duration set for Ext Range Timeout is exceeded and the device has been inactive SETUP 32 EXT RANGE gt 111 when you select a new test or when you change FREQUENCY see 3 2 20 The FREQUENCY knob 29 3 2 15 The L lt gt R button Press this button to switch between testing the left and right ear Speech test Press twice L R during the speech test to send the test signal to bo
54. ally by suitably qualified personnel using the appropriate equipment Otometrics Otometrics MADSEN ltera II Maintenance and Safety Calibration Itera II is dispatched from the factory together with a Test Report Calibration Cer tificate The Test Report specifies the transducers that have been calibrated i e those which have been supplied together with the instrument according to which standards and the equipment used for calibration Results are listed for each trans ducer at all standard frequencies In general the instrument is calibrated in dB SPL or dB HL using the stated refer ence equivalent thresholds dB HL are related to sound pressure levels dB SPL dB re 20 uPa and force levels dB re 1 UN Note Calibration has been performed only on the transducers supplied If you wish to use any other transducer for testing with Itera please contact your local distributor first 125 MADSEN Itera Il Maintenance and Safety Calibration 126 Otometrics 13 13 1 13 2 13 2 1 Otometrics Unpacking and Installing MADSEN Itera II Unpacking Itera II When you receive Itera II it is packed in special packing material The packing mate rial is designed to provide your Itera II with good and safe protection during trans port and shipping Remove the instrument and accessories carefully from the packing material Make sure that Itera II has not been damaged during transport Check that the items on the
55. ample with setting 13 set to WRAD dB Hz 40 1000 Press STORE Continues at 40 1500 Press STORE Continues at 40 2000 Press STORE Continues at 40 3000 Press STORE Continues at 40 4000 Press STORE Continues at 40 6000 Press STORE Continues at 40 8000 Press STORE Continues at 40 12500 Press STORE Continues at 40 125 Press STORE Continues at 40 250 Press STORE Otometrics Otometrics Setup of MADSEN Itera Il Parameters SETUP items dB Hz Continues at 40 500 Press STORE Continues at 40 750 Press STORE Continues at 40 1000 XX dB FIXED New fixed value See the example with setting 13 set to WRAD dB Hz 40 1000 Press STORE continues at 10 1500 Press STORE continues at 10 2000 Press STORE continues at 10 3000 Press STORE Continues at 10 4000 Press STORE Continues at 10 6000 Press STORE continues at 10 8000 Press STORE continues at 10 12500 Press STORE continues at 10 125 Press STORE continues at 10 250 Press STORE continues at 10 500 Press STORE continues at 10 750 Press STORE continues at 10 1000 XX dB ABOVE THR New fixed value above any previously located threshold value See the example with setting 13 set to WRAD dB Hz 40 1000 Press STORE
56. ances block or cover the bone conduction test ear If it does this will invalidate the test due to the occlusion effect Make sure that there is no contact between the headband which holds the Bone Conductor in place and the headset or headband supporting the headphones This will prevent vibrations from being conducted from one to the other Leave it in this position until the test is finished Instructing the patient The patient will be hearing brief tones The tones may at times appear to be very weak The tones can be heard either in the one ear in the other ear or in both ears simultaneously Instruct the patient in how to use the Patient Response switch 5 2 2 The patient response switch gt 60 The patient should press the Patient Response switch as soon as the tone is heard even if it is very weak You may prefer that the patient indicates in which ear the tone was heard by rais ing a hand The patient should not touch or move the bone conductor from its position 5 2 5 Preparing for testing with masking Free field See 6 3 2 Air conduction with masking 72 for a recommended procedure on test ing with masking Instructing the patient In addition to the tones in the test ear the patient will be hearing a noise in the other ear The tones can be heard in either ear The patient should respond to the tones in the test ear and ignore the noise The patient should press the patient response switch as soon
57. ange the pulse frequency turn the right LEVEL selector while you press and hold PULSE IMPULSE The test signal is presented within a preset period of time Impulse shortcut functions Test signal duration To change the duration of the test signal turn the right LEVEL selector while you press and hold IMPULSE 22 Otometrics Overview of MADSEN Itera II FRONT panel controls 3 2 5 The MIC CD and REVERSE column MIC Press MIC to select the signal from external or internal microphone input The inter nal microphone is located below the display External microphones are for instance the gooseneck microphone or if you are using a monitor headset the boom micro phone CD Press CD to select the signal from external CD TAPE input MIC CD shortcut functions Input signal sensitiv You can adjust the input signal sensitivity by holding ity MIC CD down the MIC or CD button and turning the LEVEL selec tor that is closest to the test signal side REVERSE Press REVERSE to toggle the function of the Interrupter between REVERSE lamp lit If REVERSE is on the test signal is activated continuously the test signal is interrupted when you press INT Normal The test signal is applied when you press INT Note The presentation only applies to the test signal The masking signal is normally always ON You can change the masking interrupter s function under SETUP 9 MASK PRESENT P 10
58. are selected using the FREQUENCY selector ON OFF is selected using the right LEVEL selector Note This setting does not influence the Frequency knob and accordingly all frequen cies including inter octave frequencies are available when you use the Frequency knob However if the frequency 125 Hz is not included in the SELECT AC FREQ set ting then it will not be included when you use the Frequency knob Select automatic frequency 21 SELECT BC FREQ Here you can select ON or cancel OFF the frequencies to be included for automatically changing frequencies when you store BC thresholds The frequencies are selected using the FREQUENCY selector ON OFF is selected using the right LEVEL selector Note This setting does not influence the Frequency knob and accordingly all fre quencies including inter octave frequencies are available when you use the Frequency knob Signal unit 22 SIGNAL UNIT HL SPL eLED FLASH If SPL is selected the dB button will flash to indicate that the display is showing SPL values and not HL values Microphone input sensitiv 23 MIC INPUT SENSE ity Selection of microphone input sensitivity MIC LED is lit If you press and hold MIC you can adjust the left microphone with the left LEVEL selector and the right microphone with the right LEVEL selector If you turn the right LEVEL selector without pressing MIC both right and left microphones are adjusted and the display shows an average of the
59. as the tone is heard You may prefer that the patient indicates in which ear the tone was heard by rais ing a hand This is particularly relevant since masked testing is used to determine that the signal is perceived by the test ear Connection to Itera II See 13 2 5 Free Field P gt 130 for a description of how to connect to Itera Otometrics Preparing MADSEN ltera II for the test Preparing the Audiometry Module for testing 5 4 Preparing the Audiometry Module for testing 1 Prepare the audiometer for the test See the appropriate audiometer manual 2 Follow the instructions in the OTOsuite User Manual Start up OTOsuite and the test device Select create a client in OTOsuite Select the test type in OTOsuite Activate the Control Panel in OTOsuite Select the test ear in OTOsuite Fetch multiple test results If you have done off line testing with MADSEN Itera you can fetch test results from the audiometer See 5 5 Fetch test results from audiometer 63 5 5 Fetch test results from audiometer To transfer test results from your audiometer Switch on the audiometer Select Tools Fetch Test Results Follow the online instructions 5 6 Preparing the patient for testing Previous exposure to high levels of sound If the patient has been exposed to high levels of sound this may create a temporary threshold shift T TS which will diminish with time If the patient is tested soon after this type of
60. at will be heard clearly by the patient Place the bone conductor on the patient See 5 2 4 Preparing for bone conduc tion testing P gt 61 Find the best position for the bone conductor Ask the patient to report when the tone seems the loudest 67 Tone Testing with MADSEN Itera II Bone Conauction threshold test 68 6 2 2 Testing Make sure that the bone conductor stays securely in place with no contact to the pinna Give the Patient Response switch to the patient and explain how it should be operated see 5 2 2 The patient response switch gt 60 Press REVERSE to deactivate the REVERSE function If you want to use a predefined duration of the signal presentation when you press the INT button press IMPULSE If masking is required see 6 3 Testing with masking P gt 69 If required turn the FREQUENCY knob to set the starting frequency Typical starting frequency 1000 Hz The signal is usually presented for each tone in the following order 1000 Hz and increasing frequencies followed by frequencies below 1000 Hz in descending order The typical test frequencies are 250 Hz to 4000 Hz Set the initial level of the presented signal to an audible level Turn the LEVEL knob to 40 dB HL This is to familiarize the patient with the test signal Other familiarization proce dures may be preferred If you intend to test both ears test the better ear first If this is unknown start with the right ear Pres
61. ate radio fields We recommend that the use of such devices in the vicinity of MAD SEN Itera II is restricted as much as possible The bone conductor cable and insert phone E A RTONES 34 cable are not to be N removed or tampered with while connected to MADSEN Itera II Either disconnect the bone conductor entirely from the instrument or ensure that the instrument itself is disconnected from the mains must take into account that other connected equipment which does not live up to the same safety requirements as this product may lead to a reduction in the overall safety level of the system When assembling an electro medical system the person carrying out the assembly 1 When selecting accessories connected to the RS232 socket and DC output the fol 2 lowing points must be considered Use of connected equipment in a patient environment Proof that connected equipment has been tested in accordance with EN60601 1 and or EN60601 1 1 and UL2601 1 and CAN CSA C22 2 NO 601 1 90 Caution Grounding continuity should be checked periodically AN 3 Avoid using extension cables The increased length of the cable may increase the resistance of the protective earth conductor beyond an acceptable level Caution Operating at the wrong voltage may blow the fuses For continued protection against fire hazard replace fuses with the same type and rat ing only 146 Otometrics App 4Standards and safety MADSEN Itera I
62. aural Speech Test In Binaural Speech testing a stimulus is presented to both ears This may be as a sin gle signal one channel or as two different signals two channel 12 65 Otometrics Speech Audiometry with MADSEN ltera II Binaural Speech Test To perform a standard one channel Binaural Speech test select Speech Test and press twice on L lt gt R The input signal currently selected in monaural is also set as input on the oppo site side as default This means that if the monaural input was the left CD input channel CD 1 and binaural is selected by pressing L R then the left CD input channel CD 1 is also assigned to the right ear CD 1 CD 1 To change the input channels see 7 1 1 Selecting input 75 7 2 1 One channel or two channel Speech testing To select one or two input channels see 7 1 1 Selecting input gt 75 You can choose to operate Itera II as a one channel or a two channel Speech audiom eter To do so select either the same input to both ears one channel or select two different inputs two channel One channel binaural testing default CD 1 is the default input channel for both ears If you wish to use CD 2 for one channel testing you must change both input channels The stimulus level is interlocked and cannot be adjusted separately Masking is available on the audiometer Two channel binaural testing Select two different input channels one
