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Grason-Stadler GSI Tympstar Manual V1 Rev C

1. Field Definition 9 Query Record XX 00 to 99 072 00 Unused 01 500 Hz 02 1000 Hz 03 2000 Hz 04 4000 Hz 05 Low Band Noise 06 High Band Noise 07 Broad Band Noise 08 Click 09 External XX LP GSI TympStar Version 1 Reference Instruction Manual D 73 7 9 7 12 ARLT Intensity Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 3 Intensity 10 2 Checksum 12 1 Carriage return 13 1 Line feed Appendix D Field Definition p 9 Query Record XX 00 to 99 073 XXX dBHL XX 7 9 8 Sensitization Individual SoftKey Commands 7 9 8 1 A R Sensitization Stimulus Ear Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Reflex Type 8 2 Checksum 10 1 Carriage return 11 1 Line feed Field Definition p 9 Query Record XX 00 to 99 074 0 IPSI 1 CONTRA 2 Cfla 3 CfCa 4 5 7 9 8 2 Sensitization Stimulus Timing Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Auto Timing 8 5 ON time 13 5 OFF time 18 5 Quantity 23 2 Checksum 25 1 Carriage return 26 1 Line feed D 74 Field Definition 9 Query Record XX 00 to 99 075 0 Manual Timing 1 Auto Timing XXXXX
2. o estie et ib sette 4 13 Tympanometry normative values 226 Hz see 4 13 Tymp screening with Reflex Tymp mode eee 4 14 Tymp screening softkey menu structure 0 4 14 AUTO S reos upto ott tede 4 15 AUTO START OBE ada cer emite did dente 4 15 BASELINE ON vrida artic qnie Re UNO IA NS PATE EVA S SE ERR QVE E E Vu dS 4 15 BASELINE ORBE abono int ias 4 16 c r 4 16 REFLEX ON RD metn ub ciere 4 16 Screenime relle x tes SCORING 4 16 Tymp screening sample 1 2 0 0 4 17 Program mode for tympanometry 4 18 Program mode softkey menu structure 2 2 4 18 Screen and diagnostic softkeys 44 000 4 18 User uci UE 4 18 Program Mode 4 18 Programming default parameters for SCREEN and DIAGNOSTIC TOG aee crosses teres agen baie fedes e bate Sur elvat e eus sh cu dien 4 19 Programming default parameters for user tests 22 1 4 20 Acoustic Reflex testin quus ean e ec tune 4 21 Reflex 5 a 4 22 Reflex Threshold softkey menu structure sese
3. 4 57 Instrument oponse e n 4 58 Softkey men Soc ota 4 58 Point format 4 58 Data Transfer Sette mete SR ed ah EP SR 4 61 angudbBe seme e Me pt e m 4 61 Test Seguente iiae 4 61 Remote Settings USES SER DE PAR ED Ve eda gast 4 62 15150 PEE 4 62 Date and D 4 62 debi 4 63 Index Appendix A Specifications PERPE 1 Appendix B TRIDNORTADINY deris dis tero Vetus Vx dd ha E EM E B 1 Appendix C Baste Problem Sowing 7 0 24 e E 1 Appendix D Remote SpecifiCalons EE ER TR YET MERE RENTA UPI M Ede D 1 Contents 4 Grason Stadler Introduction General The GSI TympStar Version 1 Middle Ear Analyzer is a technically advanced computer based admittance instrument designed to be used in a clinical or research setting The TympStar builds on the sophistication functionality and flexibility of the GSI 33 offering unparalleled testing capabilities It contains total capabilities for complete manual or automatic diagnostic testing for analy sis of middle ear function Admittance Y may be measured with a probe tone frequenc
4. inssi ii aae i nia E 4 3 ECD graphic P 4 3 lui dil fe cm 4 3 LAUD 4 3 Erasing and clearing test data oue ee tenete reper tb 4 4 Paging test data ee see ete ENVOI RR RV ASA EAR NNUS 4 5 aedes at de i ete eR i e eee esas tals 4 5 Error codes and problem reporting era op peg Ve eNews 4 5 Test PrOCOQUres T 4 6 Tympanometry Tymp 4 6 Two component tympanometry 4 7 Gradient uice ed uet t baise fea efe 4 7 Tymp Width method 4 7 Ratio Method M 4 8 Selecting gradient method ss uae ve cence o 4 8 Tymp diagnostic softkey menu structure 4 9 Automatic tympanometry test procedure sese nennen 4 9 s ouv ropes oo toda bebe dw eg 4 10 Tymp test 330270 HX o asado edi tee 4 11 B seltne 4 1 Baselme ORE ud ae Cd 4 11 Stopping the 18st rettet ee ORE YA UA 4 11 Grason Stadler Contents Manual tympanometry test 4 12 Tympanometry printout Samples gt
5. SETTINGS NRME 3 Press the VERSION softkey to display the Version Menu SELECT THE TYMPSTAR VERSION TO LAUNCH TEMPORARY PERMANENT NOTE To return to the Instrument Options menu with no version switching ac tion taken press the RETURN hardkey from the Version menu 4 64 Grason Stadler Obtaining a License Code Replacing the V1 Probe with a V2 Probe WARNING Operation 4 Press the V2 softkey The following messages will appear OBTAIN A LICENSE KEY TO LAUNCH V2 TYMPSTAR CONTACT A GSI REPRESENTATIVE WITH THE FOLLOWING CODE 0A2B3CAESD example of lock code A GSI REPRESENTATIVE WILL PROVIDE ALICENSE KEY CODE ENTER THE LICENSE KEY CODE HERE THEN PRESS THE DATA TRANSFER KEY NOTE Press the CONTINUE softkey from this screen to keep the TympStar in V1 mode 5 Press the PRINT hardkey to print out the lock code Contact a GSI representative with the lock code If a V2 upgrade is purchased a license key code and V2 probe will be provided by GSI Once you have re ceived the V2 license key and probe follow the instructions below to change the TympStar to V2 functionality To replace the TympStar probe WARNING Turn off power to the TympStar 1 Disconnect the air tubing to the brass fitting on the side of the TympStar 2 Remove the cable clamp on the side of the TympStar GSI TympStar Version 1 Reference Instruction Manual 4 65 Switching to Version 2 software Chapter 4
6. 8 5 ETF Intact Individual Softkey Commands 8 5 4 Set ETF Intact Probe Hz Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 Field Name Start of record Record type Request code Probe Tone Carriage return Line feed 8 5 2 Set ETF Intact Pressure Range Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 D 100 Field Name Start of record Record type Request code Pressure Range Carriage return Line feed Field Definition 037 0 Send 1 Query for Probe Hz value 0 226 Hz 1 678 Hz 2 1000 Hz P Field Definition pP 038 0 Send 1 Query for Pressure Range selection 0 Normal 1 Wide CR Grason Stadler 8 5 3 Set ETF Intact Pressure Rate Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Pressure Rate 6 1 Carriage return 7 1 Line feed 8 5 4 Set ETF Intact Start Pressure Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Start Pressure 6 1 Carriage return 7 1 Line feed 8 5 5 ETF Intact Ear Toggle Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Selection code 5 1 Carriage return 6 1 Line feed Remote Specifications Field Definition ZU 039 0 Send 1 Query for Pressure Rate selection 0 12 5 daPa s 1250 daPa s 2 200 daPa s 3 600 200 daPa s CR LP Field Definition 040 0 Send 1 Query
7. Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 7 9 8 8 A R Sensitization Step size Char Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 1 D 76 Field Name Start of record Request Record Record Sequence Record type Admittance Checksum Carriage return Line feed Field Name Start of record Request Record Record Sequence Record type Timebase Checksum Carriage return Line feed Field Name Start of record Request Record Record Sequence Record type step size Checksum Carriage return Line feed Appendix D Field Definition p 9 Query Record XX 00 to 99 079 0 1 8 2 0 GR Field Definition 9 Query Record XX 00 to 99 080 0 1 5 sec 1 3 0 sec 2 4 5 sec 3 6 0 sec 4 7 5 sec 5 9 0 sec 6 10 5 sec 7 12 0 sec XX Field Definition 9 Query Record XX 00 to 99 081 0 1 1 2dB 2 5dB XX CR Grason Stadler Remote Specifications 7 9 8 9 A R Sensitization Facilitator Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 2 Stimulus 9 3 Intensity 12 2 Checksum 14 1 Carriage return 15 1 Line feed 7 9 8 10 Sensitization Cursor Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 4 Cursor X value 11 4 Cursor Line 1 Y Value 15 4 Cursor Line 2 Y Value 19 2
8. Paging up down arrows Up to 26 test screens stored in memory can be printed by selecting PAGE ALL followed by PRINT Individual test results can be printed by selecting PAGE and then using the arrow key to display the test To begin printing press the PRINT hardkey Test results can be printed in graphic or tabular format Please refer to the Instrument Options section at the end of this chapter for more information If a problem is encountered during operation that causes the control processor or signal processor to shut down an alert message will appear on the screen with a code number The code number indicates the source of the problem PRINT the displayed code for reference when reporting an operational failure before attempting to RESUME testing Report repeated operational failures to a local representative or to the GSI Service Department GSI TympStar Version 1 Reference Instruction Manual 4 5 4 Test procedures Tympanometry Tymp Mode Tympanometry provides an objective means for determining the amount of mobility present within the eardrum and the ossicular chain It is however important to keep in mind the fact that the amount of mobility present within the ossicular chain may be camouflaged by a scarred or thickened eardrum Acoustic energy commonly referred to as the probe tone 226 Hz is intro duced into a hermetically sealed ear canal by means of a loudspeaker located within the probe box T
9. 418 COMPLIANCE nl iR 5 2 1 8 08 NAME ID TESTER 16 IS sec IPSI OFF AUTOMATIC RIGHT STIMULUS MARK THRESHOLO RUTO ERR MRE ERR THRESHOLO SEEK ZERO 3 Press the EAR softkey and select the right or left ear then if desired navigate through the Reflex Diagnostic softkey menu and change parameter settings for the test as required Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings Three special features are available in Reflex Threshold They are Auto Timing Mark Threshold Threshold Seek Auto Timing provides the ability to preset the stimulus timing for reflex thresh old testing This timing sequence includes the ON TIME for the stimulus presentation and the OFF TIME for measuring the recovery after the stimulus is turned off When Auto Timing is selected press and release the PRESENT hardkey to activate the Auto Timing sequence NOTE The programmed Auto Timing parameters are also used during Thresh old Seek and Auto Sequence GSI TympStar Version 1 Reference Instruction Manual 4 23 Auto timing of stimuli Minimum and maximum timing allowable for reflex threshold Manual timing of stimuli Chapter 4 The GSI Default ON TIME 15 1 5 seconds and the GSI Default OFF TIME 18 1 5 seconds The GSI default quantity QTY of presentations is 1 4 Change the ON TIME OFF TIME or Quantity of stimul
10. 500 Hz 1000 Hz 2000 Hz 4000 Hz Low Band Noise High Band Noise Broad band Noise Click External 10 Non Acoustic 11 Not used XXX 50 to 300 0 1 2 0 1 2 xxx 600 to 400 daPa 0 to 7 0 1 2 SPL XXX 35 to 120 dB Xxxxx 30800 to 30800 XXX 35 to 120 dB 4 30800 to 30800 XXX 35 to 120 dB Xxxxx 30800 to 30800 XXX 35 to 120 dB 4 30800 to 30800 XXX 35 to 120 dB 4 30800 to 30800 XXX 35 to 120 dB 4 30800 to 30800 XXX 35 to 120 dB xxxxx 30800 to 30800 0 to 7 0 NR 42 2 NR TS 3 TS XX Grason Stadler Offset 49 94 139 184 293 213 215 216 217 219 223 224 225 231 232 233 238 240 Carriage return Line Feed ETF Intact TM Chars 45 45 45 20 Field Name Start of record Record Type Record Sequence Number Patient Name Patient ID Tester Name Facility Name Probe S N Date Time Test type Test number Ear Under Test Probe Tone Start Pressure Baseline Status Gradient Status ECV CI data Number of lines Y axis scale Cursor X value Line 1 data header Line 1 cursor Y value Remote Specifications R LF Field Definition 1 Summary data record 8 Summary data record with attached XY data records 00 to 99 0 to 45 character
11. CR Field Definition p 9 Query Record XX 00 to 99 105 45 ASCII characters XX CR GSI TympStar Version 1 Reference Instruction Manual 7 9 13 Instrument Options 7 9 13 1 Offset Char 0 1 1 1 2 2 4 3 7 1 8 1 9 1 10 1 11 1 12 1 13 1 14 1 15 2 17 1 18 1 7 9 13 2 Offset Char 0 1 1 3 4 1 5 1 6 2 8 1 9 1 D 84 Print Format Command Field Name Start of record Request Record Record Sequence Record type Tymp Diagnostic Reflex Threshold Reflex Decay ETF Intact ETF Perforated ARLT A R Sensi Multiple Hz Checksum Carriage return Line feed Appendix D Field Definition 9 Query Record 00 to 99 108 0 Graphics 1 Tabular 0 Graphics 1 Tabular 0 Graphics 1 Tabular 0 Graphics 1 Tabular 0 Graphics 1 Tabular 0 Graphics 1 Tabular 0 Graphics 1 Tabular 0 Graphics 1 Tabular XX Set External Printer Settings Field Name Start of record Record type Left Column Setting Print Type Checksum Carriage return Line feed Field Definition 109 0 Left Ear 1 Right Ear 0 Color 1 Black amp White Grason Stadler 7 9 13 3 Offset Char 0 1 1 1 2 2 4 3 7 1 8 1 9 1 10 1 11 1 12 1 13 1 14 1 15 1 16 2 18 1 19 1 7 9 13 4 Offset Char 0 1 1 1 2 2 4 3 7 1 8 1 9 2 11 1 12 1 Data
12. 038 Set ETF Intact Pressure Range Used to change the Pressure range between Normal and Wide This command is only valid in the ETF Intact test mode 039 Set ETF Intact Pressure Rate Used to modify the Pressure rate parameter This command is only valid in the ETF Intact test mode 040 Set ETF Intact Start Pressure Used to modify the Start Pressure parameter This command is only valid in the ETF Intact test mode 041 ETF Intact Ear Toggle Used to toggle between Left and Right Ear This command is only valid in the ETF Intact test mode 042 Set ETF Intact Admittance Used to change the Admittance parameter This command is only valid in the ETF Intact test mode Any change that occurs due to a change in Admittance changes immediately as if the change was made navigating the menus 043 Set ETF Intact Baseline Used to modify the Baseline parameter On or Off This command is only valid in the ETF Intact test mode 044 Set ETF Intact Cursor Allows the cursor to be moved to a specified X axis position when the cursor is active and allows the user to set the Tymp peaks This command is valid in ETF Intact as long as the test is complete 045 Set ETF Intact Continue Processes continue softkey that is displayed between Tymp sweeps This is valid only when the continue softkey is displayed in ETF Intact test mode This can only be used when the continue softkey is diaplayed 046 Set ETF Perforated Pressure Max Allows selection of th
13. 082 Set A R Sensitization Facilitator Allows direct selection of the facilitator values for intensity in 1 dB steps and for the stimulus These selections will be valid depending on the current test This command is valid during an A R Sensitization test as long as a stimulus is not being presented 083 Set A R Sensitization Cursor Allows the cursor to be moved to a specified X axis position when the cursor is active This command is valid in A R Sensitization as long as a tone is not being processed and there is already data plotted 084 Set A R Sensitization Stimulus Allows selection of stimuli based on valid stimuli for the current test This command is valid during an A R Sensitization test as long as a stimulus is not being presented 085 Set A R Sensitization Intensity Allows direct selection of intensity in 1 dB steps in current valid intensity range This command is valid during an A R Sensitization test as long as a stimulus is not being presented 086 Set Multiple Hz 1 Pressure Range Used to change the Pressure range between Normal and Wide This command is only valid in the Multiple Hz 1 screen 087 Set Multiple Hz 1 Pressure Rate Used to modify the Pressure rate parameter This command is only valid on the Multiple Hz screen 1 088 Set Multiple Hz 1 Start Pressure Used to modify the Start Pressure parameter This command is only valid on the Multiple Hz screen 1 089 Set Multiple Hz 1 Delta Plot Used to ch
14. 20 dB SPL Signal to Noise Ratio gt 704 Measured with disabled probe signal and weighting for noise measurement Residual noise 25 dBA SPL Stimulus Present switch in OFF position Unwanted Acoustic Probe Signals lt 60 dBA Measured while pump is operating and probe tone is disabled Measure it with A weighted filter in SLOW Time mode The noise in normal operating mode will not affect the immittance measurement accuracy Signal separation between Ipsi and Contra channels all frequencies gt 70 dB Measured at the probes with the channel set to 90 dB Leakedsignal 20 dB SPL The radiated acoustic noise from the instrument with reflex stim off when measured at 1 meter from the instrument shall 50 dBA weighting and SLOW averaging Steady State Stimulus Initial Delay elapsed time from present bar activation to 10 stimulus amplitude 100 msec Terminal Delay elapsed time from present bar deactivation to 9096 stimulus amplitude 100 msec Risetime 7 5 2 5 msec 7 5 2 5 msec Multiplexed Stimulus Used in Reflex Threshold test mode Period data for frequencies 250 and 500 Hz Period 124 msec Stimulus on time 44 msec Stimulus off time 62 Rise and fall time 18 msec Period data for all other frequencies Period 115 msec Stimulus on time 44 msec Stimulus off time 53 msec Rise and fall time 18 msec Temporal Spec Accurac
15. 9 Query Record XX 00 to 99 027 0 226 Hz 1 678 Hz 2 1000 Hz XX GR Field Definition p 9 Query Record XX 00 to 99 028 0 1 8 2 0 7 9 3 8 Reflex Threshold Stimulus Timing Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Auto Timing 8 5 ON time 13 5 OFF time 18 5 Quantity 23 2 Checksum 25 1 Carriage return 26 1 Line feed Field Definition 9 Query Record XX 00 to 99 029 0 Manual Timing 1 Auto Timing XXXXX msec XXXXX msec XXXXX XX CR GSI TympStar Version 1 Reference Instruction Manual 7 9 3 9 Reflex Threshold Timebase Appendix D Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 030 7 1 Timebase 0 2 15 sec 1 30 sec 2 45 sec 3 60 sec 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 3 10 Reflex Threshold Step size Offset Field Name Field Definition Char 0 1 Start of record e 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 031 7 1 step size 0 1dB 1 2dB 2 5dB 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 3 11Reflex Threshold ml Scale Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 R
16. Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 8 1 Field Name Start of record Record type Request code Print Format Selections Print Format Settings Carriage return Line feed 8 15 2 Set External Printer Settings Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 8 1 Field Name Start of record Record type Request code Print Format Settings External Printer Setting Carriage return Line feed 8 15 3 Set Data Transfer Offset Char 0 1 1 3 4 1 Field Name Start of record Record type Request code GSI TympStar Version 1 Reference Instruction Manual Remote Specifications Field Definition 108 0 Send 1 Query for Print Format Settings 0 Tymp 1 Reflex Threshold 2 Reflex Decay 3 Intact 4 Perforated 5 ARLT 6 Sensi 7 Multiple Hz 0 Graphics 1 Tabular Field Definition 109 0 Send 1 Query for Print Format Settings 0 Left Column Setting 1 Print Type if Print Format Settings 0 Left Column Setting 0 Left Ear 1 Right Ear if Print Format Settings 1 Print type 0 Color 1 Black amp White LP Field Definition je 110 0 Send 1 Query for Data Transfer Settings D 127 5 1 6 1 7 1 8 1 Transfer Data Selections Transfer Data Settings Carriage return Line feed 8 15 4 Set Language Offset Char 0 1 1 3 4 1 5 1 6 1
17. Offset Char 0 1 1 3 4 1 5 1 6 3 9 1 10 1 Field Name Start of record Record type Request code Cursor Number of dots Carriage return Line feed 8 11 2 Multiple Hz 42 Continue Offset Char 0 1 1 3 4 1 5 1 6 1 Field Name Start of record Record type Request code Carriage return Line feed Field Definition ap 093 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right 2 SetHz XXX 010200 only if cursor 1 or 2 0 Position to Y axis 1 dot CR Field Definition 094 0 8 12Multiple Hz 3 Individual Softkey Commands 8 12 1 Set Multiple Hz 83 Probe Hz Offset Char 0 1 1 3 4 1 5 9 1 10 1 Field Name Start of record Record type Request code Probe Hz Carriage return Line feed Field Definition p 095 0 Send 1 Query for Admittance value XXXX 250 Hz to 2000 Hz in multiples of 50 GSI TympStar Version 1 Reference Instruction Manual D 121 8 12 2 Set Multiple Hz Cursor Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Cursor 6 3 Number of dots 9 1 Carriage return 10 1 Line feed 8 12 3 Multiple Hz 3 Continue Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Carriage return 6 1 Line feed 8 12 4 Set Multiple Hz 3 Admittance Offset Field Name
18. 1 Query for Stimulus selection 00 500 Hz 01 1000 Hz 02 2000 Hz 03 4000 Hz 04 Broad Band Noise 05 External 06 Non Acoustic D 117 Carriage return Line feed 8 9 12 Set A R Sensitization Intensity Char Offset 0 1 1 3 4 1 5 3 8 1 D 118 Field Name Start of record Record type Request code Intensity Carriage return Appendix D 07 6000 Hz E Field Definition pP 085 0 Send 1 Query for Intensity selection XXX dBHL 035 XXX depending of Stimulus GR Grason Stadler Remote Specifications 8 10Multiple Hz 1 Individual Softkey Commands 8 10 1 Set Multiple Hz 1 Pressure Range Offset 4 Field Name Field Definition Char 0 1 Start of record 1 3 Record type 086 4 1 Request code 0 Send 1 Query for Pressure Range selection 5 1 Pressure Range 0 Normal 1 2 Wide 6 1 Carriage return CR 7 1 Line feed LF 8 10 2 Set Multiple Hz 1 Pressure Rate Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 087 4 1 Request code 0 Send 1 Query for Pressure Rate selection 5 1 Pressure Rate 0 12 5 daPa s 1250 daPa s 2 200 daPa s 6 1 Carriage return CR 7 1 Line feed LF 8 10 3 Set Multiple Hz 1 Start Pressure Offset Field Name Field Definition Char 0 1 Start of record p 1 3 Record type 088 4 1 Request code 0 Send 1 Query for Start Pressure selection 5 1 Start Pressure 0 6
19. 1 3 Record type 4 1 Request code 5 1 Reflex Type 6 1 Carriage return 7 1 Line feed 8 4 2 Set Reflex Threshold Mark Threshold Offset Field Name 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Mark Line Selection 6 1 Carriage return 7 1 Line feed GSI TympStar Version 1 Reference Instruction Manual 023 0 Send 1 Query for Mark Threshold selection 0 Move Right 1 INVALID 2 Mark Line 1 3 Mark Line 2 4 NRLine 1 5 NR Line 2 LP Appendix D 8 4 3 Set Reflex Threshold Threshold Seek Offset Char 0 1 1 3 4 1 5 1 6 1 7 3 10 1 11 1 8 4 4 Set Reflex Threshold Auto Zero Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 Field Name Start of record Record type Request code Threshold Seek Parameter Type Parameter Value NOTE Field Definition 024 0 Send 1 Query for Threshold Seek selection 0 2 ON 1 OFF 2 Configure 0 Min Change 1 Start dBHL 2 Stop dBHL XXX Min Changes 2 to 80 representing 0 02 to 0 80 Start dBHL 035 dBHL to 110 dBHL Stop dBHL XXX 035 dBHL to 110 dBHL Start dBHL cannot be larger than Stop dBHL and Stop dBHL cannot be smaller than Start dBHL Carriage return Line feed Field Name Start of record Record type Request code Auto Zero Carriage return Line feed 8 4 5 Reflex Threshold Ear Toggle Offset Char 0 1 1 3 4 1 5 1 6 1 D 96 Field Name Start of r
20. 10 Press the START 39 hardkey Allow the tracing to sweep to 100 daPa then press START 44 hardkey to reverse direction Allow the tracing to sweep to 100 daPa and press the STOP hardkey The following results should be displayed graphic tracing should be at 0 5 The cavity volume C1 should be at the 0 5 The Compliance peak should be 0 5 within 5 of full scale The pressure peak daPa values should be NP No Peak Cavity volume at 0 5 mI TVMP DIAGNOSTIC 12 10 2772008 04715 pn 1 5 PRESSURE 0 5 daPa ml M 1 NP 90 5 400 200 0 200 2 NP 0 5 3 COMPLIANCE nl 0 5 eo 05 10 1 5 OFF RIGHT 22 RUTO GRADIENT EAR MORE SEQUENCE daPa Compliance and pressure peak 11 Insert the probe tip into the 2 0 cc test cavity 12 Press the START hardkey Allow the tracing to sweep to 100 daPa then press START lt hardkey to reverse direction Allow the tracing to sweep to 100 daPa and press the STOP hardkey The following results should be displayed in the same manner as above The graphic tracing should be at 2 0 The cavity volume C1 should be at the 2 0 The Compliance peak should be 2 0 within 5 of full scale The pressure peak daPa values should be NP No Peak GSI TympStar Version 1 Reference Instruction Manual 3 7 3 13 Insert the probe tip into t
21. 2 2 Record Sequence 4 3 Record type 7 45 Patient Name 52 2 Checksum 54 1 Carriage return 55 1 Line feed D 82 Appendix D Field Definition 9 Query Record 00 to 99 100 0 12 5 daPa s 1250 daPa s 2 200 daPa s GR Field Definition 9 Query Record XX 00 to 99 101 0 600 daPa 1 2 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa 5 500 daPa 6 300 daPa 7 0 daPa 8 300 daPa XX Field Definition p 9 Query Record 00 to 99 102 45 ASCII characters XX OR Grason Stadler 7 9 12 2 Offset 0 1 1 1 2 2 4 3 7 45 52 2 54 1 55 1 7 9 12 3 Offset Char 0 1 1 1 2 2 4 3 7 45 52 2 54 1 55 1 7 9 12 4 Offset Char 0 1 1 1 2 2 4 3 7 45 52 2 54 1 55 1 Patient ID Field Name Start of record Request Record Record Sequence Record type Patient ID Checksum Carriage return Line feed Tester Name Field Name Start of record Request Record Record Sequence Record type Tester Name Checksum Carriage return Line feed Facility Name Field Name Start of record Request Record Record Sequence Record type Facility Name Checksum Carriage return Line feed Remote Specifications Field Definition p 9 Query Record 00 to 99 103 45 ASCII characters XX CR Field Definition 9 Query Record 00 to 99 104 45 ASCII characters XX
22. 335 357 358 374 433 437 439 445 446 Remote Specifications PRESSURE MAXIMUM REACHED This is a valid status message which is sent when the maximum pressure selected in an ETF perforated test is reached EUSTACHIAN TUBE OPENED This is a valid status message which is sent when the Eustacian tube is opened during an ETF perforated test MANUAL MODE PRESSURE MAXIMUM REACHED This is a valid status message which is sent when the maximum pressure selected in a Manual ETF perforated test is reached MANUAL MODE EUSTACHIAN TUBE OPENED This is a valid status message which is sent when the Eustacian tube is opened during a Manual ETF perforated test PRESSURIZING TO START PRESSURE This is a status message displayed when the system pressurizes in a Tymp type test to the selected start pressure EXCEEDED TIMEBASE OFF TIME MODIFIED The selection of a new ON time in a Set Timing Parameter command has caused the current OFF time to be decreased so that the total ON and OFF time fits on the current timebase EXCEEDED TIMEBASE ON OFF TIMES MODIFIED The selection of a new timebase in a Set Timing Parameter command has caused the ON and OFF times to be decreased so that the total ON and OFF time fits on the new timebase NOTE SITE ALTITUDE DEFAULTED TO 0 REENTER IF NECESSARY The site altitude was defaulted to 0 feet because it could not be read properly from the memory NOTE STIMULUS NOT AVAILABLE CONTACT SERVICE A Stimulus
23. 45 45 9 20 Field Name Start of record Record Type Record Sequence Number Patient Name Patient ID Tester Name Facility Name Probe S N Date Time Test type Test number Ear Under Test Auto Sequence ProbeTone Timebase Number of lines Y axis scale Cursor X value Line 1 data header Line 1 cursor Y value Admittance status Stimulus Ear status Zero field On Time Zero field Appendix D Field Definition 1 Summary data record 8 Summary data record with attached XY data records XX 00 to 99 0 to 45 characters for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters 9 characters for unused characters XX XX xm for xm if 24 Hour time format 6 Reflex Decay 1 to 9 and Ato L Left Ear R Right Ear 0 Off 1 On 0 226Hz 1 678 2 2 Not used 3 gt 38 Not used 15000 to 60000 msec 0 1 or2 0 04 to 16 1 08 32 2 12to 48 16 to 64 4 20 80 04to 16 08 to 4 32 7 12to 4 48 16to 4 64 20to 80 XXXXX 0 to 60000 msec if Cursor not used 11 30800 to 30800 0 1 8 2 0 0 IPSI 19 Steady CONTRA XXxxx 1000 to 540
24. A user sub menu will be displayed Pressing the SCREEN or DIAGNOSTIC softkey displays the screening or di agnostic softkey menu across the bottom of the screen with a PROGRAM MODE status message as shown in the example below hino SCREENING TEST 1 18 23 2800 95 10 PRESSURE daPa Ci daPa mmho 400 200 e 200 REFLEX 1 1000 Hz 6 6 ROMITTRNCE ATT 92 05 00 9 5 1 0 1 5 400 200 2 PROGRRM MODE USER 1 NORMAL 600 200 200 OFF RIGHT P RANGE P RATE START GRADIENT EAR MORE daPa daPa s daPa System in PROGRAM MODE Test parameters can now be selected from the softkey menu to modify their default settings Once all the test parameters have been selected pressing the RETURN hardkey returns the display to the PROGRAM MODE sub menu Pressing the STORE softkey stores the selected parameters as defaults for fu ture screening or diagnostic tests performed by that user The STORING DATA status message will be displayed Press the TYMP or other test mode hard key to return from the Program Mode to the Test Mode with the new test parameter defaults Grason Stadler Acoustic Reflex testing Operation The acoustic reflex consists of a response by one or more middle ear muscles to suprathreshold acoustic stimulation of the auditory pathway To elicit an acoustic reflex an acoustic stimulus pure tone or noise is presented to the ear canal by a probe or earphone
25. Not used External 10 Not used 11 6000 Hz XXX 35 to 120 dB if Stimulus Ear Ipsi or Contra Not used 500 Hz 1000 Hz 2000 Hz 4000 Hz Not used Not used Broad band Noise Not used External 10 Not used 11 6000 Hz if Stimulus Ear Ipsi or Contra xxx 600 to 400 daPa 0 to 7 OONDOARWNM O ll OONDOARWN O HL 1 HL 2 SPL XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB xxxxx 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XX GSI TympStar Version 1 Reference Instruction Manual 49 94 139 184 193 213 215 216 217 219 223 224 225 231 232 233 238 240 1 Carriage return 1 Line Feed Multiple Frequency Screen 1 Field lt 1 Start of record 1 Record Type 2 Record Sequence Number 45 Patient Name 45 Patient ID 45 Tester Name 45 Facility Name 9 Probe S N 20 Date Time 2 Test type 1 Test number 1 Ear Under Test 2 ProbeTone 4 Start Pressure 1 Baseline Status 1 Gradient Status 6 ECV C1 data 1 Number of lines 1 Y axis scale 5 Cursor X value 2 Line 1 data header 6 Line 1 cursor Y value Appendix D E Field D
26. PRESSURE JaPa EARCANAL VOLUME daPa i qum P n 1 a8 200 0 200 TyMP 2 las 80 95 1 0 LS ee 400 200 200 PROGRAM MODE OIAGNO RT 226 NORMAL AUTO PROBE RONIT P RRNGE ERR MORE SEQUENCE Hz TRNCE daPa System in PROGRAM MODE Test parameters can now be selected from the softkey menu to modify their default settings Once all the test parameters have been selected pressing the RETURN hardkey returns the display to the PROGRAM MODE sub menu SCREEN DIAGNOSTIC USER 2 USER 3 STORE Pressing the STORE softkey stores the selected parameters as defaults for fu ture tests The STORING DATA status message will be displayed Press the TYMP or other test mode hardkey to return from the Program Mode to the Test Mode with the new test parameter defaults GSI TympStar Version 1 Reference Instruction Manual 4 19 Programming default parameters for user tests Chapter 4 When the system is in the Program Mode select the USER softkey for which default screening or diagnostic test parameters will be defined SCREEN DIAGNOSTIC USER 1 USER 2 USER 3 STORE Press the USER 1 USER 2 or USER 3 softkey to pro USER 1 gram individualized test parameters that will only be de m faults for the specified user Select the USER NUM SCREEN DIAGNOSTIC BER softkey followed by SCREEN or DIAGNOSTIC
27. Remote Specifications 0 YES 12 NO 0 YES 12 NO XX CR Field Definition p 9 Query Record XX 00 to 99 114 0 300 1 600 2 1200 3 2400 4 4800 5 9600 6 19 200 0 NONE 1 ODD 2 EVEN 0 1 Bit 1 2 Bits 0 1 OFF 0 GSI TYMPSTAR 1 GSI 33 XX Field Definition 9 Query Record XX 00 to 99 115 0 MM DD YYYY 1 DD MM YYYY 2 YYYY MM DD 0 12 Hour 1 24 Hour XX 11 12 1 7 9 13 8 Offset 0 1 1 1 2 2 4 3 7 2 9 2 11 4 15 2 17 1 18 1 7 9 13 9 Offset Char 0 1 1 1 2 2 4 3 7 2 9 2 11 2 13 1 14 1 D 88 Carriage return Line feed Date Command Field Name Start of record Request Record Record Sequence Record type Month Day Year Checksum Carriage return Line feed Time Command Field Name Start of record Request Record Record Sequence Record type Hour Minute Checksum Carriage return Line feed Appendix D E Field Definition 9 Query Record XX 00 to 99 116 Field Definition A 9 Query Record XX 00 to 99 117 XX XX XX E Grason Stadler Remote Specifications 8 Input Record Formats 8 1 Single Key Commands Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 001 4 1 Request code 0 Send 1 Not used 5 2 Function keycode Function Keycodes 00 26 0
28. e gt e 2 2 2 CAUTION Preface CAUTIONS ELECTRICAL POWER Electrical Shock Hazard Do not remove covers Refer servicing to quali fied personnel only Make sure the power cord plug is proper for the power outlet into which it will be plugged I e plug in a 120V rated power cord into a 120V outlet only TympsStar test results data is not stored when the power is turned off To maintain test results data in the presence of power brown outs or tempo rary power interruptions an Uninterruptable Power Supply UPS must be used CAUTION CONNECTIONS Please be careful to reconnect cables in their proper locations CAUTIONS PREVENTIVE MAINTENANCE Preventative maintenance does not require access to the interior of the instrument and may be performed by the user For this device preventa tive maintenance consists of periodically cleaning and inspecting the ex terior of the instrument Periodic electrical safety testing is recommended It is recommended a schedule be established for these purposes with at least an annual cleaning calibration and safety testing Cleaning consists of removing all dust from the exterior surface of the system with a soft brush or cloth Use a brush to dislodge any dirt on or around the connectors and panel edges Remove any dirt with a soft cloth CAUTIONS GENERAL If the system is not functioning properly do not operate it until all neces sar
29. navigate through the softkey menus shown above and change parameter settings for the test as required 5 Holding the probe in hand obtain a hermetic seal at the entrance to the ear canal The Tymp test will begin as soon as a seal is obtained The pressure will sweep from the previously selected START daPa Pressure toward ambient pressure 0 daPa The pressure sweep will continue only as far as necessary for the tymp to reach its peak point and return to the baseline When AUTO START is off the lt START hardkeys are used to initiate pressurization and the sweep Ear canal volume is measured at the Start Pressure and is recorded in real time View the ongoing test results on the graphic display area and on the pressure and compliance meters nT TVMP SCREENING TEST 8 18 28 2000 02 17 1 5 PRESSURE daPa EARCANAL UOLUME 1 0 ml 1 8 rr 15 0 3 400 200 200 GRADIENT 115 daPa REFLEX 1 1000 Hz YES COMPLIANCE nl 0 5 T T T 1 0 0 9 5 0 0 0 5 L8 1 5 NAME 10 STER 400 200 2 NM M daPa 600 200 200 WIDTH RIGHT P RANGE P RRTE START GRADIENT EAR MORE daPa daPa s daPa Tymp data is automatically re scaled upon completion of the test With BASELINE ON the compliance value at start pressure is labeled EAR CANAL VOLUME Numeric values for compliance peak ml pressure peak daPa and gradient appear as summary data at th
30. 060 Set Reflex Decay Stimulus Allows selection of stimuli based on valid stimuli for the current test This command is valid during a Reflex Decay test as long as a stimulus is not being presented 061 Set Reflex Decay Intensity Allows direct selection of intensity in 1 dB steps in current valid intensity range This command is valid during a Reflex Decay test as long as a stimulus is not being presented 062 Set ARLT Stimulus Ear Allows the Stimulus ear parameter to be selected remotely This command is valid in the ARLT test mode 063 Set ARLT Stimulus On Time Allows direct selection of the On Time parameter in msec under the constraints of the defined increments and range for the test This command is valid in the ARLT test mode as long as a stimulus is not being presented 064 Set ARLT Auto Zero Used to change the Auto Zero parameter ON or OFF This command is valid in the ARLT test mode 065 Set ARLT ml Scale Used to change the scale of the Reflex plot This command is valid in the ARLT test mode 066 ARLT Ear Toggle Used to toggle between Left and Right Ear This command is only valid in the ARLT test mode 067Set ARLT Admittance Used to change the Admittance parameter This command is only valid in the ARLT test mode Any change that occurs due to a change in Admittance changes immediately as if the change was made navigating the menus 068 Set ARLT Timebase Allows direct selection of timebase Instead of using arrows like the softkey
31. 08 Click 09 External 10 Non Acoustic Checksum XX Carriage return CR Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 61 Appendix D 7 9 3 15 Reflex Threshold Intensity Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 036 7 3 Intensity XXX dBHL 10 2 Checksum XX 12 1 Carriage return CR 13 1 Line feed LF 7 9 4 Intact Individual SoftKey Commands 7 9 4 1 ETF Intact Probe Hz Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Probe Tone 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 4 2 ETF Intact Pressure Range Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Pressure Range 8 2 Checksum 10 1 Carriage return 11 1 Line feed D 62 Field Definition 9 Query Record XX 00 to 99 037 0 226 Hz 1 678 Hz 2 1000 Hz XX CR LP Field Definition pP 9 Query Record XX 00 to 99 038 0 Normal 1 Wide XX GR Grason Stadler 7 9 4 3 Intact Pressure Rate Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Pressure Rate 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 4 4 ETF Intact Start Pressure Offset F
32. 400 TIMING ON 1 5 OFF 1 5 00 NAME 10 TESTER 46 MRNURL MODE 15 sec IPSI OFF AUTOMATIC RIGHT STIMULUS THRESHOLD RUTO EAR MORE ERR THRESHOLO SEEK ZERO 3 Press the EAR softkey to toggle between the right and left ear then if desired navigate through the Reflex Diagnostic softkey menu and change parameter settings for the test as required Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings STIMULUS EAR MARK THRESHOLD THRESHOLD SEEK AUTO ZERO EAR MORE ZN pst CONTRA CONTRA EXIT MARK MARK NR NR ON CONFIGURE MANUAL LEFT STEADY PULSED LINE1 LINE2 LINE1 LINE2 MIN START STOP EXIT CHANGE dBHL dBHL FT 0 02 SET 70 SET SET CDN ERU Y gm Y STIMULUS TIMING TIMEBASE mi MORE MANUAL TIMING AUTO TIMING SCALE 0 16 0 32 0 48 0 64 0 80 ON TIME OFF TIME y SET SET GSI TympStar Version 1 Reference Instruction Manual QTY EXIT Y SET Reflex threshold summary 4 32 Chapter 4 4 Select the test stimulus by depressing the STIMULUS hardkey Select the desired intensity by depressing the INTENSITY hardkey 5 Press MANUAL hardkey to pressurize Manual the ear canal to dynamic compliance peak pressure or to 0 daPa if the previous tymp Hold Stop data is unavailable The word MANUAL will appear on the screen b d set gt 6 Fine tune the pressure if nec
33. 7 1 8 1 Field Name Start of record Record type Request code Language Settings Language Carriage return Line feed 8 15 5 Set Test Sequence Setting 8 15 5 1 Offset Char 0 1 1 3 4 1 5 1 6 1 D 128 Appendix D 0 Tymp 1 Reflex Threshold 2 Reflex Decay 3 Intact 4 Perforated 5 ARLT 6 Sensi 7 Multiple Hz 8 Clear Test if Print format selection 00 07 test modes 0 Summary Data 1 Summary Graphics if Print format selection 08 External Printer 0 Manual 1 Auto Field Definition 111 0 Send 1 Query for Language Settings 0 LCD amp Printer 1 Keyboard 0 English 1 French 2 German 3 Spanish 4 ltalian CR Set Test Sequence Setting Reflex Threshold Field Name Start of record Record type Request code Reflex Threshold Switch 500 Hz Field Definition p 112 0 Send 1 Query for Test Sequence Settings 0 ON 1 OFF 0 5 12 NO Grason Stadler 10 11 12 13 14 15 8 15 5 2 Offset 10 12 13 1 3 1 1000 Hz 2000 Hz 4000 Hz LB Noise HB Noise BB Noise Stimulus Ear Carriage return Line feed Remote Specifications 0 YES 12 NO 0 YES 12 NO 0 YES 12 NO 0 YES 1 2 NO 0 YES 12 NO 0 YES 12 NO 0 IPSI 1 CONTRA 2 IPSI CONTRA CR Set Test Sequence
34. EU Authorized Representative Return to Authorized Representative Hm o Consult Operating Instructions 0 Patient Response Switch T 0 CA Grason Stadler lii Preface Safety Considerations Warning Accessory equipment connected to the analog and digital interfaces must be certified to the respective IEC standards IEC950 for data processing or IEC 60601 1 for medical equipment Furthermore all configurations shall comply with the system standard IEC 60601 1 1 Everyone who connects additional equipment to the signal input or signal output port configures a medical system and is therefore responsible that the system complies with the requirements of the system standard IEC 0601 1 1 If in doubt consult the technical service department or your local representative General safety precautions must be followed when operating electical equip ment Failure to observe these precautions could result in damage to the equip ment and injury to the operator or patient The employer should instruct each employee in the recognition and avoidance of unsafe conditions and the regulations applicable to his or her work environ ment to control or eliminate any hazards or other exposure to illness or injury It is understood that safety rules within individual organizations vary If a conflict exists between the material contained in this manual and the rules of the organization usi
35. Miz erator to scroll across each line of data and select the intensity values determined to be the threshold Press the MARK THRESHOLD softkey Use the arrow key to move from the top left to the bottom right tracing Press the MARK LINE 1 softkey when the cursor line is at the desired threshold value for Line 1 An Asterisk will appear Grason Stadler Threshold Seek Operation next to this tracing Continue to press the right arrow key to move to the desired threshold value for line 2 An asterisk will appear next to this tracing Press the EXIT softkey when finished Use NR LINE 1 or NR LINE 2 when no reflex threshold is measurable NOTE Mark Threshold is available during testing once data appears on the dis play It is also available in the PAGE mode It is possible to modify the Mark Threshold selection at any time Threshold Seek automates the sequence of THRESHOLD SEEK button presses used to arrive at reflex threshold values and also automates the marking of reflex threshold values To configure this function it is necessary to CHANGE BML aE set the intensity range for the stimulus pre sentation This includes the START dBHL and the STOP dBHL The Minimum Change parameter is used to determine how to Mark the threshold value The factory default pid ids settings are MIN START STOP EXIT Minimum Change 0 02 CHANGE dBHL dBHL START dBHL 70 dBHL d n eb STOP dBHL 95 dBHL c
36. PC 3 2 Interface Connections The GSI TympStar Remote interface connector is a standard 9 pin D style female connector 3 21 DCE to DTE Interface Connection Pin Assignments Left arrow lt and Right arrow gt denote the direction of the signal TXD Transmitted Data RXD Received Data RTS Request to Send CTS Clear to Send GSI TympStar Version 1 Reference Instruction Manual D 1 Appendix D GS TympStar 9 Remote Device 9 pin DCE DTE TXD BA TXD BA RXD BB RXD BB RTS CA RTS CA CTS CB CTS CB GND AB GND AB 3 3 Interface Configuration The interface configuration requires that 7 data bits be used This is fixed and not modifiable by the user The Baud Rate Parity Number of Stop bits and RTS CTS handshaking are modifiable in Instrument Options under the Remote Settings option The baud rate parity and stop bits must match that of the remote device or else there can be no communication between the GSI TympStar and the remote device Baud rate can be set to 300 600 1200 2400 4800 9600 or 19200 Available Parity settings are None Even and Odd Number of Stop bits can be set to 1 or 2 RTS CTS handshaking can be enabled or disabled 3 4 RTS CTS Hardware Handshaking The Remote Device may use the RTS signal to allow or inhibit data transmission from the GSI TympStar to the Remote Device when the RTS signal is set true asserted by the Remote Device the GSI TympStar is enable
37. XXXXX XXXXX XX Grason Stadler 7 9 8 3 Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 1 7 9 8 4 A R Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 1 Remote Specifications Sensitization Auto Zero Field Name Start of record Request Record Record Sequence Record type Auto Zero Checksum Carriage return Line feed Sensitization ml Scale Field Name Start of record Request Record Record Sequence Record type ml Scale Checksum Carriage return Line feed 7 9 8 5 A R Sensitization Ear Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 Field Name Start of record Request Record Record Sequence Record type Ear Checksum Carriage return Line feed Field Definition 9 Query Record 00 to 99 076 0 Automatic 1 Manual LP Field Definition 9 Query Record XX 00 to 99 077 0 04 to 16 1 08 to 32 2 12 to 48 3 16 to 64 4 20 to 80 5 04 to 16 08 to 32 12 to 48 8 16 to 64 20 to 80 XX Field Definition p 9 Query Record XX 00 to 99 078 0 Left 1 Right XX CR GSI TympStar Version 1 Reference Instruction Manual 7 9 8 6 Sensitization Admittance Char Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 1 11 7 9 8 7 Sensitization Timebase
38. electronic components wiring and other elements of electronic devices Follow all of your respective local laws and regulations for the disposal of batteries and any other parts of this system Check the Grason Stadler website for recommended instructions and addresses for proper return or disposal of electronic wastes relating to Grason Stadler products in Europe and other localities The contact information for the WEEE In Europe Grason Stadler A S Kongebakken 9 2765 Smgrum Denmark CRV no 21113379 Grason Stadler vii Contents Preface Introduction Installation uir 1 Conventions used in this manual sese Hu TEOS MeL li Eguipiueut Symbols eiere pe venus eum Cu Dv ii Safety ConsIderallgnss sneon T EINE ED MON TEE E AENEAN iv Product Warratiby E d E Recycling Product 1 E e Eae ond 1 1 Equipment connections and options eese 1 2 Mismo RO T 1 2 Instrument controls 5 2 oni aec i 1 3 Hardkeys and SORKeys onion apa 1 3 Rotary pressure Control 1 3 Test modes and menu navigation essere nennen nennen 1 3 Changing parameter e
39. 1 1 2dB 2 5dB CR Field Definition As 070 0 Send 1 Query for Timebase selection XX 2 50 CR Grason Stadler 8 8 10 Offset 8 8 11 Offset 8 8 12 Offset Set ARLT Cursor H Field Name Char 1 Start of record 3 Record type 1 Request code 1 Cursor 3 Number of dots 1 Carriage return 1 Line feed Set ARLT Stimulus Field Name Char 1 Start of record 3 Record type 1 Request code 2 Stimulus 1 Carriage return 1 Line feed Set ARLT Intensity Field 1 Start of record 3 Record type 1 Request code Intensity 1 Carriage return Remote Specifications Field Definition 071 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right XXX 010200 only if cursor 1 or 2 0 Position to Y axis 1 dot CR Field Definition 072 0 Send 1 Query for Stimulus selection 00 Unused 01 500 Hz 02 2 1000 Hz 03 2000 Hz 04 4000 Hz 05 Low Band Noise 06 High Band Noise 07 Broad Band Noise 08 Click 09 External Field Definition 073 0 Send 1 Query for Intensity selection XXX dBHL 035 XXX depending of Stimulus GSI TympStar Version 1 Reference Instruction Manual D 113 Appendix D 8 9 Sensitization Individual Softkey Commands 8 9 1 Set A R Sensitization Stimulus Ear Offset Field Name
40. 1 225 6 231 1 232 1 233 5 238 2 240 6 246 1 247 1 248 1 249 6 255 4 259 1 260 3 263 2 265 1 266 1 Facility Name Probe S N Date Time Test type Test number Ear Under Test Probe Tone Start Pressure Baseline Status Gradient Status ECV CI data Number of lines Y axis scale Cursor X value Remote Specifications XXXXXXXXXXX 0 to 45 characters for unused characters XXXXXXXXX 9 Characters for unused characters XX XX XM for xm if 24 Hour time format 11 Multiple Frequency Screen 1 to 9 and A to Q L z Left Ear R Right Ear 0 Not used 1 Not used 2 Not used 3 38 Frequency See Note xxx 600 to 400 daPa 0 Off 0 Off Xxxxx 30800 to 30800 0 or 1 0 0 5 to 1 5 1 0 5 to 3 0 2 0 5 to 5 0 1 0 to 7 0 4 1 0 to 9 0 5 2 5 to 15 0 6 5 0 to 25 0 7 5 0 to 435 0 xxxx 600 to 400 daPa ___ if Cursor not used Line 1 data header 1 Line 1 cursor Y value 4 30800 to 30800 if Cursor not used Admittance status 0 B 2 0 Pressure Range status 0 Normal 1 Wide 0212 5 daPa sec 1250 daPa sec 2 200 daPa sec Pressure Rate status 3 Not used Peak Compliance data 30800 to 30800 Peak Pressure data xxx 600 to 400 daPa Sweep Direction status 0 Positive to negative 1 Negative to positive Gradient data
41. 1 2dB 2 5dB CR Field Definition p 058 0 Send 1 Query for ml Scale selection 0 4 04 to 16 1 08 to 32 2 12 to 48 3 16 to 64 4 20 to 80 04 to 16 6 08 to 32 12 to 48 16 to 64 9 20 to 80 Field Definition 059 0 Send 1 get cursor value Grason Stadler 8 7 11 Offset 8 7 12 Offset 1 3 Number of dots 1 Carriage return 1 Line feed Set Reflex Decay Stimulus Field Name Char 1 Start of record 3 Record type 1 Request code 2 Stimulus 1 Carriage return 1 Line feed Set Reflex Decay Intensity Field Name Char 1 Start of record 3 Record type 1 Request code Intensity 1 Carriage return 1 Line feed GSI TympStar Version 1 Reference Instruction Manual Remote Specifications 0 Move Cursor Left 1 Move Cursor Right XXX Oto 200 only if cursor 1 or 2 0 Position to Y axis 1 dot CR Field Definition 060 0 Send 1 Query for Stimulus selection 00 250 Hz 01 500 Hz 02 1000 Hz 03 2000 Hz 04 4000 Hz 05 Low Band Noise 06 High Band Noise 07 Broad Band Noise 08 Click 09 External LP Field Definition pP 061 0 Send 1 Query for Intensity selection XXX dBHL 035 XXX depending of Stimulus D 109 Appendix D 8 8 ARLT Individua
42. 1 Reference Instruction Manual 1 3 Chapter 1 Pressing the softkeys displayed across the bottom of the LCD allows the user to navigate through the Tymp Diagnostic parameter menus diagrammed below GSI default softkey selections are circled on menu diagrams The first level of parameter menu selections includes AUTO SEQUENCE P RANGE START GRADIENT EAR and MORE First level P RANGE START GRADIENT EAR MORE SEQUENCE daPa daPa WIDE 600 400 200 MORE TYMP WIDTH RATIO D LEFT daPa ml 500 300 300 MORE Second level BASELINE MORE Default selection DIAGNOSTIC TEST 2 1271572000 92123 pm 1 6 PRESSURE EARCANAL VOLUME daPa nl 1 0 pp r r r LINE d 1 480 200 200 TYMP 2 TYMP 3 8 5 core ince 0 8 9s eo NRME 10 STER 400 200 First level npn NORMAL AUD KIHI irst level 8010 P RRNGE START GRADIENT EAR WORE SEQUENCE daPa daPa A second level of menus can be displayed by pressing the MORE softkey and includes P RATE BASELINE and MORE jal DIAGNOSTIC TEST 2 1271572000 92124 ph 1 5 EARCANAL VOLUME 1 0 1 200 TyMP 2 TYMP 3 0 5 0 0 400 200 8 200 daPa 50 0 P RRTE BASEL INE MORE daPa s The MORE softkey is used to toggle between the top and lower levels of menus whi
43. 2 5 Ohms Standard 9 pin RS232C serial port for interfacing with outside computer ____ Funtin Signallve Impedance Pin E RXD DCE output 8 VDC output 300 Ohm 8 CTS DCE output 8 VDC output 300 Ohm TXD DCE input 30 VDC input 5 KOhm 2 3 RTS DCE input 30 VDC input 5 KOhm SIG_GND Signal Ground 1122 ae MUNI QUERN Tae Standard VGAport for external monitor Pin Funetion Signal level 1 Rea 07 0 7 Vp 2 Horizontal Sync 5 Vp p 30kHz to 80kHz 2 3 10 13 5 Vp p 55Hz to 90 Hz 4 9 11 Unused 12 15 NOTE A 226 Hz Y tympanogram is displayed on the LCD screen in a 1 1 aspect ratio and on the external VGA monitor in a 1 4 1 aspect ratio The Pressure horizontal axis appears to be stretched out by 40 on the VGA monitor GSI TympStar Version 1 Reference Instruction Manual A 7 Electrical Appendix A Standard PS 2 keyboard port for external Keyboard Signal level 5 KOhm 5 VDC input 5 KOhm 5 KOhm output output Signal level STROBE 45 Ohm 45 Ohm 4 NS ae eee CS SVC output 4S Ohm L 16 OS VDC output 45 Ohm SEL IN 18 19 Ground Ground 20 21 22 23 24 25 The following apply to the TympStar system 1 Class 1 Medical Equipment 2 Type B Medical Equipment 3 IPXO ingress of water ordinary equipment 4 Equipment n
44. 2 Record Sequence XX 00 to 99 4 3 Record type 048 7 4 Cursor X value XXXX 11 4 Cursor Y Value XXXX 600 to 400 15 2 Checksum XX 17 1 Carriage return CR 18 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 65 7 9 5 4 Perforated Ear Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Ear 8 2 Checksum 10 1 Carriage return 11 1 Line feed Appendix D Field Definition p 9 Query Record XX 00 to 99 048 0 Left 1 Right XX CR E 7 9 6 Reflex Decay Individual SoftKey Commands 7 9 6 1 Reflex Decay Probe Hz Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Probe Tone 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 6 2 Reflex Decay Stimulus Ear Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Reflex Type 8 2 Checksum 10 1 Carriage return 11 1 Line feed Field Definition 9 Query Record XX 00 to 99 050 0 226 Hz 1 678 Hz XX CR Field Definition p 9 Query Record XX 00 to 99 051 0 IPSI 1 CONTRA Grason Stadler Remote Specifications 7 9 6 3 Reflex Decay Stimulus On Time Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 5 Parameter value
45. 3 Remove the two retaining screws that secure the probe connector to the TympStar 4 Pull the connector straight out and away from the side of the TympStar chassis Reverse this sequence to connect the new Version 2 probe to the ipo Con X tact aGSI representative to have the removed probe returned to GSI 1 Press the V2 softkey from the Version menu The following messages will appear SELECT THE TYMPSTAR VERSION TO LAUNCH TEMPORARY PERMANENT OBTAIN A LICENSE KEY TO LAUNCH V2 TYMPSTAR CONTACT GSI REPRESENTATIVE WITH THE FOLLOWING CODE 0A2B3CAESD example of lock code GSI REPRESENTATIVE WILL PROVIDE A LICENSE KEY CODE ENTER THE LICENSE KEY CODE HERE THEN PRESS THE DATA TRANSFER KEY Using an external keyboard type in the license key code as indicated by the on screen instructions Press the DATA TRANSFER hardkey The message SWITCHING TO AV2 INSTRUMENT WAITING FOR WARMSTART will appear The system will then reboot and reinitialize as a V2 TympStar Grason Stadler Appendix The GSI TympStar Version 1 meets or exceeds the following standards fications for aural acoustic admittance instruments IEC 1027 1991 03 ANSI 53 39 1987 ANSI 53 6 1996 ANSI 53 7 1995 IEC 645 1 1992 IEC 126 1973 also BS 6111 1981 BS ISO 389 2 1994 Y2K Compliant UL 2601 1 Part 1 General Requirements for Safety CSA C22 2 No 601 1 M90 Canada C CE Mark per Medical Dev
46. 3 data header Line 3 cursor Zero field Zero field Zero field Peak Compliance data Peak Pressure data Zero field Zero field Checksum Carriage return Line Feed ETF Perforated TM Chars Field Name Start of record Record Type Record Sequence Number Appendix D 1 50 daPa sec 2 200 daPa sec 3 600 200 daPa sec 30800 to 30800 Peak XXX 600 to 400 daPa if no Peak 0 positive to negative 1 negative to positive L2 30800 to 30800 if Cursor not used 4 30800 to 30800 if no Peak 600 to 400 daPa if no Peak L3 V value xxxxx 30800 to 30800 E if Cursor not used 4 30800 to 30800 ifno Peak 600 to 400 daPa if no Peak CR Field Definition 1 Summary data record 8 Summary data record with attached XY data records XX 00 to 99 Grason Stadler Remote Specifications 4 45 Patient Name 0 to 45 characters for unused characters 49 45 Patient ID 0 to 45 characters for unused characters 94 45 Tester Name 0 to 45 characters for unused characters 139 45 Facility Name XXXXXXXXXXX 01 45 characters for unused characters 184 9 Probe S N 9 characters for unused characters 193 20 Date Time XX XX xm
47. 336 6 342 5 347 5 352 5 357 5 362 2 364 1 365 1 7 17 ARLT Offset Chars 0 1 1 1 2 2 4 45 49 45 94 45 139 45 184 9 193 20 213 2 215 1 216 1 217 2 219 5 224 1 225 1 D 36 Number of traces Intensity unit Trace 1 intensity Trace 1 amplitude 5096 decay time Zero field Zero field Zero field Checksum Carriage return Line Feed Field Name Start of record Record Type Record Sequence Number Patient Name Patient ID Tester Name Facility Name Probe S N Date Time Test type Test number Ear Under Test Probe Tone Timebase Number of lines Y axis scale Appendix D 0 or 1 0 1 2 SPL 35 to 120 dB 30800 to 30800 Xxxxx 1000 to 54000 msec NA if value unavailable NO 150 point not found XX CR Field Definition 1 Summary data record 8 Summary data record with attached XY data records XX 00 to 99 XXXXXXXXXXX 0 to 45 characters for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters 9 characters for unused characters XX XX xm for xm if 24 Hour time format 7 ARLT 1 to9 and Ato L Left Ear R Right Ear 0 226Hz xxxxx 500 to 2000 0 1 or2 0 04to 16 1 08
48. 500 1 10 1 45000 2000 40000 2000 0 38000 2000 1 10 1 60000 2000 54000 2000 0 52000 2000 1 10 1 NOTE GSI TympStar Version 1 Reference Instruction Manual The sum of the On time and Off Time cannot be greater than 90 of the timebase and the ON time cannot be 0 8 4 9 Offset 8 4 10 Offset 8 4 11 Offset Set Reflex Threshold Timebase Field Name Char 1 Start of record 3 Record type 1 Request code 1 Timebase 1 Carriage return 1 Line feed Set Reflex Threshold Step size Field Name Char 1 Start of record 3 Record type 1 Request code 1 step size 1 Carriage return 1 Line feed Set Reflex Threshold ml Scale Field Name Char 1 Start of record 3 Record type 1 Request code 1 ml Scale 1 Carriage return 1 Line feed Appendix D Field Definition 030 0 Send 1 Query for Timebase selection 0 15 sec 1 30 sec 2 45 3 60 sec CR LF Field Definition p 031 0 Send 1 Query for Step Size selection 0 1dB 1 2dB 2 5dB CR Field Definition p 032 0 Send 1 Query for ml Scale selection 0 04 to 16 1 08 to 32 2 12 to 48 3 4 16 64 4 20 to 80 04 to 16 08 to 32 7 12 to 48 8 16 to 64 20 to 80 Grason Stadler 8 4 12 Set Reflex Threshold Click Rate Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 Clic
49. 9 Chapter 2 2 Turn the TympStar and printer on Anytime the external printer is connected and turned the TympStar will automatically direct printing to the external printer To redirect printing to the internal printer turn the external printer off or disconnect it Setting external printer parameters To setthe external printer parameters 1 Press the ETF hardkey to select the Tymp Reflex Etf Special ETF test mode then press the RE E TURN hardkey to display sub menu pum re J INTACT PERF INSTRUMENT PROGRAM TM TM OPTIONS MODE daPa ERRCRNRL VOLUME dafa nmi 00 400 200 0 200 4 400 en TYMP 3 INSTRUMENT PROGRRM OPTIONS MODE PRESSURE daPa 1 600 400 200 00 400 200 0 200 946 400 TYMP 2 TYMP 33 COMPLIANCE S 06 95 Le 15 0 5 E DATA TRANSFER LRNGURGE ST REMOTE SETTINGS SETTINGS play the PRINT FORMAT softkey selection 3 Press the PRINT FORMAT softkey and then the MORE softkey to display the 2 10 Grason Stadler Installation EXTERNAL PRINTER SETUP softkey selection 4 PresstheEXTERNALPRINTERSETUPsoftkeytodisplaytheExternalPrinter PRESSURE TYMP 1 55600 400 200 0 290 400 Tymp 2 TYMP 3 LEFT ERR wo c Me UL s SETTING Left column printout Setup Menu data 5 Press the LEFT COLUMN SETTING softkey of the External Printer Setup PRESSURE ERRCRHRL VOLUME i Sm Same Ane Se Sic e
50. A portion of this stimulus is carried by the ossicular chain to the cochlea From the cochlea the 8 nerve carries the information to the brain stem where a determination is made as to whether the stimulus is sufficiently intense to elicit a response When a response is elic ited the 7 nerve carries the command to the stapedius muscle to contract Contraction of this muscle and or the tensor tympani stiffens the eardrum and the ossicular chain thereby decreasing the ease with which sound enters the auditory pathway Thus the end result of an acoustic reflex is a slight decrease in the ability of the eardrum and the ossicular chain to conduct acoustic energy to the cochlea Since the acoustic reflex causes a relatively small decrease in mobility 0 02 ml or greater using a probe tone of 226 Hz within the middle ear system it is important to conduct this test at a pressure level where the greatest response occurs Therefore acoustic reflex threshold and decay measurements are gen erally carried out at the pressure value where peak mobility occurred during a tympanogram If no peak is observed the acoustic reflex tests are performed at atmospheric pressure 0 daPa Acoustic reflex measurements can be obtained Ipsilaterally or Contralaterally For Ipsilateral testing the stimulus is presented to the same ear where the measurements are made For Contralateral testing the measurements are made with the probe in one ear while the stimulus is p
51. Cursor not used Y Normal Wide Not used Not used 200 daPa sec 600 200 daPa sec ll Grason Stadler 249 255 259 260 263 264 265 266 267 268 269 271 272 N Peak Compliance data Peak Pressure data Sweep Direction status Gradient data Reflex Type status Reflex Frequency 1 Reflex Frequency 2 Auto Start status Reflex 1 data Reflex 2 data Checksum Carriage return Line Feed Remote Specifications 30800 to 30800 if no Peak xxx 600 to 400 daPa if no Peak 0 positive to negative 1 negative to positive Gradient RATIO XXX 1 to 999 daPa If Gradient TYMP WIDTH XXXX 00 to 990 0 if Gradient could not be calculated if Gradient Status OFF 0 Off 1 Ipsi 2 Contra 3 Ipsi and Contra 0 500 Hz 1 1000 Hz 2 2000 Hz 3 4000 Hz if Reflex Type Off 0 500 Hz 1 1000 Hz 2 2000 Hz 3 4000 Hz If Reflex Type Off or Ipsi and Contra 0 Off 120n 0 1 2 NR 3 YES 4 lt gt 5 lt gt 6 NT CAL if Reflex Type 0 NA 1 NT 2 NR 3 YES 4 NT lt gt 5 lt gt 6 NT CAL if Reflex Type Off or if 2nd frequency not selected CR GSI TympStar Version 1 Reference Instruction Manual D 27 7 1 3 Offset 4
52. ETF Perforated TM Manual manual test test mode press the MANUAL hardkey procedure Hol 2 The Pressure Knob will allow the pressure to sweep only a in the direction of the pre selected maximum pressure 1 eo 400 daPa sut 9 3 The Pressure Knob will be inactivated once nd the maximum pressure is established Transfer _ 4 prompt message on the LCD will inform Y the user when the previously set maximum 9 T pressure is reached or if the Eustachian tube has ened Manual 57 Stimulus A 2 ETF Perforated TM A healthy Eustachian tube has been shown to open at approximately 150 normative data mm A higher pressure level i e greater than 350 mm might be required to open a blocked Eustachian tube NOTE 1 02 mm 1 daPa Holmquist J Eustachian Tube Evaluation Acoustic Impedance and Admittance The Measure ment of Middle Ear Function A Feldman and L Wilber eds Williams and Wilkins 1976 4 50 Grason Stadler Program mode for ETF Softkey menu structure Program mode Operation Default test parameters may be programmed for the ETF Intact and ETF Per forated TM test modes The structure of softkey menu selections is diagrammed below Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings Press the ETF hardkey then press the RE TURN hardkey to display the ETF su
53. GSI or elsewhere when approved for use by GSI NOTE A 226 Hz Y tympanogram is displayed on the LCD screen in a 1 1 aspect ratio and on the external VGA monitor in a 1 4 1 aspect ratio The Pres sure horizontal axis appears to be stretched out by 40 on the VGA monitor 2 4 Grason Stadler Installation Probe Acoustic electric and pneumatic con nections to the probe are provided by the connector on the right side of the GSI TympStar enclosure The connectors allow for removal of probe pod assembly Power The power entry module contains the power plug outlet power ON OFF switch and instrument fuses Prior to applying power to the instru ment make sure that the power cord is plugged firmly into the power entry module by pressing the cord connector into its receptacle GSI TympStar Version 1 Reference Instruction Manual 2 5 Chapter 2 Preparing the probe assembly CAUTION CAUTION The ipsi probe tip and tubing are at tached to the probe box at the factory i Connect the contra insert phone cable to the jack on the top of the probe pod E d if contra reflex testing is to be per formed If contra testing will not be performed on a regular basis it is not necessary to keep the contra phone at tached to the probe box at all times CAUTION Be sure that the plug is inserted all the way into the jack to ensure proper operation CAUTION To ensure the accuracy of
54. GSI Part 4204 0251 USA GSI Part 1010 9686 GSI Part 1015 9600 52cm x 38cm x 32cm Height with LCD lowered 6 inches 15cm Weight 16 58 pounds 7 53 kg Shipping weight 29 50 pounds 13 38 kg Top Case LCD Housing Front amp Rear amp Hinges LCD Lens Switches Labels Softkey Panel Probe Cord Probe Top amp Bottom Housings Probe Tip Eartips Tubing Lexan 500 w 10 Glass amp 2 Blowing Agent UL 94V0 Rated GE 405 OR Duralan Shincor Shin Etsu Novacor KE 95 1 U Lexan amp Polycarbonate Mylar Polyvinyl Chloride PVC Cycolac KJW UL 94V0 Rated Polypropolene Kraton 3226 Vinyl and Polyurethane GSI TympStar Version 1 Reference Instruction Manual A 9 Calibration requirements Appendix A GSI recommends quarterly calibration checks for GSI TympStar along with annual certification ASHA requires quarterly electro acoustic calibration checks and annual electro acoustic calibration Itis good practice to perform daily biologic checks See the Calibration Checks section of Chapter 3 in this manual more information or Chapter 4 Calibration in the TympStar Service Manual for com plete calibration instructions Grason Stadler Appendix Bibliography TympStar Version 1 GENERAL ANSI 53 39 1987 American National Standard Specifications for Instruments to Measure Aural Acoustic Immittance ASA 71 1987 Feldman A Wilbur L Acoustic Impedance am
55. LCD daPa ETF PERFORRTED TM TEST 1 117057 i t 02 300 i 0 1 200 300 400 C2 03 299 199 NAME 10 TESTER 9 50 sec 400 59 RIGHT PRESSURE TIME ERR MAX daPa SEC 3 Press the EAR softkey to toggle between the right and left ear then if desired navigate through the ETF Perforated TM softkey menu and change parameter settings for the test as required Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings PRESSURE TIME SEC EAR MAX daPa 50 V SET LEFT 600 400 ser SEC GSI TympStar Version 1 Reference Instruction Manual 4 47 maximum levels allowable Chapter 4 minimum and maximum levels allowable in the Perforated TM mode are shown below Default Minimum Maximum Increment Pressure Max 400 600 daPa 400 daPa 50 daPa Time 50 Seconds 30 Seconds 60 Seconds 10 Seconds 4 Ensure that the probe is placed securely in the ear canal Manual and press the START hardkey 5 The pressure will sweep at 50 daPa sec toward the selected maximum pressure value for the test Stat gt 6 The pressure sweep as a function of time can be viewed e on the graphic display on the LCD 7 If the Eustachian tube opens before the maximum pressure is reached the tracing will indicate the pressure value where the tube opened as redu
56. OFF and is changed to ON remotely and the probe is in a sealed cavity a test starts as it would when the softkey itself was changed using softkey presses This command is only valid in the Tymp Screening test mode 019 Set TYMP Screening Reflex Type Used for the selection of the Reflex type or to turn off the Reflex type This command is only valid in the Tymp Screening test mode 020 Set TYMP Screening Stimulus Hz Used for modifying the different stimulus Hz 500 1000 2000 4000 When Ipsi or Contra is selected as Reflex type two stimuli can be turned on This command is only valid in the Tymp Screening test mode 021 Set TYMP Screening Cursor Allows the cursor to the moved to a specified X axis position when the cursor is active and allows the user to set the Tymp peaks This command is valid in Tymp Screening as long as the test is complete and a line has already been plotted 022 Set Reflex Threshold Stimulus Ear Allows the Stimulus ear parameter to be selected remotely This command is valid in a Reflex Threshold test 023Set Reflex Threshold Mark Threshold Sets the Threshold marker NR or to the specified trace This command is valid in a Reflex Threshold test after test has been run This incoming record can only be used when in the mark threshold menu 024 Set Reflex Threshold Threshold Seek Allows the configuration of the minimum change start dBHL stop dBHL of the Threshold Seek This command is valid during a
57. QTY 1 499 200 200 TIMING ON 9 1 2 00 NAME 10 TESTER 16 15 sec IPSI OFF MANUAL RIGHT STIMULUS MARK THRESHOLO AUTO EAR MORE EAR THRESHOLO SEEK ZERO 8 Scroll through available stimuli by pressing the STIMULUS hardkey Selection of Non Acoustic is also made in this manner The STIMULUS hardkey can be held down continuously for rapid scrolling and wrap around Stimulus 2 9 Press the INTENSITY hardkey to select the intensity level dBHL for stimulus presentations The intensity can be changed in 5 dB steps NOTE The display of Intensity contains an asterisk if non GSI calibration data is used 10 With probe insert securely fitted in the ear canal press the lt START hardkey The ear will be pressurized to dynamic compliance peak pressure as recorded by the last tymp run or to 0 daPa if previous tymp data is unavailable The Pressure Knob is active for fine tuning pressure 73 between stimulus presentations for all reflex type tests 3 Pressure NOTE VU For testing patients exhibiting hyperflaccid or sharply sloped tymps it is helpful to OFFSET THE PRESSURE in reflex threshold tests This re moves the fluctuations seen on the Compliance meter between stimulus presentations GSI TympStar Version 1 Reference Instruction Manual 4 25 Auto Zero Mark Threshold Chapter 4 Offset the pressure 20 30 d
58. TympStar Version 1 measures compliance using a 226 Hz probe tone The TympStar Version 1 measures compliance and shows the tracing on the graphic display as a solid line Lights are provided on the probe to indicate test status in the following manner Solid Green Test In Progress Solid Amber Occlusion e Blinking Amber Leak Blinking Green OK to begin a test The liquid crystal display LCD shows axes for the graphic display of the selected test and pressure and compliance meters DIAGNOSTIC TEST 2 12 15 2000 02 33 pn 5 PRESSURE daPa EARCANAL VOLUME 1 2 daPa ml j r r 1 r 8 8 2 400 200 200 TYMP 2 TYMP 3 COMPLIRNCE nl EA ona 0 5 6 6 0 5 1 0 1 5 NAME ID e 400 0 200 a daPa NORMRL 200 OFF RIGHT AUTO P RRNGE START 777 GRADIENT ERR SEQUENCE daPa GSI TympStar Version 1 Reference Instruction Manual 4 3 CLEAR hardkey ERASE hardkey Erasing and clearing test data Chapter 4 THE TEST STATUS line to the right of the graphics area of screen displays alert messages invalid selections and other messages to user STIMULUS INTENSITY 409 200 200 TIMING ON FF QTY 10 TESTER I6 sec INURLIO INTENSITY LIMIT REACHED MARK THRESHOLO Test Status Line Test tracings meter displays with digital readouts and ear canal