63. aw GiG CEDERE USA 60 5 2 3 Preparing for air conduction testing 60 5 2 4 Preparing for bone conduction testing 61 5 2 5 Preparing for testing with masking 62 DO a Preesfield agat a ets talon ds eta a ct i folu Ur YE 62 Otometrics Otometrics Table of Contents MADSEN Itera Il e User Manual 5 4 Preparing the Audiometry Module for testing 63 5 5 Fetch test results from audiometer 4000 Log EL AE RAE A 63 5 6 Preparing the patient for testing Koi Megas Pea 63 Tone Testing with MADSEN Itera 1 65 6 1 Air Conduction threshold test Pda 65 ONSE Prerequisites MM I 65 Testing ZWEI trabes ido vui vies 65 6 13 Sound Field testing 145 SOG exuere ER DER REPRE PEN RUE 67 6 2 Bone Conduction threshold test eire havea tare RR ra ea UR Rn 67 GA BIEGANIE rr 67 022 A Teng Los Ae cate caer edo e b Once RNS 68 6 3 Testing with masking sanaat s yasa asua RED SED Ve pier 69 63 1 When is masking required 2 acre ou sce ee oe D e inert deed 69 6 3 2 Air conduction with masking 72 6 3 3 Bone conduction with masking 12g ties wi die ex Pur Reg Pu 73 6 44 Storing thresholds 4324800 oxi P we Tes CETERO AP cid od eb a dard ad 74 Speech Audiometry with MADSEN Itera Il 75
64. ays enter tester details and test date entry for manually entered audiograms enter special test and tuning fork test results perform over the rim testing using the audiometer as a handy control panel while you follow stimulus settings and test progress on your PC display 4 2 The Audiometry Module menu system and toolbar The Menu bar is located at the top of the window Some of the menu items are also available as icons The icons available in the Toolbar depend on the test functions included in your OTOsuite and or whether a test device is connected General icons E de 9 eg D Navigator Contral Panel QO Task wizard The general OTOsuite menu system and toolbar are described in the OTOsuite User Manual Audiometry icons MER l Some of the icons in the Audiometry toolbar are toggle icons Click to toggle to another selection The menu selections and toolbar specific to the Audiometry Module are described below Note Some of the menu selections and functions are device specific and may not apply to your setup 36 Otometrics Navigating in the OTOsuite Audiometry Module The Audiometry Module menu system and toolbar File OTOsuite menu New Audiogram A e Click to select new audiogram You will be a prompted to save or cancel current data Edit menu Audiometric properties Ctrl U e Click to enter Tester name Test Date and air conduction transducer f
65. ck to display the right ear audiogram on the left side of the window and the left ear audiogram on the right side of the window when Split view is enabled Audiogram Legend Click to enable or disable the display of the audio gram legend The legend contains the most com monly used symbols for the audiogram It is not configurable Standard All High frequencies Frequency range Click to choose between viewing Standard frequencies Allfrequencies High frequencies 1 Standard frequencies Displays the audiogram from 125 to 8000 Hz Otometrics Navigating in the OTOsuite Audiometry Module The Audiometry Module Control Panel Standard High frequencies Ur All frequencies Displays the audiogram from 125 to 20 000 Hz High frequencies Displays the audiogram from 8000 to 20 000 Hz Tools menu Curves and Symbols Click to select the Curves and Symbols dialog box This dialog box and its related function are spe cific to configuring the curves and symbols to be displayed on the audiogram or speech graph dur ing testing See 4 9 Curves and symbols selection gt 52 Fetch test results See description in 5 5 Fetch test results from audiometer gt 63 Options See description of how to work with user options and User Tests in the OTOsuite User Manual Additional icons Import A
66. ction alternating current amplitude modulation automatic bone conduction CD compact disc player change direct current default external extended range external fixed talk over level frequency modulation frequency Hearing Instrument Simulation Hearing Instrument Simulation Filter hearing level 135 App 2MADSEN Itera Il Abbreviations HP INT INT LCD LED LEV LP MANU MASK MCL MIC MICL MICR MILI MIRI MOD NBN PC PCT 136 high pass internal interrupter left liquid crystal display light emitting diode level low pass manual masking Most Comfortable Level microphone left external microphone right external microphone left internal microphone right internal microphone modulation narrow band noise right ear parameters personal computer percent right Otometrics SF SIG SISI SP SPL SPN STEN THR TON TRA TRANSD UCL VU WARB WBN WRB Otometrics sound field signal short increment sensitivity index special output same as SF sound pressure level speech noise Stenger threshold tone transducer transducer UnComfortable Level volume unit warble wide band noise white noise warble left ear App 2MADSEN Itera II Abbreviations 137 App 2MADSEN Itera Il Abbreviations 138 Otometrics App 3 Technical Specifications MADSEN II App 3 1 Accessories TDH39 TC8
67. differences between the thresholds in the two ears see 6 3 Testing with masking P 69 Sound Field testing When you select SF transducer and Free Field speakers F E are assigned as transduc ers SETUP 5 SF TRANSDUCER P 103 the results are stored as an individual threshold curve using the applicable Sound Field symbols 3 1 Display 17 The symbol used for Sound Field applies to both ears unless masking has been used Tip If ear specific data is retrieved by blocking the contra lateral ear activate the masking on the audiometer to use the correct symbols This is especially important when you use Itera II with the OTOsuite Audiometry Module Set the masking level to e g 10 dB and note in the Comments field that the contra lateral ear was blocked Bone Conduction threshold test Note In Bone Conduction testing masking is always necessary in order to determine in which ear the presented tone signal is actually heard This is because of the reduced level of inter aural attenuation Note Make sure that there are no interfering ambient sounds particularly at low fre quencies If necessary place the patient in a sound booth Prerequisites Press TONE Press BC If required select another stimulus type WARBLE or PULSE Press the REVERSE button to set the stimulus signal to continuous presentation use full for placing the bone conductor correctly on the patient Set the dB level to a level th
68. display setup Fixes one of the four left right configurations SIGNAL AS L R The signal for the left ear is shown on the left side and that for the right ear on the right side Masking is on the opposite side SIGNAL AS R L The signal for the left ear is shown on the right side and that for the right ear on the left side Masking is on the opposite side Otometrics 111 Setup of MADSEN Itera II Parameters SETUP items 112 Stimuli knob Default setting FIX SIGNAL ON L FIX SIGNAL ON R 37 STIMULI KNOB The signal is shown on the left side and mask ing on the right side The signal is shown on the right side and mask ing on the left side Controls the functions of the left and right LEVEL knobs FIX SIG TOL FIX SIG TOR FOLLOW DISPLAY 38 DEFAULT SETTING The signal is controlled by the left LEVEL knob and masking by the right LEVEL knob The signal is controlled by the right LEVEL knob and masking by the left LEVEL knob The stimuli signal masking controlled by the left and right LEVEL knobs correspond to the placing left right of the stimuli on the display Sets all SETUP parameters to default Press STORE The default values are 3 AC TRANSDUCER None 4 BC TRANSDUCER None 5 SF TRANSDUCER None 6 AC MASKING None 7 BC MASKING None 8 SF MASKING None 9 MASK PRESENT Continuous 10 TON MASK SIG NBN 11 SPEECH MASK SIG SPN 12 SPEECH COUNT FA
69. duction 128 Fitting on patient When you fit the bone conductor on the patient Instruct the patient in what you are about to do Note 77e bone conductor cable and insert phone E A RTONE cable must not be removed or tampered with while Itera II is powered on Either disconnect the bone con ductor entirely from the instrument or make sure that the instrument itselfis disconnected from the power source Ifasound booth is not available place the patient facing away from Itera II This is to avoid visual clues during testing fapplicable set the switch on the Talk Back microphone to ON and set the level of Talk Back 3 2 16 The SETUP button gt 27 Position the bone conductor vibrator so that it rests comfortably against the mastoid bone behind the ear and is not in contact with the pinna or against the patient s forehead If Itera II is calibrated for this see SETUP 4 BC TRANSDUCER P 102 to choose between Forehead and Mastoid depending on the preferred placement of the bone conductor Testing with masking If you intend to use masking either use the mono insert phone recommended or fit the headphones so that the red right phone is applied to the poorer ear for masking and the other phone is applied to the patient s temple region leav ing the test ear uncovered 61 Preparing MADSEN Itera II for the test Free field 5 3 62 Important The masking transducer must not under any circumst
70. e according to half gain rule using either 6 dB less steep slope 12 dB medium steep slope or 18 dB steep slope 3 The frequency where the most amplification is wanted 4 kHz is the highest available is identified and the cut off frequency is set accordingly 4 A gain is set to approximate half the hearing loss at the frequency selected in step 3 half gain rule again 5 Apply the simulation and ask the patient whether it is comfortable or too loud or soft and adjust the reference level accordingly Make yourself familiar with the process before using it on the patient The HIS procedure Connect accessories Connect the various accessories you will be using for the HIS test to Itera II Audiogram Use an audiogram stored in Itera II or Enter an audiogram in Itera Prepare the patient Prepare the patient for the simulation for instance by fitting headphones on the patient and explain the process Select test Press SPECIAL twice if required until HIS is shown on the display Press the appropriate function key to select HIS Oneof the following messages will appear HIS filters Both calculated 89 Special tests with MADSEN Itera II Hearing Instrument Simulation HIS Sufficient audiograms are available for both ears HIS filters R OK COPY R gt L ear Sufficient audiogram is available for one ear only in this case the Right ear Press Yes to copy the right a
71. e OTOsuite Audiometry Module Customization 8 3 SISI Test P 83 8 4 ABLB Fowler 86 8 5 STENGER Test 87 8 6 Hearing Instrument Simulation HIS gt 88 Press SPECIAL Three special tests will be shown on the display Press the function key below the test you wish to perform If your Itera II is con figured with more than three special tests press SPECIAL until you see the test you wish to use These tests are optional To add any of these tests to your configuration contact your local supplier Customization With Itera II you can quickly and easily customize your test sequences for maximum efficiency Customizing your Setup Shortcuts Make the changes you want in the setup of Itera II and save these changes in the spe cific test setup Example l 2 3 Set dB STEP to 1 dB press button 1 in the dB STEP column Press SETUP twice to enter setup mode Turn the Left dB LEVEL knob until SAVE TEST SETUP is shown on the dis play 4 Press STORE Turn Itera II off and then on again It now remembers your preferred settings A number of functions in Itera II can be activated by a shortcut so that you just have to press and hold the appropriate button and turn the knob For a full list of shortcuts see 10 2 3 Temporary changes in the setup P gt 100 Example 1 Press the SPEECH button to select Speech mode 2 Press MIC to select microphone 3 Press and hold MIC while you turn t