59. TympStar covers Refer servicing to qualified person nel WARNINGS ELECTRICAL GROUNDING This device uses a three wire power cord with a hospital grade plug for international applications IEC 601 1 approved plug The chassis is earth grounded For grounding reliability connect the device to a hospital grade or hospital only receptacle for international applications IEC 601 1 ap proved receptacle Inspect the power cord often for fraying or other damage Do not operate the apparatus with a damaged power cord or plug Improper grounding is a safety hazard Do not use extension cords for the TympStar Extension cords can cause ground integrity and impedance problems Periodically check the system ground integrity WARNING EXPLOSION This system is not explosion proof Do not use in the presence of flam mable anesthetics or other gasses WARNINGS CONNECTIONS Do not switch on any system power until all cables have been properly connected and verified See this manual for setup instructions which accompanies all deliveries of the system Switch off the system power before connecting or disconnecting any sys tem component s or accessories This may damage the device s WARNINGS GENERAL Proper use of this device depends on careful reading of all instructions and labels Follow all safety standards set by each place of employment Prolonged use of auditory stimuli can cause damage to patient hearing Grason Stadler
60. Up Down or Set Activator Facilitator Stimulus command is invalid due to a problem with reading the stimulus SPL calibration data from memory NOTE GSI DEFAULTS USED REPROGRAM Indicates that there was a problem with reading the Program Mode User test parameters from memory when selecting a test so the GSI default test parameters were used NOTE TEST NOT AVAILABLE CONTACT SERVICE Indicates that when selecting a Reflex type test the information stored in memory which defines if the stimuli were calibrated in the User Custom SPL mode could not be read properly NOTE REFLEX DECAY NOT AVAILABLE CONTACT SERVICE Indicates that when selecting the Special hard key the information stored in memory which defines if the stimuli were calibrated in the User Custom SPL mode could not be read properly The unit will default to a Multiple Frequency test instead ALERT PRINTER ERROR CHECK PAPER OR RELEASE LEVER Indicates that the printer is unable to print due to either being out of paper or the release lever is in the wrong position ALERT INVALID SELECTION PROBE TONE NOT SELECTED Command was invalid in the Altitude Calibration mode due to not having selected a probe tone ALERT ALTITUDE LIMIT REACHED The minimum or maximum altitude selection limit was reached for a Step Altitude Up Down command in the Altitude Calibration mode ALERT ACTIVATOR STIMULUS DEFAULTED Indicates that the activator stimulus was defaulted due to a Set Facilitator Stim
61. XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB 4 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB xxxxx 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 0 to 7 0 NR 1 23 2 NR TS 3 TS L2 30800 to 30800 if Cursor not used GSI TympStar Version 1 Reference Instruction Manual D 29 357 358 359 360 365 370 372 374 377 379 383 384 385 388 394 397 403 406 412 415 421 424 430 433 439 442 448 450 452 454 ANO Admittance status Stimulus Ear status Timing Manual Auto On Time Off Time Zero field Activator Stimulus Click Rate Zero field Pressure Number of traces Intensity unit Trace 1 intensity Trace 1 amplitude Trace 2 intensity Trace 2 amplitude Trace 3 intensity Trace 3 amplitude Trace 4 intensity Trace 4 amplitude Trace 5 intensity Trace 5 amplitude Trace 6 intensity Trace 6 amplitude Trace 7 intensity Trace 7 amplitude Trace Mark Trace Type Zero field Checksum Appendix D ll lt 51 Steady CONTRA Pulsed CONTRA 0 Manual 1 Automatic XXXXX 1000 to 54000 msec if Manual Timing XXXXX 0 to 52000 if Manual Timing 250 Hz
62. Zero field Number of lines Line 1 data header Admittance status Peak Compliance data Peak Pressure data Cursor X data Line 1 Y scale Line 1 cursor Y value Line 2 Y scale Line 2 cursor Y value Checksum Carriage return Line Feed NOTE Appendix D 0 Not used 1 Not used 2 Not used 3 gt 38 Frequency NA Resonance frequency could not be determined See Note xxx 600 to 400 daPa 0 or 2 p 0 Delta Y 1 Delta B 2 Delta G 30800 to 30800 if no Peak xxx 600 to 400 daPa if no Peak 250 to 2000 Hz if Cursor not used 3 0 to 3 0 1 7 5 to 7 5 2 15 0 to 15 0 Xxxxx 15000 to 15000 E if Cursor not used 0 5 to 180 degrees 1 2 5 to 90 2 5 to 45 xxxxx 5 to 180 degrees if Cursor not used XX R LF Frequency in Hz Probe Tone value 2 x 50 Field Name Start of record Record Type Record Sequence Number Patient Name Patient ID Tester Name Field Definition 1 Summary data record 8 Summary data record with attached XY data records XX 00 to 99 0 to 45 characters for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters Grason Stadler 139 45 184 9 193 20 213 2 215 1 216 1 217 2 219 4 223 1 224
63. and gradient if selected for the last tymp run appear as summary orr data to the right of the meter area on the LCD as shown below With the Baseline on it is possible to read the tymp peak compliance value directly because the ear canal volume is removed from the measurement PRESSURE EARCANAL VOLUME 1 8 daPa ml TYMP 1 5 6 2 200 TYMP 2 TYMP 3 GRADIENT 105 daPa NORMAL 200 OFF RIGHT AUTO P RRNGE START GRADIENT SEQUENCE daPa daPa When the baseline function is off the label C1 appears in place BASELINE of ear canal volume indicating compliance at start pressure ON OFF With the Baseline off it PRESSURE Ci 1 2 is not possible to read the putem ner ie 16 31 wa 200 200 2 static acoustic compli a ance directly In this case the tymp peak compli we anceis calculated by sub o 00 05 tracting C1 from the tymp ml value static acoustic compliance tymp ml 11 Pressing the STOP hardkey ends the tymp test Further tymp data cannot be stored on that page STOP is automatically entered upon completion of the third pressure sweep The user may abandon automatic testing by pressing the STOP hardkey at any point for difficult to test patients The Manual mode may be entered as described later in this section Upon com
64. both For example the USER 1 softkey might have been programmed to initiate screening but USER 1 can not initiate diagnostic tests unless it is reprogrammed Each USER softkey is totally independent of others and CNET SCREEN DIAGNOSTIC can be programmed to provide either screening or diag nostic functions Pressing the PROGRAM MODE softkey places the instrument in the Program Mode and provides access to programming functions for setting overall in strument or user specific defaults Tests can not be performed in the Program Mode Pressing the PROGRAM MODE softkey displays the Program Mode sub menu and displays the PROGRAM MODE message in the status area of the screen Grason Stadler Programming default parameters for SCREEN and DIAGNOSTIC modes Operation nl TYMP DIAGNOSTIC TEST 1 10 29 2000 05 45 pn ne PRESSURE daPa ERRCRNRL VOLUME daPa ml 400 200 200 TYMP 2 3 0 5 COMPLIRNCE nl gt eee 0 5 0 0 8 5 1 0 1 5 0 0 NAME 1D 400 200 0 9208 PROGRAM MODE S NOSTIC System in PROGRAM MODE When the system is in the Program Mode select the test for which defaults will be defined Pressing the SCREEN or DIAGNOSTIC softkey displays the screening or diagnostic softkey menu across the bottom of the screen with a PROGRAM MODE status message as shown in the example below 1 5
65. calibration the tygon tubing supplied with the ipsi probe assembly should not be cut or altered in any way The system has been specifically calibrated to meet specifications with the tubing length supplied with your unit A spare set of tubing is provided If the replace ment tubing supplied with your instrument is used recalibration is un necessary Grason Stadler Installation Powering the instrument Prior to applying power CAUTION WARNING Applying power Place the GSI TympStar on a desk or countertop CAUTION Do not place instrument on power or probe cord The location should be near a hospital grade grounded electrical outlet Con firm that the power cord is plugged firmly into the power entry module the left side of the GSI TympStar 2 insert the power plug into the hospital grade electrical outlet WARNING Injury to personnel or damage to equipment can result when a three prong to two prong adapter is connected between the GSI TympStar power plug and the source of electrical power Operate the POWER SWITCH on the left side of the instrument to the ON position marked as 1 NOTE LCD will not display any information dur ing the first approximately 5 seconds while the instrument s computer performs a number of internal tests to verify the condition of internal hardware Upon the conclusion of internal system tests an Initialization screen will be displayed show
66. daPa Units ml mmho x 1000 ml mmho x 1000 ml mmho x 1000 ml mmho x 1000 daPA ml mmho x 1000 ml mmho x 1000 ml mmho x 1000 ml x 1000 ml mmho x 1000 degrees ml mmho x 1000 Range 600 to 400 600 to 400 0 to 30000 600 to 400 0 to 30000 0 to 30000 to 1000 0 to 30000 600 to 400 250 to 2000 600 to 400 Range 30800 to 30800 30800 to 30800 30800 to 30800 30800 to 30800 600 to 400 30800 to 30800 30800 to 30800 30800 to 30800 30800 to 30800 30800 to 30800 45 to 180 30800 to 30800 unbaselined values If baseline is selected the baselined values may be obtained by subtracting the Y axis values from the Earcanal Volume 7 2 4 Embedded Control Codes 7 2 4 4 Penup Code Value 7FFFH Embedded in the X and Y graphical data to indicate the end of the graph of a stimulus Purpose presentation during a Reflex type test The code indicates to the plotting routines not to plot draw between the previous plotted point and the next point to produce the blank space between stimulus graphs on the LCD screen GSI TympStar Version 1 Reference Instruction Manual Appendix D 7 3 End of Summary and XY Data Record Offset Field Name Field Definition Char 0 1 Start of record 1 1 3 End of data record 2 2 Record Sequence Number 00 to 99 4 2 Checksum XX 6 1 Carriage Return CR 7 1 Line Feed LF 7 4 Error Record Offset Field Name Field
67. data collection buffering and transmission is in progress all front panel pushbuttons except for the STOP hard key are invalid Pressing any of these invalid keys results in the error message ALERT INVALID SELECTION DATA TRANSFER IN PROGRESS being displayed momentarily with the word ALERT flashing When the transmission is complete all pushbuttons are valid and the TRANSMISSION IN PROGRESS message will be erased If the DATA TRANSFER hard key is operated while a data transfer is already in progress the current transfer is terminated The warning message ALERT DATA TRANSFER ALREADY IN PROGRESS flashes momentarily When a data transfer from the GSI TympStar to the Remote Device is initiated or at any time during the transmission if the Remote Device disables the transmission by setting the RTS line false for greater than 10 seconds the GSI TympStar aborts the transmission The error message ALERT DATATRANSFER INHIBITED DATATRANSFER ABORTED is displayed momentarily with the word ALERT flashing This error message replaces the DATA TRANSFER IN PROGRESS message No error record will be sent to the Remote Device The information that is transmitted consists of either test results or unit status information in formatted records In all cases the format of the records are the same for a Version 1 and Version 2 TympStar unit The parameters that are not selectable on Version 1are indicated as the default selection such as Probe Tone 226 Hz
68. for Start Pressure selection 0 600 daPa 1 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa 5 500 daPa 6 300 daPa 720 daPa 8 4300 daPa Field Definition AE 041 0 Send 1 Query for ear selection LP GSI TympStar Version 1 Reference Instruction Manual D 101 8 5 6 Set ETF Intact Admittance Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Admittance 6 1 Carriage return 7 1 Line feed 8 5 7 Set ETF Intact Baseline Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Baseline 6 1 Carriage return 7 1 Line feed 8 5 8 Set ETF Intact Cursor Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Cursor 6 3 Number of dots 9 1 Carriage return 10 1 Line feed D 102 Appendix D Field Definition Field Definition p 043 0 Send 1 Query for Baseline selection 0 2 ON 1 OFF GR Field Definition 044 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right 2 Set Tymp 1 Peak 3 Set Tymp 2 Peak 4 Set Tymp 3 Peak XXX 010200 only if cursor 1 or 2 0 Position to Y axis 1 dot Grason Stadler Remote Specifications 8 5 9 Set ETF Intact Continue Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 045 4 1 Req
69. further check the Eustachian tube function while a pressure gradient exists between the ear canal middle ear space and the nasopharynx the patient is asked to swallow some water If the tube is functioning properly some air pressure will be released as the patient swallows the water If the tube is mal functioning very little 1f any pressure will be released Thus itis possible to record changes in pressure when the Eustachian tube opens and closes in re sponse to swallowing as a function of time The structure of softkey menu selections are diagrammed below Please refer to Chapter 1 Introduction for instructions regarding navigating through soft key menus and changing parameter settings PRESSURE TIME SEC EAR MAX daPa 50 4 SET LEFT 600 400 d ser SEC Holmquist J Eustachian Tube Evaluation Acoustic Impedance and Admittance The Measure ment of Middle Ear Function A Feldman and L Wilber eds Williams and Wilkins 1976 4 46 Grason Stadler Operation ETF Perforated TM 1 Press the hardkey to select the automatic test ETF test mode then press the procedure RETURN hardkey to display the ETF es Bi LZ Ww sub menu _ Return Bn INTACT PERF INSTRUMENT PROGRAM TM TM OPTIONS MODE 2 Press the PERF TM softkey to place the instrument in the ETF Perforated TM test mode Default test parameters will be displayed above the softkeys on the
70. if value unavailable Field Definition 1 Summary data record 8 Summary data record with attached XY data records XX 00 to 99 to 45 characters for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters Grason Stadler 184 193 213 215 216 217 219 224 225 226 231 233 239 240 241 242 247 252 254 20 k Probe S N Date Time Test type Test number Ear Under Test ProbeTone Timebase Number of lines Y axis scale Cursor X value Line 1 data header Line 1 cursor Y value Admittance status Stimulus Ear status Timing Manual Auto On Time Off Time Zero field Activator Stimulus Remote Specifications 9 characters for unused characters XX XX XXXX XX XX xm for xm if 24 Hour time format 8 ARST 1 to 9 and A to Q L z Left Ear R Right Ear 0 226 2 1 Not used 2 Not used 3 gt 38 Not used 1500 to 12000 msec 0 1 or2 4 04 to 16 08 to 32 12 to 48 16 to 64 20 to 80 04 to 16 08 to 32 12 to 48 16 to 64 20to 80 XXXXX 0 to 10800 msec if Cursor not used 11 30800 to 30800 if Curso
71. is invalid An integer other than 0 or a 1 was entered 0 and 1 represent ON and OFF The error subcode indicates the current test where the error is occurring Integer selection for Reflex Type is invalid The error subcode indicates the current test where the error is occurring Integer selection for Stimulus Hz is invalid Either an invalid choice was made or too many stimuli were turned on Only one stimulus can be turned on for a reflex type of IPSI CONTRA while two stimuli can be on with a reflex type of IPSI or CONTRA The error subcode indicates the current test where the error is occurring Invalid Integer selection for Stimulus EAR Integer may not represent a Stimulus Ear value or the Stimulus Ear value may not be valid for this test The error subcode indicates the current test where the error is occurring Invalid selection for mark threshold This could be either that the trace they are trying to mark does not exist or that the integer representing the type of mark is invalid The error subcode indicates the current test where the error is occurring Invalid selection of the Threshold Seek parameter that needs to be changed Only the integers 0 4 are valid here The error subcode indicates the current test where the error is occurring Integer selection for Auto Zero is invalid An integer other than a 0 or a 1 was entered The error subcode indicates the current test where the error is occurr
72. is pressurizing before starting a test ALERT INVALID SELECTION TEST IN PROGRESS An invalid command was sent while the system is running a test This will occur on most key presses other than stop when any data is being plotted ALERT INVALID SELECTION MUST MAKE SOFTKEY SELECTION An invalid command when the start keys are pushed from the Multiple Hz stop NEXT SERIES menu ALERT INVALID SELECTION NO TEST DATA STORED Page Print or Clear command sent when there is not any test data stored in page memory ALERT PAGE MEMORY FULL MUST CLEAR TEST DATA TO RESUME Command is invalid due to insufficient page memory available ALERT INVALID SELECTION NO TEST DATA DISPLAYED Data Transfer or Erase command sent when there is not any test data displayed on the screen ALERT INVALID SELECTION STORING TEST DATA Command is invalid while storing the test data when the HOLD or STOP mode is being entered ALERT TEST IN PROGRESS LEFT EAR STILL BEING TESTED The Ear selection switch on the Probe box was changed from the Left position to the Right position while a test was in progress ALERT TEST IN PROGRESS RIGHT EAR STILL BEING TESTED The Ear selection switch on the Probe box was changed from the Right position to the Left position while a test was in progress TEST COMPLETE REMOVE PROBE A Tymp Screening test with Auto Start selected has completed successfully Grason Stadler 280 281 283 284 288 295 310 318 333
73. lus Signal Specifications PressureMaximumLimits 800 daPa to 600 daPa Programmed Pressure Ranges Normal 200 to 400 daPa Wide 400 to 600 daPa Pressure Accuracy 10 or 10 daPa whichever is greater in cavities from 0 5 cc to 5 0 cc Pressure Sweep Rate 12 5 daPa sec 50 daPa sec 600 200 daPa sec Manual Sweep Rate Limit 600 daPa sec Sweep Rate Accuracy 10 Pressure System Leak Rate lt 1 0 daPa sec Measured at 600 and 400 daPa while pressure servo is disabled Pure Tone Stimulus Frequencies for Contra phone and for Ipsi phone with time multiplexed stimulus See Table 3 Frequency Accuracy 3 Total Harmonic Distortion Reference 5 at 500 Hz 85dBHL ANSIS3 39 1987 lt 5 at 1000Hz 3000Hz 100dBHL Section 7 5 2 2 Frequency Accuracy lt 5 at 4000Hz 75dBHL Section 7 5 2 3 Harmonic Distortion lt 10 at the maximum dBHL settings Noise Stimulus The uniformity of the spectrum level of acoustic pressure for the noise signal over 20 averages measured acoustically within their respective band limits will be 10 dB for insert or probe type earphones 5 dB for supra aural type earphones Noise Band Widths Low Band 125 1600 Hz High Band 1600 4000 Hz Broad Band 125 4000 Hz Relative to level at 1 kHz Band edges accurate to within 15 Roll off rate gt 12 dB Octave Stimulus Level Control Tone Stimulus The transfer of reference equivalent threshold values are based
74. on the article Reference Threshold Levels For The ER 3A Insert Phone by Laura Ann Wilber Barbara A Krueger and Mead C Killion J Acoustic Soc Am Suppl 1 Vol 81 Spring 1987 GSI determined the transfer data from an IEC 711 coupler to an ANSI HA 1 coupler Using this data the reference threshold values were determined for both the Ipsi and Contra insert earphones for calibration in an ANSI HA 1 2cc coupler Noise Stimulus The transfer of reference threshold values was done by GSI using the Threshold Determination Method The transfer data from an 711 to anANSI HA 1 coupler was determined by GSI GSI TympStar Version 1 Reference Instruction Manual 3 Appendix Intensity levels are reduced as a function of volume at a rate of 1 dB SPL foreach 1 ml Intensity reduction begins at 1 2 ml Table 3 Upper limit of HL range in Reflex Threshold Mode Pure Tone Stimulus Hz Probe E Eme um pm ao w pm pus 78 70 7j Lower limit of HL range for all stimulus signals 35 dB HL Contra stead Hearing Level Increment 5 0 dB Hearing Level Increment Accuracy 20 5 dB Hearing Level Control Linearity 1 0 dB Grason Stadler Stimulus Presentation Control Temporal Specifica tions Of Stimulus Presentation Specifications Signal ON OFF Ratio gt 70 dB OFF mode signal level
75. or as a null selection sequence of characters such as for the Click Rate D 4 Grason Stadler Remote Specifications 5 2 Record Types The types of output records are as follows Record Type Record Description 1 Summary data record Contains test parameter and summary test results XY Graphical data record Contains X Y graphical data Due to the large amount of data that may have to be transmitted the data is sent in multiple records with each record containing up to 29 XY data pairs End of XY Graphical data record Sent to indicate the end of a series of Summary and XY Graphical data records Error record Use to indicate error conditions which may occur during remote control of the GSI TympStar The following error conditions are indicated See Section 9 for a description of the error codes Current X Y data record Contains the current Y axis and X axis values or other parameter values of importance in the current unit state Unit identifier data record Contains the unit type GSI TympStar version 1 2 unit identifier number and software revision information The unit identifier number is defaulted to 0000 until it is set by the Remote Device Once set by the Remote Device it is defaulted back to 0000 when the User Default data is loaded in the Calibration Mode At this time the Signal Processor software revision will default to 00 00 Test mode change status record When enabled automatically sent by
76. p 9 Query Record XX 00 to 99 090 0 Left 1 Right XX CR GSI TympStar Version 1 Reference Instruction Manual Appendix D 7 9 9 6 Multiple Hz 1 Cursor Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 091 7 4 Cursor X value XXXX 11 4 Cursor Y Value XXXX 15 2 Checksum XX 17 1 Carriage return CR 18 1 Line feed LF 7 9 10 Multiple Hz 2 Individual SoftKey Commands 7 9 10 1 Multiple Hz 2 Cursor Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 093 7 4 Cursor X value XXXX 11 4 Cursor Y Value XXXX 15 2 Checksum XX 17 1 Carriage return CR 18 1 Line feed LF 7 9 11 Multiple Hz 3 Individual SoftKey Commands 7 9 11 1Multiple Hz 3 Probe Hz Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 095 7 4 Probe Hz XXXX 250 2000 Hz in multiples of 50 11 2 Checksum XX 13 1 Carriage return CR 14 1 Line feed LF D 80 Grason Stadler 7 9 11 2Multiple Hz Cursor Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 4 Cursor X value 11 4 Cursor Y Value 15 4 Cursor Y Value 19 2 Checksum 21
77. parameters Left column setting and Print Type are changed remotely with this command code 110 Set Data Transfer Settings Provides to the TympStar the format of the transferred data This command is valid under Instrument Options The Data Transfer format can be changed for all tests between summary and summary plus graphics The clear test parameter can also be modified using this command 111 Set Language Used to process a language change for either the LCD and printer or the keyboard The language choices will match the softkey choices English French German Spanish and Italian This command is valid only in Instrument Options GSI TympStar Version 1 Reference Instruction Manual D 21 Appendix D 112 Set Test Sequence Setting Reflex Threshold Used to setup the Test sequence for Auto Sequence testing This command controls the Reflex Threshold settings This command is valid only in Instrument Options 113 Set Test Sequence Setting Reflex Decay Used to setup the Test sequence for Auto Sequence testing This command controls the Reflex Decay settings This command is valid only in Instrument Options 114 Set Remote Settings Allows the Remote Settings Baud Rate Parity Stop bits and RTS CTS to be queried using the remote system 115 Date Time Formats Used to adjust Date and time formats This command is valid only in Instrument Options 116 Set Date Command Used to adjust the Date month day year This command is val
78. record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Threshold Seek 8 3 Min Change 11 3 Start dBHL 14 3 Stop dBHL 17 2 Checksum 19 1 Carriage return 20 1 Line feed 7 9 3 4 Reflex Threshold Auto Zero Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Auto Zero 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 3 5 Reflex Threshold Ear Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Ear 8 2 Checksum 10 1 Carriage return 11 1 Line feed D 58 Field Definition p 9 Query Record XX 00 to 99 024 0 ON 1 OFF XXX XXX XXX XX Field Definition ap 9 Query Record 00 to 99 025 0 Automatic 1 CR Field Definition p 9 Query Record XX 00 to 99 026 0 Left 1 Right XX CR Grason Stadler Remote Specifications 7 9 3 6 Reflex Threshold Probe Hz Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Probe Tone 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 3 7 Reflex Threshold Admittance Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Admittance 8 2 Checksum 10 1 Carriage return 11 1 Line feed Field Definition
79. record character ASCII and a valid checksum for the record If the record was not received correctly the Remote Device must respond with a NAK negative acknowledge response record See Section 8 for the format of the ACK and NM records Upon receipt of an ACK record the GSI TympStar transmits the next record if additional records are to be transmitted or deletes the test data just transmitted from the page memory if the Auto Clear feature is selected and then terminate the transmission process If a record is received the GSI TympStar retransmits the same record A maximum of 2 retransmissions of a record will be attempted by the GSI TympStar Ifthe recordis still not received correctly the data transfer will be aborted The error message ALERT DATA TRANSFER ERROR DATA TRANSFER ABORTED will be displayed on the LCD screen momentarily with the word ALERT flashing No error record will be sent to the Remote Device This ARQ Protocol is required only for data transmission from the GSI TympStar to the Remote Device and is not used for transmissions from the Remote Device to the GSI TympStar 5 5 2 Not Received After each record is transmitted by the GSI TympStar the GSI TympStar waits for a maximum of 10 seconds for the ACK or NAK record If one or the other is not received within the time limit the GSI TympStar assumes that the record was not received correctly by the Remote Device and retransmits the record just as if a NA
80. site s altitude press the SPECIAL softkey the RETURN hardkey then the ALTITUDE CAL key The Altitude Calibration screen will be displayed BLTITUDE CALIBRATION ALTITUDE CALIBRATION 10 26 2000 10 44 pn INSTALLATION SITE 4000 ft 11 DIRECT READING COMPLIANCE RLTITUDE 1812 meters VALUES USE ALTITUDE SOFTKEVS t TO SELECT CUSTOMER SITE Altitude stored for STANOARO BAROMETRIC 25 86 ALTITUOE OR CURRENT this site PRESSURE AT ALTITUDE 657 HG BAROMETRIC PRESSURE PRESS DATA TRANSFER TO STORE DATA i2 SELECT PROBE TONE TO BE TEST CAVITY READINGS i CALIBRATED NOMINAL SER NOMINAL CUSTOMER 18 FOLLOM INSTRUCTIONS BELOW TO LEVEL VALUES SITE VALUES CALIBRATE ERCH PROBE TONE 50 i 0 58 nl rected compliance TUDE LEFT RIGHT values If the altitude shown on the screen is correct it is likely that the instrument is calibrated If the altitude shown on the screen is not correct or to be absolutely certain of a valid altitude calibration perform the calibration procedure contained in Chapter 4 Altitude Calibration Mode CAUTION Do not proceed with the calibration checks in this section unless completely certain that the altitude calibration for this instrument is valid at your location CAUTION Equivalent compliance values Equivalent corrected compliance values for pre operation calibration checks at various altitudes are shown on the screen and in the table below For ex ample i
81. the Eustachian tube should remain closed for an extended period of time a negative pressure relative to atmospheric pressure may develop within the middle ear This causes the tympanic membrane to retract inward thus stiffening the eardrum Air pres sure is decreased at the rate of 50 mm H O hour if the tube remains closed In time fluid may develop within the middle ear space further stiffening the middle ear system and reducing the ability of the ossicular chain to conduct sound to the cochlea Since a malfunctioning Eustachian tube can lead to middle ear disease and hearing loss it is helpful to be able to determine the patency of the Eustachian tube in patients who are susceptible to middle ear problems The purpose of this test is to try to force the Eustachian tube to open through use of pressure gradients and swallowing on the part of the patient A series of three tympanograms are obtained under the three different conditions described below NOTE In each case to avoid the effects of hysteresis the tympanogram is re corded in the SAME sweep direction Condition 1 A tympanogram sweep is performed with the normal pressure range selected 200 to 400 daPa Condition 2 A positive pressure of 400 daPa is established within the ear canal and the eardrum is pushed inward As this membrane moves inward the volume of the middle ear space is reduced This in turn causes air that is present within the middle ear space
82. the data transfer has been cancelled ALERT INVALID SELECTION MUST SELECT TEST TO DISPLAY Invalid selection since in page but no test to be displayed was selected yet LARGE TIMEBASE ON TIME MODIFIED Indicates the status of the on time since the on time was changed by a change in the timebase PRINT CANCEL IN PROGRESS Indicates that the print cancel softkey was selected and that the TympStar is currently canceling the print job ALERT NO PROBE POWER OFF ATTACH PROBE AND POWER ON This error indicates that there was no probe found This is usually the resul of trying to runa test with the probe off ALERT NEW PROBE POWER OFF amp POWER ON Indicates that the TympStar has recognized a new probe and that the calibration process needs take place before progressing THRESHOLD SEEK IN PROGRESS Status message that threshold seek is in progress and searching for the correct trace to mark This is only available in Reflex threshold tests ALERT NOT AVAILABLE Indicates that a certain function of the Tympstar is not available It may be available in later versions of the TympStar software CLEARING TEST DATA Indicates that the clear test command has been called and that the system is in the process of clearing test s ALERT INVALID SELECTION WHILE MARK THRESHOLD IS ACTIVE Invalid selection when most keys are pressed while mark threshold is active ALERT INVALID SELECTION WITH NONACOUSTIC STIMULUS Indicates that the user tried to
83. the first stimulus presenta tion up to two more ascending presentations will follow in an attempt to lo cate a reflex response Refer to the table below Screening Reflex Test Intensity Presentations dB HL per Frequency HL level Stimulus Frequency 500Hz 1000Hz 2000Hz 4000Hz dBHL dBHL dBHL dBHL 85 85 85 80 95 95 95 90 105 105 105 100 90 90 90 90 Tymp screening includes screening acoustic reflex The structure of softkey menu selections is diagrammed below Please refer to Chapter 1 Introduc structure tion for instructions regarding navigating through softkey menus and chang ing parameter settings P RANGE P RATE START GRADIENT EAR MORE daPa daPa s daPa Les 600 400 200 d 400 RATIO OFF LEFT daPa mi BASELINE AUTO REFLEX STIMULUS MORE START Hz OFF on OFF est CONTRA IPSI CONTRA 500 2000 4000 Tymp screening softkey menu structure 4 14 Grason Stadler AUTO START ON AUTO START OFF BASELINE ON Operation 1 Select Tymp test mode if necessary by n Refl Etf Special pressing the TYMP hardkey ymp Reflex Etf Specia amp 2 Press RETURN hardkey on the LCD panel and the SCREEN softkey to display the Tymp Screening menu 3 Place the appropriate size SCREENING eartip on probe tip The probe box may be positioned on the velcro wristband as a convenience during screening tests 4 Press the EAR softkey and select the right or left ear then if desired
84. the previous transmission The record sequence number is provided to allow the Remote Device a means to detect if a record it has received is a new record or a retransmission of the previous record 5 3 4 Record Size The actual length and format of the data records vary based on the type of test and the length of the test the number and amount of lines used The record contains data only for the number of lines or traces which were actually used during the test The maximum total size of all records in any case do not exceed 512 bytes The record formats defined in Section 7 are for the worst case condition when the maximum amount of data for a test is transmitted D 6 Grason Stadler Remote Specifications 5 4 Summary and XY Graphical Data When the Summary and XY Graphical record type is selected upon entering the Remote Mode the actual X and Y axis values used to plot the graphs on the LCD screen are sent in addition to the test parameter and numerical test results The test s summary data and XY graphical data transferred to the Remote Device are broken up into a sequence of records This is necessary due to the large amount of XY graphical data that may be transmitted for a test The first record is a summary data record record type 8 to transfer the test parameter information and summary test results This record is followed by a series of XY Graphical data records If no XY data exists yet for this test a summary data record is tr
85. the selections and return to the Instrument Options softkey menu The STORING DATA message will appear on the screen above the softkey labels DATA TRANSFER SETTINGS TYMP REFLEX REFLEX CLEAR STORE MORE THRESHOLD DECAY TEST PAN GRAHPIC GRAPH GRAPH ETF ETF MORE INTACT PERF TM TE GRAPH GRAPH LANGUAGE The language displayed on the screen printed on reports and provided for key 1 1 board interaction can be English French LCD amp PRINTER KEYBOARD German Spanish or Italian tec rux cemara rrt exc Fur cuusra rraL The Auto Sequence function conducts a predefined sequence of tests when the AUTO SEQUENCE softkey is pressed The sequence of tests always includes Tymp Diagnostic at 226 Hz Y and can be configured by the user to also in clude Reflex Threshold and Reflex Decay testing as well Press REFLEX THRESHOLD and then ON to include Reflex Threshold testing Press RE FLEX DECAY and then ON to include Reflex TEST SEQUENCE Decay testing Press STORE to store the con REFLEX REFLEX figurations and return to THRESHOLD DECAY the Instrument Options softkey menu Lon RAR GSI TympStar Version 1 Reference Instruction Manual 4 61 Remote Settings GSI Suite Date and Time Chapter 4 NOTE Refer to the Auto Sequence Program Mode for details regarding program ming this feature Communication settings for the RS232 serial port are configured using the Remote Settings softkey menu functions Press
86. to 32 2 12 48 3 16 64 4 20to 80 5 04 to 16 6 08 to 32 Grason Stadler 226 231 233 239 240 241 242 247 252 254 256 259 261 265 266 267 270 276 281 286 291 296 298 304 305 306 BNW Cursor X value Line 1 data header Line 1 cursor Y value Admittance status Stimulus Ear status Zero field On Time Zero field Number Averaged Activator Stimulus Click rate Zero field Pressure Number of traces Intensity unit Trace 1 intensity Trace 1 amplitude 1096 ON time 9096 ON time 1096 OFF time 9096 OFF time Line 2 data header Line 2 cursor Y value Admittance status Stimulus Ear status Zero field Remote Specifications 7 12 to 48 8 16to 64 9 20 to 80 0 to 1800 msec if Cursor not used 11 30800 to 30800 if Cursor not used IPSI Steady CONTRA Il Ow 100 to 1800 msec 0 to 50 0 OFF 0 Not used 1 500 Hz 2 1000 Hz 3 2000 Hz 4 4000 Hz 5 Low Band Noise 6 High Band Noise 7 Broad band Noise 8 Click 9 External 10 Not used 11 Not used XXX 50 to 300 sec xxx 600 to 400 daPa 0 or 1 0 1 2 SPL XXX 35 to 120 dB 30800 to 30800 XXXXX 0 to 1800 msec if value unavailable XXXXX 0 to 1800 msec NA if value u
87. to start an Auto Sequence test The user must be on the Tymp Diagnostic screen for this remote command to be valid 003 Set TYMP Diagnostic Probe Hz Used to change the Probe Hz parameter This command is only valid in the Tymp Diagnostic test mode Any change that occurs due to a change in Probe Hz changes immediately as if the change was made navigating the menus 004 Set TYMP Diagnostic Admittance Used to change the Admittance parameter This command is only valid in the Tymp Diagnostic test mode Any change that occurs due to a change in Admittance changes immediately as if the change was made navigating the menus 005 Set TYMP Diagnostic Pressure Range Used to change the Pressure range between Normal and Wide This command is only valid in the Tymp Diagnostic test mode GSI TympStar Version 1 Reference Instruction Manual D 11 Appendix D 006 TYMP Diagnostic Ear Toggle Used to toggle between Left and Right Ear This command is only valid in the Tymp Diagnostic test mode 007 Set TYMP Diagnostic Pressure Rate Used to modify the Pressure rate parameter This command is only valid in the Tymp Diagnostic test mode 008 Set TYMP Diagnostic Start Pressure Used to modify the Start Pressure parameter This command is only valid in the Tymp Diagnostic test mode 009 Set TYMP Diagnostic Baseline Used to modify the Baseline parameter On or Off This command is only valid in the Tymp Diagnostic test mode 010 Set TYMP Diagnostic Gra
88. to transferring test results to the GSI Suite This is accomplished automatically if auto sequence is used or manually via the Mark Threshold Softkey See the GSI Suite User Manual which has been included with all TympStars starting in July 2011 for further details The date and time formats and settings displayed on the screen and on printed reports are configured using the Date Time softkey menu Press the desired DATE and TIME formatting softkeys and use the up and down arrows to set the DATE and TIME Press the STORE softkey to store the configurations and return to the Options softkey menu NOTE The softkeys labeled MONTH DAY YEAR display the value selected using the up and down arrows Pressing the MONTH DAY YEAR keys will not alter the settings and will result in an Invalid Selection message Grason Stadler Facility Name Version Operation NOTE Be certain to press the STORE softkey prior to returning to the Main Options menu to insure that all data and time settings are saved The Facility Name softkey menu and an external keyboard can be used to store a facility name that will be displayed on the screen and on printed reports MI ETF INTRCT TH TEST 9 11 08 2000 00 47 am 1 5 i PRESSURE daPa EARCANAL VOLUME daPa er 1 1 8 600 400 200 0 200 400 21 M COMPLIANCE T 0 5 00 5 10 15 8 8 ENTER FACILITY NAME
89. to tympanometric data 8 Press the STOP hardkey to store the last two tracings in memory These results can be printed by pressing the PAGE hardkey to retrieve the results and then pressing the PRINT hardkey NOTE The word MANUAL will appear on the printout indicating a manual test TYMP DIAGNOSTIC TEST 3 vtm 226 Hz R TYMP DIAGNOSTIC TEST 1 Ytm 226 Hz L 1 5 4 5 400 200 0 f 50 daPa s EARCANAL VOLUME 1 0 daPa TYMP 1 5 EARCANAL VOLUME 0 9 TYMP 2 TYMP 3 daPa ml GRADIENT 0 7 200 daPa 200 TYMP 20 0 2 TYMP gt 20 0 3 Ear canal volume 0 2 to 2 0 ml actual size will vary with age and bone structure Compliance peak 0 2 to 1 8 ml Pressure peak 150 to 100 daPa GSI TympStar Version 1 Reference Instruction Manual Tymp screening with Reflex Tymp mode Tymp screening softkey menu Chapter 4 The Screening mode is an automated test mode designed to yield rapid Tymp and Reflex test results The screening eartips that are provided will comfort ably seal the ear by HAND HOLDING the probe against the outer portion of the ear canal The user may run one tympanogram sweep on a test screen followed by an Ipsi Contra or Ipsi Contra Reflex test if desired The pressure at which the Reflex test is performed is automatically set to the dynamic com pliance peak pressure measured during the Tymp test If a reflex response compliance change of 05 ml is not detected upon
90. which an invalid character is being entered 000 Patient Name 001 Patient ID 002 Tester Name 003 Facility Name Invalid test data request Data was requested to be printed transferred or cleared for a test which is greater than 26 The error subcode indicates the action requested for the test greater than 26 000 Print Test 001 Clear Test 002 Transfer Test Invalid test data request Data was requested to be printed transferred or cleared for a test which has not yet been performed Example Current test is but data was requested for test 5 The error subcode indicates the action requested for the invalid test 000 Print Test 001 Clear Test 002 Transfer Test Invalid selection in Instrument Options An integer selection for setting Instrument options was not valid The error subcode indicates the instrument options menu item causing the error 000 Invalid Menu Item 001 Print Format 002 Data Transfer 003 Language 004 Test Sequence 005 Remote Settings 006 Date Time Formats 007 Set Date 008 Set Time Invalid Current XY Data request This command is invalid in Multiple Frequency Screen 2 Invalid selection with Program Mode Records Error entering Altitude Calibration using the remote system Error using record that is not available in Version 1 Error using record for single key press The keycode entered must be between 1 and 26 to represent the hardkeys or softkeys GSI Ty
91. 0 Send 1 Query for Time 0 Hour 1 Minute CR Grason Stadler Remote Specifications 8 16 Remote Function Records 8 16 1 Transmit Current XY Data Request Command Offset Char 0 1 1 3 4 1 5 1 6 1 Field Name Field Definition Start of record Record type 118 Request code 0 Send Carriage return CR Line feed LF 8 16 2 Transmit Test Data Request Command Offset Char 0 1 1 3 4 1 5 2 7 1 8 1 9 1 Field Name Field Definition Start of record iu Record type 119 Request code 0 Send Test number XX 00 Transmit all test 01 to 26 Transmit test selected Record format 0 Summary record 1 Summary amp Graphic record Carriage return CR Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 131 Appendix D 8 17ACK NAK Records 8 17 1 Record Received OK Acknowledgement ACK Offset Field Name Field Definition Char 0 1 Start of record P 1 3 Record type 120 4 1 Request code 0 Send 5 1 Carriage return CR 6 1 Line feed LF 8 17 2 Record Received Incorrectly Acknowledgement Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 121 4 1 Request code 0 Send 5 1 Carriage return CR 6 1 Line feed LF D 132 Grason Stadler Remote Specifications 9 Error Record Formats 9 1 Error Record Definitions Error Code 001 002 003 004 00
92. 0 Softkey 1 01 Softkey 2 02 Softkey 03 Softkey 4 04 Softkey 5 05 Softkey 6 06 TYMP 07 REFLEX 08 09 SPECIAL 10 11 START_L 12 ERASE 13 RETURN 14 PAGE 15 CLEAR 16 17 DATA X 18 STIM 192 STIMU 20 D 21 U 22 PRINT 23 UNUSED 24 25 HOLD 26 PRESENT 7 1 Carriage return CR 8 1 Line feed LF 8 2 Tymp Diagnostic Individual SoftKey Commands 8 2 1 Start Auto Sequence Command Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 002 4 1 Request code 0 Send 1 Not used 5 1 Carriage return CR 6 1 Line feed LF 8 2 2 Set TYMP Diagnostic Probe Hz Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 003 4 1 Request code 0 Send 1 Query for Probe Hz value 5 1 Probe Tone 0 226 Hz 1 678 Hz 2 1000 Hz 6 1 Carriage return CR 7 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 89 8 2 3 Offset 8 2 4 Offset 8 2 5 Offset 8 2 6 Offset Appendix D Set TYMP Diagnostic Admittance Field Name Field Definition Char 1 Start of record 3 Record type 004 1 Request code 0 Send 1 Query for Admittance value 1 Admittance 0 1 8 2 0 3 B G 1 Carriage return CR 1 Line feed LF Set TYMP Diagnostic Pressure Range Field Name Field Definition Char 1 Start of record p 3 Record type 005 1 Re
93. 00 daPa 1 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa 5 500 daPa 6 300 daPa 7 0 daPa 8 4300 daPa 6 1 Carriage return CR 7 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 119 8 10 4 Set Multiple Hz 1 Delta Plot Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Admittance 6 1 Carriage return 7 1 Line feed 8 10 5 Multiple Hz 1 Ear Toggle Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Selection code 5 1 Carriage return 6 1 Line feed 8 10 6 Set Multiple Hz 1 Cursor Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Cursor 6 3 Number of dots 9 1 Carriage return 10 1 Line feed 8 10 7 Multiple Hz 1 Continue Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Carriage return 6 1 Line feed D 120 Appendix D Field Definition Field Definition 090 0 Send 1 Query for ear selection CR Field Definition 091 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right 2 Set Peak XXX 010200 only if cursor 1 or 2 0 Position to Y axis 1 dot CR Field Definition 092 0 Send Grason Stadler Remote Specifications 8 11Multiple Hz 2 Individual Softkey Commands 8 11 1 Set Multiple Hz 2 Cursor
94. 00 msec Grason Stadler 253 255 257 260 262 266 267 268 271 277 282 287 292 297 299 305 306 307 308 313 318 320 322 325 327 2 Zero field 2 Activator Stimulus Click rate Zero field Pressure Number of traces Intensity unit BNW Trace 1 intensity Trace 1 amplitude 5096 Decay time Zero field Zero field Zero field Line 2 data header Line 1 cursor Y value nm 01 0101 1 Admittance status 1 Stimulus Ear status Zero field On Time Zero field Zero field Activator Stimulus MNNOO gt 3 Click Rate 2 Zero field 4 Pressure Remote Specifications Not used 500 Hz 1000 Hz 2000 Hz 4000 Hz Low Band Noise High Band Noise Broad band Noise Click External 10 Not used 11 Not used XXX 50 to 300 sec OO 600 to 400 daPa 0 or 1 0 HL 1 2 SPL XXX 35 to 120 dB 4 30800 30800 1000 to 54000 msec NA if value unavailable NO if 50 point not found L2 30800 to 30800 if Cursor not used 1000 to 54000 msec 0 Not used 1 500 Hz 2 1000 Hz 3 2000 Hz 4 4000 Hz 5 Low Band Noise 6 High Band Noise 7 Broad band Noise 8 Click 9 External 10 Not used 11 Not used XXX 50 to 300 sec xxx 600 to 400 daPa GSI TympStar Version 1 Reference Instruction Manual D 35 331 1 332 1 333 3
95. 1 Field Name Start of record Record type Request code ml Scale Carriage return Line feed 8 9 5 Sensitization Ear Toggle Offset Char 0 1 1 4 1 5 1 6 1 Field Name Start of record Record type Selection code Carriage return Line feed GSI TympStar Version 1 Reference Instruction Manual Remote Specifications Field Definition 076 0 Send 1 Query for Auto Zero selection 0 Automatic 1 Manual CR Field Definition 077 0 Send 1 Query for ml Scale selection 0 4 04 to 16 1 4 08 to 32 2 4 12 to 48 4 16 to 64 4 4 20 to 80 5 04 to 4 16 08 to 32 7 12 to 48 8 16 to 64 20 to 80 Field Definition 078 0 Send 1 Query for ear selection CR D 115 8 9 6 Set A R Sensitization Admittance Offset 8 9 7 Offset 8 9 8 Offset D 116 Field Name Char 1 Start of record 3 Record type 1 Request code 1 Admittance 1 Carriage return 1 Line feed Set A R Sensitization Timebase Field Name Char 1 Start of record 3 Record type 1 Request code 1 Timebase 1 Carriage return 1 Line feed Set A R Sensitization Step size Field Name Char 1 Start of record 3 Record type 1 Request code 1 step size 1 Carriage return 1 Line feed Appendix D Field Definition Field Definition 080 0 Send 1 Que
96. 1 Manual 6 1 Carriage return CR 7 1 Line feed LF 8 7 5 Reflex Decay Ear Toggle Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 054 4 1 Selection code 0 Send 1 Query for ear selection 5 1 Carriage return CR 6 1 Line feed LF 8 7 6 Set Reflex Decay Admittance Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 055 4 1 Request code 0 Send 1 Query for Admittance value 5 1 Admittance 0 1 8 2 0 6 1 Carriage return CR 7 1 Line feed LF 8 7 7 Set Reflex Decay Timebase Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 056 4 1 Request code 0 Send 1 Query for Timebase selection 5 1 Timebase 0 2 15 sec 1 30 sec GSI TympStar Version 1 Reference Instruction Manual D 107 8 7 8 Offset 8 7 9 Offset 8 7 10 Offset D 108 1 Carriage return 1 Line feed Set Reflex Decay Step size Field Name Char 1 Start of record 3 Record type 1 Request code 1 step size 1 Carriage return 1 Line feed Set Reflex Decay ml Scale Field Name Char 1 Start of record 3 Record type 1 Request code 1 ml Scale 1 Carriage return 1 Line feed Set Reflex Decay Cursor Field Name Char 1 Start of record 3 Record type 1 Request code Appendix D 2 45 sec 60 Field Definition p 057 0 Send 1 Query for Step size selection 0 1
97. 1 Carriage return 22 1 Line feed 7 9 11 3Multiple Hz 3 Admittance Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Admittance 8 2 Checksum 10 1 Carriage return 11 1 Line feed Remote Specifications Field Definition 9 Query Record 00 to 99 096 XXXX XXXX XXXX Extra cursor value if B G Admittance otherwise LP Field Definition 9 Query Record XX 00 to 99 098 7 9 11 4Multiple Hz 3 Pressure Range Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Pressure Range 8 2 Checksum 10 1 Carriage return 11 1 Line feed Field Definition 9 Query Record XX 00 to 99 099 0 Normal 1 Wide XX CR GSI TympStar Version 1 Reference Instruction Manual D 81 7 9 11 5Multiple Hz 3 Pressure Rate Char Offset Field Name 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Pressure Rate 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 11 6Multiple Hz 3 Start Pressure Char Offset Field Name 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Start Pressure 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 12 Keyboard Entry Records 7 9 12 1 Patient Name Char Offset Field Name 0 1 Start of record 1 1 Request Record
98. 12 2 Checksum 14 1 Carriage return 15 1 Line feed 7 9 6 4 Reflex Decay Auto Zero Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Auto Zero 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 6 5 Reflex Decay Ear Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Ear 8 2 Checksum 10 1 Carriage return 11 1 Line feed Field Definition p 9 Query Record XX 00 to 99 052 XXXXX XX Field Definition 9 Query Record 00 to 99 053 0 Automatic 1 Manual CR LP Field Definition p 9 Query Record XX 00 to 99 054 0 Left 1 Right XX GSI TympStar Version 1 Reference Instruction Manual 7 9 6 6 Reflex Decay Admittance Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 1 11 7 9 6 7 Reflex Decay Timebase Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 7 9 6 8 Reflex Decay Step size Offset NAD 10 11 Char Wh Field Name Start of record Request Record Record Sequence Record type Admittance Checksum Carriage return Line feed Field Name Start of record Request Record Record Sequence Record type Timebase Checksum Carriage return Line feed Field Name Start of record Request Record Record Sequence Record type step s
99. 17 1 18 1 Remote Specifications TYMP Screening Cursor Field Name Start of record Request Record Record Sequence Record type Tymp 1 X value Tymp 1 Y Value Checksum Carriage return Line feed Field Definition p 9 Query Record XX 00 to 99 021 XXXX XXXX XX 600 to 400 7 9 8 Reflex Threshold Individual SoftKey Commands 7 9 3 1 Reflex Threshold Stimulus Ear Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 1 Field Name Start of record Request Record Record Sequence Record type Reflex Type Checksum Carriage return Line feed Field Definition p 9 Query Record XX 00 to 99 022 0 IPSI 1 CONTRA STEADY 2 CONTRA PULSED XX CR 7 9 3 2 Reflex Threshold Mark Threshold Offset Char 0 1 1 1 2 2 4 3 7 1 8 1 1 10 1 11 2 13 1 14 1 Field Name Start of record Request Record Record Sequence Record type Line 1 Marked Trace Line 1 Mark Type Line 2 Marked Trace Line 2 Mark Type Checksum Carriage return Line feed GSI TympStar Version 1 Reference Instruction Manual Field Definition p 9 Query Record XX 00 to 99 023 The number of the trace marked NR NR TS us E The number of the trace marked NR TS Pop Il XX R L F 7 9 3 3 Reflex Threshold Threshold Seek Offset Field Name Char 0 1 Start of
100. 3 3 Set TYMP Screening Start Pressure Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 014 4 1 Request code 0 Send 1 Query for Start Pressure selection 5 1 Start Pressure 0 600 1 400 2 200 daPa 3 200 daPa 4 400 daPa 6 1 Carriage return CR 7 1 Line feed LF 8 3 4 Set TYMP Screening Gradient Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 015 4 1 Request code 0 Send 1 Query for Gradient selection 5 1 Gradient 0 TYMP WIDTH 1 RATIO 2 OFF 6 1 Carriage return CR 7 1 Line feed LF 8 3 5 TYMP Screening Ear Toggle Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 016 4 1 Selection code 0 Send 1 Query for ear selection 5 1 Carriage return CR 6 1 Line feed LF 8 3 6 Set TYMP Screening Baseline Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 017 4 1 Request code 0 Send 1 Query for Baseline selection 5 1 Baseline 0 2 ON 1 OFF 6 1 Carriage return CR 7 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 93 Appendix D 8 3 7 Set TYMP Screening Auto Start Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 018 4 1 Request code 0 Send 1 Query for Auto Start selection 5 1 Auto Start 0 2 ON 1 OFF 6 1 Carriage return CR 7 1 Lin
101. 4 22 Reflex Threshold automatic test procedure sse 4 23 SU 4 23 Auto timing of stimuli etr or SUR RIPE eau qe sto a MER tup HAE 4 24 Minimum and maximum timing allowable for reflex threshold 4 24 Manual timing of stimuli 4 24 PIN CMM DM S 4 26 Mark Threshold 2 eee tote aude 4 26 Threshold Seek eod e tiet eden E eec 4 27 Manual threshold testing 4 28 Reflex threshold sample 4 30 Reflex Threshold MANUAL test procedure eene 4 31 threshold tete 4 32 Program mode for Reflex Threshold d aus 4 33 Softkey men SI Ho BTE Css codon 4 33 Prouram MOOS 4 33 Reflex D cay testing E E 4 35 Softkey mMenu SICHCBUEO 4 35 Minimum and maximum timing levels allowable in Reflex Decay 4 36 Reflex Decay sample esee ec ie Used tse Ras 4 38 Program mode Tor Reflex D amp eay osse een een 4 30 Eustachian Tube Function Testing for Intact Eardrums sss 4 41 Pressure s wallow test eoe teli se
102. 400 200 Facility Name location Press the FACILITYNAME softkey The screen will display the ENTER FACIL ITY NAME message and the blinking cursor will show the location of the name that can be entered from the keyboard Enter the desired header information and press the STORE softkey NOTE The maximum number of characters allowed for a Facility Name is 45 The Version function provides an easy way for a TympStar Version 1 to be upgraded to a Version 2 instrument Version 2 functionality provides ex panded testing capability and includes 678 and 1000 Hz probe tones multi frequency tympanometry and ARLT testing A license code must be obtained from Grason Stadler to upgrade a TympStar Version 1 to a Version 2 To change from a TympStar Version 1 to a Version 2 1 Press the hardkey to select the ETF test mode then press the RE TURN hardkey to display the ETF sub menu Tymp Reflex Etf Special V Ww 2 3 INTACT PERF INSTRUMENT PROGRAM TM TM OPTIONS MODE GSI TympStar Version 1 Reference Instruction Manual 4 63 Chapter 4 EARCANAL VOLUME TYMP 1 200 460 2 TYMP 3 COMPLIANCE 10 5 9 9 0 TESTER 8 INSTRUMENT OPTIONS 2 Press the INSTRUMENT OPTIONS softkey then the MORE softkey to dis play the VERSION softkey selection i PRESSURE EARCANAL VOLUME daPa ST TYMP 1 600 400 200 0 200 4400 TYNP 2 TYMP 33 Sp
103. 42 Lampe R Weir M McLeod Aspinall K Artalejo L Tympanometry in Acute Otitis Media J Dis Child 1981 135 233 235 Paradise J Smith C Bluestone C Tympanometric Detection of Middle Ear Effusion in Infants and Young Children Pediatrics 1976 58 198 210 GRADIENT Fiellau Nikolajsen M Tympanometry and Middle Ear Effusion A Cohort Study in Three Year Old Children J Ped Otorhinolaryngology 1980 2 39 49 de Jonge R Normal Tympanometric Gradient A Comparison of Three Methods Audiology 1986 25 299 308 ACOUSTIC REFLEX Block M Wiley T Acoustic Reflex Growth and Loudness J Speech And Hear 1979 Res 22 295 310 Borg E Recovery of the Human Intra aural Muscle Reflex after Pauses of Various Depth Acta Otolaryngology 1980 90 1 5 Chiveralls K FitzSimons R Beck G Kerhohan Diagnostic Significance of the Stapedius Reflex Br J Audiol 1976 10 122 128 Clemis J Acoustic Reflex Testing in Otoneurology Otolaryngol Head and Neck Surg 1984 92 2 141 144 Cretin W Vanpeperstraete P Van Camp K Doclo J An Experimental Study on Diphasic Acoustic Reflex Patterns in Normal Ears Scan Audiol 1976 5 3 8 Dallos P Dynamics of the Acoustic Reflex Phenomenological Aspects J Acoust Soc Am 1964 36 11 2175 2183 Djupesland G Zwislocki J the Cr
104. 5 006 007 008 010 011 Error Sub code 000 000 000 000 000 000 000 000 Record Type Record Type Error Description Invalid CRLF record termination The record received was not terminated by the valid ASCII character sequences CR then LF in the proper character positions Record is invalid for current state The command specified cannot be processed because it is not valid for the state of the system which is defined by the operating state RUN HOLD STOP or MANUAL whether the test is stopped or in hold or has been started and measurements are being made Record is invalid for current test mode The command specified cannot be processed because it is not valid for the test selected Tymp Diagnostic Reflex Threshold etc Record is invalid for current state or test mode The command specified cannot be processed because it is not valid for the state of the system which is defined by the operating state RUN HOLD STOP or MANUAL or the command specified cannot be processed because it is not valid for the test selected Tymp Diagnostic Reflex Threshold etc Invalid character for Request Code This should be a 0 for sending a remote record and a 1 for querying a value Non numeric character in a numeric field Example The ASCII character in the ON time field of a Set Timing Parameter command to set the ARLT ON time to 1 000 msec 1201 000CRLF Invalid rec
105. 50 daPa sec 2 200 daPa sec 3 600 200 daPa sec 30800 to 30800 if no Peak XXX 600 to 400 daPa ifno Peak 0 positive to negative 1 negative to positive Grason Stadler 286 289 291 297 298 299 300 306 310 311 314 316 317 Gradient data Line 3 data header Line 3 cursor Y value Admittance status Pressure Range status Pressure Rate status Peak Compliance data Peak Pressure data Sweep Direction status Gradient data Checksum Carriage return Line Feed Remote Specifications If Gradient RATIO XXX 1 to 999 daPa If Gradient TYMP WIDTH XXXX 00 to 990 0 if Gradient could not be calculated if Gradient Status OFF L3 4 30800 to 30800 if Cursor not used 0 12 5 daPa sec 1250 daPa sec 2 200 daPa sec 3 600 200 daPa sec XXXxx 30800 to 30800 Peak XXX 600 to 400 daPa if no Peak 0 positive to negative 1 negative to positive If Gradient RATIO XXX 1 to 999 daPa If Gradient TYMP WIDTH XXXX 00 to 990 0 if Gradient could not be calculated if Gradient Status OFF XX CR GSI TympStar Version 1 Reference Instruction Manual 7 1 2 Tymp Screening Offset 4 Field Name Chars 0 1 Start of record 1 1 Record Type 2 2 Record Sequence Number 4 45 Patient Name 49 45 Patien
106. 6 REFLEX I 1000 Hz YES 1 1 daPa ml 0 14 GSI TympStar Version 1 Reference Instruction Manual 4 17 Program mode for Tympanometry Program mode softkey menu structure Screen and diagnostic softkeys User softkeys Program Mode Chapter 4 Up to three users may permanently redefine and store per USER NUMBER individualized default criteria to fit testing needs Default test parameters may be reprogrammed for the Tymp Diagnostic or Tymp Screening tests The structure of softkey menu selections is diagrammed below Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings Press the TYMP hardkey then press the RETURN hardkey to display the tymp sub menu Wes Tymp Reflex Etf Special SCREEN DIAGNOSTIC USER1 USER 2 USER 3 PROGRAM MODE Pressing the SCREEN or DIAGNOSTIC softkey provides direct access to screening or diagnostic test functions that use the system defaults For ex ample to run screening tests with system defaults press the SCREEN softkey Pressing one of the 3 USER softkeys provides access to test functions with defaults previously programmed by or for one of up to three users For ex ample to run screening tests or diagnostic tests with defaults programmed earlier by user 1 press the USER 1 softkey Each USER softkey can be programmed to provide access to either screening or diagnostic test functions but not
107. 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 9 2 Multiple Hz 1 Pressure Rate Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 087 7 1 Pressure Rate 0 12 5 daPa s 1250 daPa s 2 200 daPa s 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 78 Grason Stadler 7 9 9 3 Multiple Hz 1 Start Pressure Field Name Remote Specifications Field Definition Char Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 7 9 9 4 Multiple Hz 1 Delta Plot Start of record Request Record Record Sequence Record type Start Pressure Checksum Carriage return Line feed Field Name 9 Query Record XX 00 to 99 088 0 600 daPa 1 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa 5 500 daPa 6 300 daPa 7 0 daPa 8 300 daPa XX LP Field Definition Char Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 Start of record Request Record Record Sequence Record type Admittance Checksum Carriage return Line feed 7 9 9 5 Multiple Hz 1 Ear Field Name sg 9 Query Record XX 00 to 99 089 0 Y 1 B 2 G XX CR P Field Definition Char Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 Start of record Request Record Record Sequence Record type Ear Checksum Carriage return Line feed
108. 9 94 139 184 193 213 215 216 217 218 220 225 226 227 232 234 240 241 242 Reflex Threshold Chars 45 45 45 20 Field Name Start of record Record Type Record Sequence Number Patient Name Patient ID Tester Name Facility Name Probe S N Date Time Test type Test number Ear Under Test Auto Sequence ProbeTone Timebase Number of lines Y axis scale Cursor X value Line 1 data header Line 1 cursor Y value Admittance status Stimulus Ear status Timing Manual Auto Appendix D Field Definition 1 Summary data record Summary data record with attached XY data records XX 00 to 99 XXXXXXXXXXX 0 to 45 characters for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters 9 characters for unused characters XX XX XXXX XX XX xm for xm if 24 Hour time format 2 Reflex Threshold 1 to 9 and Ato ll L Left Ear R Right Ear 0 Off 1 0 226Hz 1 678 Hz 2 1000 Hz XXXXX 15000 to 60000 msec 0 1 or2 0 04 to 16 1 08 to 32 2 12 to 48 3 16 to 64 4 20 to 80 5 04 to 16 6 08 to 32 7 12 to 48 8 16 to 64 9 20 to 80 XXXXX 0 to 60000 msec if Cu
109. CAY 10 RUTOMATIC RIGHT _ STIM ON AUTO ERR MORE TIME ZERO System in PROGRAM MODE to display the Reflex Decay menu across the bottom of the screen The PRO GRAM MODE REFLEX DECAY status message will shown in the status area of the screen GSI TympStar Version 1 Reference Instruction Manual 4 39 40 Chapter 4 Test parameters can now be selected from the usual softkey menu as done in preparation for a test Once all the test parameters have been selected press ing the RETURN hardkey returns the display to the PROGRAM MODE sub menu Pressing the STORE softkey stores the selected parameters as defaults for future tests STORING DATA status message will be dis played Press the SPECIAL or other test mode hardkey to return from the Program Mode to the Reflex Decay test with the new test param eter defaults REFLEX STORE DECAY Tymp Reflex Etf Special 7 Grason Stadler Eustachian Tube Function Testing for Intact Eardrums Pressure swallow test Operation One purpose of the Eustachian tube is to equalize pressure between the middle ear space and ambient pressure Normally the Eustachian tube temporarily opens during a swallow or yawn thereby allowing an exchange of air between the middle ear and the nasopharynx Between swallows slight fluctuations may occur in the pressure level within the middle ear since the cells which line the middle ear absorb air from the cavity If
110. CR 7 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 123 8 13Keyboard Entry Records 8 13 1 Patient Name Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 45 Patient Name 50 1 Carriage return 51 1 Line feed 8 13 2 Patient ID Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 45 Patient ID 50 1 Carriage return 51 1 Line feed 8 13 3 Tester Name Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 45 Tester Name 50 1 Carriage return 51 1 Line feed D 124 Appendix D Field Definition 102 0 Send 1 Query for Patient Name Any valid keys including numbers letters and the special characters of period comma hyphen and apostrophe There will also be certain foreign characters that are valid depending on the keyboard language that is selected under instrument options CR Field Definition ap 103 0 Send 1 Query for Patient ID Any valid keys including numbers letters and the special characters of period comma hyphen and apostrophe There will also be certain foreign characters that are valid depending on the keyboard language that is selected under instrument options CR Field Definition 104 0 Send 1 Query for Tester Name Any valid keys including numbers letters and the special charact
111. Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Admittance 6 1 Carriage return 7 1 Line feed D 122 Appendix D Field Definition 096 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right 2 Set Peak XXX 010200 only if cursor 1 or 2 0 Position to Y axis 1 dot Field Definition aK 097 0 Send C Field Definition Grason Stadler Remote Specifications 8 12 5 Set Multiple Hz 3 Pressure Range Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 099 4 1 Request code 0 Send 1 Query for Pressure Range selection 5 1 Pressure Range 0 Normal 1 2 Wide 6 1 Carriage return CR 7 1 Line feed LF 8 12 6 Set Multiple Hz 3 Pressure Rate Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 100 4 1 Request code 0 Send 1 Query for Pressure Rate selection 5 1 Pressure Rate 0 12 5 daPa s 1250 daPa s 2 200 daPa s 6 1 Carriage return CR 7 1 Line feed LF 8 12 7 Set Multiple Hz 3 Start Pressure Offset Field Name Field Definition Char 0 1 Start of record p 1 3 Record type 101 4 1 Request code 0 Send 1 Query for Start Pressure selection 5 1 Start Pressure 0 600 daPa 1 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa 5 500 daPa 6 300 daPa 7 0 daPa 8 300 daPa 6 1 Carriage return
112. Checksum CR Line Feed LF NOTE Frequency in Hz Probe Tone value 2 x 50 GSI TympStar Version 1 Reference Instruction Manual D 45 7 2 XY Graphical Data Record 7 2 1 Record Format Offset 11 O Na o lol eS ll Field Name Start of record Record Type Record Sequence Number Test number Number of XY data Number of XY data Number of XY data Data pair 1 X Data pair 1 X Data pair 1 X Data pair 1 X Data pair 1 Y Data pair 1 Y Data pair 1 Y Data pair 1 Y Data pair 2 X Data pair 2 X Data pair 2 X Data pair 2 X Data pair 2 Y Data pair 2 Y Data pair 2 Y Data pair 2 Y Data pair 29 Data pair 29 Data pair 29 Data pair 29 Data pair 29 Data pair 29 Data pair 29 Data pair 29 Checksum Carriage Return Line Feed digit 4 digit 3 digit 2 digit 1 digit 4 digit 3 digit 2 digit 1 digit 4 digit 3 digit 2 digit 1 digit 4 digit 3 digit 2 digit 1 X digit X digit X digit X digit Y digit Y digit Y digit Y digit NURA Appendix D Field Definition 2 XY Graphical data record XX 00 to 99 1 to 9 and AtoQ XXX 0 to 29 pairs for Line 1 XXX 0 to 29 pairs for Line 2 XXX 0 to 29 pairs for Line 3 Hex digit in ASCII format MSB Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format Hex
113. Checksum 21 1 Carriage return 22 1 Line feed 7 9 8 11A R Sensitization Stimulus Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 2 Stimulus GSI TympStar Version 1 Reference Instruction Manual Field Definition 9 Query Record XX 00 to 99 082 00 500 Hz 01 2 1000 Hz 02 2000 Hz 03 4000 Hz 04 Broad Band Noise 05 External 06 6000 Hz 07 Non Acoustic XXX dBHL XX LP Field Definition p 9 Query Record XX 00 to 99 083 XXXX XXXX XXXX XX CR Field Definition 9 Query Record XX 00 to 99 084 00 500 Hz 01 1000 Hz 02 2000 Hz 03 4000 Hz 04 Broad Band Noise 05 External 06 Non Acoustic 07 6000 Hz Appendix D 9 2 Checksum XX 11 1 Carriage return CR 12 1 Line feed LF 7 9 8 12 A R Sensitization Intensity Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 085 7 3 Intensity XXX dBHL 10 2 Checksum XX 12 1 Carriage return CR 13 1 Line feed LF 7 9 9 Multiple Hz 1 Individual SoftKey Commands 7 9 9 1 Multiple Hz 1 Pressure Range Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 086 7 1 Pressure Range 0 Normal 1 Wide
114. Definition Char 1 Start of record P 1 1 Record Type 4 Error record 2 2 Record Sequence Number 00 to 99 4 3 Error Code See Section 9 7 4 Error Sub Code See Section 9 11 2 Checksum XX 13 1 Carriage Return CR 14 1 Line Feed LF 7 5 Current X Axis and Y Axis Data Record Normal Mode Test X Axis and Y Axis Quantity Tymp Diagnostic Tymp Screen Tymp Tymp Screen Reflex Reflex Threshold ETF Intact TM ETF Perforated TM Reflex Decay ARLT ARST Multiple Frequency Screen 1 Multiple Frequency X Pressure daPa Y Compliance Baseline ml mmho x 1000 X Pressure daPa Y Compliance Baseline ml x 1000 X Time Y Compliance Reference compliance ml mmho x 1000 X Time Y Compliance Reference compliance ml mmho x 1000 X Pressure daPa Y Compliance Baseline ml mmho 1000 X Pressure daPa Y Time msec X Time msec Y Compliance Reference compliance ml mmho x 1000 X Pressure daPa Y Compliance Reference compliance ml mmho x 1000 X Pressure daPa Y Compliance Reference compliance ml mmho x 1000 X Pressure daPa Y Compliance ml mmho x 1000 Record not valid Grason Stadler Remote Specifications Screen 2 Multiple Frequency X Pressure daPa Screen 3 Y Compliance ml mmho x 1000 NOTE If Baseline is not selected the baseline value 0 Time values are referenced to the Y axis Ti