72. e or more times until SISI appears and press the appropriate function key to select the test The following display appears 20 SISI 0 1000 0 25R The top line shows the intensity dB HL to which the increments have been added the test name and the current SISI 96 score The bottom line shows the number of dB increments currently transmitted the test tone frequency and the scale of the SISI dB increments 2 Set the number of increments for the test Press SETUP once and use the right LEVEL knob 3 To start the SISI test press the START STOP button The test stops automatically when the selected number of steps in intensity has been reached and a beep is heard Automatic scoring of responses The percentage of correct responses 96 score is updated automatically Short increment indication The presence of a short increment in intensity is indicated by the little L or R test ear indicator in the display changing momentarily to a rectangle Scoring of responses The patient must use the Patient Response switch to register each increment that has been heard Manual scoring If the patient is unable to use the Patient Response button but registers an incre ment heard in another way you can press PASS right INT button to indicate that the tone was heard Pausing the test You can pause the SISI test by pressing START STOP again During the pause SISI will flash in the display To resume the test press ST
73. e selected test ear Refer to your Audiometer manual for a description of availa Warble ble stimulus types L Binaural headset Masking zy The Masking Panel shows the masking used and AL the selected test ear Refer to your Audiometer EI manual for a description of available masking Narrow Band Noise types yos The Test Panel shows the test type used Refer to your Audiometer manual for a description of available test types gt Manual Audiometry Otometrics 41 Navigating in the OTOsuite Audiometry Module The stimulus bar The Connection Panel Connection Note Jf there is a risk that patient selected in the audiometer does not correspond to the patient shown in the OTOsuite or NOAH status bar a Connected to the audiometer warning triangle will be shown on the screen n netsh ie ee Make sure that you select the correct Z patient either in the audiometer or in OTOsuite 4 4 The stimulus bar Intensity OU 1000 _ 302 E Ch1 Insert Left UB Hois sert Binaural Ch2 Stimulus indicator Stimulus being presented Transducer Masking on indicator Routing Stimulus bar colour indicator During online testing the stimulus bar shows The stimulus and level being presented Stimulus type The current frequency Masking when presented and masking level Masking type Intensity Indicated b
74. e threshold If this has been done previously and a different level is established in this step do not overwrite the previously recorded threshold The conditions may have changed if the masking transducers were placed following the first test for example due to the occlusion effect 2 Press MASK ON to activate masking Set the masking level at the air conduction threshold of the masking ear and make sure that it is heard by the patient If it is not increase the masking level Present the tone to the test ear at the previously confirmed unmasked bone con duction threshold level If the tone is not heard increase the level in 5 dB steps until the patient responds When the patient responds increase the masking level in 5 dB steps After each increase present the tone no more than twice The tone is considered heard if the patient responds at least once 7 Tone Testing with MADSEN Itera II Storing thresholds If the tone is heard when the masking level has been increased with at least three 5 dB steps the so called masking plateau has been reached and the test tone level is considered the masked hearing threshold level Ifthe tone is not heard when the masking level is increased increase the test tone level until the tone is heard by the patient Repeat from step 5 If the test tone level at the masking plateau established in step 5 is within 5 dB from the unmasked threshold level you can skip
75. ectronic equipment WEEE App 4 1 2 Warning notes Do not use the instrument in the presence of flammable anaesthetics gases No parts may be eaten burnt or in any other way used for purposes other than audiometry or the fitting of hearing instruments The instrument and any device to be connected which has its own power supply should be turned off before any connections are established Otometrics 145 App 4Standards and safety MADSEN Itera II and the Audiometry Module MADSEN Itera 1 tis recommended that an annual calibration be performed on headphones and bone conductor see Ch 9 Furthermore it is recommended that calibration be performed if the equipment has suffered any potential damage e g headphone dropped on the floor Note that calibration has been performed only on the transducers supplied If you wish to use any other transducer for testing with MADSEN Itera II please contact your local distributor first For safety reasons accessories connected to the equipment s outlet fittings must be identical to the type supplied with the system This class of equipment is allowed in domestic establishments when used under the jurisdiction of a health care professional Unwanted noise may occur if MADSEN Itera II is exposed to a strong radio field and such noise may interfere in the process of recording a correct audio gram Many types of electrical devices e g mobile telephones may gener
76. ed Parameter Cut off frequency Slope LP filter frequencies 250 500 1000 2000 Hz 6 12 18 dB octave HP filter frequencies 1000 2000 3000 4000 Hz 6 12 18 dB octave Gain above a selectable reference level 0 5 10 15 20 25 dB 0 5 10 15 20 25 dB See Starting simulation P gt 91 and Increasing the output level manually 92 to continue the procedure Filter examples Any filter whose amplification is set to 0 dB has no effect Otometrics Special tests with MADSEN Itera II Hearing Instrument Simulation HIS 250 Hz 20dB 200 500 1000 2000 5000 10000 Fig 12 Low pass filter graph Fig 12 gt 95 shows a graph where the characteristics of a low pass bass filter are set to an amplification of 20dB for frequencies under 250 Hz 2000 Hz 25dB 200 500 1000 2000 5000 10000 Fig 13 High pass filter graph Fig 13 95 shows a graph where the characteristics of a high pass treble filter are set to an amplification of 25dB for frequencies over 2000 Hz 95 Special tests with MADSEN Itera II Overview of Monaural Binaural Test signals and the Masking side 8 7 96 Overview of Monaural Binaural Test signals and the Masking side Test signal Masking signal Monaural Binaural Ipsi Contra THR X X SPEECH X X X X SISI X X ABLB X STEN X HIS X Fig 14 Monaural binaural test signals and masking side Oto
77. election The ear being tested is indicated with L or R in the display The display side for L and R can be changed in the settings See 36 DISPLAY 111 Frequency Signal Signal m 20 LTON 2000 NBNR The selected test frequency for tone testing is shown at the center Masking If masking for the contralateral ear is enabled this is shown on the opposite side Symbols used Right ear Left ear Resp No resp Resp No resp P P KU Air unmasked s s Air masked Otometrics 3 2 Otometrics Overview of MADSEN Itera II FRONT panel controls Right ear Left ear Resp No resp Resp No resp S S i Li Bone unmasked P P i i Bone masked tn tn tna inu Sound field unmasked binaural applies to s both ears n M a pt Sound field masked a a UCL UnComfortable uat aun Loudness level h bed MCL Most Comforta i ble Loudness level Other symbols Stored results on this frequency FRONT panel controls You can access all basic functions directly by using the buttons and knobs on the Itera II front panel The button light indicators Each button has its own function Some buttons have a light to indicate whether the function is currently active or not Press the button to activate Press the button again to deactivate 19 Overview of MADSEN Itera II FRONT panel controls 3
78. es 124 device 123 149 Index A B C D E F GH J K 150 Combined audiogram enabling disabling 38 Configuration Wizard 115 connections AC 32 accessories 31 BC 32 CD TAPE 32 DC POWER OUT 33 EXTERNAL MIC MONITOR HEADSET 32 headphone 32 MONITOR 32 PATIENT RESPONSE 33 RS232 33 SP SF 32 supply voltage 33 TALK BACK 32 Control Panel Audiometry description 39 controls 19 counter start or stop 25 Curves and symbols 52 selecting 39 data transmission 24 data transmission 24 dB level for new frequency 106 level for new transducer 106 space setting 111 dB STEP key 29 DC POWER OUT connection 33 DC POWER OUT voltage 30 default settings 112 default test parameters 102 delete measuring points 23 thresholds 23 Device software interfacing 11 display 17 setup 111 L M P Q R S T U V W X Y z E ear selection 27 ERASE key 23 EXT RANGE key 26 extended range dB space setting 111 on or off 26 timeout setting 111 EXTERNAL MIC MONITOR HEADSET connection 32 F Fetch test results from audiometer 39 filter HIS 93 Firmware update test devices Aud 131 Fowler 86 alternating tone frequency setup 27 storing results 87 frequency butterfly 105 change test f 26 change with STORE 104 changing 29 dB level for new f 106 pulse 108 select automatic 109 select manual 109 specifications 139 warble 109 wrap 104 FREQUENCY key 29 Frequency range audiogram viewing 38 front panel 19 display 17 functions AC
79. flashes as long as you keep pressing the button You can also switch between all available inputs Turn the frequency selector while you press MIC or CD In this case you get access to all possible microphone and CD options If you select CD for one ear and the microphone for the other both MIC and CD will light up Otometrics 7 1 2 Otometrics Speech Audiometry with MADSEN ltera II Monaural Speech Test One channel or two channel testing You can choose to operate Itera II as a one channel or a two channel speech audiom eter To do so select either the same input to both ears one channel or select two different inputs two channel When you use two channel testing there are 16 possible combinations of inputs Regular one channel monoaural testing default CD_1 is the default input channel for right or left ears Masking is available for the opposite ear Two channel monoaural testing This test requires special routing See 7 3 1 Mixing input signals for two channel monaural Speech P gt 80 Adjusting input sensitivity You can adjust the strength of the input signal 1 Press and hold the selected input button and use the right LEVEL selector while you check the bar indicator at the bottom of the display 2 Make sure that the speech signal is reproduced correctly with the dB value stated in the display the VU meters must move into line with 0 dB on the VU meter scale Selecting masking for speech aud
80. gresses with the next frequency when you press STORE See 13 FREQ CH AT STORE b 104 9 Continue to use the right and or left LEVEL knob to increase decrease intensities until you have determined all thresholds 10 Continue to press STORE after each threshold is found to store that particular threshold 11 After each threshold is determined and stored you will notice that as you turn the LEVEL knob to scroll frequencies each stored threshold at that particular fre quency will be marked by an asterisk and the relevant audiogram symbol indicating the stored threshold 12 If you are not performing the test online with the OTOsuite Audiometry Mod ule plot the results in an audiogram sheet 13 Repeat this procedure for the other ear Note Ifthe difference between the air conducted threshold and the unmasked bone con duction threshold of the same ear is 15 dB or greater it is recommended that you retest bone conduction thresholds with masking applied to tbe contralateral ear See 6 3 Testing with masking P 69 Testing with masking To prepare the patient for masking see 5 2 5 Preparing for testing with masking 62 When is masking required When to use masking for Air Conduction testing If the difference between the thresholds in the two ears is 40 dB TDH39 or 60 dB EAR 3A or greater it is recommended that you test the poorer ear again with masking applied to the better ear 69 Tone Testing with MADSEN