115. ERRCRNRL UOLUME daPa nl SSS TYMP 1 1 6 609 400 200 0 200 490 TYMP 2 TYMP 3 COMPLIANCE nl NORMAL 50 200 ON RIGHT P RRNGE P RRTE START BRSEL ERR daPa daPa s daPa System in PROGRAM MODE Test parameters can now be selected from the usual softkey menu as done in preparation for a test Once all the test parameters have been selected press ing the RETURN hardkey returns the display to the PROGRAM MODE sub menu Pressing the STORE softkey stores the modified parameters as defaults for future tests The STORING DATA status message will be displayed Press the ETF or other test function hardkey to return from the Program Mode to the ETF Intact test mode with the new test parameter defaults Grason Stadler Altitude Calibration Mode When to use Altitude Calibration Calibration procedure Equivalent cor rected compliance values Operation The GSI TympStar is calibrated at our factory where the altitude is very close to sea level When the TympStar is installed at higher altitudes the test cavity readings will be higher than their nominal values due to the differences in the density of air from site to site Refer to the following table for expected changes in cavity values based upon altitude Altitude in Feet Cavity size 0 1000 2000 3000 4000 5000 6000 7000 8000 0 5 ml 0 5 0 53 0 55 0 58 060 0 63 0 65 0 68 0 70 2 0 ml 2 0 2 1 22 23 24 25 26 27 2 8 NOTE Day to day variations in barom
116. Field Definition Char 0 1 Start of record 1 3 Record type 074 4 1 Request code 0 Send 1 Query for Stimulus Ear selection 5 1 Reflex Type 0 IPSI 12 CONTRA 2 Cfla 3 CfCa 4 5 6 1 Carriage return CR 7 1 Line feed LF 8 9 2 Set A R Sensitization Stimulus Timing Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 075 4 1 Request code 0 Send 1 Query for Stimulus timing selection 5 1 Auto Timing 0 Manual Timing 1 Auto Timing 6 1 Parameter type 0 ON time See chart of 1 OFF time valid selections 2 Quantity below 7 5 Parameter value XXXXX 12 1 Carriage return CR 13 1 Line feed LF Timebase On Time Off Time Quantity Min Max Incr Min Max Incr Min Max Incr 1500 125 1250 125 0 1125 125 1 10 1 3000 125 2625 125 0 2500 125 1 10 1 4500 250 4000 250 0 3750 250 1 10 1 6000 250 5250 250 0 5000 250 1 10 1 7500 500 6500 500 0 6000 500 1 10 1 9000 500 8000 500 0 7500 500 1 10 1 10500 500 9000 500 0 8500 500 1 10 1 12000 500 10500 500 0 10000 500 1 10 1 ror J The sum of the On time and Off Time cannot be greater than 90 of the timebase and the ON time cannot be 0 D 114 Grason Stadler 8 9 3 Set A R Sensitization Auto Zero Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 Field Name Start of record Record type Request code Auto Zero Carriage return Line feed 8 9 4 Set A R Sensitization ml Scale Offset Char 0 1 1 3 4 1 5 1 6 1 7
117. GSITYMPSTAR User V 1 SI Stadler Part Number 2000 0100 Rev C Title GSI TympStar Version 1 Middle Ear Analyzer Reference Instruction Manual Copyright 2011 Grason Stadler rights reserved No part of this publication may be reproduced or transmitted in any form or by any means without the prior written permission of Grason Stadler The information in this publication is proprietary to Grason Stadler Compliance The CE 0344 mark identifies compliance with the medical Device Directive 93 42 EEC Grason Stadler is an ISO 13485 certified corporation European Authority Representative EC REP Grason Stadler Kongebakken 9 2765 Smgrum Denmark Electromagnetic Compatibility Electromagnetic compatibility EMC Please refer to the Electromagnetic Compatibility Reference Guide on CD part number 482 6387xx information concerning your system Compatibilit lectromagn tique CEM Veuillez vous reporter au guide de r f rence de compatibilit lectromagn tique sur CD num ro de pi ce 482 6387xx pour des informations sur la CEM relatives votre systeme Elektromagnetische Vertraglichkeit EMV Informationen ber die EMV des Systems finden Sie im Referenz Handbuch Elektromagnetische Vertr glichkeit auf der CD Teilenummer 482 6387xx Compatibilit elettromagnetica EMC Vedere la guida alla consultazione per la compatibilit elettromagnetica conte
118. IGHT P RANGE P RATE START BASELINE EAR daPa daPa s daPa 4 Press the EAR softkey to toggle between the right and left ear then if desired navigate through the ETF Intact softkey menu and change parameter settings for the test as required Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings P RANGE P RATE START BASELINE E AR daPa daPa s daPa aay 12 5 d 600 200 600 400 200 200 400 T on OFF LEFT 500 300 0 300 MORE GSI TympStar Version 1 Reference Instruction Manual 4 43 44 4 5 With the probe eartip securely sealing the ear canal press Manual the lt START hardkey 6 The ear canal will be pressurized to 200 daPa The cun pressure will automatically sweep to 400 daPa or until the HOLD hardkey is pressed The ear canal will be Start vented e 7 The ear canal will AUTOMATICALLY be pressurized to 400 daPa Pressure will be maintained while a prompt message on the LCD directs the operator to have patient swallow water The ear canal will be vented once the CONTINUE softkey is pressed 8 Tymp 2 will sweep automatically as above The ear canal will be vented when either 400 daPa is reached or the HOLD hardkey is pressed 9 The ear canal will AUTOMATICALLY be pressurized to 400 daPa Pressure will be maintained while a prompt message asking to have patient swallow is displayed
119. K record had been received Each record will contain a record sequence number that allows the Remote Device to determine if a record is a retransmission of an incorrectly received record or is a new record GSI TympStar Version 1 Reference Instruction Manual D 7 Appendix D 5 5 3 Transmitting Series of Data Blocks When the GSI TympStar is transmitting a series of Summary and XY Graphical data block records each record is sent using the ARQ protocol and the transmission proceeds in this manner until all data block records have been transmitted At that time the GSI TympStar transmits an End of Data record See Section 7 for the record format to inform the Remote Device that all data has been transferred The Remote Device must again respond with an ACK or NAK to complete the transfer 5 6 Auto Clear Operation If the Auto Clear feature is selected prior to the transfer of data then after Summary test data or Summary and XY Graphical data has been successfully transmitted to the Remote Device the test data is automatically cleared from the LCD screen and from the page memory The Auto Clear function operates only for data transfers initiated by the Data Transfer hard key If the data transfer occurs while in STOP all summary and XY Graphical test data for the test just completed are cleared from the LCD screen and the page memory The test remains in STOP and the test number is not incremented when the next test is started If the data tra
120. Manual 3 13 Intensity limits check for reflex threshold Chapter 3 1 Press the STIMULUS EAR softkey and select IPSI STIMULUS EAR IPSI CONTRA CONTRA 2 Select the 500 Hz stimulus in the upper right corner STEADY FUSED of the screen by pressing the STIMULUS hardkey S7 Stimulus A 3 Continuously increase the stimulus intensity by pressing the INTENSITY up hardkey The INTENSITY LIMIT REACHED message will be displayed under the level meters 7 at intensities above 105 dB HL daPa STIMULUS INTENSITY pepeg 600 400 200 0 200 400 TIMING COMPLIANCE 15 sec INUALIO INTENSITY LIMIT RERCHEO MANUAL 15 ROMIT STIMULUS TIMEBRSE TRNCE TIMING This message is displayed for intensity limits of 110 dB HL for selected stimuli of 500 Hz amp 1000 Hz 105 dB HL for selected stimulus of 2000 Hz 100 dB HL for selected stimulus of 4000 Hz 95 dB HL for noise bands NOTE Any signal intensity greater than 100 dB HL for the ipsi probe or contra phone causes the HIGH INTENSITY SELECTED message to be dis played 4 Press the STIMULUS EAR softkey and select STIMULUS EAR CONTRA STEADY or CONTRA PULSED IPSI CONTRA CONTRA 5 Continuously increase the stimulus intensity by SE pressing the INTENSITY up hardkey The INTENSITY LIMIT REACHED message will be displayed at the following levels 120 dB HL for selected stimuli 500 1000 2000 Hz 115 dB HL for selected stimulus 4000 Hz 115
121. NAD 10 11 Char Wh Field Name Start of record Request Record Record Sequence Record type step size Checksum Carriage return Line feed Appendix D Field Definition p 9 Query Record XX 00 to 99 067 0 1 8 2 0 GR Field Definition 9 Query Record 00 to 99 068 0 500 msec 1 1000 msec 2 1500 msec 3 2000 msec XX CR Field Definition 9 Query Record XX 00 to 99 069 0 1 1 2dB 2 5dB XX CR LP Grason Stadler 7 9 7 9 ARLT Average Offset Field Name Char Start of record Request Record Record Sequence Record type Average Checksum Carriage return Line feed 7 9 7 10 ARLT Cursor Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 4 Cursor X value 11 4 Cursor Line 1 Y Value 15 4 Cursor Line 2 Y Value 19 2 Checksum 21 1 Carriage return 22 1 Line feed 7 9 7 AMARLT Stimulus Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 2 Stimulus 9 2 Checksum 11 1 Carriage return 12 1 Line feed Remote Specifications Field Definition p 9 Query Record XX 00 to 99 070 XX 2 50 XX GR Field Definition p 9 Query Record XX 00 to 99 071 XXXX XXXX XXXX XX
122. P DIAGNOSTIC TEST 2 12 15 2000 02133 pn 1 54 PRESSURE daPa EARCANAL VOLUME 1 2 daPa ml TYMP 1 0 6 2 200 TYMP 2 3 0 5 0 01 P d qre P 400 200 200 NORMAL 200 OFF RIGHT AUTO P RANGE START GRADIENT ERR MORE SEQUENCE daPa daPa 8 View ongoing test results on the graphic display area and on the pressure and Compliance meters The Y axis of the graph is labeled in ml of equivalent compliance at Y 226 Hz The X axis or pressure axis is labeled in daPa 1 daPa air pressure 1 02 mm H20 Specifications comply with the current ANSI Middle Ear Standard 9 pressure sweep continues to the end of the pressure range and automatically enters HOLD The HOLD hardkey can be pressed prior to completion of the sweep 10 Otherwise the numeric measure for ear canal volume is displayed in real time at the right of the level meters Up to three tympanograms can be run on one test screen The direction of the pressure sweep may be reversed via selection of the ap propriate START gt hardkey An arrow below the X axis of the graphic trace indicates the direction of the pressure sweep for the last tymp tracing Grason Stadler Tymp test Y at 226 Hz Baseline ON Baseline OFF Stopping the test Automatic scaling Operation Upon completion of a pressure sweep or reversal of direction BASELINE numeric values for compliance peak ml pressure peak daPa
123. Parity error The parity of a character received by the GSI TympStar did not match the parity bit in the character Could be caused by a transmission error or a mismatch in the parity selections between the GSI TympStar and the Remote Device Received character error Break detect A Break condition is when the Transmit Data line TXD Pin 2 is in the space low state for greater than one character time An invalid Minus sign is present in a record field where it should not exist A Remote invalid key press occurred The validation performed on single keystroke command is the same as for the corresponding front panel hard or soft key The error subcode indicates the error or status message which would flash on the screen if the corresponding hard or soft key had been operated Integer selection for Probe Hz was not a valid selection For example in Tymp Diagnostic a 4 is selected when only 0 71 and 2 are valid choices The error subcode indicates the current test where the error is occurring Integer selection for Admittance is not a valid selection Integer may not represent an admittance value or the admittance value may not be valid for this test The error subcode indicates the current test where the error is occurring Integer selection for Pressure Range is invalid An integer other than a 0 or a 1 was entered The error subcode indicates the current test where the error is occurring Integer se
124. Patients and for VIIIth Nerve Tumor Patients Ear and Hear 1981 2 4 180 181 Oviatt D Kileny P Normative Characteristics of Ipsilateral Acoustic Reflex Adaptation Ear and Hear 1984 5 3 145 152 B 6 Grason Stadler Bibliography Rosenhall U Liden G Nilsson E Stapedius Reflex Decay in Normal Hearing Subjects J Am Aud Soc 1979 4 157 163 Wilson R Stechler J Jones H Margolis R Adaptation of the Acoustic Reflex J Acoust Soc Am 1978 64 782 791 EUSTACHIAN TUBE FUNCTION ETF Bluestone C Paradise Beery Q Physiology of The Eustachian Tube in the Pathogenesis of Middle Ear Effusion on Children Laryngoscope 1972 82 1654 1670 Bluestone C Paradise J Beery Q Physiology of the Eustachian Tube Function Ann Otol 1972 90 552 562 Givens G Seidemann M Acoustic Immittance Testing of the Eustachian Tube Ear and Hearing 5 5 297 299 Holmquist J Eustachian Tube Function Assessed with Tympanometry Acta Otolaryngol 1969 68 501 508 Riedel C Wiley T Block M Tympanometric Measures of Eustachian Tube Function J Speech and Hear Res 1987 30 207 214 Seidemann M Givens D Tympanometric Assessment of Eustachian Tube Patency in Children J Speech and Hear Disord 1977 42 487 496 Seifert M Seidemann M Givens G An Examination of Variables Involved in Tympanomet
125. Query Record XX 00 to 99 060 00 250 Hz 01 500 Hz 02 1000 Hz 03 2000 Hz 04 4000 Hz 05 Low Band Noise 9 2 11 1 12 1 7 9 6 12 Offset 0 1 1 1 2 2 4 3 7 3 10 2 12 1 13 1 7 9 7 ARLT Individual SoftKey Commands Checksum Carriage return Line feed Reflex Decay Intensity Field Name Start of record Request Record Record Sequence Record type Intensity Checksum Carriage return Line feed 7 9 7 1 ARLT Stimulus Ear Char Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 Field Name Start of record Request Record Record Sequence Record type Reflex Type Checksum Carriage return Line feed 7 9 7 2 ARLT Stimulus On Time Char Offset 0 1 1 1 2 2 4 3 7 5 12 2 14 1 15 1 D 70 Field Name Start of record Request Record Record Sequence Record type Reflex Type Checksum Carriage return Line feed Appendix D 06 High Band Noise 07 Broad Band Noise 08 Click 09 External GR Field Definition 9 Query Record XX 00 to 99 061 XXX dBHL XX CR Field Definition p 9 Query Record XX 00 to 99 062 0 IPSI 1 CONTRA GR Field Definition p 9 Query Record XX 00 to 99 063 XXXX XX GR P Grason Stadler 7 9 7 3 ARLT Auto Zero Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Aut
126. Record XX 00 to 99 016 0 Left 1 Right XX Field Definition p 9 Query Record XX 00 to 99 017 0 ON 1 OFF XX CR GSI TympStar Version 1 Reference Instruction Manual 7 9 2 7 TYMP Screening Auto Start Char Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 7 9 2 8 TYMP Screening Reflex Type Char Offset 0 1 1 1 2 2 4 3 7 1 8 2 10 1 11 7 9 2 9 TYMP Screening Stimulus Hz Char Offset 0 1 1 1 2 2 4 3 7 1 8 1 9 1 10 1 11 2 13 1 14 1 D 56 Field Name Start of record Request Record Record Sequence Record type Auto Start Checksum Carriage return Line feed Field Name Start of record Request Record Record Sequence Record type Reflex Type Checksum Carriage return Line feed Field Name Start of record Request Record Record Sequence Record type 500 Hz 1000 Hz 2000 Hz 4000 Hz Checksum Carriage return Line feed Appendix D Field Definition p 9 Query Record XX 00 to 99 018 0 ON 1 OFF XX Field Definition p 9 Query Record XX 00 to 99 019 0 OFF 1 IPSI 2 CONTRA 3 IPSI CONTRA XX Field Definition p 9 Query Record XX 00 to 99 020 0 OFF 1 0 OFF 1 0 OFF 12 0 OFF 12 XX Grason Stadler 7 9 2 10 Offset 0 1 1 1 2 2 4 3 7 4 11 4 15 2
127. Record Sequence XX 00 to 99 4 3 Record type 009 7 1 Baseline 0 2 ON 1 OFF 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 1 8 TYMP Diagnostic Gradient Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 010 7 1 Gradient 0 OFF 1 TYMP WIDTH 2 RATIO 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 1 9 TYMP Diagnostic Cursor Offset Field Name Field Definition Char 0 1 Start of record P 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 011 7 4 Tymp 1 X value XXXX 600 to 400 11 4 Tymp 1 Y Value XXXX 15 4 Tymp 2 X value XXXX 600 to 400 19 4 Tymp 2 Y Value XXXX 23 4 Tymp 3 X value XXXX 600 to 400 27 4 Tymp 3 Y Value XXXX 31 2 Checksum XX 33 1 Carriage return CR 34 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual Appendix D 7 9 2 Tymp Screening Individual SoftKey Commands 7 9 2 1 TYMP Screening Pressure Range Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 012 7 1 Pressure Range 0 Normal 1 Wide 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 2 2 TYMP Screening Pressure Rate Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequen
128. Reflex Threshold test 025 Set Reflex Threshold Auto Zero Used to change the Auto Zero parameter ON or OFF This command is valid in a Reflex Threshold test 026 Reflex Threshold Ear Toggle Used to toggle between Left and Right Ear This command is only valid in the Reflex Threshold test mode GSI TympStar Version 1 Reference Instruction Manual D 13 Appendix D 027 Set Reflex Threshold Probe Hz Used to change the Probe Hz parameter This command is only valid in the Reflex Threshold test mode Any additional changes that occurs due to a change in Probe Hz occurs immediately as if the change was made from navigating the menus 028 Set Reflex Threshold Admittance Used to change the Admittance parameter This command is only valid in the Reflex Threshold test mode Any screen or test change that occurs due to a change in Admittance changes immediately as if the change was made navigating the menus 029 Set Reflex Threshold Stimulus Timing Allows direct modification of timing ON Time OFF Time and Quantity parameters in msec in the defined increments and range for the test This command is valid in all Reflex Threshold tests as long as a stimulus is not being presented 030 Set Reflex Threshold Timebase Allows direct modification of timebase Instead of using arrows like the softkeys an integer is used to select one of the 4 possible timebases 15s 30s 45s and 60s This commandis valid in Reflex Threshold tests 031 Set Reflex T
129. Send 1 Query for ear selection 5 1 Carriage return CR 6 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 105 Appendix D 8 7 Reflex Decay Individual Softkey Commands 8 7 1 Set Reflex Decay Probe Hz Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Probe Tone 6 1 Carriage return 7 1 Line feed 8 7 2 Set Reflex Decay Stimulus Ear Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Reflex Type 6 1 Carriage return 7 1 Line feed 8 7 8 Set Reflex Decay Stimulus On Time Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 5 Parameter value 10 1 Carriage return 11 1 Line feed Timebase On Time Min Incr 15000 1000 13000 1000 30000 1000 27000 1000 45000 2000 40000 2000 60000 2000 54000 2000 D 106 Field Definition p 050 0 Send 1 Query for Probe Hz value 0 226 Hz 1 678 Hz GR Field Definition p 051 0 Send 1 Query for Stimulus Ear selection 0 IPSI 1 CONTRA Field Definition Y 052 0 Send 1 Query for Stimulus On Time selection XXXXX Grason Stadler Remote Specifications 8 7 4 Set Reflex Decay Auto Zero Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 053 4 1 Request code 0 Send 1 Query for Auto Zero selection 5 1 Auto Zero 0 Automatic
130. Setting Reflex Decay Field Name Start of record Record type Request code Reflex Decay Switch 500 Hz 1000 Hz 2000 Hz 4000 Hz IPSI CONTRA Carriage return Line feed Field Definition p 113 0 Send 1 Query for Test Sequence Settings 0 ON 1 OFF 0 YES 1 NO 0 5 12 NO 0 YES 1 0 YES 1 0 YES 1 0 YES 1 NO GSI TympStar Version 1 Reference Instruction Manual D 129 8 15 6 Date Time Settings 8 15 6 1 Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 8 1 8 15 6 2 Offset Char 0 1 1 3 4 1 5 1 6 4 10 1 11 1 8 15 6 3 Offset Char 0 1 1 3 4 1 5 1 6 2 8 1 9 1 D 130 Date Time Formats Field Name Start of record Record type Request code Date Format Time Format Carriage return Line feed Set Date Command Field Name Start of record Record type Request code Parameter Type Parameter Value Carriage return Line feed Set Time Command Field Name Start of record Record type Request code Parameter Type Parameter Value Carriage return Line feed Appendix D Field Definition 115 0 Send 1 Query for Date and Time Formats 0 MM DD YYYY 1 DD MM YYYY 2 YYYY MM DD 0 12 Hour 1 24 Hour CR Field Definition 116 0 Send 1 Query for Date 0 Month 12 Day 2 Year XXXX CR Field Definition 117
131. The ear canal will be vented once the CONTINUE softkey is pressed 10 Tymp 3 will sweep automatically as above NOTE The anatomical structure of the Eustachian tube is such that equalization of negative pressure in ear canal is more difficult than equalization of positive pressure 11 Tymps 1 2 and 3 are displayed and stored on the same page in memory for recall 12 Test data can be erased or cleared using the ERASE or CLEAR hardkey on the LCD panel Please refer to Erasing and clearing test data earlier in this chapter 13 Test data can be recalled by PAGING through the test screens Please refer to Paging test data earlier in this chapter Grason Stadler Operation ETF Intact sample 14 The test data is automatically stored at the completion of the test and may printout be printed by selecting the test number using the PAGE hardkey followed by pressing the PRINT hardkey ETF INTACT TM TEST 1 ml Ytm 226 Hz R 1 5 400 200 0 200 daPa Tt 50 daPa s EARCANAL VOLUME 0 8 daPa TYMP 1 5 2 20 3 20 15 Numeric summary data appears to the right of the meters on the LCD follows EAR CANAL VOLUME for Tymp 1 only daPa ml TYMP I 5 0 4 2 20 0 5 3 20 0 5 ETF Intact The amount of pressure peak shift between tymp tracings is relatively small normative data i e 15 20 daPa or nonexistent if there is an ETF problem An observable peak shift f
132. Threshold hard key called Diagnostic The structure of softkey menu selections is diagrammed below Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings Press the REFLEX hardkey then press the RETURN hardkey to display the reflex sub menu ww Tymp Reflex Etf Special DIAGNOSTIC USER 1 USER 2 USER 3 USER 4 PROGRAM MODE Pressing the DIAGNOSTIC softkey provides direct access to diagnostic test functions that use the current system defaults Most often this test mode is entered directly by pressing the REFLEX hardkey Pressing one of the 4 USER softkeys provides access to test functions with defaults previously programmed by or for one of up to four users For ex ample to run diagnostic tests with defaults programmed earlier by user 1 press the USER 1 softkey Each USER softkey can be programmed to provide access to diagnostic test functions and is totally independent of the DIAGNOSTIC softkey or the other USER softkeys Pressing the PROGRAM MODE softkey places the instrument in the Reflex Threshold Program Mode and provides access to programming functions for setting overall instrument or user specific defaults Tests can not be performed in the Program Mode Pressing the PROGRAM MODE softkey displays the PROGRAM MODE message in the status area of the screen DIAGNOSTIC USER 1 USER 2 USER 3 USER 4 STORE GSI Ty
133. Transfer Settings Field Name Start of record Request Record Record Sequence Record type Tymp Diagnostic Reflex Threshold Reflex Decay ETF Intact ETF Perforated ARLT A R Sensi Multiple Hz Clear Test Checksum Carriage return Line feed Language Field Name Start of record Request Record Record Sequence Record type LCD amp Printer Language Keyboard Language Checksum Carriage return Line feed Remote Specifications Field Definition 9 Query Record XX 00 to 99 110 0 Summary Data 1 Summary Graphics 0 Summary Data 1 Summary Graphics 0 Summary Data 1 Summary Graphics 0 Summary Data 1 Summary Graphics 0 Summary Data 1 Summary Graphics 0 Summary Data 1 Summary Graphics 0 Summary Data 1 Summary Graphics 0 Summary Data 1 Summary Graphics 0 Manual 1 2 Auto XX LP Field Definition pP 9 Query Record XX 00 to 99 111 0 English 1 French 2 German 3 Spanish 4 Italian 0 English 1 French 2 German 3 Spanish 4 Italian XX LP GSI TympStar Version 1 Reference Instruction Manual 7 9 13 5 Test Sequence Setting Appendix D 7 9 13 5 1Set Test Sequence Setting Reflex Threshold Offset NAD 10 11 12 13 14 15 16 18 19 Char U a Field Name Start of record Request Record Re
134. Type 2 Record Sequence Number 45 Patient Name 45 Patient ID 45 Tester Name 45 Facility Name 9 Probe S N 20 Date Time 2 Test type 1 Test number 1 Ear Under Test Remote Specifications 0 1 8 2 0 0 Normal 1 Wide 0 12 5 daPa sec 1 50 daPa sec 2 200 daPa sec 3 Not used 30800 to 30800 if no Peak 600 to 400 daPa if no Peak 0 positive to negative 1 negative to positive Field Definition 1 Summary data record 8 Summary data record with attached XY data records 00 to 99 0 to 45 characters for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters 9 characters for unused characters XX XX xm for xm if 24 Hour time format 10 Multiple Frequency Screen 2 1 to 9 and Ato Q L Left Ear R Right Ear GSI TympStar Version 1 Reference Instruction Manual D 43 217 219 223 224 225 231 232 234 235 241 245 250 251 257 258 264 266 267 7 1 11 Multiple Frequency Screen 3 Dn o0 Offset Chars 0 1 1 1 2 2 4 45 49 45 94 45 D 44 Probe Tone Resonance Frequency Start Pressure Zero field Zero field
135. a 9 is selected as the integer for Time sec when only 0 to 3 are valid choices this error code will be returned The error subcode indicates the current test where the error is occurring Integer selection for the Stimulus part of the Facilitator is not a valid selection The number entered may not represent a valid stimulus or the stimulus selected may not be valid for this test The error subcode indicates the current test where the error is occurring The value of the numeric field for the cursor is out of range This means that the value entered needs to be changed to a value from 1 200 The error subcode indicates the current test where the error is occurring The value of a numeric field for the Stimulus timing is out of range or not in the specified increment The table time below the input record type shows the valid times and Increments The error subcode indicates the parameter type that is out of range or incremented incorrectly 000 ON time 001 OFF time 002 Quantity The value of a numeric field for the click rate is out of range or not in the specified increment This means that the value is not in the range from 10 300 or is not a multiple of 10 The value of the numeric field for the Intensity Timing is out of range The error subcode indicates the Intensity entered that is out of range The value of the numeric field for the Pressure Max is out of range or not in the specified increment Example Specify
136. a range of 400 daPa to 600 daPa At no time is it possible to exceed specified maximum limits Pressure can be varied automatically or manually and from nega tive to positive or from positive to negative values Pressure within the ear canal is monitored continuously in order to maintain pressure ac curacy throughout each test sequence 1 2 Grason Stadler Introduction Instrument controls A combination of hardkeys and softkeys are used to select the test modes and parameters and to conduct tests Hardkeys and softkeys Hardkeys are located on the front panel and the sides of the LCD panel provide fixed functions that do not change Softkeys are located directly un der the LCD and change to support the requirements of a test session LCD panel Softkey Hardkeys Front panel Pressure control Rotary pressure A rotary pressure control is also provided to change or fine tune pressure within control the ear canal Test modes and Selecting a test mode by pressing a hardkey causes the required test screen to menu navigation be displayed on the LCD with the appropriate menu of test parameters shown across the bottom The softkeys are then used in conjunction with a few hard keys to navigate through the menus and set parameter values for the selected tests For example pressing the TYMP hardkey causes the Tymp Diagnostic screen to be displayed Tymp Diagnostic screen Tymp parameter menu GSI TympStar Version
137. aPa in the same direction as the pressure peak as shown below TYMP DIAGNOSTIC TYMP DIAGNOSTIC TEST 2 ml 1 Ytm 226 Hz R Ytm 226 Hz R 20 30 daPa i A 20 30 daPa in negative in positive direction direction 400 200 0 200 daPa 50 daPa s 400 200 0 200 EARCANAL VOLUME 50 EARCANAL VOLUME 0 9 1 2 3 11 Compliance be automatically zeroed each time the PRESENT hardkey is pressed to maintain a constant baseline To activate the this feature press the AUTO ZERO softkey and then press AUTOMATIC before selecting START Press AUTO ZERO after START to manually AUTO ZERO the compliance meter AUTO ZERO MANUAL AUTOMATIC 12 Press PRESENT hardkey A brief prestimulus baseline 757 Stimulus A is drawn The stimulus is presented for the time 2 specified by STIMULUS TIMING parameters in AUTO TIMING for as long as the PRESENT hard key is Intensity A pressed in MANUAL timing 13 The intensity of the reflex activating signal is labeled above the initial baseline of the reflex tracing The amplitude of the response is labeled below the intensity NOTE The criterion for a reflex response is a repeatable compliance change of 0 02 ml or greater Often multiple tracings are obtained for one stimu MARK THRESHOLD lus presentation but only one represents the re flex threshold Mark Threshold allows the op gt MARK MARK
138. and graphic display ateach sensitivity A qualitative check of each test mode 18 also recommended This is accomplished by listening to each test tone using the ipsi probe and contra phone Cushion the probe box assembly and test cavity on the velcro shoulder mount provided Rest it on your lap or in a nearby chair away from instrument and other vibrations that may cause artifact and affect measurements NOTE If the GSI TympStar does not function properly during pre operation checks or test routines contact a local GSI Representative or the GSI Service Department Insert the probe all the way into the test cavity when running a test uf 1 1 1 mmho 10 m Pa s 8 GSI TympStar Version 1 Reference Instruction Manual 3 3 Chapter 3 Altitude Barometric Altitude and weather barometric pressure and temperature changes affect pressure calibration admittance measurements due to the resulting changes in air density These changes cause a shift in admittance readings For example the density of air molecules in a given volume decreases with dropping barometric readings or with increasing altitudes GSI calibrates the GSI TympStar to a barometric pressure of 760 mm Hg 30 of Hg at 21 degrees C 70 degrees F If this instrument has not been cali brated to the on site altitude perform the altitude calibration contained in Chapter 4 Altitude Calibration Mode To verify that this instrument has calibrated at this
139. ange the Admittance parameter for screen 2 This command is only valid in Multiple Hz screen 1 090 Multiple Hz 1 Ear Toggle Used to toggle between Left and Right Ear This command is only valid on the Multiple Hz 1 screen GSI TympStar Version 1 Reference Instruction Manual D 19 Appendix D 091Set Multiple Hz 1 Cursor Allows the cursor to be moved to a specified X axis position and for a peak to be selected when the cursor is active This command is valid following the completion of Multiple Hz screen 1 092 Multiple Hz 1 Continue Processes the continue softkey following the completion of a Multiple Hz screen 1 test This can only be used when the continue softkey is displayed 093 Multiple Hz 2 Continue Processes the continue softkey following the completion of a Multiple Hz screen 2 test This can only be used when the continue softkey is displayed 094 Set Multiple Hz 2Cursor Allows the cursor to be moved to a specified X axis position and for a probe tone to be selected when the cursor is active This command is valid following the completion of Multiple Hz screen 2 095 Set Multiple Hz 43 Probe Hz Allows selection of the probe tone from Multi Hz 2 in the standard increment and range This command is valid during a Multiple Frequency Screen 3 test when a Tymp is not in progress 096 Set Multiple Hz 3 Cursor Allows the cursor to be moved to a specified X axis position and for a peak to be selected when
140. ansmitted followed by an End of XY Graphical data record See Section 7 for the record format The actual number of XY Graphical data records vary based on the actual amount of graphical information stored for the test The last XY Graphical data record for each line may contain a fewer number of XY data pairs than the others of that line based on the number of XY data pairs left to transmit The sequence in which the XY data pairs are transmitted is the XY data pairs for line 1 in left to right order the data pairs for line 2 in left to right order and then the data pairs for line 3 in left to right order The record series will be terminated with an End of XY Graphical data record See Section 7 for the format of this record 5 5 Transmission Verification Protocol 5 5 1 Protocol When any type of record is transmitted to the Remote Device the GSI TympStar knows that the record has been correctly received by the Remote Device This is accomplished by using an Auto Repeat Request ARQ type protocol Under this protocol the GSI TympStar will transmit a record and then wait for a reply from the Remote Device to indicate the successful or unsuccessful receipt of the record If the record was received correctly the Remote Device responds with an ACK acknowledge response record The determination of a successful record receipt will be the responsibility of the Remote Device to define but at a minimum should include checking for a valid start of
141. ault revision CR Field Definition 7 Mode change record 00 to 99 0 Stop 1 Hold 2 Run 3 Continue Softkey displayed 4 Clear page s to continue 5 Reflex type test stimulus presentation complete 6 Self Calibration complete 7 Default Cal data load complete 8 Y YBG calibration in current cavity complete Xx 7 8 Summary Data Record with Attached XY Data Records See Section 1 0 Summary Data Records Grason Stadler Remote Specifications 7 9 Input Record Query Results 7 9 1 Tymp Diagnostic Query Results 7 9 1 1 TYMP Diagnostic Probe Hz Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 003 7 1 Probe Tone 0 226 Hz 1 678 Hz 2 1000 Hz 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 1 2 TYMP Diagnostic Admittance Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 004 7 1 Admittance 0 1 8 2 0 3 B G 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 1 3 TYMP Diagnostic Pressure Range Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 005 f 1 Pressure Range 0 Norma