81. he right LEVEL knob You will then adjust the sensitivity of this microphone 15 Getting started with MADSEN Itera Il and the OTOsuite Audiometry Module Customization 16 Otometrics 3 Overview of MADSEN Itera II Display Settings and the test as it progresses are shown on the display See 3 1 Display P gt 17 Front panel Itera II is operated from the front panel See 3 2 FRONT panel controls 19 Rear panel connections The rear panel contains the sockets for connecting various accessories and the socket for power connection See 3 3 Socket connections rear panel 31 Side panel The side panel contains the ON OFF switch See 3 4 Side panel 34 3 1 Display The display is placed in the top center of the front panel Test signal indicator Audiogram symbols Stored threshold Signal 4 Signal 20 x LTON Ear indicator Ear indicator Function key markers Fig 1 Itera Il front panel During startup the display briefly shows information regarding the device type and version and then shows the test screen last used Otometrics 17 Overview of MADSEN Itera II Display 18 The abbreviations used on the display are explained in App 2 MADSEN Itera II Abbreviations B 135 Top line During Tone testing the upper line in the display shows the intensity numeri cally in dB HL for the left and right ear For Speech testing and HIS the upper line is transformed into one or two VU meters Ear s
82. hone is selected compared to the one that is physically connected to Itera II the measurements will be incorrect 4 BC TRANSDUCER Choose between calibrated bone conductors Otometrics SF transducer AC masking BC masking SF masking Masking presentation Otometrics Setup of MADSEN Itera Il Parameters SETUP items None B 71M Mastoid B 71F Forehead 5 SF TRANSDUCER Choose between calibrated headphones free field loudspeakers None HDA 200 TDH39 EAR T E A R TONE 3A EF 6 AC MASKING Select masking transducer for AC None AC TRANSDUCER BC TRANSDUCER SF TRANSDUCER 7 BC MASKING Select masking transducer for BC None AC TRANSDUCER SF TRANSDUCER 8 SF MASKING Select masking transducer for SF None AC TRANSDUCER BC TRANSDUCER SF TRANSDUCER 9 MASK PRESENT Set mode for masking interrupter CONTINUOUS The masking signal is always present FREE NORMAL The maskingsignal follows the right interrupter present when button is pressed FREE INVERSE The maskingsignal follows the right interrupter disappears when button is pressed 103 Setup of MADSEN Itera II Parameters SETUP items LOCKED NORMAL The masking signal follows the right and left interrupter present when button is pressed LOCKED INVERSE The masking signal follows the right and left interrupter disappears when button is pressed Tone masking signal 10 TO
83. ication that there may be frequencies where testing with masking is recommended The audiogram symbol will flash at the specific frequencies where contralateral masking may be recommended 1 Katz J Lezynski J 2002 Clinical Masking In J Katz ed Handbook of Clinical Audiology Williams and Wilkins Baltimore 2 Based on criteria described in Clinical Masking Essentials of Audiology Stanley A Gelfand Thieme 1997 and Measurement of Pure Tone Hearing Thresholds Audiologists Desk Reference Vol 1 James W Hall III H Gus tav Mueller Singular Publishing Group 1997 and Munro K J Agnew N A comparison of inter aural atten uation with the Etymotic ER 3A insert earphone and the Telephonics TDH 39 supra aural earphone Br J Audiol 1999 33 259 262 Otometrics Otometrics Navigating in the OTOsuite Audiometry Module The Masking Assistant The bone conduction masking criterion is configurable 0 15 dB air bone gap Select Tools Options Tone Masking Assistant BC Masking Criterion Only stored thresholds measured without masking are checked Levels which did not evoke a response are excluded from the check This means that as soon as a masked threshold has been stored the flashing stops for that frequency Terminology AC AC test ear ACc AC contra BC BC BCc BC contra Min IA Minimum inter aural attenuation When is masking required Masking is recommended when the fol
84. ignal switched ON or OFF in the monitor headphone SETUP 27 MONITOR ON OFF P 110 Talk back shortcut functions Setup volume To adjust the volume press and hold TALK BACK while turning the right LEVEL selector 3 2 18 The MASK column OFF No masking ON To adjust the masking intensity independently of the signal level use the right LEVEL selector LOCK Makes the masking level follow the stimulus signal level You can adjust the differ ence between the stimulus signal and the masking signal by using the right LEVEL selector Note By default you can only adjust the test signal volume by using the LEFT selector regardless of whether you are testing the right or left ear To adjust the masking signal volume use the RIGHT selector To change the default setting select SETUP 37 STIMULI KNOB P 112 28 Otometrics Overview of MADSEN Itera II FRONT panel controls MASK shortcut functions Masking transducer When masking is already selected and you press the same selection masking button once more the masking transducer the masking signal type and the name of the transducer if applicable the serial no appear in the display The transducer button flashes and you can then select a different masking transducer by pressing one of the three TRANSD buttons AC BC or SF Masking noise in Select the masking ear press and hold MASK ON and Speech press L R to toggle between left right and both ea
85. ime 0 25 to 2 5 sec in steps of 0 25 sec 141 App 3Technical Specifications MADSEN Itera Il Technical Specifications 142 Operator output Two stereo monitor sockets 8 pole DIN horseshoe for headphones One socket is fitted with a Talk Over Mic Input option The monitor signal follows the test signal although the volume can be adjusted individually for each channel The Talk Back signal from patient to operator is mixed with the monitor signal Static force of transducer headbands 39 45N 0 5N B 71 5 4 N 0 5N RS232 interface Format 8 data bit 1 stop bit Parity Equal Baud rate 9600 19200 38400 57600 Baud Protocol XON XOFF Transport and storage Temperature 40 C to 70 C Air humidity 1096 to 9096 non condensing Air pressure 500 hPa to 1060 hPa Operating environment Mode of operation Continuous Temperature 10 C to 35 C Air humidity 30 to 90 non condensing Air pressure 860 hPa to 1060 hPa Operation in temperatures exceeding 20 C or 60 C may cause permanent dam age Warm up time lt 10 min Otometrics Otometrics App 3Technical Specifications MADSEN Itera Il Technical Specifications Disposal MADSEN Itera II can be disposed of as normal electronic waste according to local regulations Dimensions Approx 450 x 290 x 85 mm 17 7 x 11 4 x 3 3 inches Weight Approx 4 5 kg 9 9 Ib Power supply Internal 100 240 VAC 50 60 Hz Power consumption
86. iogram you can offset the symbols in relation to the audiogram grid in the fields Horizontal Offset and Vertical Offset You can superimpose symbols on the audiogram where two different points share the same value i e air and bone threshold In order to see both superim posed symbols you can define an offset direction for each individual symbol Otometrics Navigating in the OTOsuite Audiometry Module Curves and symbols selection Curve and Symbols Options Tore Graphical Speech Test hated Condhon Threthold Unsded Aided 1 O ua Aided 2 Symbols Urmacked x o 7 No Response x 7 Resp atm 22 o 7 Masked G a 7 makena 5 A 7 Curve and Symbols Options Tore Graphical Speech Test Azjed Conon Theethold Az Conduction Unsded Bene Conduction Aided i O ua Aided 2 M FB SXXQOXX 11 lt lt numammh oE tX gt trt perexX lt xKaetr ts lt popu gt BEX gt X x add MaskedNA L A 7 Creating new symbols 1 Use Microsoft Powerpoint to create vector graphics that you save as Enhanced Meta Files emf 53 Navigating in the OTOsuite Audiometry Module The Masking Assistant 4 10 54 2 The outer size of the EMF file must not be larger than or equal to 1 x 1 inches 2 5 x 2 5 cm Note Ifthe symbols are created larger than that this may severely compromise the per formance of OT
87. iometry If you select masking the masking signal is displayed in the first line of the display You can select Speech noise SPN or White noise Wide Band Noise WBN To adjust the masking signal type selection select SETUP 11 SPEECH MASK SIG 104 575 77 Speech Audiometry with MADSEN Itera II Binaural Speech Test 7 2 78 The counter function in speech audiometry There are three ways of counting words in a Speech test To select the counting method select SETUP 12 SPEECH COUNT P 104 Use the right LEVEL selector to select the counting method 1 OK Words 5 25 Press PASS to count words heard 2 FAIL WORDS 5 25 Press FAIL to count unheard words 3 OK amp FAIL WORDS Here you can press both PASS and FAIL to count heard and unheard words with the advantage that you do not need to listen to the whole list of words nor state the number of words in the list Selecting number of words in list Use the FREQUENCY selector to select the number of words 5 25 in the list Resetting the counter value Ifyou change the dB level the counter value will be reset for starting a new test Important Be careful not to change the dB level before you have made a note of the results Interrupting the speech signal You can interrupt the speech signal by deactivating the REVERSE button Note There are no interrupt buttons in Speech mode since they are used for counting words Bin
88. ipment 2 3 Customization 15 5 Preparing MADSEN tera II for the test P 59 5 Switch on Itera II Itera II is ready for testing as soon as it is switched on 6 Launch the OTOsuite Audiometry Module if required 7 8 You are ready to start testing Itera II automatically starts in manual test mode Itera II controls 3 2 FRONT panel controls 19 Otometrics 13 Getting started with MADSEN Itera Il and the OTOsuite Audiometry Module Getting started Tests Ext range LR Transducers Signal indicators Setup Masking Signal dB Input j TALKOVER RESPONSE START STOP LeR Pres Twice 5 DR T2 M SPADA 3 a 00 Se SPISIE w w w 4 jw we tate F FREQUENCY P D a adea le Start Pause Frequency selection Erase knob Store toggle status of thresholds Present interrupt signal word count buttons Stimulus masking intensity knobs Test types Manual air conduction testing To perform manual air conduction testing see 6 1 Air Conduction threshold test B 65 Bone conduction testing To perform bone conduction testing see 6 2 Bone Conduction threshold test gt 67 Speech testing To perform speech testing see 7 Speech Audiometry with MADSEN Itera II gt 75 Special tests 8 1 MCL tone testing p gt 83 8 2 UCL tone testing 83 14 Otometrics 2 3 2 3 1 2 3 2 Otometrics Getting started with MADSEN Itera II and th
89. is displayed and the button s that has have been wrongly set flash in the correct position three short flashes Masking Itera II cannot perform masking during an ABLB Test STENGER Test The Stenger Test is used to reveal a unilateral non organic hearing loss in one ear 1 Before you perform a Stenger test measure the patient s tone thresholds for the left and right ears 2 To select the Stenger test press SPECIAL one or more times until STEN appears 3 Select the test by pressing STEN once The following display appears 87 Otometrics Special tests with MADSEN Itera II Hearing Instrument Simulation HIS 20 STEN 15 L 1000 TON A tone is transmitted at the same frequency on the left and right sides simultane ously The display shows the signal selected as stimulus This is either TON WRB or NBN To change the stimulus see Changing stimulus P gt 88 4 Press either of the INT buttons to present the tone to the patient Changing dB level 5 You can change the dB level setting separately for the right and the left ear Set the dB level to 10 dB above the threshold in the better ear and 10 dB below the threshold in the poorer ear 6 You can present the signal in two ways present the signal to the patient by pressing the INT button or press the REVERSE button to keep the signal continuous You can then inter rupt the test signal by pressing the INT button Signal presentation