142. b menu Tymp Reflex Etf Special INTACT PERF INSTRUMENT PROGRAM TM TM OPTIONS MODE Pressing the INTACT TM or PERF TM softkey provides direct access to ETF Intact TM or PERF TM test functions that use the system defaults For ex ample to run ETF Intact TM tests with system defaults from this menu press the INTACT TM softkey Pressing the PROGRAM MODE softkey places the instrument in the Program Mode and provides access to programming functions for setting ETF Intact TM or PERF TM test function defaults Tests can not be performed in the Program Mode Pressing the PROGRAM MODE softkey displays the PRO GRAM MODE message in the status area of the screen ETF INTACT 11705722004 05705 pn 1 5 PRESSURE daPa EARCANAL VOLUME daPa DERE RENT LS p aces TYMP 1 1 8 600 400 200 0 200 400 2 TYMP 3 COMPLIANCE 9 5 puu 0 5 00 9 5 10 1 5 0 0 10 TESTER 400 200 0 200 PROGRAM MODE When the system is in the Program Mode select the test ETF Intact TM or PERF TM for which defaults will be defined The appropriate ETF screen will be displayed with the softkey menu across the bottom of the screen and a PROGRAM MODE status message GSI TympStar Version 1 Reference Instruction Manual 4 51 4 n ETF INTRCT TH TEST 1 11 85 2000 06 06 pn 1 6 PRESSURE daPa
143. canal with a back and forth twisting motion Pull the pinna upward and backward for adults and down and back for children The probe tip should sit firmly within the ear canal without being held If leakage occurs a different size eartip may be needed If the wrist attachment is used for screening tests the operator should wrap the wristband around their wrist with the velcro facing away from wrist The probe box should be placed on top of the wrist with the LEDs visible to the operator SCREENING EARTIPS should be used to achieve a hermetic seal when the probe tip is hand held against the outer portion of the ear canal GSI TympStar Version 1 Reference Instruction Manual 3 15 Chapter 3 Grason Stadler Operation This chapter contains the following information Overview of functions page 4 1 Test procedures page 4 6 TYMP page 4 6 REFLEX page 4 21 ETF page 4 41 SPECIAL page 4 53 Auto sequence tests page 4 55 nstrument Options page 4 58 Overview of functions Test and other The four test modes of automatic or manual operation available are functions TYMP REFLEX ETF SPECIAL Tymp mode includes Diagnostic Tymp e Screening Tymp and Reflex Automatic Only Reflex mode includes Acoustic and Non Acoustic Reflex Threshold ETF mode includes Eustachian Tube Function for intact and perforated eardrums nstrument Options Special test mode includes Reflex Decay Altitude Cal Auto sequen
144. cay occurred during the test GSI TympStar Version 1 Reference Instruction Manual 4 37 Chapter 4 Reflex Decay sample printout REFLEX DECAY ml Y 226Hz I 500 Hz 0 3 5 mi 226Hz 1000 Hz 0 10 0 OFF 3 5 daPa 5 90 00 Tac DECAY TIME SEC NA NA 4 38 Grason Stadler Program mode for Reflex Decay Operation Default test parameters may be programmed for the system Reflex Decay tests The structure of softkey menu selections is diagrammed below Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings Press the SPECIAL hardkey then press the RETURN hardkey to display the Special tests sub menu eS 2 Tymp Reflex Etf Special Return yg REFLEX DECAY ALTITUDE PROGRAM CAL MODE Pressing the PROGRAM MODE softkey places the instrument in the Program Mode and provides access to programming functions for setting overall in strument defaults Tests cannot be performed in the Program Mode Pressing the PROGRAM MODE softkey displays the PROGRAM MODE message in the status area of the screen Once the system is in the Program Mode press the REFLEX DECAY softkey jar REFLEX DECAY TEST 18 1170472000 02 00 PRESSURE daPa STIMULUS 1000 Hz INTENSITV 80 Pt 400 200 e 200 DECAY TIME SEC COMPLIANCE nl ee 2 1 PROGRAM MODE REFLEX DE
145. ce 4 3 Record type 7 1 Pressure Rate 8 2 Checksum 10 1 Carriage return 11 1 Line feed Field Definition p 9 Query Record XX 00 to 99 013 0 200 daPa s 1 600 200 daPa s XX CR 7 9 2 3 TYMP Screening Start Pressure Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Start Pressure 8 2 Checksum 10 1 Carriage return 11 1 Line feed D 54 Field Definition ap 9 Query Record XX 00 to 99 014 0 600 daPa 1 2 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa XX CR Grason Stadler 7 9 2 4 TYMP Screening Gradient Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 1 11 Field Start of record Request Record Record Sequence Record type Gradient Checksum Carriage return Line feed 7 9 2 5 TYMP Screening Ear Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 7 9 2 6 TYMP Screening Baseline Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 1 11 Field Start of record Request Record Record Sequence Record type Ear Checksum Carriage return Line feed Field Name Start of record Request Record Record Sequence Record type Baseline Checksum Carriage return Line feed Remote Specifications Field Definition 9 Query Record XX 001099 015 0 OFF 1 TYMP WIDTH 2 RATIO Me Field Definition p 9 Query
146. ce tests can include Diagnostic Tymp Acoustic Reflex Threshold if desired Reflex Decay if desired GSI TympStar Version 1 Reference Instruction Manual 4 1 Default parameters Test parameters AUTO P RANGE SEQUENCE daPa Chapter 4 GSI developed default parameters for each selected test are displayed on the lower portion of the LCD above the six softkeys Alternative choices may be made by pressing the appropriate test parameter softkey Test parameter soft keys Pressing a test parameter softkey causes a new menu of choices to be pre sented across the bottom of the screen for that function The menu structure for the Tymp diagnostic functions is diagrammed below as an example START GRADIENT EAR MORE daPa NORMAI WIDE 600 400 200 2200 400 MORE TYMP WIDTH RATIO OFF RIGHT LEFT 1 daPa ml GSI default parameter Al 300 0 2 BASELINE MORE daPa s i dec The softkey is used to toggle between the top and lower levels of menus while the test screen portion above the softkeys remains unchanged NOTE The GSI default parameters are circled on the menu structure diagrams Grason Stadler Program modes Probe tone frequency LCD graphic tracing Probe lights LCD screen Operation test modes allow the user to individually program a unique set of default test parameters User programmed parameters override GSI developed de fault parameters The
147. ced pressure value where the tube closes again is recorded as 8 If the Eustachian tube does not open before the maximum pressure is reached the tracing will continue at the maximum pressure as a straight line 9 Instruct the patient to swallow water while the tracing is in progress 10 If the Eustachian tube opens while swallowing some pressure will be released from the ear canal middle ear space 11 The tracing will move downward to the pressure level present after the tube closes again 12 Repeat steps 9 through 11 until no more pressure is released while swallowing or until the allowable time has elapsed 13 The opening and closing pressures are summarized to the right of the meter area on the LCD Grason Stadler Operation 14 Terminate the test at any point and store in memory by Manual selecting the STOP hardkey 15 Test data can be erased or cleared using the ERASE or a uw CLEAR hardkey on the LCD panel Please refer to Erasing and clearing test data earlier in this chapter Start lt gt 16 Test data can be recalled by PAGING through the test screens Please refer to Paging test data earlier in this chapter ETF Perforated TM 17 The test data may be printed by pressing the PRINT hardkey after selecting sample printout the test number using the PAGE hardkey GSI TympStar Version 1 Reference Instruction Manual 4 49 Chapter 4 ETF Perforated TM 1 After placing the instrument in the
148. cord Sequence Record type Reflex Threshold Switch 500 Hz 1000 Hz 2000 Hz 4000 Hz LB Noise HB Noise BB Noise Stimulus Ear Checksum Carriage return Line feed Field Definition p 9 Query Record XX 00 to 99 112 0 ON 1 OFF 0 YES 1 NO 0 YES 1 NO 0 YES 1 NO 0 YES 1 NO 0 YES 1 NO 0 YES 1 NO 0 YES 1 NO 0 IPSI 1 CONTRA 2 IPSI CONTRA XX 7 9 13 5 2Set Test Sequence Setting Reflex Decay Offset MANO 10 11 Char Field Start of record Request Record Record Sequence Record type Reflex Decay Switch 500 Hz 1000 Hz 2000 Hz 4000 Hz Field Definition p 9 Query Record XX 00 to 99 113 0 2 ON 1 OFF 0 YES 1 NO 0 YES 1 NO 0 YES 1 NO 0 YES 1 NO Grason Stadler 12 1 13 1 14 2 16 1 17 1 7 9 13 6 Offset 0 1 1 1 2 2 4 3 7 1 8 1 9 1 10 1 11 1 12 2 14 1 15 1 7 9 13 7 Offset Char 0 1 1 1 2 2 4 3 7 1 8 1 9 2 IPSI CONTRA Checksum Carriage return Line feed Remote Settings Field Name Start of record Request Record Record Sequence Record type Baud Rate Parity Stop Bits RTS CTS Data Format Checksum Carriage return Line feed Date Time Formats Field Name Start of record Request Record Record Sequence Record type Date Format Time Format Checksum GSI TympStar Version 1 Reference Instruction Manual
149. d 2 2 If any accessories are missing notify a GSI Representative immediately Table 2 1 TympStar Accessories Supplied GSI Part 8000 0078 GSI Part 2000 1036 GSI Part 2000 9610 Contra insert phone Calibration cavity V1 Probe cleaning kit 2 boxes Eartips 1 pkg 8 standard sizes 4 ea Color coded GSI Part 1700 9660 1 pkg 6 special sizes 2 ea GSI Part 1700 9670 1 pkg 6 screening sizes 2 ea GSI Part 1700 9622 Reference Instruction Manual GSI Part 2000 0100 Quick User Guide GSI Part 2000 0108 Printer paper 2 rolls for orders including printer GSI Part 1700 9619 Spare set of probe tubing GSI Part 2000 9617 Probe mount shoulder Probe mount wrist Probe mount clothes GSI Part 1700 9646 GSI Part 1700 9642 GSI Part 1700 9608 GSI Suite Audometic Data Management Software GSI Part 1010 9686 NOTE Additional quantities of any accessory can be ordered from aGSI Rep resentative or directly from Grason Stadler Inc See the Specifications for optional accessories available and their respective catalog numbers Printer Probe cleaning Probe mount paper kit wrist Probe clothes clip Eartips special sizes Eartips Probe mount screening sizes shoulder Eartips standard sizes Calibration Contra Spare set of cavity insert phone probe tubing Grason Stadler Installation Table 2 1 Continued TympStar Accessories Supplied Printer paper adhesive backed for orders
150. d display the Instrument Options softkey menu TEST SEQUENCE 3 Press the TEST SEQUENCE softkey to display the REFERS choices for Auto Sequence tests THRESHOLD DECAY 4 Press the REFLEX THRESHOLD softkey to include reflex threshold testing in the Auto REKREA THRESHOLD Sequence ON OFF STIMULUS STIMULUS EAR Hz 5 Press the STIMULUS EAR softkey to select IPSI ONLY CONTRA ONLY or IPSI AND CONTRA for reflex testing STIMULUS EAR IPSI CONTRA IPSI AND CONTRA 6 Press the STIMULUS HZ softkey to select the stimuli to be included in the Reflex Threshold Auto Sequence STIMULUS Hz Scroll through each stimulus and toggle the YES NO soft 242 key to program it as stimulus for the test sequence Press ow By the RETURN hardkey and toggle the ON OFF softkey to turn Reflex Threshold on 7 Press the REFLEX DECAY softkey to include REFLEX DECAY Reflex Decay testing in the Auto Sequence The STIMULUS EAR softkey is used to select the ON OFF STIMULUS STIMULUS stimulus ear for Reflex Decay as IPSI CONTRA S or IPSI and CONTRA NOTE Only the STIMULUS EAR s and STIMULUS HZ selected under Reflex Threshold are available for selection in Reflex Decay 8 Use the up and down arrows to display the stimulus STIMULUS EAR ear s selected in Reflex Threshold that will receive stimulus Toggle the YES NO softkey to select or de stimutus AY YES NO select the displayed stimulus ear 15 GSI TympStar Version 1 Reference Instruction Ma
151. d in ETF Perforated test while it is pressurizing to the selected maximum pressure ALERT PNEUMATIC SYSTEM ERROR IF ERROR REPEATS CONTACT SERVICE Indicates that a problem exists in the pneumatic system which prevents the pump from establishing the desired pressure ALERT CAN NOT CONTINUE WITH DIFFERENT COMPONENT Indicates that in a Tymp Diagnostic test it is invalid to change the admittance selection while in HOLD and then try to restart the tymp sweeping in the same direction After changing the admittance it is only valid to resume sweeping in the opposite direction ALERT ONLY ONE LINE LEFT CHOOSE A DIFFERENT COMPONENT Indicates that in a Tymp Diagnostic test it is invalid to perform 2 tymps in the same test with B G selected ALERT NO VALID PEAK SET The Multiple Frequency Screen 1 Continue command is invalid unless there is a valid peak set for the tymp ALERT INVALID SELECTION WHILE CURSOR IS ACTIVE Invalid selection when most keys are hit while the cursor is active ALERT SOFTKEY INVALID IN THIS MODE Invalid selection because Mark threshold or cursor was selected incorrectly from page mode ALERT MUST CALIBRATE 678HZ BEFORE 1000HZ Indicates that the Data Transfer command in the Altitude Calibration mode is invalid until after 678 Hz has been calibrated if calibration of all probe tone frequencies is required due to an altitude change OCCLUSION TEST ABORTED Indicates that an occlusion was detected during a test except Tymp Scree
152. d off by pressing the REMOTE hard key again Pressing the REMOTE hard key allows the GSI TympStar to send and receive information over the RS 232 interface Data transmission by the GSI TympStar can be initiated by pressing the DATA TRANSFER hard key or remotely via a command sent by the Remote Device The GSI TympStar will be able to receive commands from the Remote Device at any time during its operation while the Remote function is selected and the GSI TympStar is not processing a previous front panel operation or remote command These commands will allow the Remote Device direct access to most of the GSI TympStar front panel hard and soft keys to select test parameters and control test execution Outgoing data from the TympStar may be sent in one of two formats GSI 33 or TympStar The former sends out data in the format identical to the GSI 33 instrument predecessor to the TympStar The latter extends the GSI 33 format to include data unique to the TympStar instrument for example 26 tests the GSI 33 is limited to 8 The GSI 33 or TympStar formats are selected under the Instrument Options menu Remote Setup see Chapter 4 3 Serial Interface 3 1 General Operation The Remote function will communicate with a Remote Device over an RS 232 compatible asynchronous interface The GSI TympStar is configured as a DCE Data Communication Equipment device and would normally connect to a DTE Data Terminal Equipment device such as a personal computer
153. d to transmit data When the RTS signal is set false by the Remote Device the GSI TympStar is inhibited from transmitting data The Remote Device should insure that RTS is set true prior to requesting data from the GSI TympStar to prevent a timeout error on the GSI TympStar due to it being inhibited from transmitting data The GSI TympStar uses the CTS signal to allow or inhibit data transmission from the Remote Device to the GSI TympStar When the CTS signal is set true asserted by the GSI TympStar the Remote Device may transmit to the GSI TympStar When the CTS signal is set false by the GSI TympStar the Remote Device must not transmit to the GSI TympStar Failure to comply with this condition may result in loss of data transmitted to the GSI TympStar The GSI TympStar does not currently use the DTR and DSR signals and therefore does not support handshaking using these signals The GSI TympStar will set the CTS line false to prevent data transmission by the Remote Device while the GSI TympStar is processing either a front panel pushbutton operation or a command record set from the Remote Device The CTS line will also be set false by the GSI TympStar during all data transfers to the Remote Device When the processing is complete the CTS line will be set true to allow transmission by the Remote Device 3 5 Baud Rate Selection To minimize transmission times the highest baud rate that is supported on both the GSI TympStar and the Remote device shou
154. dB HL for noise bands Grason Stadler Pre Operation Instructing the patient General Explain to the patient that they are about to have their ears tested and that unlike other audiometric tests they are asked to refrain from speaking excessive movement and swallowing unless directed to do so When testing children it is often desirable to seat them so that they are able to watch the instrument as the tests are conducted This tends to increase their cooperation and lessens any feelings of apprehension Positioning the Position the shoulder mount for the probe box over the patient s shoulder on probe box the same side as the ear to be tested The velcro strip should be facing away from the body The probe box is then positioned on front of the velcro strip Suggested probe Ear canal examination with an illuminated otoscope is an essential prerequi insertion technique site to successful middle ear testing Such examination achieves the follow ing Detects the presence of potentially obstructive cerumen Assists in determining the proper angle of probe insertion Helps to determine the proper size eartip to achieve an airtight seal of the ear canal Select the correct size eartip and position it fully on the probe The eartip should be pushed firmly onto the tip of the probe until it is fully seated The three probe tubes should be nearly flush with the top surface of the eartip Insert the probe tip securely into the ear
155. de press STORE to store the formatting selections and return to the Instrument Options softkey menu Grason Stadler Operation TABULAR LEFTCOLIMN PEINT SETTING TYPE NOTE When the tabular format is selected for printing Reflex Threshold re sults the operator must indicate which tracing on the display represents the threshold value per frequency tested This is accomplished using the Mark Threshold command Alternatively when Threshold Seek is used with the tabular print format the GSI TympStar will automatically enter the threshold data in the table Press the EXTERNAL PRINTER SETUP softkey The LEFT COLUMN SET TING softkey is used to select left or right ear data for printing in the left column of the printout The PRINT TYPE setting is used to select color or black and white printouts NOTE When using a black and white HPLaserJet printer the BLACK WHITE setting must be used GSI TympStar Version 1 Reference Instruction Manual 4 59 Grason Chapter 4 Stadler ity 1 P Data Transfer Settings Language Test Sequence Operation Test result data for each test type can be transferred to a computer over the RS232 serial communications port in the form of a numeric summary or a numeric summary and graphic data Press SUMMARY for numeric summary transfers Press SUMMARY GRAPHIC for transfers of numeric summa ries and graphic data When all the setting selections have been made press STORE to store
156. dient Used to set the Gradient ON and modify the type of Gradient to be used This command is only valid in the Tymp Diagnostic test mode 011Set TYMP Diagnostic Cursor Allows the cursor to be moved to a specified X axis position when the cursor is active and allows the user to set the Tymp peaks This command is valid in Tymp Diagnostic as long as the test is either complete or in HOLD and a line has already been plotted 012 Set TYMP Screening Pressure Range Used to change the Pressure range between Normal and Wide This command is only valid in the Tymp Screening test mode 013Set TYMP Screening Pressure Rate Used to modify the Pressure rate parameter This command is only valid in the Tymp Screening test mode 014 Set TYMP Screening Start Pressure Used to modify the Start Pressure parameter This command is only valid in the Tymp Screening test mode 015 Set TYMP Screening Gradient Used to set the Gradient ON and modify the type of Gradient to be used This command is only valid in the Tymp Screening test mode 016 TYMP Screening Ear Toggle Used to toggle between Left and Right Ear This command is only valid in the Tymp Screening test mode D 12 Grason Stadler Remote Specifications 017 Set TYMP Screening Baseline Used to modify the Baseline parameter On or Off This command is only valid in the Tymp Screening test mode 018 Set TYMP Screening Auto Start Used to change the Auto Start selection If selection is
157. digit in ASCII format MSB Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format MSB Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format MSB Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format MSB Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format MSB Hex digit in ASCII format Hex digit in ASCII format Hex digit in ASCII format Xx Grason Stadler 7 2 2 X Value Description Test Tymp Diagnostic Tymp Screening Reflex Threshold ETF Intact TM ETF Perf TM Reflex Decay ARLT ARST Mult Hz screen 1 Mult Hz screen 2 Mult Hz screen 3 Data Type Pressure Pressure Time Pressure Time Time Time Time Pressure Probe Hz Pressure 7 2 3 Y Value Description Test Tymp Diagnostic Tymp Screening Reflex Threshold ETF Intact TM ETF Perf TM Reflex Decay ARLT ARST Mult Hz Screen 1 Mult Hz Screen 2 Line 1 Line 2 Mult Hz Screen NOTE The Y axis values for Tymp Diagnostic and ETF Intact TM are transmitted as Data Type Compliance Compliance Compliance Compliance Pressure Compliance Compliance Compliance Compliance Compliance Phase Compliance Remote Specifications Units daPa daPa msec 2 daPa msec 2 msec 2 msec 2 msec 2 daPa Hz
158. e an TVMP 1 600 400 200 8 200 400 2 COMPLIRNCE TWMP 3 0 5 0 0 NRME 10 TESTER SELECT DATA FOR LEFT COLUMN ON EXTERNAL PRINTOUT Color or black and Menu to set the left column of the printed data to the left or right ear white 6 Press the PRINT TYPE softkey of the External Printer Setup Menu to set the BLACK amp WHITE printout to Black and White or Color 4 NOTE The setting must be Black and White for grayscale printers GSI TympStar Version 1 Reference Instruction Manual 2 11 Chapter 2 Adjusting the display contrast The contrast of the Liquid Crystal Display LCD can be adjusted to suit indi vidual viewing tastes at any time by turning the LCD CONTRAST control located at the left side of the enclosure 2 12 Grason Stadler Installation Front panel controls Hardkeys Tymp Reflex Ef LCD housing Softkey Front panel Pressure Control Hardkey Front panel controls consist of a combination of hardkeys with fixed func tions that do not change and softkeys located under the LCD that change to support the changing requirements of a test session A rotary pressure control is provided to change or fine tune pressure within the ear canal ofthe push button controls on the front panel are hardkeys Three hardkeys are also located on the left and right sides of the LCD housing Their functions are printed directly on the push butto
159. e feed LF 8 3 8 Set TYMP Screening Reflex Type Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 019 4 1 Request code 0 Send 1 Query for Reflex Type selection 5 1 Reflex Type 0 OFF 1 IPSI 2 CONTRA 3 IPSI CONTRA 6 1 Carriage return CR 7 1 Line feed LF 8 3 9 Set TYMP Screening Stimulus Hz Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 020 4 1 Request code 0 Send 1 Query for Stimulus Hz selection s 5 1 500 Hz 0 ON 1 OFF 6 1 1000 Hz 0 ON 1 OFF 7 1 2000 Hz 0 1 OFF 8 1 4000 Hz 0 1 OFF 9 1 Carriage return CR 10 1 Line feed LF 94 Grason Stadler Remote Specifications 8 3 10 Set Screening Cursor Field Definition Char Offset Field Name 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Cursor 6 3 Number of dots 9 1 Carriage return Line feed 021 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right 2 Set Tymp 1 Peak XXX Oto 200 only if cursor 1 or 2 0 Position to Y axis 1 dot CR 8 4 Reflex Threshold Individual SoftKey Commands Field Definition Char p 022 0 Send 1 Query for Stimulus Ear selection 0 IPSI 1 CONTRA STEADY 2 CONTRA PULSED CR Field Definition Char 8 44 Set Reflex Threshold Stimulus Ear Offset Field Name 0 1 Start of record
160. e length of time automatically set ON TIME OFF TIME QTY EXIT inl Y 226Hz 1000 Hz 0 1 5 OFFI1 S 0 STIMULUS 884 INTENSITY 600 400 200 0 200 400 TIMING 16 20 COMPLIANCE 9 00 nl eA 8 1 2 NAME ID TESTER MANUAL 15 STIMULUS TIMING 7 Press the STOP hardkey Grason Stadler Pre Operation 8 To check the ipsi stimuli place an eartip on the ipsi probe 9 Select the 500 Hz stimulus in the upper right corner of the screen by pressing the STIMULUS hardkey 10 Hold the ipsi probe against the outer portion of the ear canal and press the PRESENT hardkey Listen for the time multiplexed tone available in ipsi Ascertain that the 226 Hz probe tone can also be heard 11 Repeat the above procedure selecting 1000 2000 4000 Hz the three noise bands and clicks 12 Connect the contra insert phone to probe box Ensure that the contra phone jack is firmly seated in the probe box receptacle Place the eartip on the contra insert phone 13 Press the STIMULUS EAR softkey and select STIMULUS EAR CONTRA STEADY IPSI CONTRA CONTRA STEADY PULSED 14 Check the contra steady stimuli following the procedure described above for the ipsi probe 15 Press the STIMULUS EAR softkey and select CONTRA PULSED 16 Check the contra pulsed stimuli following the procedure described above for the ipsi probe GSI TympStar Version 1 Reference Instruction
161. e maximum pressure in the standard increment and range This command is valid during an ETF Perforated TM test while the test is stopped 047 Set ETF Perforated Time sec Allows the selection for the time Any changes that occur to the screen when the time is changed occur immediately Instead of using the arrows to change the Time an integer will be used to select between the 4 Time choices 30s 40s 50s and 60 s This command is only valid in the ETF Perforated test mode when the test is stopped GSI TympStar Version 1 Reference Instruction Manual D 15 Appendix D 048 Set ETF Perforated Cursor Allows the cursor to be moved to a specified X axis position when the cursor is active This command is valid in the ETF Perforated test mode when a test has finished plotting 049 ETF Perforated Ear Toggle Used to toggle between Left and Right Ear This command is only valid in the ETF Perforated test mode 050 Set Reflex Decay Probe Hz Used to change the Probe Hz parameter This command is only valid in the Reflex Decay test mode Any change that occurs due to a change in Probe Hz occurs immediately as if the change was made from navigating the menus 051 Set Reflex Decay Stimulus Ear Allows the Stimulus ear parameter to be modified remotely This command is valid in a Reflex Decay test 052 Set Reflex Decay Stimulus On Time Allows direct selection of the On Time parameter in msec under the constraints of the defined increments and ran
162. e pages will be used throughout the remainder of this manual as a convenience to the user GSI default parameter GSI default parameters are circled on menu structure diagrams shown throughout settings the remainder of this manual START daPa 600 400 200 4400 MORE GSI default value 500 300 0 300 MORE GSI TympStar Version 1 Reference Instruction Manual 2 15 Chapter 2 Grason Stadler Pre Operation This chapter contains the following information Cleaning probe tubes page 3 1 e Eartips page 3 2 Preparing test materials page 3 3 Calibration checks page 3 3 nstructing the patient page 3 15 e Suggested probe insertion technique page 3 15 Cleaning probe tubes CAUTION CAUTION To ensure measurement accuracy it is essential to clean the probe tip daily to be certain that the tubes are clean and free of cerumen Remove the probe eartip and tygon tubing at tached to the three metal probe tubes at the rear of the probe tip CAUTION Do not alter the length of the tubing by cut ting it When reconnecting the tygon tub ing to the probe tubes ensure that there are no sharp edges or burrs on the probe tubes that could cut the tygon tubing E Using the cleaning wires shipped with this instrument remove debris from each tube by pushing the wire through the tube from the back to the front of the probe tip as follows CAUTION Avoid getting the probe moist Do not place an earti
163. e right of the meter area of the LCD GSI TympStar Version 1 Reference Instruction Manual 4 15 BASELINE OFF REFLEX OFF REFLEX ON Screening reflex test scoring Chapter 4 With BASELINE OFF the compliance value at start pressure is labeled as T TVMP SCREENING TEST 5 18723720940 ITAS 1 5 PRESSURE daPa 1 6 i daPa nl oor OO mmt 5 1 3 2 pps 0 9200 GRADIENT 115 daPa REFLEX 0 5 i COMPLIRNCE ml 1 0 1 5 8 6 9 5 90 0 0 5 1 0 NAME i ID 400 200 0 200 TENERE RENE OFF ON IPSI 1800 m BASELINE AUTO REFLEX STIMULUS MORE The screening test concludes at completion of tymp data collection without performing a reflex test REFLEX When GSI defaults for the reflex are utilized the 1000 Hz Ipsi stimulus is automatically presented orr msi CONTRA IPSV CONTRA upon the completion of tymp data collection Other possible reflex stimuli choices include e Ipsi Up to two frequencies are selectable Contra Up to two frequencies are selectable e Ipsi Contra One test frequency is presented to each ear Press the STIMULUS Hz softkey to select a test frequency Press the EXIT softkey following the selection The screening reflex test results are scored as follows below the tymp data REFLEX I 1000 2 YES Ifan acoustic reflex was present REFLEX 2000 2 NR c lfnoreflex was measured NT No Test is used in place of NR
164. e sent by the Remote Device as a sequence of ASCII characters starting with a vertical bar and ending with an ASCII carriage return CR and line feed character LF Any record that is sent to the TympStar from a remote system that does not start with a vertical bar is ignored In order to reduce the risk of an invalid record being accepted by the GSI TympStar due to a transmission error the GSI TympStar only accepts a CR LF sequence at the end of a record All multiple character fields are right justified with any unused character positions filled with ASCII SPACE characters The minus sign of negative values in a numeric field may be located in any character position to the left of the most significant digit of the number The plus sign of positive values is implied so a numeric field containing a positive number should not contain a character 6 2 Special Command Descriptions The types of input records that may be sent to the GSI TympStar are as follows NOTE All of these commands are only valid in the top menus of the test they are associated with unless otherwise specified All cursor records are only available when in that specific cursor screen 001 Single Key Commands Used to initiate a hardkey or softkey press The remote key press that is sent acts exactly like a key press on the TympStar and the keys are valid in the same instrument states as the corresponding hard or soft key 002 Start Auto Sequence Command Used
165. ecord Record type Selection code Carriage return Line feed E Field Definition p 025 0 Send 1 Query for Auto Zero selection 0 Automatic 1 Manual GR Field Definition 026 0 Send 1 Query for ear selection GR Grason Stadler 8 4 Set Reflex Threshold Probe Hz Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Probe Tone 6 1 Carriage return 7 1 Line feed 8 4 7 Set Reflex Threshold Admittance Remote Specifications Field Definition p 027 0 Send 1 Query for Probe Hz value 0 226 Hz 1 678 Hz 2 1000 Hz GR Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 028 4 1 Request code 0 Send 1 Query for Admittance value 5 1 Admittance 0 1 8 2 0 6 1 Carriage return CR 7 1 Line feed LF 8 4 8 Set Reflex Threshold Stimulus Timing Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 029 4 1 Request code 0 Send 1 Query for Stimulus timing selection 5 1 Auto Timing 0 Manual Timing 1 Auto Timing 6 1 Parameter type 0 ON time See chart of 1 OFF time valid selections 2 Quantity below 7 5 Parameter value XXXXX 12 1 Carriage return CR 13 1 Line feed LF Timebase On Time Off Time Quantity Min Incr Min Max Incr Min Max Incr 15000 1000 13500 500 0 12500 500 1 10 1 30000 1000 27000 500 0 26000
166. ecord type 7 1 ml Scale 8 2 Checksum 10 1 Carriage return 11 1 Line feed D 60 Field Definition p 9 Query Record XX 00 to 99 032 0 4 04 to 16 1 08 to 32 2 12 to 48 3 16 to 64 4 20 to 80 04 to 16 08 to 32 7 12 to 48 16 to 64 20 to 80 XX Grason Stadler 7 9 3 12 Offset 0 1 1 1 2 2 4 3 7 3 10 2 12 1 13 1 7 9 3 13 Offset Char 0 1 1 1 2 2 4 3 7 4 11 4 15 4 19 2 21 1 22 1 7 9 3 14 Offset Char 0 1 1 1 2 2 4 3 7 2 9 2 11 1 12 1 Remote Specifications Reflex Threshold Click Rate Field Name Field Definition Start of record Request Record 9 Query Record Record Sequence XX 00 to 99 Record type 033 Click Rate XXX 50 to 300 in multiples of 10 Checksum XX Carriage return CR Line feed LF Reflex Threshold Cursor Field Name Field Definition Start of record Request Record 9 Query Record Record Sequence XX 00 to 99 Record type 034 Cursor X value XXXX Cursor Line 1 Y Value XXXX Cursor Line 2 Y Value XXXX Checksum XX Carriage return CR Line feed LF Reflex Threshold Stimulus Field Name Field Definition Start of record Request Record 9 Query Record Record Sequence XX 00 to 99 Record type 035 Stimulus 00 250 Hz 01 500 Hz 02 1000 Hz 03 2000 Hz 04 4000 Hz 05 Low Band Noise 06 High Band Noise 07 Broad Band Noise
167. ee 4 41 Softkey men 4 42 GSI TympStar Version 1 Reference Instruction Manual Contents 3 Contents ETF Intact automatic test procedure 4 43 BTP Intact sample perte atero Case qd utei 4 45 ETI Infaetnormaltve sene dana Set NRI en nen Usu Dada 4 45 Eustachian Tube function testing for perforated eardrums 4 46 Softkey menu Structure 4 46 ETF Perforated TM automatic test procedure 4 47 Minimum and maximum levels allowable eene 4 48 ETF Perforated TM sample Baud 4 49 ETF Perforated TM manual test procedure sese 4 50 ETF Perforated TM normative data esses ener nnne 4 50 Program mode for ETE a uu oo ced les cat 4 51 DONKEY METI uie s pen E ut ut E e it 4 51 Moden 4 51 Altitude Calibration Mode ie oneri eia e rede tsp lad e 4 53 Calibr tion procedure necesse ao ONGs esM Publ aM adu ies 4 53 ANULO SSQUENICS e SEITE d iut teased Dat 4 55 Auto Sequence test procedure 4 55 Auto Sequence program MOE sy oae eee aeos esee tete ege vis
168. efinition 1 Summary data record 8 Summary data record with attached XY data records 00 to 99 0 to 45 characters for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters 9 characters for unused characters XX XX xm for xm if 24 Hour time format 9 Multiple Frequency Screen 1 1to9 and Ato L Left Ear R Right Ear 0 226Hz 1 Not used 2 Not used 3 38 Not Used 600 to 400 daPa 0 Off 0 Off 30800 to 30800 0 or 1 0 0 5 to 41 5 1 0 5 to 43 0 2 0 5 to 5 0 3 1 0 to 7 0 4 1 0 to 9 0 5 2 5 to 15 0 6 5 0 to 25 0 7 5 0 to 35 0 600 to 400 daPa if Cursor not used L 1 30800 to 30800 if Cursor not used Grason Stadler 246 247 248 249 255 259 260 263 265 266 7 1 10 Offset 49 94 139 184 193 213 215 216 1 Admittance status 1 Pressure Range status 1 Pressure Rate status 6 Peak Compliance data 4 Peak Pressure data 1 Sweep Direction status 3 Gradient data 2 Checksum 1 Carriage return 1 Line Feed Multiple Frequency Screen 2 Field Name Chars 1 Start of record 1 Record