90. le modulation size 108 patient communication talk over 24 patient response shown on display 23 25 switch connection 33 PATIENT RESPONSE connection 33 pc interface cable connection 33 153 Index A B C D E F G H I J K L M N P Q R S T U V W X Y Z 154 power switch 34 powering 131 Preparing for testing connecting cables 59 pulse frequency 30 PULSE key 22 range extended 26 receiving the instrument 127 reference level HIS 91 replacement fuses 124 RESPONSE key 23 25 REVERSE key 23 Right Left audiogram viewing 38 RS232 connection 33 S safety 145 save test setup 102 Screens Aided Speech 51 Audiometry module main window 35 Speech 48 Tone Audiogram Module 45 sensitivity talk back microphone 110 Settings Control Panel 39 settings defaults 112 setup parameters 99 SETUP key 27 SF key 21 SF masking select transducer 103 SF transducer select headphones free field loudspeaker 103 shortcut parameters 99 SIGNAL key 22 signal unit select 109 SISI 83 changing number of small increments 27 masking 85 signal type selection 30 storing results 85 Sound field testing 67 SP SF connection 32 special Hearing Instrument Simulation HIS 88 SPECIAL key 21 special tests 83 Fowler ABLB 86 SISI 83 Stenger 87 special transducer 21 specifications 139 accessories 139 speech in noise 80 SPEECH key 21 Speech test the Speech screen 48 speech test heard words 31 masking setup in one ear 27
91. line of this display will show Ref 65 dB SPL and from here you can change the setting to any level between 50 and 80 dB To do so use the right LEVEL selector within three seconds This Reference Level is displayed in SPL The effect of the HIS filters is to increase the level by their respective amplifi cation factors at low and high frequencies When the display shows L 0 HIS 0 R the zeros indicate that the hearing level corresponds to the Reference Level over the entire frequency range To change this see Adjusting HIS Master Volume gt 92 Muting the simulator If required you can temporarily mute the output Press REVERSE to deactivate the output the button indicator turns off Both OUTPUT indicators light up automatically Simulating amplification The HIS always starts in unsimulated mode The display shows HIS to indicate that the simulation filters are not activated This means that the sound is presented without simulated amplification Starting simulation To start simulating you must activate the HIS filters by pressing the START STOP button To show the benefit of a hearing instrument use the START STOP button to switch between simulating and not simulating the amplification The display shows a symbol for the ear where a simulation filter is activated 91 Special tests with MADSEN Itera II Hearing Instrument Simulation HIS No filter activated Filter activated L Master
92. lowing conditions are met AC AC ACc Min IA or AC gt BCc Min IA BC lt AC x dB denotes configurable Air Bone gap criterion Tools gt Options gt Audiometry gt Tone gt Masking assistant gt BC Masking Criterion Min IA is frequency specific These are the Min IA tables for TDH 39 and Otometrics Inserts used in the Masking Assistant H Min IA Supraaural Phone TDH 39 frequency specific Hz TDH 39 125 35 Katz amp Lezynski 2002 250 48 Munro amp Agnew BJA 1999 500 44 Munro amp Agnew BJA 1999 1 Katz J Lezynski J 2002 Clinical Masking In J Katz ed Handbook of Clinical Audiology Williams and Wilkins Baltimore Munro K J Agnew N A comparison of inter aural attenuation with the Etymotic ER 3A insert earphone and the Telephonics TDH 39 supra aural earphone Br J Audiol 1999 33 259 262 Hall JW MUELLER HG 1997 The audiologists desk reference Volume I Singular Publishing Group San Diego 55 Navigating in the OTOsuite Audiometry Module The Masking Assistant Hz TDH 39 750 40 N A fulfill traditional approach 1000 48 Munro amp Agnew BJA 1999 1500 40 N A fulfill traditional approach 2000 44 Munro amp Agnew BJA 1999 3000 56 Hall J W III amp Mueller III Munro amp Agnew BJA 1999 4000 50 Katz J Munro amp Agnew BJA 1999 6000 44 Hall J W III amp Mueller G
93. metrics 9 1 9 2 9 3 Otometrics Managing Data and Results Transferring test results from the audiometer to the PC To transfer test results from your audiometer Switch on the audiometer n the OTOsuite Audiometry Module select Tools Fetch Test Results Follow the onscreen instructions Storing data You can store one set of AC data and one set of BC data including thresholds for each frequency You can delete these thresholds one by one or collectively You can transfer these data to a pc with the OTOsuite Audiometry Module Printing results Audiograms that have been saved in the OTOsuite Audiometry Module can be printed from the pc 97 Managing Data and Results Printing results 98 Otometrics 10 10 1 10 2 10 2 1 Setup of MADSEN Itera II Parameters What does SETUP do You can define all of the Itera II s normal parameters and setups under SETUP Permanent changes You can change the parameters permanently and save them in a specific test setup of your choice 10 2 1 Permanent changes in the setup P gt 99 1SAVE TEST SETUP b 102 Temporary changes You can make temporary changes to the various parameters during a test These changes will not be saved 10 2 3 Temporary changes in the setup P gt 100 How to use SETUP Permanent changes in the setup 1 To access changing your parameters press twice on SETUP When the SETUP function is active the SETUP indicat
94. mulus bar 4 4 2 The Speech stimulus bar 0 0 25 40 dB SPN Left Ch2 3 20 40 5 32444 1 2 3 Speech score Masking On VU meter Stimulus being word count presented Fig 6 Features specific to the Speech stimulus bar During online testing the stimulus bar shows Speech Score Word Count Displays the percentage correct incorrect and the amount of words cor rect incorrect out of a given number of words You can display speech score and word count either as Correct or as Incorrect To set your preference select Tools Options Speech View Score Presentation VU Meter Displays the sensitivity of the test microphone or speech material Otometrics Navigating in the OTOsuite Audiometry Module The Tone test screen 4 5 The Tone test screen During online testing the screen reflects the test done by the audiometer as it progresses m SE Stimulus bar f X w Pese l kawy 4 oj emit XL rmm PRUNUS Stimulus marker Work area Legend box wezma 4 5 1 The work area the Tone screen the audiogram The audiogram of the selected Client is displayed During testing the threshold symbols are entered automatically in the audiogram Cross Hatch E Indicates your current stimulus level and frequency A The color of the cross hatch indicates the routing Blue left Red right and Black binaural
95. nds on whether presentation mode is set to normal or REVERSE is activated This is shown by the output indicator see 3 2 6 The OUTPUT test signal indicators 23 Normally the test signal is present when you press the button If you press REVERSE the test signal disappears Speech testing Press this button to count unheard words FAIL 3 2 24 Right INT button PASS Usually functions in total parallel with the left INT button Use the right INT button to control the masking signal This will either present or interrupt the masking signal depending on the setting in SETUP 9 MASK PRESENT 103 PASS Speech testing Press this button to count heard words PASS SISI Use the right INT button to register Pass when the patient is unable to use the Patient Response switch 3 3 Socket connections rear panel The socket connections on the back of Itera II are protected by a guard which is hinged onto the front panel and held shut by a spring clip at each end Open this guard in order to connect or disconnect accessories or cables to the back of Itera II Otometrics 31 Overview of MADSEN Itera II Socket connections rear panel Oq M0 0 0 6 00 0 0 0 0 0 RS232 DC power Patient interface out 1 5 10V Response 3 3 1 Description OO OO O OO 32 Digital aux Talk Back Monitor Ext Mic CD Tape SF AC AC BC AC SF AC Monitor Right Left Right Left headset 2 1 Fig 3 Itera
96. on destructive input voltages for input and output sockets relative to earth connection when the instrument is switched on Maximum Non Destructive Voltage MADSEN Itera ll SP left and right socket 10 V AC 10 V DC AC left and right socket 10 V AC 10 V DC BC socket 10 V AC 10 V DC CD TAPE left and right socket 12 V AC 12 V DC Speech Talk Over socket 12 V AC 12 V DC Monitor socket 12 V AC 12 V DC Patient Mic Talk Back socket 12 V AC 12 V DC Digital Aux For future use 5VAC 5 V DC Patient Response socket 12VAC 12 V DC DC Power out 30 V AC 30 V DC AC mains inlet 1500 V AC 370 V DC RS232 interface sockets pin 1 nc 240 V AC 240 V DC pin 2 RxDout I5VAC 15 V DC pin 3 TxDin 30 V AC 30 V DC pin 4 DTR 30 V AC 30 V DC pin 5 ISO Gnd 30 V AC 30 V DC 133 App 1Maximum Non Destructive Voltage MADSEN Itera II RS232 interface sockets pin 6 DSR 30 V AC 30 V DC pin 7 RTSin 30 V AC 30 V DC pin 8 CTSout 15 V AC 15V DC pin 9 nc 240 V AC 240 V DC Relative to pin 5 on the RS232 interface socket For information on how to use MADSEN Itera II with a PC consult your local sup plier 134 Otometrics App 2 MADSEN Itera II Abbreviations ABLB AC AC AUTO BC CD CH DC DEF EXT EXT R EXTERN FIX EM FREQ HIS HISF AL Otometrics alternate binaural loudness balance air condu
97. or a manually entered audiogram Note The air conduction transducer is stored when you have selected it in the transducer section of the Con trol Panel and data points are entered on the audiogram View menu Masking Assistant amp 8 Click to enable or disable the Masking Assistant The Masking Assistant causes an unmasked threshold to flash repeatedly if masking is recom mended Overlays Click to enable or disable the overlays Overlays display pictures severity speech banana speech letters and or unusable area on the audiogram Note Overlays can also be displayed by selecting them from the overlay box below or next to the audiogram To view hide the overlay box select Tools gt Options gt General Otometrics 37 Navigating in the OTOsuite Audiometry Module The Audiometry Module menu system and toolbar 38 Combined Audiogram EJ CN Combined View Menu item Click to toggle between viewing both ears in a single audiogram combined audiogram or both a left and a right audiogram on your screen Icon Click to view both ears in a single audiogram Left Right Right Left Split View lcon Click to view separate audiograms for each ear Menu item Click to display the left ear audiogram on the left side of the window and the right ear audiogram on the right side of the window when Split view is enabled Menu item Cli
98. or light flashes Most other buttons are deactivated and audiometry cannot be performed 2 Turn the left LEVEL selector to select the parameter item you wish to change When you select a new item the item number is displayed briefly in the bottom line for instance Item 5 As a rule the top line in the display contains a description of the current param eter for instance SF TRANSDUCER Otometrics 99 Setup of MADSEN Itera II Parameters How to use SETUP The bottom line contains the value that you can change The values available are shown one line at a time for instance None HDA 200 TDH39 EAR T E A R TONEG3A F F To change the actual parameter value for most items use the right LEVEL selec tor Changes made under SETUP will be saved when you leave SETUP and will apply the next time Itera II is switched on The most recently selected item will also be the one displayed the next time you activate SETUP To exit this function press twice on SETUP 10 2 2 Return to default settings To return to the default settings see 38 DEFAULT SETTING 112 10 2 3 Temporary changes in the setup 100 ShortCuts ShortCut is a faster way to access some of the parameters Changes made to parame ters via ShortCut will not be saved when Itera II is switched off Warble frequency gt 22 Warble modulation 22 Pulse frequency 22 Test signal duration gt 22 Input signal sensiti
99. ord an audiogram see 6 Tone Test ing with MADSEN Itera II gt 65 82 Otometrics 8 Special tests with MADSEN Itera II 1 Prepare the patient for testing as described in 5 Preparing MADSEN Itera II for the test 59 2 Ifyou press SPECIAL the available special tests are shown in groups of three To select the required test press the relevant function key below the test name If SPECIAL flashes more tests are available If Itera II features more than three special tests depending on the software ver sion press SPECIAL twice to see more tests The three tests last used will always be displayed first when you press SPECIAL 8 1 MCL tone testing To test for MCL Most Comfortable Level using tones Press SPECIAL one or more times and press the appropriate function key to select No masking the stored value symbol is M No response cannot be stored 8 2 UCL tone testing To test for UCL UnComfortable Level using tones Press SPECIAL one or more times and press the appropriate function key to select No masking the stored value symbol is U No response cannot be stored 8 3 SISI Test The SISI Short Increment Sensitivity Index test consists of brief random incre ments in intensity Otometrics 83 Special tests with MADSEN Itera II SISI Test 84 The dB increments are presented randomly at intervals of 4 to 6 seconds and the per mitted response time is 2 seconds 1 Press SPECIAL on
100. ore Level Msk Score Level Score Level Msk 12 120 50 12 75 12 120 50 17 Fig 9 Speech testing tabular view The Speech Table displays the scores for right binaural and left ear data collection During testing the word count results are shown automatically Entering results in Score tables To enter the results in the Score tables simply left click in the required field Deleting results in Score tables To delete specific results in the Score tables simply right click in the required field and select Delete Storing results in Score tables To store results in the Score tables simply right click in the required field and select Store PTA field To select the frequencies from which the average is to be calculated select Tools Options Audiometry General PTA Frequency and enter your selections Otometrics 49 Navigating in the OTOsuite Audiometry Module The Speech test screen 50 Speech testing graph view 65 06 24 25 Owl Fig 10 Speech testing graph view The Speech Graph screen displays the speech graph which includes SDT SRT MCL UCL noted by a line blue left red right at the corresponding dB level Symbols will be shown based on the location corresponding to the dB level of pres entation and the percentage of correct responses 4 6 2 The Legend box The Legend box shows the audiogram symbols used in the graphs 4 6 3 Terms and abbreviations used in
101. ou select SPECIAL For a description of the special tests see 8 1 MCL tone testing p gt 83 8 2 UCL tone testing 83 8 3 SISI Test P 83 8 4 ABLB Fowler gt 86 8 5 STENGER Test 87 8 6 Hearing Instrument Simulation HIS gt 88 Current test settings When you switch to a new test the current setting of the test that you are leaving will be saved and re established when you return to the test The TRANSD column transducers Press to select the output transducer AC Press AC to select the Air Conductor BC Press BC to select the Bone Conductor SF Press SF to select the Special Transducer The identity of the transducer selected under SETUP is displayed as long as you press the button 21 Overview of MADSEN Itera II FRONT panel controls If a headphone transducer is not selected under SETUP 3 AC TRANSDUCER P 102 4 BC TRANSDUCER P 102 and 5 SF TRANSDUCER 103 the relevant transducer cannot be selected 3 2 4 The SIGNAL column WARBLE Presentation of warble tone stimulus WRB Warble shortcut functions To change the warble frequency press and hold WARBLE while you turn the left LEVEL selector Warble frequency Warble modulation To change warble modulation width press and hold WARBLE while you turn the right LEVEL selector PULSE The test signal is presented with a Pulse Pause ratio of 50 Pulse shortcut functions Pulse frequency To ch
102. r It will be available either as the standard AC transducer or as an SF transducer Make sure that it is selected in SETUP 7 BC MASKING P 103 The test procedure is similar to that described in 6 3 3 Bone conduction with masking 73 Min IA is frequency specific These are the Min IA tables for TDH 39 and EAR 3A that you can use to optimize the use of masking The numbers are rounded down to the closest 5 dB step Min IA TDH 39 Hz dB Source 125 35 Katz amp Lezynski 2002 250 48 Munro amp Agnew BJA 1999 1 Katz J Lezynski J 2002 Clinical Masking In J Katz ed Handbook of Clinical Audiology Williams and Wilkins Baltimore Otometrics Tone Testing with MADSEN Itera II Testing with masking Hz dB Source 500 44 Munro amp Agnew BJA 1999 750 40 N A traditional approach 1000 48 Munro amp Agnew BJA 1999 1500 40 N A traditional approach 2000 44 Munro amp Agnew BJA 1999 3000 56 Munro amp Agnew BJA 1999 4000 50 Munro amp Agnew BJA 1999 6000 44 Munro amp Agnew BJA 1999 8000 42 Munro amp Agnew BJA 1999 Min IA EAR 3A Hz dB Source 125 35 N A traditional approach 250 48 Munro amp Agnew BJA 1999 500 44 Munro amp Agnew BJA 1999 750 40 N A traditional approach 1000 48 Munro amp Agnew BJA 1999 1500 40 N A traditional approach 2000 44 Munro amp Agnew BJA 1999
103. r reficere e kg 87 8 6 Hearing Instrument Simulation HIS E Ri e ERR ERRANT 88 BGN The HIS procedure 4 2 22 3 95 3 Ee vb CRUS DIOC Zs AOI 89 Table of Contents MADSEN Itera Il e User Manual 8 6 2 Viewing thresholds and filters 92 8 6 3 Manually adjusting the HIS filters dw rx ea ead 93 8 7 Overview of Monaural Binaural Test signals and the Masking side 96 9 Managing Data and Results 97 9 1 Transferring test results from the audiometer to the PC 97 9 2 String crest 4 naa sm o o RW kes kd d Ewe dod 97 9 3 Printing KEANE cet OKA 97 10 Setup of MADSEN Itera Il Parameters 99 10 1 Whatdors SETUP dor aa kla oc pe ad yada r ede ee ade ta 99 10 2 Dopo SE SETUP seri odes e ces potet ego etica dens et APR RN 99 10 2 1 Permanent changes in the setup 99 10 2 2 Return to default settings 100 10 2 3 Temporary changes in the setup 100 IUOS E DUT RENE e Ds EEE O AE 101 11 Configuring OTOsuite 115 Lil od ni po bas 116 12 MADSEN II Maintenance and Safety 123 Gooey a ere at Peces a WG oz Po hada pa
104. r the right and left SF socket 3 3 Socket connections rear panel P gt 31 They must be connected according to calibration To verify the calibration press AC SF and the display will show the trans ducer calibrated for that output a Fig 16 EAR 3A insert phones only one shown 13 2 3 Bone conduction Connect the bone conduction transducer plug into the BC socket located in the back panel of Itera II 3 3 Socket connections rear panel gt 31 128 Otometrics Unpacking and Installing MADSEN Itera II Installation af Dou Fig 17 Bone conductor B71 13 2 4 External microphone In speech testing and patient communication there are two possible external micro phone solutions Gooseneck or Boom microphone on the monitor headset Connect the chosen microphone solution to the EXTERNAL MIC MONITOR HEADSET socket 3 3 Socket connections rear panel gt 31 Connecting one of these disables the internal talk over microphone Gooseneck Fig 18 Gooseneck microphones Otometrics 129 Unpacking and Installing MADSEN ltera II Installation Monitor headset Fig 19 Monitor headset with boom microphone 13 2 5 Free Field Without Power Amplifier Plug the Free Field transducer cables directly into the R SF and L SF sockets located in the back panel of Itera II 3 3 Socket connections rear panel P
105. rphones are in constant contact with your patients and should therefore be kept clean Wipe them regularly with a moist cloth Eartips The eartips are disposable and therefore should not be cleaned or re used There are no special requirements for the disposal of the ear tips If you use the E A RTONE 3A insert phone note that the standard yellow foam insert tips are disposable and therefore should not be cleaned or re used There are no special requirements for the disposal of the insert tips Bone conductor The bone conductor should periodically be wiped clean with a dry cloth 12 2 3 Replacing fuses s To replace or inspect a fuse proceed as explained below Warning Risk of fire Before replacing a fuse first switch off the instrument and disconnect it from the mains power supply The fuse holders are located next to the AC power connector or they are integrated with the power connector To remove a fuse Unscrew the end of the fuse holder using a screwdriver with a blade at least 6 mm wide or remove the power connector Fuse types The fuse is a push fit in the end of the fuse holder When you replace fuses use only fuses of type T1A L 250 V 5 mm x 20 mm Calibration You can download new software to Itera II and if this involves no change to the transducers Itera II does not need recalibration Annual calibration It is recommended that Itera II headphones and bone conductors are calibrated annu
106. rs 3 2 19 The dB STEP column Choose between the following attenuator steps 1 dB 2 5 dB 5 dB If the indicator light on the selected button flashes this indicates that the display has been set up to show SPL values SETUP 22 SIGNAL UNIT P 109 instead of HL 3 2 20 The FREQUENCY knob Change of frequency When you turn the knob clockwise the frequency is increased and when you turn the knob counter clockwise the frequency is decreased Both octave and inter octave frequencies are available when you use the Frequency knob The exception is 125 Hz which follows the setting in SETUP 20 SELECT FREQUENCY AC FREQ 109 FREQUENCY shortcut functions Display graphs HIS Ifyou turn this knob in HIS mode various graphs will be mode shown see 8 6 Hearing Instrument Simulation HIS 88 Otometrics 29 Overview of MADSEN Itera II FRONT panel controls 3 2 21 dB LEVEL LEVEL 3 2 22 dB LEVEL LEVEL 30 Left Intensity change Changes the intensity for the test signal regardless of whether the signal is being sent to the left or right ear To change this setting select SETUP 37 STIMULI KNOB P 112 When you turn the knob clockwise the intensity is increased and when you turn the knob counter clockwise the intensity is decreased Masking and intensity If the masking signal is in LOCK mode the intensity is also changed here Shortcut functions dB LEVEL left shortcut
107. s L lt gt R to select the ear you wish to test Press the INT button right or left to present the tone to the patient for 1 to 1 5 seconds If the patient does not respond to the presented signal turn the LEVEL knob to increase the signal level in steps of 10 dB until the patient responds Reduce the signal level by 20 dB until the patient does not respond to the signal Increase the signal level in steps of 5 dB and present the signal to the patient at each level until the patient responds to the signal Reduce the signal level by 10 dB and present signals at levels increased by 5 dB until the patient responds Repeat item 5 1 to 3 times until the patient has responded 3 times at the same level This level represents the unmasked hearing threshold at 1000 Hz based on 3 5 ascending series In some situations it may be satisfactory with two responses at the same level Otometrics 6 3 6 3 1 Otometrics Tone Testing with MADSEN Itera II Testing with masking If the patient has responded less than 3 times at the same level after 5 series present a signal at 10 dB above the level where a response was last registered Then repeat items 3 to 6 7 When the threshold is determined press STORE to store that particular thresh old See 3 2 13 The STORE button 26 8 Turn the FREQUENCY knob to select the next frequency You can link the Store and Next Frequency functions so that the test pro