169. eful in confirmation of retrocochlear pathology The stimulus for the test is typically presented as a steady tone Ipsilaterally or Contralaterally at 10 dB HL above reflex threshold intensity level 500 Hz and 1000 Hz are the best frequencies for this test An individual exhibits adaptation decay if the amplitude of the reflex re sponse decays to 50 of peak amplitude typically within 10 seconds The structure of softkey menu selections is diagrammed below Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings STIMULUS EAR STIMULUS ON TIME TIMEBASE AUTO ZERO mi EAR SCALE 10 SET 15 SET MANUAL on 2 06 0 32 0 48 0 64 0 80 CE SEC 1 Press the SPECIAL hardkey to enter Refl Etf Special the Reflex Decay test mode oe pecia 2 Default test parameters are displayed above the softkeys across the bottom of the LCD screen WI REFLEX DECAY TESTI PRESSURE daPa STIMULUS 1000 Hz 00 INTENSITY 80 dBHL 600 400 200 0 200 488 DECAY TIME SEC 15 T T T T T T T T T 1 16 1 51 10 15 RUTOMRTIC 16 RIGHT STIMULUS STIM N TIMEBRSE RUTO nl ERR TIME ZERO SCALE 3 Press the EAR softkey to toggle between the right and left ear then if desired navigate through the Reflex Decay softkey menu and change parameter settings for the test as req
170. elcro strip on the shoulder mount or clothes clip and position it on the patient 3 Position the appropriate size eartip on the probe tip and securely insert it in the ear canal to obtain a hermetic seal 4 Press the EAR softkey to select the right or left ear Navigate through the softkey menus shown above and change parameter settings for the test as required NOTE Changes to default parameters remain selected until the Manual system power is turned off or a different test mode Re flex or Special is selected Hold Stop 5 Press the START hardkey to pressurize the e o ear canal to selected start pressure and initiate collection of tymp data from a positive to negative direction e Start 5 initiates data collection from a negative e to positive direction GSI TympStar Version 1 Reference Instruction Manual 4 9 Sweep direction Chapter 4 NOTE The START daPa pressure selection overrides the P RANGE daPa pres sure range choice For example if the current P RANGE is set at NOR MAL 400 daPa to 200 daPa the user can still select 400 daPa as the starting pressure for a test The START daPa pressure setting can be changed while in STOP 6 If the occlusion message appears on the LCD the probe tip should be examined for the presence of cerumen 7 If the leak message is displayed attempt to reposition the probe or select an alternate size eartip nl TYM
171. eng COR Db weal 14 Press the THRESHOLD SEEK softkey to activate automatic threshold detection and marking When THRESHOLD SEEK is on an amplitude change equal to or greater than the MIN CHANGE value is automatically marked on the tracing as the threshold value Pressing the MIN CHANGE softkey displays up down arrows for setting the minimum change to mark a threshold This value can be set in the range from 0 02 to 0 8 NOTE Threshold Seek should only be used with quiet cooperative patients 15 Use the STIMULUS hardkeys to select the desired activating stimulus then press and release the PRESENT hardkey Auto Timing controls the stimulus presentation timing for each intensity level 16 The reflex graph will display the response 0 the selected stimulus at 70 dBHL If the compliance change is measured as 0 02 or greater the stimulus presentation is presented at the same level a second time to ensure that a repeatable response is acquired Asterisk and TS indicator 226Hz 19000 Hz R 0N 1 5 0 1 5 5 GSI TympStar Version 1 Reference Instruction Manual 4 27 CAUTION Manual threshold testing WARNING Chapter 4 If it is the stimulus presentation sequence will stop and the display will contain the tracing as well as an asterisk and the letters TS The asterisk indicates reflex threshold and the letters TS indicate that the threshold was determinedwith the Threshold Seek protocol 17 If the measured co
172. ers of period comma hyphen and apostrophe There will also be certain foreign characters that are valid depending on the keyboard language that is selected under instrument options CR Grason Stadler Remote Specifications 8 13 4 Facility Name Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 105 4 1 Request code 0 Send 1 Query for Facility Name 5 45 Facility Name Any valid keys including numbers letters and the special characters of period comma hyphen and apostrophe There will also be certain foreign characters that are valid depending on the keyboard language that is selected under instrument options 50 1 Carriage return CR 51 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 125 8 14Print Clear Handling 8 14 1 Print Test Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 2 Test Carriage return Line feed CON 8 14 2 Clear Test Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 2 Test Carriage return Line feed CON D 126 Appendix D Field Definition pP 106 0 Send 00 Print All tests 01 26 Print test selected CR LF Field Definition 59 107 0 Send 00 Clear All tests 01 26 Print test selected CR Grason Stadler 8 15Instrument Options 8 15 1 Set Print Format Command
173. ese dar eto 1 5 Ment diaprams c 1 5 GSI default parameter settings 1 5 Unpacking and inspecting the GSI TympStar Version 1 2 1 Tympstar Accessories Supplied ee dise deua ed ETE 2 2 Equipment cOnneCtOons coe ee ortis eR C TAS SERIE AREE SS dS IRR AEN TREE een FR ges 2 4 panel cocto uto tu aV EN 2 4 DP RET 2 5 POWOP e cM EC C aie 2 5 Preparing the probe een Foe deerat orav eno de 2 6 Powering the instrument H 2 7 Prior to applying 2 7 Applying DOWEEL adu ad 2 7 Preparing th printer ies ertt t 2 8 Paper SUPPLY ND 2 8 Adjusting display contrast c os roo eres tede 2 12 Front panel Controls ete eges iie e edd 2 13 RAT re M RH cc 2 13 Nili qm 2 15 Mer didt ams nodi iae prec S ed 2 15 GSI default parameter ree o Reset dtes mirae 2 15 GSI TympStar Version 1 Reference Instruction Manual Contents 1 Pre Operation Operation Contents 2 Contents Cleammng probe 0665 suot
174. essary by e rotating the PRESSURE knob Data Pressure Manual 57 Stimulus A 7 Use the AUTO ZERO softkey if necessary to ensure zeroing of compliance meter prior to presenting the stimulus compliance can be automatically zeroed each time the PRESENT hardkey is pressed to maintain a constant baseline by setting the AUTO ZERO softkey to AUTOMATIC before selecting the MANUAL Mode AUTO ZERO MANUAL AUTOMATIC 8 Depress PRESENT hardkey View the Compliance Meter for a detectable compliance change of 0 02 ml or greater The intensity level may be changed between stimulus presentations Reflex threshold manual mode Results are viewed on the compliance meter only and no printout is available MANUAL or AUTOMATIC timing can be used Reflex threshold automatic START key mode Results are displayed in real time on the compliance meter and graph The stimulus timing may be set to Manual timing Pressing and holding the PRESENT hardkey determines how long the stimulus is ON Automatic timing A momentary press of the PRESENT hardkey causes the preset ON OFF times to be utilized Grason Stadler Program mode for Reflex Threshold Softkey menu structure Program mode Operation Up to four users may permanently redefine and store per USER NUMBER individualized default criteria to fit Reflex Diagnostic testing needs Default test parameters may also be programmed for the main Reflex
175. estie n estu 3 1 Caring for eartips eeren E 3 2 Preparing test materials ode a e i 3 3 Calibration checks i dde E RE E EE une 3 3 Test cavity calibration eet eio eerta s suse a 3 3 Altitude Barometric pressure calibration 0 001 3 4 Equivalent compliance values de octies ies deiade 3 4 Tracing Meter Calibration check for Tympanometry 3 5 Pressure range check for tympanometry eene 3 9 Manual pressure check for tympanometry seen 3 9 Screening reflex check tymp screening 3 10 Reflex threshold mode check eris peo 3 11 Intensity limits check for reflex threshold sees 3 14 Instructing tlie patienternes ber 3 15 General ice Dieu podia E 3 15 Postttoning the probe ouo eot I Io UE EI M PR Re 3 15 Suggested probe insertion technique 0220 0 3 15 OVERVIEW Ol FUNCTIONS uo e dele dated duode ee dean 4 1 Test and other functions oon iei e to en ite ddp d 4 1 IDDOFault parasielers enc i 4 2 PrOSTAPDATOQSS Dada 4 3 Probe tone frequencl s
176. etric pressure will have no significant ef fect on these readings If the location is at an altitude higher than sea level but it is desired to have the test cavities read at sea level 1 e read the nominal value of 0 5 ml and 2 0 ml it will be necessary to perform the Altitude Calibration prior to using the TympsStar If located at altitudes higher than sea level and it is desired to have the test cavity readings reflect the differences in the density of air do not perform the Altitude Calibration 1 Press the SPECIAL hardkey then the RETURN hardkey to display the Special softkey menu Tymp Reflex Etf V ww V ww REFLEX DECAY ALTITUDE PROGRAM CAL MODE Special 2 Press the ALTITUDE CAL softkey to place the instrument in the Altitude Calibration test mode and display the ALTITUDE CALIBRATION screen i PRESS DATA TRANSFER TO START SEQUENCE i2 PRESS DATA TRANSFER TO START 2 mt CAL ONLY USE ALTITUDE CAL MODE WHEN USTING CAVITY VOLUMES TO RERO 0 5 2 0 AND 5 0 REGARDLESS OF SITE ALTITUDE SEE REFERENCE MANUAL FOR DETAILS TEST CAVITY READINGS NOMINAL CUSTOMER SITE VALUES i 0 50 nl Big Wi 777 LEFT RIGHT GSI TympStar Version 1 Reference Instruction Manual 4 53 Chapter 4 3 Press the PRINT LEFT softkey to print the text seen on the left side of the screen Press the PRINT RIGHT softkey to print the instructions on the right side of the screen 4 Follow the instructions pr
177. f located at 4 000 feet using the 226 Hz probe tone in the 2 0 cc cavity the screen should show an altitude of 4000 feet a site value of 2 31 ml ml and the test cavity measurement should read 2 31 ml 40 1 Tracing Meter Calibration check for Tympanometry Pre Operation Equivalent 2 Values Altitude feet 0 0 1000 2000 3000 4000 5000 Enarvar eos ose ose 2 31 NOTE The Table has been corrected for changes in altitude in reference to a 226 Hz probe tone The Tymp Diagnostic screen and menus will be used for this calibration check DIAGNOSTIC TEST 2 12 15 2000 02 23 pn 1 5 PRESSURE EARCANAL VOLUME daPa nl 1 0 TT 1 400 200 200 2 3 8 5 0 0 400 200 TESTER daPa NORMAL 200 OFF RIGHT 2 AUTO P RANGE START GRADIENT EAR WORE SEQUENCE daPa daPa Tymp Diagnostic screen AUTO P RANGE START GRADIENT EAR MORE SEQUENCE daPa daPa 22 NORMA WIDE 600 400 200 400 MORE TYMP WIDTH RATIO RIGHT LEFT daPa ml d 300 300 MORE P RATE BASELINE MORE daPa s 12 5 50 OFF Tymp Diagnostic menus To check the tracing meter calibration for tympanometry 1 In the Tymp Diagnostic mode place the eartip on the probe tip and listen to the 226 Hz probe tone 2 Depress the START daPa softkey at the bottom of the LCD The following s
178. for tymp screening 3 10 Children 3 15 Cleaning probe tubes 3 1 Cleaning wires 2 2 3 1 Clear hardkey 4 4 Clearing test data 4 4 Cochlea 4 21 4 41 Communication 1 2 2 4 Compliance 4 8 Compliance change 4 26 Contra insert phone 1 2 2 2 2 6 Contralateral testing 4 21 Controls 2 10 Cooperation 3 15 D Damage 2 1 2 7 Data and the cursor 4 5 Data transfer 2 11 Date and time 4 62 Default parameter settings 1 5 2 12 Default parameters 4 2 Default parameters 4 20 Default parameters for user tests 4 20 Disinfect eartips 3 2 Dustcover 2 3 E Ear canal 4 6 Ear canal examination 3 15 Eardrum 4 6 Earphone 4 21 Eartips 1 2 3 2 3 15 Eartip screening sizes 2 2 Eartip special sizes 2 2 Eartip standard sizes 2 2 Equalize pressure 4 41 Equipment connections 2 4 Equipment connections and options 1 2 Equivalent compliance values 3 4 Erase 2 12 Erase hardkey 4 4 4 13 Erasing and clearing test data 4 4 Error codes and problem reporting 4 5 ETF 2 10 ETF mode 4 1 ETF intact automatic test procedure 4 43 ETF intact normative data 4 45 ETF perforated TM automatic test procedure 4 47 ETF perforated TM manual test procedure 4 50 ETF perforated TM normative data 4 50 GSI TympStar Version 1 Reference Instruction Manual Index 1 ETF perforated TM sample printout 4 49 Eustachian tube 4 41 Eustachian tube function testing for perforated TM 4 46 Eustachian tube function testingfor intact TM 4 41 F Fro
179. for xm if 24 Hour time format 213 2 Test type 5 Perforated TM 215 1 Test number 1 to 9 and A to Q 216 1 Ear Under Test L LeftEar R 2 Right Ear 217 5 Timebase XXxxx 30000 to 60000 msec 222 4 Maximum Pressure 600 to 400 daPa 226 4 Open Pressure 1 600 to 400 if value unavailable or test not started 230 4 Close Pressure 1 600 to 400 daPa if value unavailable or test not started 234 4 Open Pressure 2 xxx 600 400 daPa if value unavailable or test not started 238 4 Close Pressure 2 xxx 600 to 400 daPa if value unavailable or test not started 242 4 Open Pressure 3 xxx 600 400 daPa if value unavailable or test not started 246 4 Close Pressure 3 xxx 600 to 400 daPa if value unavailable or test not started 250 1 Y axis scale 0 600 to 50 daPa 1 400 to 50 daPa 1 test not started 251 5 Cursor X value XXXXX 0 to 60000 sec if Cursor not used or test not started 256 6 Cursor Y value 600 to 400 daPa if Cursor not used or test not started 262 2 Checksum XX 264 1 Carriage return CR 265 1 Line feed L GSI TympStar Version 1 Reference Instruction Manual D 33 7 1 6 Offset 49 94 139 184 193 213 215 216 217 218 220 225 226 227 232 234 240 241 242 243 248 Reflex Decay Chars 1 1 2 45 45
180. frequency NOTE If the STOP dBHL setting under Threshold Seek exceeds the maximum available intensity level for a stimulus the stimulus presentation will stop at this maximum level If reflex decay stimuli have been selected in the TEST SEQUENCE sub menu the intensity level for each stimulus is automatically presented at 10 dB above the threshold level obtained during the reflex threshold test sequence described above NOTE Reflex threshold testing must be performed prior to Reflex Decay testing The stimuli available for Reflex Decay testing are dependent upon the stimuli selected for Reflex Threshold testing 4 The test sequence will automatically terminate upon completion The test data is automatically stored The results can be reviewed by pressing the PAGE hardkey and then can be printed by pressing the PRINT hardkey Please refer to Paging test data earlier in this chapter 5 Test data can be cleared using the CLEAR hardkey on the LCD panel Please refer to Clearing test data earlier in this chapter Grason Stadler Auto Sequence program mode Operation Reflex Threshold and Reflex Decay tests can be programmed to be included in the Auto Sequence of tests as follows Press the ETF hardkey then press the RETURN hardkey to display the ETF sub menu INTACT PERF INSTRUMENT PROGRAM TM TM OPTIONS MODE 2 Press the INSTRUMENT OPTIONS softkey to place the instrument in the Instrument Options programming mode an
181. gation 1 3 Test parameters 4 2 Test results 1 1 Test results 2 4 Test sequence 4 61 Test status 1 2 Test status line 4 4 Testing capabilities 1 1 Testing children 3 15 Thermal paper 2 9 Thermal printer 2 8 Threshold seek 4 27 Timebase 4 24 Timing allowable for reflex threshold 4 24 Timing levels allowable in reflex decay 4 36 Timing of stimuli 4 24 Tip 3 1 3 15 Tone 4 21 Traces 4 3 Tracing meter calibration check for tympanometry 3 5 Tubes 3 1 Tubing 2 6 Tygon tubing 2 6 3 1 Tymp 2 10 Tymp diagnostic 4 9 Tymp diagnostic functions 4 2 Tymp diagnostic softkey menu structure 4 9 Tymp mode 4 1 4 6 Tymp peak 4 12 Tymp screening sample printout 4 17 Tymp screening softkey menu structure 4 14 Tymp width 4 7 Tymp width method 4 7 Tympanic membrane 4 41 Tympanometric gradient 4 7 Tympanometry normative values 4 13 Tympanometry printout samples 4 13 U Unpacking and inspecting the GSI TympStar 2 1 User softkeys 4 18 V monitor 1 2 2 4 Weather 3 4 Z Zephiran chloride 3 2 Index 4 Grason Stadler
182. ge for the test This command is valid in the Reflex Decay test mode as long as a stimulus is not being presented 053 Set Reflex Decay Auto Zero Used to change the Auto Zero parameter ON or OFF This command is valid in a Reflex Decay test 054 Reflex Decay Ear Toggle Used to toggle between Left and Right Ear This command is only valid in the Reflex Decay test mode 055 Set Reflex Decay Admittance Used to change the Admittance parameter This command is only valid in the Reflex Decay test mode Any change that occurs due to a change in Admittance changes immediately as if the change was made navigating the menus 056 Set Reflex Decay Timebase Allows direct selection of timebase Instead of using arrows like the softkeys an integer is used to select one of the 4 possible timebases 15s 30s 45s and 60s This command is valid in the Reflex Decay test mode 057 Set Reflex Decay Step size Allows the user to remotely change the step size which controls the increments for the probe intensity This command is valid in the Reflex Decay test mode 058 Set Reflex Decay ml Scale Used to change the scale of the Reflex plot This command is valid in the Reflex Decay test mode D 16 Grason Stadler Remote Specifications 059Set Reflex Decay Cursor Allows the cursor to be moved to a specified X axis position when the cursor is active This command is valid in Reflex Decay as long as a tone is not being processed and there is already data plotted
183. hanks J Lilly D Evaluation of Tympanometric Estimates of Ear Canal Volume J Speech And Hear 1981 Res 24 557 566 Shanks J Tympanometry Ear and Hear 1984 5 5 268 280 Shurin P Pelton S Finkelstein J Tympanometry in the Diagnosis of Middle ear Effusion N Eng J Med 1977 296 412 417 Thompson D Sills J Recke K Bui D Acoustic Admittance and the Aging Ear J Speech And Hear 1979 Res 22 29 36 B 2 Grason Stadler Bibliography Van Camp K Raman Creten W Two Component Versus Admittance Tympanometry Audiol 1974 15 120 127 Van Camp K Creten W Vanpeperstraete P Van de Heyning P Tympanometry Detection Of Middle Ear Pathologies Acta Otolaryngol Belgica 1979 Van Camp Vogeleer Tympanometric Approach To Otosclerosis Scand Audiol 1986 15 109 114 Van Camp K Creten W Van de Heyning P Decraemer W Vanpeperstraete P Search For The Most Suitable Immittance Components and Probe Tone Frequency in Tympanometry Scand Audiol 1983 12 27 34 Van de Heyning P Van Camp K Creten W Vanpeperstraete P Incudo Stapedial Joint Pathology A Tympanometric Approach J Speech and Hear 1982 Res 25 611 618 Vanhuyse V Creten W Van Camp K On the W Notching Of Tympanograms Scand Audiol 1975 4 45 50 Vanpeperstraete P Creten W the Asym
184. he 5 0 cc test cavity 14 Press the START gt hardkey Allow the tracing to sweep to 100 daPa then press START hardkey to reverse direction Allow the tracing to sweep to 100 daPa and press the STOP hardkey The following results should be displayed in the same manner as above The graphic tracing should be at 5 0 The cavity volume C1 should be at the 5 0 The Compliance peak should be 5 0 within 5 of full scale The pressure peak daPa values should be NP No Peak Grason Stadler Pressure range check for tympanometry Manual pressure check for tympanometry Pre Operation 1 Press the P RANGE daPa softkey then select the WIDE pressure range Check to insure that the X axis of the graph and the pressure meter display a range of 600 to 400 daPa 917157291 01112 pe ERRCRHAL VOLUME dia me 1 P RANGE 692 400 200 8 9200 400 21 a me 3 daPa NORMAL WIDE 25 200 OFF RIGHT 9 START GRROLENT SEQUENCE 2 Press the P RANGE daPa softkey then select the NORMAL pressure range Check to insure that the X axis of the graph and the pressure meter display a range of 400 to 200 daPa nt UTRGRUSTTC TEST T 9171572001 01112 pe 15 PRESSURE 4 P RANGE LME MEME ET daPa 6 5 COMPLIANCE 0 0 Fes 6 0 5 1 0 1 5 wer NORMAL WIDE 5 RIGHT science p
185. he information necessary to install and operate the GSI TympStar Version 1 Middle Ear Analyzer This information is essential for the efficient use of the middle ear analyzer and must be read and understood to avoid test errors GSI TympStar Version 1 Reference Instruction Manual Conventions used in this manual Icons This manual uses the following icon conventions to draw special attention to information NOTES Note icons indicate important related information reminders recommen dations and suggestions Notes are shown in bold type CAUTIONS Caution icons indicate information regarding a situation or condition that could result in equipment malfunction or damage or in lost data Cau tions are shown in bold type CAUTION WARNINGS Warning icons indicate information regarding a situation or condition that could result in personal injury or death Do not proceed until having thoroughly read and understood the warning information Warn WARNING ings are shown in bold type Operating controls P 8 References to user controls on the instrument s front panel LCD panel are shown as UPPER CASE in operating procedures and other instructions Equipment Symbols Attention consult accompanying documents um oem m fa h Warning Dangerous Voltage a B Patient Applied Part according to IEC60601 1 oem i Grason Stadler Equipment Symbols Continued Preface Lt Fuse EC REP
186. he intensity of this tone is monitored via a micro phone also located within the probe box Measurements are taken at fixed time intervals As pressure within the ear canal is varied the eardrum is subjected to varying degrees of stress which alters mobility of the eardrum Maximum mobility will occur when the pressure on both sides of the eardrum are equal Changes in mobility of the eardrum tend to produce changes in the probe tone level within the ear canal Probe tone intensity changes indicate the amount of sound energy entering the middle ear Compliance is calculated based on these measurements Since the sound pres sure level of the probe tone within the ear canal varies as a function of mobil ity it is possible to record these changes in mobility as a function of pressure While the recording is visualized in the horizontal direction X axis as a func tion of differential pressure across the eardrum the tracing also moves in the vertical direction Y axis as a function of mobility or compliance of the middle ear system A graphic presentation of this information is known as a tympano gram Grason Stadler Gradient Tymp width method Operation The Gradient function can be activated from the Tymp GRADIENT menu by pressing the GRADIENT softkey in the TYMP menu then selecting the TYMP WIDTH or RATIO method of calculating the gradient value daPa TYMP WIDTH RATIO OFF ml When TYMP WIDTH is selected tympanometric g
187. he point of peak mobility will be shifted in the positive direction approximately 15 to 20 daPa relative to the first tympanogram NOTE If the Eustachian tube is functioning properly a shift in the pressure peak of approximately 15 to 20 daPa in both directions will be observed How ever if the Eustachian tube is malfunctioning there will be little if any observable difference in the pressure peak recorded from Condition 1 to Condition 2 to Condition 3 The structure of softkey menu selections are diagrammed below Please refer to Chapter 1 Introduction for instructions regarding navigating through soft key menus and changing parameter settings P RATE START BASELINE E AR daPa s daPa LEFT NORMAL WIDE 12 5 ns 600 200 600 400 200 ds 400 500 300 0 300 MORE Grason Stadler Operation ETF Intact 1 Press the hardkey to select the automatic test ETF test mode and display the ETF procedure Intact menu o 2 Pressure range automatically defaults to the Normal Tymp Reflex Etf Special 3 Default test parameters are displayed above softkeys on the LCD mT ETF INTRCT TM TEST 2 717 1 8 PRESSURE JaPa EARCANAL VOLUME daPa ml 1 8 r r rrrrrrrmT TYP 1 v3 600 400 200 60 200 400 2 COMPLIRNCE nl 8 5 r T T rT 1 0 5 60 05 L0 L5 8 94 ID Sp TESTER 400 200 200 daPa NORMAL S 200 ON R
188. hreshold Step size Allows the user to remotely change the step size which controls the increments for the probe intensity This command is valid in Reflex Threshold tests 032 Set Reflex Threshold ml Scale Used to change the scale of the Reflex plot This command is valid in Reflex Threshold tests 033 Set Reflex Threshold Click Rate Allows selection of click rate in the standard increment and range This command is valid during a Reflex Threshold test as long as a stimulus is not being presented 034 Set Reflex Threshold Cursor Allows the cursor to be moved to a specified X axis position when the cursor is active This command is valid in Reflex Threshold as long as a tone is not being processed and there is already data plotted 035 Set Reflex Threshold Stimulus Allows selection of stimuli based on valid stimuli for the current test This command is valid during a Reflex Threshold test as long as a stimulus is not being presented 036 Set Reflex Threshold Intensity Allows direct selection of intensity in 1 dB steps in current valid intensity range This command is valid during a Reflex Threshold test as long as a stimulus is not being presented D 14 Grason Stadler Remote Specifications 037 Set ETF Intact Probe Hz Used to change the Probe Hz parameter This command is only valid in the ETF Intact test mode Any change that occurs due to a change in Probe Hz occurs immediately as if the change was made from navigating the menus
189. ic tracing should be at 0 0 EAR CANAL VOLUME should be 2 0 TYMP should be NP REFLEX should be I 1000 Hz NR NOTE NR indicates No Reflex response for the stimulus presented t SCREENING TEST 6 10 20 2000 01 58 1 5 PRESSURE daPa EARCANAL VOLUME 2 0 i ml 1 0 oo 1 NP peo 208 8 200 GRRDIENT REFLEX I 1000 Hz NR COMPLIRNCE nl 0 5 5 6 90 5 10 15 NAME 10 6 t 400 200 8 ie TESTER RR DRE NORMAL 28 YMP WIDTH RIGHT P RANGE START GRADIENT R SRE daPa daPa s daPa Grason Stadler Reflex threshold mode check Pre Operation 5 Place a screening eartip on the probe tip Position the probe against the entrance of the ear canal applying a gentle pressure to maintain a tight seal The screening test will begin automatically Listen to the reflex test stimulus following the tymp test The results will be displayed at the conclusion of the test SCREENING TEST 8 18 28 2008 82117 pm PRESSURE EARCANAL VOLUME 0 7 daPa TWMP 1 10 8 4 200 GRADIENT 95 daPa REFLEX 1 1000 Hz VES TESTER 400 200 8 200 nee daPa NORMAL 680 200 290 TYMP WIDTH RIGHT P RRHGE P RATE START GRADIENT EAR MORE daPa daPa s daPa 1 Insert the ipsi probe tip into the 2 0 cc test cavity 2 Press the REFLEX hardkey ie axe um v YV VY Y NOTE Remove the con
190. ice Directive 93 42 Grason Stadler A S en 9 2765 Smorum Denmark CVR no 21113379 European authority representative EN60601 1 1990 Safety Requirements for Medical Electrical Equipment EN60601 1 2 Medical Electrical Equipment Emissions and Immunity Requirements This equipment has been tested for radio frequency emissions and has been verified to meet Radiated and Conducted Emissions per EN 55011 1998 Group 1 Class A and per CISPR Class A GSI TympStar Version 1 Reference Instruction Manual A 1 Sensitivity ranges Probe signal Appendix A The following admittance measurements give maximum range at 226 Hz Y in ml Table 1 Tymp Mode Frequency Digital Read Out Graphical Including Cursor Display 226 Hz 7 0 to 47 0 1 0 to 47 0 Accuracy at 226Hz 0 1 ml or 5 whichever is greater Table 2 Reflex Mode Frequency Digital Read Out Graphical Including Cursor Display 226 Hz 7 0 to 7 0 0 16 to 0 80 0 16 to 0 80 Accuracy 226 Hz is 0 02 ml or 5 whichever is greater Sinusoidal signal with the following characteristics Frequency 226 Hz Frequency accuracy 31 Harmonic distortion lt 2 Measured in an HA 1 2cc coupler Signal level 85 dB SPL In Real Ear and in Normal Test Mode NOTE The probe tone level is set to be nominally 70 dB HL Signal level accuracy 31 5 dB SPL Grason Stadler Pneumatic System Acoustic Reflex Activating Stimu
191. id only in Instrument Options 117 Set Time Command Used to adjust the Time hour minute This command is valid only in Instrument Options 118 Transmit Current XY Data Request Command Allows the Remote Device to get current values of the current Y axis and X axis quantities or other values for the current unit mode This record is not valid during a Multiple Frequency Screen Z2 test This command is valid at all times except during Screen 2 of a Multiple Frequency test 119 Transmit Test Data Request Command Allows the Remote Device to get the test data for the specified test in the specified format This command is valid in all tests as long as the test is not in progress or a stimulus is being presented 120 Record Received OK Acknowledgement ACK Indicates to the GSI TympStar that the record just transmitted to the Remote Device was received correctly This record is valid in all tests after the GSI TympStar has transmitted data to the Remote Device 121 Record Received Incorrectly Acknowledgement NAK Indicates to the GSI TympStar that the record just transmitted to the Remote Device was received incorrectly This record is valid in all tests after the GSI TympStar has transmitted data to the Remote Device 6 2 1 Input Records For the detailed Input record formats see Section 8 D 22 Grason Stadler 7 Output Record Formats Remote Specifications X ASCII character representing the particular value being defined All co
192. ield Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Start Pressure 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 4 5 ETF Intact Ear Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Ear 8 2 Checksum 10 1 Carriage return 11 1 Line feed Remote Specifications Field Definition 9 Query Record 00 to 99 039 0 12 5 daPa s 1250 daPa s 2 200 daPa s 3 600 200 daPa s XX CR Field Definition 9 Query Record XX 00 to 99 040 0 600 daPa 1 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa 5 500 daPa 6 300 daPa 7 0 daPa 8 300 daPa XX Field Definition p 9 Query Record XX 00 to 99 041 0 Left 1 Right XX GSI TympStar Version 1 Reference Instruction Manual D 63 7 9 4 6 Intact Admittance Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Admittance 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 4 7 ETF Intact Baseline Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Baseline 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 4 8 ETF Intact Cursor Offset Field Name Char 0 Start of record 1 Request Record 2 Record Sequence 4 Record type 7 T
193. igan 1986 McMillan P Bennett M Marchant C Shurin P Ipsilateral And Contralateral Acoustic Reflexes In Neonates Ear And Hear 1985 6 6 320 324 McMillan P Marchant C Shurin P Ipsilateral Acoustic Reflexes in Infants Ann Otol Rhinol Laryngol 1985 94 145 148 Weatherby L Bennett M Neonatal Acoustic Reflex Scand Audio 1980 9 103 110 Wiley T Goldstein R Tympanometric AndAcoustic Reflex Studies in Neonates J Speech Hear 1985 Res 28 265 272 REFLEX DECAY ADAPTATION Fowler C Wilson R Adaptation of the Acoustic Reflex Ear and Hear 1984 5 5 281 288 Givens G Seidemann Systematic Investigation of Measurement Parameters of Acoustic Re flex Adaptation J Speech and Hear Dis 1979 XLIV 534 542 Habener S Snyder J Stapedius Reflex Amplitude and Decay in Normal Hearing Ears Arch Otolaryngol 1974 100 294 297 Hirsch A Anderson H Elevated Stapedius Reflex Threshold and Pathologic Reflex Decay Acta Otolaryngol 1980 368 1 28 Jerger J Jerger S Acoustic Reflex Decay 10 Second or 5 Second Criterion Ear and Hear 1983 4 1 70 71 Olsen W Noffsinger D Kurdziel S Acoustic Reflex and Reflex Decay Arch Otolaryngol 1975 101 622 625 Olsen W Stach B Kurdziel S Acoustic Reflex Decay in 10 Seconds and in 5 Seconds for Meniere s Disease
194. including a printer GSI Part 1770 9643 GSI TympStar dustcover GSI Part 1700 9618 Power cord with hospital grade plug GSI Part 4204 0251 USA Power cord part varies depending on location Printer paper Power cord with hospital grade plug GSI TympStar dustcover GSI TympStar Version 1 Reference Instruction Manual 2 Chapter 2 Equipment connections Rear panel TympStar options that can be connected to the rear panel include RS232 serial communication a keyboard for entering patient information an HP DeskJet or LaserJet printer and a VGA monitor for displaying test results Q eae YQ dq Ye g ee RS232 Keyboard VGA serial port monitor NOTE Please refer to Appendix A Specifications for the technical requirements of each of the connections shown above Functional in TympStar Version 2 only CAUTION Improper connections to the GSI TympStar can damage the instrument and void the warranty CAUTION WARNING Connecting unapproved sources of energy to the GSI TympStar can cre ate a serious electrical shock hazard Refer to Appendix A Specifica tions for the technical requirements of each of the connections shown above WARNING WARNING ANY EQUIPMENT CONNECTED TO THE GSI TYMPSTAR AND USED IN THE PATIENT VICINITY MUST BE POWERED BYAN ISO LATED POWER SOURCE TO MAINTAIN THE ELECTRICAL WARNING SAFETY OF THE OVERALL SYSTEM The isolated power source can be purchased directly from
195. ing ETF Perforated TM test maximum pressure of 111 daPa The specified increment is 50 daPa so valid values would be 100 or 150 daPa The error subcode indicates the maximum pressure entered that is out of range The value of a numeric field for the Stimulus On Time out of range or not in the specified increment The table below the input record type shows the valid times and increments The value of a numeric field for the ARLT Average is out of range This implies that the value is not in the range from 2 50 Grason Stadler 131 132 133 134 135 136 137 138 139 140 141 Intensity 000 Field Action Action Menu Item 000 000 000 000 000 Remote Specifications The value of the numeric field for the Intensity part of the Facilitator is out of range The error subcode indicates the Intensity entered that is out of range The value of a numeric field for the Multiple Hz 43 Probe Hz is out of range or not in the specified increment This means that the value is not in the range from 250 2000 or is not a multiple of 50 Invalid character entered for one of the keyboard entry fields These fields are limited to all numbers letters as well as special characters including the hyphen apostrophe period and comma Also the appropriate foreign characters will be valid with the language selected under keyboard language in instrument options The error subcode indicates the field for