108. s been increased with at least three 5 dB steps the so called masking plateau has been reached and the test tone level is considered the masked hearing threshold level 5 If the tone is not heard when the masking level is increased increase the test tone level until the tone is heard by the patient Repeat from step 4 6 If the test tone level at the masking plateau established in step 4 is within 5 dB from the unmasked threshold level you can skip step 7 7 Keep the established masking level and confirm the masked hearing threshold level To do so Otometrics 6 3 3 Otometrics Tone Testing with MADSEN Itera II Testing with masking Decrease the test tone level by 10 dB and increase in 5 dB steps The patient should respond within 5 dB from the previously determined masked threshold level If not repeat from step 2 If required test the remaining frequencies in the same way and switch to the other ear Bone conduction with masking Suggested procedure Prerequisites Prerequisites as in 6 2 Bone Conduction threshold test 67 Prepare the patient for testing with masking See 5 2 5 Preparing for testing with masking gt 62 It is recommended to use the default setup used in connection with selecting MASK ON for presenting the masking signal as continuous presentation This means that you will not be using the INT button to control the masking sig nal Testing 1 Establish the unmasked bon
109. sensitivity 109 selection 23 talk back connection 32 modulation specifications 140 modulation size warble 108 monaural speech test 75 input selection 75 input sensitivity 77 masking 77 speech in noise 80 word count 78 monitor left setting 110 ON OFF setting 110 right setting 110 MONITOR connection 32 monitor headset connection 32 Most Comfortable Level Itera II 83 Navigating in Audiometry 35 No response 26 ON OFF power switch 34 Overlays viewing 37 overview instrument 17 P parameters AC masking 103 AC transducer 102 baud rate 111 BC masking 103 BC transducer 102 CD power supply 111 L M N O P Q R S T U V W X Y z CD tape input sensitivity 109 changing 27 dB level new frequency 106 dB level new transducer 106 default settings 112 display setup 111 extended range dB space 111 extended range timeout 111 frequency change with STORE 104 impulse length 108 internal beep 110 item selection 30 light in LEDs 110 masking presentation 103 microphone input sensitivity 109 monitor left 110 monitor ON OFF 110 monitor right 110 pulse frequency 108 save test setup 102 select automatic frequency 109 select manual frequency 109 set default test parameters 102 setup 99 SF masking 103 SF transducer 103 shortcut 99 signal unit 109 speech count 104 speech masking signal 104 stimuli knob 112 talk back microphone sensitivity 110 talk over 110 tone masking signal 104 warble frequency 109 warb
110. sponse button 1000 _ 302 Dual Responder setup If separation is activated when the patient presses the Patient Responder button a response indication coloured Red or Blue is shown depending on the button pressed If separation is not activated when the patient presses the Patient Responder button then either button will show the same response indication Amber 51 Navigating in the OTOsuite Audiometry Module Curves and symbols selection 4 9 52 Red Indicates that the patient is pressing the right response button Blue 304 MB Red and blue Indicates that the patient is pressing both response buttons FOOT _ 1302 Rym Ch2 Curves and symbols selection 4 9 1 Selecting a symbol or curve You can select a symbol and or a curve style for a specific measurement 1 To do so select Tools gt Curves and Symbols Click on the selections that apply to your measurement under Test Transducer and Aided Condition The current symbols and line style are shown Double click on the symbol you wish to change The Symbols selection dialog box is shown 4 Double click on the symbol you wish to use QN U To change the line style of the curve select from the Line Style drop down list To change the color double click on the current Color square Select a new color or click on Define custom colors to select a color not shown Click OK To optimize viewing of the aud
111. tch When the patient presses the Patient Response switch this lights the RESPONSE indicator light and gives an audible beep from Itera II DC POWER OUT Power supply for the CD TAPE player Adjustable from SETUP 35 CD POWER SUPPLY 111 OFF and 1 5 10 volt DC 500 mA Use the right LEVEL selector to select Note Remember to use an adapter if necessary so that the CD has the correct polarity The centre pin is and the sheath is OV Note Jt is recommended that Itera II supplies power to the CD Tape player RS 232 INTERFACE To connect Itera II to a PC use the optional 9 pole PC RS232 interface cable The installation must be carried out in accordance with EN 60601 1 1 plus adden dum in the form of Part 1 General provisions 1 and UL2601 1 CAN CSA C22 2 NO 601 1 90 The supplementary provisions on the reliability of electro medical systems It is a general rule for all electrical equipment used in the proximity of the patient that The connected equipment must comply with EN60601 1 and or EN60601 1 l Any PC connected to Itera II must comply with the requirements of IEC 950 Safety of information technology equipment including electrical business equip ment For information on how to use Itera II with a PC see 9 Managing Data and Results 97 Supply voltage connection 100 240 V AC 50 60 Hz 60 VA Fuse 2 T 1A 250 5 mm 20 mm 33 Overview of MADSEN Itera II Side panel Warning Before
112. th ears giv ing Binaural Speech Use L lt gt R to mix the signals in speech testing Use L lt gt R to control setup masking in one ear in binaural speech testing 3 2 16 The SETUP button Otometrics Changing the setup temporarily To change the setup of Itera II temporarily Use the Shortcut function See 10 2 3 Temporary changes in the setup P gt 100 These changes will not be saved when you switch off Itera II Changing the setup permanently To change the setup of Itera II permanently Use the SETUP button to access the various parameters See 10 2 1 Permanent changes in the setup 99 1 Press SETUP twice to change default settings see 10 Setup of MADSEN tera II Parameters 99 Pressing SETUP twice to access the setup function serves to prevent accidental changes in the setup SISI Press SETUP to enable the number of small increments to be changed using the right LEVEL selector Fowler ABLB Press SETUP to enable changing the frequency of the alternating tone using the right LEVEL selector 27 Overview of MADSEN Itera II FRONT panel controls 3 2 17 The TALK BACK button The patient s speech is always fed back to the operator s monitor headphone You can remove the signal lowering the Talk Back volume SETUP 26 TALK BACK MIC P 110 or by setting the switch on the Talk Back microphone to OFF You can choose to have the test signal and or the masking s
113. the current stimulus and masking choices both numerically and graphically in the displayed audiogram s while testing with a connected Otometrics audiometer As the module is part of OTOsuite audiograms can be used directly in other OTO suite modules such as AURICAL Visible Speech for an optimized workflow inde pendent of NOAH The OTOsuite Audiometry Module lets you work with NOAH or save and view results via XML files The current version supports basic tone audiometry and speech testing special tests depending on the audiometer being used Masking Assistant The special Masking Assistant feature will notify you of thresholds that you might consider checking again with masking applied You may use this feature not only dur ing testing but also to pinpoint possible masking issues with previously recorded audiograms The applied masking rules match the general recommendations in the audiometry literature Over the rim testing Testing with the audiometer connected to a PC allows you to use the audiometer pri marily as a handy control panel while you follow the actual stimulus settings and test progress on your standard PC display The large stimulus and patient response graph ics at the top of the display gives you a clear overview while keeping your focus on the patient Patient test planning The OTOsuite Audiometry Module supports planning of patients for safe offline testing in the field You create a list of patien
114. the same level If the patient has responded less than 3 times at the same level after 5 series present a signal at 10 dB above the level where a response was last registered Then repeat item 6 When the threshold is determined press STORE to store that particular thresh old See 3 2 13 The STORE button gt 26 Select the next frequency You can link the Store and Next Frequency functions so that the test progresses with the next frequency when you press STORE See 13 FREQ CH AT STORE 104 Continue to use the right and or left LEVEL knob to increase decrease intensities until you have determined all thresholds Note Jf the thresholds measured at 1000 Hz in the ear differ by 10 dB or more even the other frequencies should be retested 10 Continue to press STORE after each threshold is found to store that particular threshold 11 After each threshold is determined and stored you will notice that as you turn the LEVEL knob to scroll frequencies each stored threshold at that particular fre quency will be marked by an asterisk and the relevant audiogram symbol indicating the stored threshold 12 If you are not performing the test online with the OTOsuite Audiometry Mod ule plot the results in an audiogram sheet Otometrics 6 1 3 6 2 6 2 1 Otometrics Tone Testing with MADSEN Itera II Bone Conduction threshold test 13 Repeat this procedure for the other ear Note ftbere are
115. tically still be set to simulate a three band hearing instrument by selecting different cut off frequencies and adjusting the differ ent gains and the reference level Note In the standard automatic HIS setup described in 8 6 1 The HIS procedure P 89 this is done automatically To be able to change the HIS filter parameters for the left or right ear press either the left or right INT button This will display the filter characteristic for the selected ear as shown below roi LEFTEAR LP Second line 250Hz 12s Odb The top line The top line shows the selected ear and shows whether the currently displayed param eters apply to the low pass LP or high pass HP filter 93 Special tests with MADSEN Itera II Hearing Instrument Simulation HIS The second line The second line shows the filter s 3 dB cut off frequency the filter slope in dB per octave and the asymptotic amplification at the filter cut off frequency Changing values The arrow points to a setting which you can change To change a setting Use the left LEVEL knob to move the arrow to the required setting Use the right LEVEL knob to change the setting Moving the arrow also steps between the LP and HP filters When you have set up the filter values press the relevant INT button to return to the normal HIS screen You can press the START STOP here and the filters are updated online if you change a value while the filter is activat
116. ting started with MADSEN Itera II and the OTOsuite Audiometry Module 13 2 Unpacking Itera ll a cuc a zd DO rgo ede e Nba av aa 13 DP Gettin6 EIER 13 2 3 Q stOmiZaoD ka atus a dee kaq hast n HAS kaykata tests hua yq aus 15 23 1 Customizing your Setup de qat eut o daten uQ vele d Mert hse anura 15 2 32 Sh FiEUiS SE AE O due Rude e duse Rd etit us 15 Overview of MADSEN Itera II 17 DIT RM CT 17 22 FRONT panel Controls aby eda retenta it ES EXCEL Rud i So teca a o as 19 gt Front panel layout u s aa aaa sesto tole rb ie Rot Pet eal 20 3 22 erede de mee dot Rau yi pu e RS 21 3 2 3 The TRANSD column transducers 21 3 2 4 The SIGNAL column 22 3 2 5 The MIC CD and REVERSE column 23 3 2 6 The OUTPUT test signal indicators i29 oat i Ye E Pg 23 32 7 The ERASE button eere eie ree 23 3 2 8 The XMIT b tton isle edu TR b aa E e ds 24 3 29 The MICA microphone mada wio R 24 3 2 10 The TALK OVER button 24 3 2 11 The RESPONSE indicator a una s naa 25 3 2 12 The START STOP button wirs RII 25 3 2 13 The STORE button roa cet ces ce ln E ce 26 3 2 14 The EXT RANGE button
117. trics Index A B C D E G H J K L M N O P Q R S T U V W X Y z Otometrics 163 Index A B C D E G H J K L M N O P Q R S T U V W X Y z 164 Otometrics
118. ts which clearly show the device s current setting Sound level frequency and other information are clearly displayed on the display Speech input signals can be taken from a CD player tape recorder and internal or external microphones The masking signal for speech audiometry can be presented together with the speech signal for the ear being examined Speech in Noise The MADSEN Itera II can be used in connection with the OTOsuite Audiometry Module for monitoring of test results data export and storage printing and NOAH compatibility Output options There are three output options standard headphones AC bone conductors BC special output SF which can be connected for instance to a free field loud speaker or insert phone see available output in 5 SF TRANSDUCER P 103 Itera II can be calibrated for several types of headphones simultaneously Introduction to MADSEN Itera Il and the OTOsuite Audiometry Module The Audiometry Module Transferring data to and from a pc The test results are stored in the device even when it is switched off The results can be transferred to a PC and displayed in OTOsuite see 9 Managing Data and Results gt 97 You can download new firmware to Itera II and if this involves no change to the transducers Itera II does not need to be recalibrated 1 2 The Audiometry Module El OTOsuite 10 The OTOsuite Audiometry Module software provides a comprehensive overview of
119. ts that can then be downloaded to audi ometers supporting patient planning MADSEN Xeta Each planned patient can Otometrics 1 2 1 1 3 1 3 1 1 3 2 1 4 Otometrics Introduction to MADSEN Itera Il and the OTOsuite Audiometry Module Intended use now be safely identified selected and tested on the audiometer based on his name and personal identification The results can be bulk uploaded to the PC later on For specific information regarding audiometric test procedures and settings please see the documentation for the specific audiometer OTOsuite Audiometry Module interfacing to audiometers The OTOsuite Audiometry Module is designed to interface with the following test devices produced by Otometrics Audiometers produced by Otometrics e MADSEN Xeta Air Bone Masking e MADSEN Itera II Air Bone Masking Speech MADSEN Astera Air Bone Masking Speech special tests AURICAL Plus and MADSEN Conera download of data via LINK Intended use MADSEN Itera II Itera II is intended for diagnostic and clinical use by audiologists and other health care professionals in testing the hearing of their patients The Audiometry Module The OTOsuite Audiometry Module is intended for screening and diagnostic use by audiologists and other health care professionals in testing the hearing of their patients About this manual Installation See 13 Unpacking and Installing MADSEN Itera II gt 127 and 3 Overview of
120. udiogram to the left ear If you select No in this example the Hearing Instrument Simulation will be made for the right ear only HIS filters None Missing data L amp R No sufficient audiograms are available Enter the audiogram s manually or set the HIS filters manually 8 6 3 Manually adjusting the HIS filters 93 To continue press either one of the INT buttons Adjust input sensitivity Adjust the input sensitivity 7 2 2 Adjusting input sensitivity 79 Start the Hearing Instrument Simulation You are now ready to start the simulation The default settings for the simulation are Transducer Input MIC live speech AC Alternately SF Alternately CD 7 2 1 One channel or two channel Speech testing P gt 79 90 Otometrics Otometrics Special tests with MADSEN Itera II Hearing Instrument Simulation HIS HIS reference level 65 dB SPL The level for normal speech considered for a person with nor mal hearing is around 65 dB SPL Alternately See Adjust HIS reference level P gt 91 start the simulation press START STOP Adjust HIS reference level Adjust the HIS reference level The level for normal speech considered for a per son with normal hearing is around 65 dB SPL Press SETUP once to view the Reference Level for instance 65 dB To change this Reference Level for the HIS test press SETUP once The lower
121. udiometry Data Click to import audiometry data from AURICAL Plus and MADSEN Conera See the OTOsuite User Manual Eje w 4 3 The Audiometry Module Control Panel Note The appearance of the Control Panel depends on the test device used Otometrics 39 Navigating in the OTOsuite Audiometry Module The Audiometry Module Control Panel The general function of the Control Panel is described in the OTOsuite User Man ual The Audiometry Module Control Panel shows the settings available for the specific test in the connected audiometer wom om Fig 4 The MADSEN Itera Il Control Panel 4 3 1 The MADSEN Itera II Control Panel When you activate the Audiometry Module Control Panel OTOsuite automatically connects to your Otometrics audiometer and displays the Control Panel You cannot operate MADSEN Itera II from the Control Panel This Control Panel is divided into a number of sections where you can view various settings and a section for controlling communication with the audiometer 40 Otometrics Navigating in the OTOsuite Audiometry Module The Audiometry Module Control Panel NEL d b 0 MN Tv Le mmo DANI EN a ire wa m sa 40 1000 10 mmm EM Ime w a Moi m MM ma 15 m 6 t w u Y Control Panel aerr dios O The Stimulus Panel shows the stimulus type used and th
122. uest your supplier can obtain a service manual from the factory The service manual contains electrical diagrams descriptions lists of components and calibra tion instructions etc Warning For the sake of safety and in order not to void the warranty the cabinet should only be opened and serviced by autborised service personnel at authorised work shops In case of any defects please make a detailed description of the defect s and contact Jour supplier Do not use a defective instrument Note There are no user serviceable parts inside the Itera II cabinet When dismantling the Itera II unit there is a risk of electric shock Cleaning and maintenance Itera II requires no preventive maintenance However it is recommended that you observe the following guidelines Cleaning the device Make sure that the instrument is kept clean and free of dust Remove dust using a soft brush and take special care to remove any accumula tions of dirt on or around the buttons on the front panel 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 To clean the display use a dry cloth or soft brush Note that the display is lami nated for maximum readability and must therefore be treated with care 123 MADSEN Itera Il Maintenance and Safety Calibration 12 3 124 12 2 2 Cleaning accessories Earphones The ea
123. urn the left LEVEL knob Using STORE in the SISI test Note A maximum of four different sets of SISI values can be stored for both left and right ear Storing results When the test is completed for a frequency press STORE to store 85 Special tests with MADSEN Itera II ABLB Fowler SISI score number of dB increments administered dB increment dB level for test signal and masking signal if applicable An symbol appears by the frequency and an x o symbol for the left or right side Test the next frequency 20 xSISI 0 NOOO 0225 8 4 ABLB Fowler 86 In the ABLB Alternate Binaural Loudness Balance test also known as the Fowler test a tone is transmitted at the same frequency to the left and right ear alternately The patient must decide when the same volume is achieved in both ears The patient can indicate this by pressing the Patient Response switch 1 To select the Fowler test press SPECIAL once or more until ABLB appears 2 Press ABLB once and a display similar to the following will appear 20 ABLB 15 1000 22 Algi The top line shows the intensity for Right and Left channel and the test name The frequency of the test tone and the rate of alternation from ear to ear and back again the alternating frequency appear on the bottom line Changing alternating frequency To change the alternating frequency 1 Press SETUP once and use the right LEVEL knob 0 25 2 5 Hz
124. vity MIC CD 23 Output level headphone 25 Fixed dB level talkover level 25 MIC sensitivity gt 25 Talkover signal to headphone 25 Setup volume gt 28 Masking transducer selection 29 Masking noise in Speech 29 Display graphs HIS mode 29 Warble modulation P gt 30 Signal type SISI P gt 30 Master volume HIS gt 30 Otometrics 10 3 Otometrics Setup of MADSEN Itera Il Parameters SETUP items Parameter selection SETUP gt 30 Talkback level B 30 Warble modulation amplitude gt 30 Pulse frequency 30 Impulse time 30 Input sensitivity speech B 31 Word counting method speech P gt 31 Alternating Fowler frequency P gt 31 Master volume HIS gt 31 Parameter selection SETUP 31 Power out voltage P gt 31 SETUP items SETUP items 1 SAVE TEST SETUP p 102 2 SET DEE TEST P p gt 102 3 AC TRANSDUCER P 102 4 BC TRANSDUCER 102 5 SF TRANSDUCER P 103 6 AC MASKING P 103 7 BC MASKING P 103 8 SF MASKING 103 9 MASK PRESENT P gt 103 10 TONE MASK SIG 104 11 SPEECH MASK SIG 104 12 SPEECH COUNT P 104 13 FREQ CH AT STORE 104 14 DB LEV NEW TRA b 106 15 DB LEV NEW FREQ P 106 16 PULSE FREQUENCY P 108 17 IMPULSE LENGTH P 108 18 WARBLE MOD SIZE gt 108 19 WARBLE FREQUENCY P 109 20 SELECT AC FREQ gt 109 21 SELECT BC FREQ 109 22 SIGNAL UNIT P 109 23 MIC INPUT SENSE P 109 24 CD INPUT SENSE P 10
125. witch a beep is issued in the headphones If this situation is repeated the test is paused Reinstruct the patient meme Before testing check that the Response indicator lights up when the Patient g Response button is pressed 5 2 3 Preparing for air conduction testing Headphones insert phones Make sure that the headphones and insert phone s are properly connected Connection to Itera 11 See 13 2 Installation P gt 127 for a description of how to connect to Itera II Fitting on patient Place the patient facing away from Itera II in a sound booth if one is available 60 Otometrics 5 2 4 Otometrics Preparing MADSEN Itera II for the test Preparing the test equipment Set the switch on the Talk Back microphone to ON and set the level of Talk Back 3 2 5 The MIC CD and REVERSE column 23 Fit the headphones on the patient with the RED phone on the right ear Choose the ear with the better hearing to be tested first Instructing the patient The patient will be hearing brief tones The tones may at times appear to be very weak Instruct the patient in how to use the Patient Response switch 5 2 2 The patient response switch gt 60 The patient should press the Patient Response switch as soon as the tone is heard even if it is very weak Preparing for bone conduction testing gt Connection to Itera II Make sure that the bone conductor is properly connected See 13 2 3 Bone con
126. y the dB level above the channel status bars Masking is denoted by square brackets around the level calibrated in effective masking level The green triple wave symbol above the level indicates that the stimulus is currently being presented 42 Otometrics Otometrics Navigating in the OTOsuite Audiometry Module The stimulus bar Stimulus bar color Indicates the routing for each channel Blue left ear Red right ear Blue Red binaural Gray unspecified Stimulus transducer and routing indicators The stimulus masking type the transducer and the routing for each channel Stimulus marker The stimulus cross is your visual aid to identify the frequency and level being tested Stimulus marker zs The Masking level indicator The masking level indicator is shown behind the curves and symbols when when masking is on Masking level indicator 43 Navigating in the OTOsuite Audiometry Module The stimulus bar 44 4 4 1 The Tone stimulus bar 20 1000 _ 1302 Ch1 War ble Insert Left X NB Noise Insert Binas al Symbol Frequency Fig 5 Features specific to the Tone stimulus bar During online testing the stimulus bar shows Symbol Indicates the symbol being used when storing a data point i e blue square indicating left masked air conduction threshold Frequency Indicated by the Hz value in the center of the sti

MADSEN Itera II User Manual

Contents

Download Pdf Manuals

Related Search

Related Contents