196. ing Invalid selection of the stimulus timing parameter that is desired to be changed Only the integers 0 4 are valid here The error subcode indicates the current test where the error is occurring Integer for selection of timebase is incorrect The integer selected does not properly represent a valid timebase The error subcode indicates the current test where the error is occurring GSI TympStar Version 1 Reference Instruction Manual D 135 119 120 121 122 123 124 125 126 127 128 129 130 D 136 Test see 10 2 2 Test see 10 2 2 Test see 10 2 2 005 008 Test see 10 2 2 Parameter type 000 Intensity Max Pressure 000 000 Appendix D Integer selection for Step size was not a valid option For example in Reflex Decay 7 is selected when only 0 17 and 2 are valid Step size choices The error subcode indicates the current test where the error is occurring Integer for selection of ml Scale is incorrect The integer selected does not properly represent a valid ml Scale The error subcode indicates the current test where the error is occurring Integer selection for the Stimulus is not a valid selection Integer may not represent a valid stimulus or the stimulus selected may not be valid for this test The error subcode indicates the current test where the error is occurring Integer selection for Time sec is not a valid selection For example if
197. ing the time and date TympStar model version and software version number 1279577990 04 18 This screen will be displayed for ap proximately 20 seconds while the system software ERR ANALYZER prepares for test ing PROBE S N 11110012 GSI TympStar Version 1 Reference Instruction Manual 2 7 Chapter 2 Preparing the internal printer Paper supply The thermal printer is located in the center of the front panel Confirm that an adequate paper supply is installed in the GSI TympStar prior to beginning test session NOTE The edges of the thermal paper will turn red as the paper supply runs out Raise the printer cover by pressing the bottom edge of the cover and lifting it The roll of thermal paper rests in the paper tray directly in front of the printer If it is necessary to replace a nearly exhausted roll of paper rotate the release lever on the left side of the printer to its back position and gently pull the remaining paper out of the printer Orient the new paper roll as shown on the inside of the paper tray rotate the release lever back to the forward position and feed the paper into the printer paper entrance until the printer motor and roller pulls the paper into the printer Grason Stadler Installation NOTE Thermal paper can be printed on only one side If printing is unsuccess ful after changing paper rolls check the paper orien
198. ited to the same valid character set as if the patient ID was being entered from the keyboard This command is valid when the cursor is active 104 Tester Name Allows the entry of the tester name via the Remote system The field is still limited to 45 characters and is limited to the same valid character set as if the tester name was being entered from the keyboard This command is valid when the cursor is active 105 Facility Name Allows the entry of the facility name via the Remote system The field is still limited to 45 characters and is limited to the same valid character set as if the tester name was being entered from the keyboard This command is valid when facility name is selected from Instrument options and the cursor is active 106 Print Tests Allows the printing of a single test or all tests The desired test to be printed will be selected in the remote record This command is valid when in Page mode 107 Clear Tests Allows the clearing of a single test or all tests The desired test to be cleared will be selected in the remote record This command is valid when in Page mode 108 Set Print Format Command Provides to the TympStar the format of the printout This command is valid under Instrument Options The print format can be changed for all test modes except A R Sensi between Tabular and Graphical 109 Set External Printer Settings Provides to the TympStar the format of the external printer printout The External Printer
199. itical Band in the Acoustic Stapedius Reflex J Acoust Soc Am 1973 54 5 1157 1159 Gersdorff M Dynamic Study of The Acoustico Facial Reflex by Impedance Measurement Arch Otorhinolaryngol 1980 228 101 112 B 4 Grason Stadler Bibliography Hodges A Ruth R Subject Related Factors Influencing the Acoustic Reflex Sem In Hear 1987 8 4 339 357 Johnson N Terkildsen Normal Middle Ear Reflex Thresholds towards White Noise and Acoustic Clicks In Young Adults Scand Audiol 1980 9 131 135 Leis B Lutman M Calibration of Ipsilateral Acoustic Reflex Stimuli Scand Audiol 1979 8 93 99 Liden G Peterson J Harford E Simultaneous Recording of Changes In Relative Impedance and Air Pressure During Acoustic and Non Acoustic Elicitation Of Middle Ear Reflexes Acta Otolaryngol 1970 263 208 217 Margolis R Dubno J Wilson R Acoustic Reflex Thresholds for Noise Stimuli J Acoust Soc Am 1980 68 3 892 895 Moller A Acoustic Reflex in Man J Acoust Soc Am 1962 34 8 1524 1534 Popelka G Margolis R Wiley T Effect of Activating Signal Bandwidth on Acoustic Reflex Thresh olds J Acoust Soc Am 1976 59 1 153 159 Popelka G Hearing Assessment with the Acoustic Reflex Grune amp Stratton Inc New York 1981 Silman S The Acoustic Reflex Basic Principles and Clinical Ap
200. ize Checksum Carriage return Line feed Appendix D Field Definition p 9 Query Record XX 00 to 99 055 0 1 8 2 0 GR Field Definition 9 Query Record XX 00 to 99 056 0 15 sec 1 30 sec 2 45 sec 3 60 sec XX CR Field Definition 9 Query Record XX 00 to 99 057 0 1dB 1 2dB 2 5dB XX CR LP Grason Stadler 7 9 6 9 Reflex Decay ml Scale Remote Specifications Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 058 7 1 ml Scale 0 04 to 16 1 08 to 32 2 12 to 48 3 16 to 64 4 20 to 80 04 to 16 08 to 32 7 12 to 48 16 to 64 20 to 80 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 6 10 Reflex Decay Cursor Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 059 7 4 Cursor X value XXXX 11 4 Cursor Line 1 Y Value XXXX 15 4 Cursor Line 2 Y Value XXXX 19 2 Checksum XX 21 1 Carriage return CR 22 1 Line feed LF 7 9 6 11Reflex Decay Stimulus Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 2 Stimulus GSI TympStar Version 1 Reference Instruction Manual Field Definition 9
201. k Rate 8 1 Carriage return 9 1 Line feed 8 4 13 Set Reflex Threshold Cursor Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Cursor 6 3 Number of dots 9 1 Carriage return 10 1 Line feed 8 4 14 Set Reflex Threshold Stimulus Offset Field Name Char 0 1 Start of record 1 3 Record type 4 1 Request code 5 2 Stimulus 7 1 Carriage return 8 1 Line feed Remote Specifications Field Definition i 033 0 Send 1 Query for Timebase selection XXX 50 to 300 in multiples of 10 GR FE Field Definition 034 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right XXX 010200 only if cursor 1 or 2 0 Position to Y axis 1 dot LP Field Definition pP 035 0 Send 1 Query for Stimulus selection 00 250 Hz 01 500 Hz 02 1000 Hz 03 2000 Hz 04 4000 Hz 05 Low Band Noise 06 High Band Noise 07 Broad Band Noise 08 Click 09 External 10 Non Acoustic LP GSI TympStar Version 1 Reference Instruction Manual D 99 8 4 15 Set Reflex Threshold Intensity Offset Char 0 1 1 3 4 1 5 3 8 1 9 1 Field Name Start of record Record type Request code Intensity Carriage return Line feed Appendix D Field Definition 036 0 Send 1 Query for Intensity selection XXX dBHL 035 XXX depending of Stimulus
202. l 1 2 Wide 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual 7 9 1 4 TYMP Diagnostic Ear Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Ear 8 2 Checksum 10 1 Carriage return 11 1 Line feed Appendix D Field Definition p 9 Query Record XX 00 to 99 006 0 Left 1 Right XX 7 9 1 5 Diagnostic Pressure Rate Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Pressure Rate 8 2 Checksum 10 1 Carriage return 11 1 Line feed Field Definition 9 Query Record 00 to 99 007 0 12 5 daPa s 1250 daPa s 2 200 daPa s 3 600 200 daPa s CR 7 9 1 6 TYMP Diagnostic Start Pressure Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Start Pressure 8 2 Checksum 10 1 Carriage return 11 1 Line feed D 52 Field Definition 9 Query Record XX 00 to 99 008 0 600 daPa 1 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa 5 500 daPa 6 300 daPa 7 0 daPa 8 300 daPa XX Grason Stadler Remote Specifications 7 9 1 7 TYMP Diagnostic Baseline Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2
203. l Please refer to Erasing and clearing test data earlier in this chapter 25 Test data can be recalled by PAGING through the test screens Please refer to Paging test data earlier in this chapter GSI TympStar Version 1 Reference Instruction Manual 4 29 4 Reflex Threshold 26 The test data is automatically stored at the completion of the test and may sample printout be printed by selecting the PAGE hardkey followed by the PRINT hardkey NOTE An asterisk indicates an operator selected reflex threshold value An as terisk accompanied by the letters TS indicate a reflex threshold value selected automatically by the Threshold Seek feature REFLEX THRESHOLD M 226Hz I 1000 Hz N 1 5 OFF 1 5 Operator selected threshold I 2000 Hz OFF 1 5 daPa 10 Threshold selected automatically by the Threshold Seek feature 4 30 Grason Stadler Operation Reflex Threshold Manual reflex testing is useful when a quick reflex test is preferred or when MANUAL test an approximate starting intensity level for threshold testing is desired procedure 1 Press the REFLEX hardkey to select y Tymp Reflex Etf Special the Reflex Diagnostic test mode 2 Default test parameters are displayed above the softkeys across the bottom of the LCD screen REFLEX THKESHULU TEST T 81 18 2001 03 48 pn PRESSURE STIMULUS 1800 Hz 00 INTENSITV 70 dBHL 400 200 200
204. l Softkey Commands 8 8 1 Set ARLT Stimulus Ear Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 8 8 22 Set ARLT Stimulus On Time Offset Char 0 1 1 3 4 1 5 5 10 1 11 1 Timebase Min 500 100 1000 100 1500 150 2000 150 Field Name Start of record Record type Request code Reflex Type Carriage return Line feed Field Name Start of record Record type Request code Reflex Type Carriage return Line feed On Time Max Incr 450 50 900 50 1350 150 1800 150 8 8 3 Set ARLT Auto Zero Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 D 110 Field Name Start of record Record type Request code Auto Zero Carriage return Line feed Field Definition 062 0 Send 1 Query for Stimulus Ear selection 0 IPSI 1 CONTRA GR Field Definition 063 0 Send 1 Query for Stimulus On Time selection XXXX see chart below for valid values CR Field Definition ap 064 0 Send 1 Query for Auto Zero selection 0 Automatic 1 Manual Grason Stadler 8 8 4 Set ARLT ml Scale Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 Field Name Start of record Record type Request code ml Scale Carriage return Line feed 8 8 5 Ear Toggle Offset Char 0 1 1 4 1 5 1 6 1 Field Start of record Record type Selection code Carriage return Line feed 8 8 6 Set ARLT Admittance Offset Cha
205. ld be selected D 2 Grason Stadler Remote Specifications 4 Remote Mode Entry and Exit 4 1 Remote Hard key The Remote mode is entered or exited by pressing the REMOTE hard key or via a Remote Mode command sent from the Remote Device If not in Remote mode the word REMOTE will show up in the lower right side of the screen when the REMOTE hard key is pressed If the REMOTE status message is already showing pressing the REMOTE hard key will exit the remote mode and clear the REMOTE status message 4 2 Remote Instrument Options settings The Record Type and Clear Test options are set in Instrument Options for the GSI TympStar under Data Transfer Settings For the Record Type option all tests can have a selected record type Summary or Summary and Graphics The default Record Type setting is SUMMARY The RECORD TYPE softkey allows the operator to select what type of information is transmitted by the GSI TympStar when the DATA TRANSFER hard key is operated A Summary Data record contains test identifier information test parameter selections and summary test results A Summary XY Graphical Record format contains test identifier information test parameter selections summary test results and the X Y graphical test results The current RECORD TYPE softkey selection will be displayed as either SUMMARY or SUMMARY XY above the softkey For the Auto Clear option two options can be chosen Automatic or Manual The default Clear Test
206. le the test screen portion above the softkeys remains unchanged 1 4 Grason Stadler Sub menu of START daPa Changing parameter settings Menu diagrams GSI default param eter settings Introduction Pressing a parameter menu softkey STATUE Sub menu of daPa causes a sub menu of parameter START settings to be displayed Often sub 400 200 20 400 MORE menus will contain MORE soft key selections that provide access TRPA 500 300 0 300 MORE to additional setting alternatives EARCANAL VOLUME daPa 1 Settings can be changed for a selected parameter by pressing the desired softkey as shown in this example of changing the Probe Hz from 226 to 1000 Making the new selection returns the display to the previous menu level with the new setting shown above the selected parameter If no change is desired the display can be returned to the previous level by pressing the RETURN hardkey In the manner described above menus can be navigated and settings can be changed for any of the test modes Menu structure diagrams like the diagrams shown on these pages will be used throughout the remainder of this manual as a convenience to the user START GSI default parameters are circled on daPa menu structure diagrams shown throughout the remainder of this T manual GSI default value 500 300 0 300 MORE GSI TympStar Version 1 Reference Instructio
207. lection for Pressure Rate is not a valid selection Integer may not represent a pressure rate value or the pressure rate value may not be valid for this test The error subcode indicates the current test where the error is occurring Integer selection for Start Pressure is not a valid selection For example in an ETF Intact test a 9 is selected as the integer for start pressure when only 0 to 8 are valid choices error subcode indicates the current test where the error is occurring Grason Stadler 107 108 109 110 111 112 113 114 115 116 117 118 Test see 10 2 2 Test see 10 2 2 Test see 10 2 2 001 001 001 Test see 10 2 2 002 002 Test see 10 2 2 Test see 10 2 2 Test see 10 2 2 Remote Specifications Integer selection for Baseline is invalid An integer other than a 0 or a 1 was entered The error subcode indicates the current test where the error is occurring Integer selection for Gradient was not a valid option For example in Tymp Diagnostic a 6 is selected when only 40 717 and 2 are valid choices The error subcode indicates the current test where the error is occurring Integer selection for Cursor is invalid the integer chosen does not represent the moving of the cursor turning it off or setting a peak The error subcode indicates the current test where the error is occurring Integer selection for Auto Start
208. me 0 Offset Field Name Field Definition Char 0 1 Start of record 1 1 Record Type 5 Current data record 2 2 Record Sequence Number XX 00 to 99 4 1 X axis unit 0 Time 1 Pressure 5 5 X axis value Time XXXXX 0 to 60000 msec Pressure 600 to 400 daPa 10 1 Y axis unit 0 Compliance Current selected Admittance If B G selected B 1 Pressure 11 6 Y axis value Compliance 30800 to 30800 Pressure 600 to 400 daPa For non Reflex type tests 17 12 Zero Field For Reflex type tests 17 4 Pressure Pressure 600 to 400 daPa 21 8 Zero Field 29 2 Checksum 31 1 Carriage Return CR 32 1 Line Feed LF 7 6 Unit Identifier Record Offset Field Name Field Definition Char 0 1 Start of record 1 1 6 Unit identifier record 2 2 Record Sequence Number XX 00 to 99 4 2 Unit type 0 GSI TympStar Version 1 1 GSI TympStar Version 2 6 4 Unit ID Number XXXX 0000 z Default number GSI TympStar Version 1 Reference Instruction Manual D 49 Software Revision 1 Software Revision 2 Zero field Checksum Carriage Return Line Feed 7 7 Mode Change Record Offset Char 0 1 1 1 2 2 4 1 5 2 7 1 8 1 Field Name Start of record Record Type Record Sequence Number New Mode Checksum Carriage Return Line Feed Appendix D XX XX CP Revision XX XX SP Revision 00 00 Def
209. meter is changed the menu on the LCD screen does not change as it does when softkeys are manually operated If a parameter which is represented by a softkey in the currently displayed menu is modified the new parameter value is indicated above the softkey on the status line just as if the parameter had been changed manually If a single keystroke softkey or hardkey is remotely pressed the screen and menu changes as it does when these keys are manually operated If the softkey corresponding to the modified parameter is not in the currently displayed menu the parameter will still be changed immediately but the new parameter value is not indicated on the status line until the menu containing that softkey is displayed by manually operating softkeys or the RETURN hard key If a parameter whose status is indicated on the LCD screen in a position other than the status line i e Intensity Stimulus Auto Timing ON OFF Quantity etc is changed the new parameter selection is indicated at the time of the change in its normal position on the LCD screen When mode switches are made by the Remote Device the same parameter defaults which would have occurred if the parameter was changed manually still occur Examples of this are remotely pressing the TYMP hard key which causes all of the Tymp test softkeys to be defaulted to the parameters stored in the User memory or selecting a long Reflex Threshold ON time which may force the OFF time to default to a shor
210. metry of Susceptance Tympanograms Scand Audiol 1979 Wilson R Shanks J Kaplan S Tympanometric Changes At 2a6 Hz And 678 Hz Across 10 Trials and for Two Directions Of Ear Canal Pressure Change J Speech And Hear 1984 Res 27 257 266 Wiley T Oviatt D Block M Acoustic Immittance Measures in Normal Ears J Speech and Hear 1987 Res 30 161 170 Zwislocki J Acoustic Method for Clinical Examination of the Ear J Speech and Hear 1963 Res 6 4 303 314 Zwislocki J Feldman A Acoustic Impedance of Pathological Ears ASHA Monograph 1970 No 15 Washington SCREENING TYMPANOMETRY AND REFLEX ASHA Guidelines for Acoustic Immittance Screening of Middle Ear Function 1979 April 283 288 Bess F Bluestone C Harrington D Klein J Harford E Use of Acoustic Impedance Measurement In Screening for Middle Ear Disease in Children Ann Otol Rhinol And Laryngol 1978 87 2 288 Brooks D Objective Method of Detecting Fluid in the Middle Ear J Int Audiol 1968 7 280 286 GSI TympStar Version 1 Reference Instruction Manual B 3 Appendix B Brooks D Use of the Electro Acoustic Impedance Bridge in the Assessment of Middle Ear Function J Int Audiol 1969 8 563 569 Groothius J Sell S Wright P Thompson J Altemeier W Otitis Media in Infancy Tympanometric Findings Pediatrics 1979 63 3 435 4
211. mpStar Version 1 Reference Instruction Manual 4 33 4 g REFLEX THRESHOLD TESTS IU73I7ZUUU PRESSURE daPa STIMULUS 1000 Hz dd ad 80 INTENSITY 70 dBHL 200 200 TIME ont 1 5 F 1 5 16 COMPLIRNCE d nl PROGRAM MODE I 7 NES peus iT aaa System in PROGRAM MODE When the system is in the Program Mode select the test diagnostic or user specific for which defaults will be defined Pressing any softkey displays the Reflex Threshold mode softkey menu across the bottom of the screen with a PROGRAM MODE status message Test parameters can now be selected from the usual softkey menu as done in preparation for a test Once all the test parameters have been selected press ing the RETURN hardkey returns the display to the PROGRAM MODE sub menu Pressing the STORE softkey stores the selected parameters as defaults for fu ture tests The STORING DATA status message will be displayed Press the REFLEX or other test mode hardkey to return from the Program Mode to the Reflex Threshold mode with the new test parameter defaults To run a reflex threshold diagnostic test press the REFLEX hard key To select a USER reflex threshold test press the REFLEX hardkey followed by the RETURN hardkey and then the USER softkey Grason Stadler Reflex Decay testing Softkey menu structure Operation Reflex Decay is a diagnostic test particularly us
212. mpStar Version 1 Reference Instruction Manual D 137 Appendix D 9 2 Error Subcodes 9 2 4 Error Record 101 Subcode Definitions Error Sub code 164 178 209 214 216 217 218 219 259 260 261 270 271 276 277 278 279 D 138 Error Status Message and Description ALERT INVALID SELECTION A General error message indicating that the command is invalid for the current instrument state This message is used for invalid softkeys and various other common improper selections LEAK TEST ABORTED Leak occurred while a test other than Tymp Screening with Auto Start selected was in progress The STOP mode is automatically entered VALID INTENSITY LIMIT REACHED Indicates that the minimum or maximum Intensity limit was reached for an Intensity Up Down or Set Activator Facilitator command OCCLUSION REMOVE PROBE Occlusion was detected during a Tymp Screening test with Auto Start selected The STOP mode is automatically entered ALERT INVALID SELECTION PRINTER ACTIVE Page Print or Clear command sent while a printout was in progress ALERT INVALID SELECTION IN PROGRAM MODE Clear Page Erase Manual or Hold command sent while in the Program Mode ALERT INVALID SELECTION AUTO START SELECTED START RIGHT or START LEFT command sent while in Tymp Screening Test with Auto Start selected ALERT INVALID SELECTION PRESSURIZING TO START PRESSURE An invalid command was sent while the system
213. mpliance change is less than the programmed MIN CHANGE the intensity will automatically increased by 5 dB and the stimulus will be presented at 75 dBHL Once again the response will be displayed and automatically evaluated against MIN CHANGE criterion If itis met the same intensity will be presented a second time as a check for repeatability NOTE The stimulus intensity is automatically incremented in 5 dB steps up to the STOP dB HL only if a repeatable response is not measured at the lower intensity level CAUTION Care should be taken when programming the STOP dB HL parameters to avoid exposure to high intensity levels 18 Erase sub threshold tracings on a reflex line in reverse sequence by pressing the ERASE hardkey on the LCD panel Cle d ha prior to pressing the CONTINUE softkey Pressing the CONTINUE softkey places data on a line in memory 19 The intensity level may be changed between stimulus Simit A presentations without using the Threshold Seek feature by pressing the appropriate INTENSITY hard key 57 A WARNING 1 The time period of exposure to intensity levels above 100 m dB HL should be kept to a minimum Selecting an inten f sity above 100 dBHL results in the alert message High intensity selected to appear Extreme care should be 777 used in presenting stimuli at high intensity levels during acoustic reflex measurements 20 Press the CONTINUE softkey at the end of a li
214. mpliance values are transmitted as Compliance x 1000 For example a transmitted value of 1234 equals 1 234 ml or mmho All Gradient values are transmitted as Gradient x 100 7 1 Summary Data Records 7 1 1 Tymp Diagnostic Offset Field Name Char 0 1 Start of record 1 1 Record Type 2 2 Record Sequence Number 4 45 Patient Name 49 45 Patient ID 94 45 Tester Name 139 45 Facility Name 184 9 Probe S N 193 20 Date Time 213 2 Test type 215 1 Test number 216 1 Ear Under Test 217 1 Auto Sequence 218 2 ProbeTone 220 4 Start Pressure 224 1 Baseline Status 225 1 Gradient Status of last Tymp run 226 6 data 232 1 Number of lines Field Definition 1 Summary data record 8 Summary data record with attached XY data records XX 00 to 99 XXXXXXXXXXX 0 to 45 characters for unused characters 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters XXXXXXXXX 9 Characters for unused characters XM for xm if 24 Hour time format 0 Tymp Diagnostic 1to 9 andAto Q L Left Ear R Right Ear 0 Off 1 On 0 226Hz 1 678 Hz 2 1000 Hz 3 gt 38 Not used XXX 600 to 400 daPa 0 Off 1 On 0 Off 1 Tymp Width daPa 2 Ratioml XXXXX 30800 to 30800 0 1 20r3 GSI TympStar Versio
215. n 1 Reference Instruction Manual D 23 233 234 239 241 247 248 249 250 256 260 261 264 266 272 273 274 275 281 285 Y axis scale Cursor X value Line 1 data header Line 1 cursor Y value Admittance status Pressure Range status Pressure Rate status Peak Compliance data Peak Pressure data Sweep Direction status Gradient data Line 2 data header Line 2 cursor Y value Admittance status Pressure Range status Pressure Rate status Peak Compliance data Peak Pressure data Sweep Direction status Appendix D 0 5to 41 5 0 5to 3 0 0 5to 5 0 1 0to 7 0 1 0to 9 0 2 5to 15 0 5 0to 25 0 5 0 to 35 0 XXXX 600 to 400 daPa if Cursor not used NOOR WD 11 30800 to 30800 if Cursor not used Y B G B G Normal Wide 12 5 daPa sec 50 daPa sec 200 daPa sec 600 200 daPa sec 30800 to 30800 ifno Peak found XXX 600 to 400 daPa if no Peak found 0 positive to negative 1 negative to positive If Gradient RATIO z OWN XXX 1 to 999 daPa If Gradient TYMP WIDTH XXXX 00 to 990 0 if Gradient could not be calculated jf Gradient Status OFF Ep XXXXX 30800 to 30800 jf Cursor not used 0 1 8 2 0 3 B G 0 Normal 1 Wide 0 12 5 daPa sec 1
216. n Manual 1 5 Chapter 1 Grason Stadler Installation This chapter contains the following information Unpacking and inspecting the GSI TympStar and accessories page 2 1 Equipment connections page 2 4 Preparing the probe assembly page 2 6 Powering the instrument page 2 7 Preparing the internal printer page 2 8 Preparing an external printer page 2 9 Adjusting display contrast page 2 12 Front panel controls page 2 13 Unpacking and inspecting the GSI TympStar This GSI TympStar was carefully tested inspected and packed for shipping It is a good practice after receiving the instrument to examine the outside of the container for any signs of damage Notify the carrier if any damage is noted Carefully remove the GSI TympStar and TympStar accessories from the ship ping container If the instrument or accessories appears to have suffered dam age notify the carrier immediately so that a proper claim can be made Be certain to save all packing material so that the claim adjuster can inspect it as well As soon as the carrier has completed the inspection notify a GSI Representative If the instrument or an accessory must be returned to the factory repack it carefully in the original container if possible and return it prepaid to the fac tory for the necessary adjustments GSI TympStar Version 1 Reference Instruction Manual 2 1 Chapter 2 Check all the accessories against the itemized lists in Tables 2 1 an
217. n or nearby on the panel and do not change The front panel hardkey functions include Causes GSI or operator programmed default criteria for diagnostic tymp test to be automatically set up Causes GSI or operator programmed default criteria for reflex threshold test ing to be automatically set up Causes GSI or operator programmed default criteria for eustachian tube func tion intact eardrum test to be automatically set up GSI TympStar Version 1 Reference Instruction Manual 2 13 Special Page Print Remote Data Transfer Pressure control Manual Hold Stop Start Stimulus Intensity Present Chapter 2 Causes GSI TympStar to initialize to GSI or operator programmed default criteria for reflex decay test Tymp Reflex Etf Special wv 2 Allows operator to recall and display e Page tests in memory or in progress Allows operator to print selected test results Used when GSI TympsStar is inter faced with external computer Imple ments a common handshake routine to ensure that the RS232 link is in place Used to send test data to an external computer Rotary knob used to manually change or fine tune the pressure within the ear canal Allows the user to run each applicable test procedure manually The pressure con trol is used to change pressure manually within the ear canal Allows the current test sequence to be temporarily halted without venting the ear ca
218. n sub code unless the function sub code is not used All fields of all other record types must contain a value in the range specified for the record in Section 8 6 1 1 Keystroke Command Validation For single keystroke commands that remotely control the hard keys and soft keys the validation process includes the validation of the corresponding pushbutton These Invalid remote commands display an error message on the LCD screen and are also sent back to the remote device The error record that is sent is in the standard error record format with 101 as the error code and a subcode representing the string number of the error message that was displayed Therefore remote commands which activate a hard or soft key are only valid during tests in which that hard or soft key is normally available 6 1 2 Non Keystroke Command Validation For all other invalid remote commands an error message is not displayed on the LCD screen and an error message record is transmitted to the Remote Device indicating the invalid command D 10 Grason Stadler Remote Specifications 6 1 3 Miscellaneous Validation On a Version 1 unit all test parameters tests or features that are unique to Version 2 are invalid If any errors occur the GSI TympStar will not accept the record and an error message record will be sent back to the Remote Device to indicate the type of error that had occurred See Section 9 for the description of the error records Allinput records must b
219. nal pressure Allows the current test sequence to be terminated The ear canal is vented Data on the current page is stored in memory Causes the selected test sequence to begin in the direction indicated by the associated arrow Allows available stimuli to be scrolled up or down and selected This feature is available only for Reflex type tests Allows operator to select and set desired intensity dB HL This feature is available only for Reflex type tests Allows selected stimulus to be presented either manually or according to pre set automatic timing This feature is available only for Reflex type tests Grason Stadler Installation Three hardkeys are also located on the left and right sides of the LCD housing Their functions are printed directly on the push button and do not change The LCD housing hardkey functions include Clear Deletes selected tests stored in memory Erase Erases current display of test results prior to placing test results in memory Return Allows the operator to go back to next higher level in the softkey menu De pressing Return while in Clear Page or Print mode restores the instrument to the mode previously selected Softkeys Only the push buttons located directly under the LCD are softkeys Their functions are displayed on the LCD and change in support of the current test activities DIAGNOSTIC Softkeys Menu diagrams Menu structure diagrams like the diagrams shown on thes
220. navailable XXXXX 010 1800 msec NA if value unavailable 0 to 1800 msec NA if value unavailable 4 2 30800 to 30800 1 if Cursor not used 0 2 Y 1 2 0 0 IPSI 1 Steady CONTRA GSI TympStar Version 1 Reference Instruction Manual D 37 307 312 317 319 321 324 326 330 331 332 335 341 346 351 356 361 363 364 49 94 139 On Time Zero field Zero field Activator Stimulus Click rate Zero field Pressure Number of traces Intensity unit A DY C Trace 1 intensity Trace 1 amplitude 1096 ON time CO 5 9096 ON time 5 1096 OFF time 5 9096 OFF time 2 Checksum Carriage return 1 Line Feed Acoustic Reflex Sensitization Field Name Chars 1 Start of record 1 Record Type 2 Record Sequence Number 45 Patient Name 45 Patient ID 45 Tester Name 45 Facility Name Appendix D XXxxx 10010 1800 msec 0 Not used 1 500 Hz 2 1000 Hz 3 2000 Hz 4 4000 Hz 5 Low Band Noise 6 High Band Noise 7 Broad band Noise 8 Click 9 External 10 Not used 11 Not used XXX 50 to 300 sec xxx 600 to 400 daPa 0 or 1 0 1 HL 2 SPL XXX 35 to 120 dB 30800 to 30800 0 to 1800 msec if value unavailable 0 to 1800 msec if value unavailable Xxxxx 010 1800 msec if value unavailable 010 1800 msec
221. ne of tracings to resume tracings on the next line or next page NOTE MARK THRESHOLD softkey is also available prior to selecting CON TINUE This allows the operator to set the threshold value per line Grason Stadler Operation 21 If STIMULUS EAR TIMING or STIMULUS settings are changed during a reflex test a new line of tracings is generated Each line is appropriately labeled and indicates the pressure of the last reflex presentation REFLEX THRESHOLO TEST 3 81710720017 02130 pn PRESSURE 10 STIMULUS 1000 Hz INTENSITY 90 dBHL 409 200 9 200 TIMING ON 1 5 E 5 CURSOR sec 0 1 m LINE 15 0 00 nl 00 Jane Doe I0 12345667 TESTER abc 416 16 sec OFF 22 Changing the test EAR or TIMEBASE settings causes a new test page to be selected The previous test page is automatically stored in memory 23 Initiate Reflex Decay testing by pressing the SPECIAL hardkey or terminate the ea um ums threshold test by pressing the STOP V hardkey Manual NOTE Pressure from the last reflex threshold presentation is re tained and automatically set when any other Reflex type test mode is selected If the STOP hardkey has been de Pme pressed in a Reflex test mode the START hardkey must be 1 pressed to repressurize the ear canal to the peak value 2 e Hold Stop 24 Test data can be erased or cleared using the ERASE or CLEAR hardkey on the LCD pane
222. ng this instrument the more stringent rules should take precedence WARNING The GSI TympStar Middle Ear Ana lyzer is designed to be used with a hos pital grade outlet Injury to personnel or damage to equipment can result when a three prong or two prong adapter is connected between the GSI TympStar power plug and an AC outlet or exten RELIABLE GROUND sion cord CAN ONLY BE OBTAINED t WHEN THE AC QUTLET y IS OF E QUIVALENT WARNING HOSPITAL GRADE The use of ACCESSORY equipment not complying with the equivalent safety requirements of this equipment may lead to a reduced level of safety of the resulting system Consideration relating to the choice shall include Use of the ACCESSORY in the PATIENT VICINITY Evidence that the safety certification of the ACCESSORY has been performed in accordance with the appropriate IEC 601 1 and or IEC 601 1 1 harmonized national standard ANY EQUIPMENT CONNECTED TO THE GSI TYMPSTAR AND USED IN THE PATIENT VICINITY MUST BE POWERED BYAN ISO LATED POWER SOURCE TO MAINTAIN THE ELECTRICAL SAFETY OF THE OVERALL SYSTEM The isolated power source can be purchased directly from GSI or elsewhere when approved for use by GSI GSI TympStar Version 1 Reference Instruction Manual iv WARNING WARNING WARNING WARNING WARNING Preface WARNING ELECTRIC SHOCK HAZARDS Do not open the case of the TympStar Refer servicing to qualified per sonnel Do not remove any
223. ning with Auto Start in progress and that the test was stopped LEAK TEST ABORTED REMOVE PROBE Indicates that a leak was detected during a Tymp Screening test with Auto Start selected and that the test was stopped ALERT REMOTE MODE NOT SELECTED Indicates that the Data Transfer command will not be able to process while not in the remote mode ALERT INVALID SELECTION DATA TRANSFER IN PROGRESS Indicates that the TympStar is trying to transfer data and that the key pressed is invalid during data transfer ALERT INVALID WHILE TEST IN PROGRESS Invalid while test is running for Tymp type tests and while Reflex type tests are plotting ALERT INVALID WHILE IN PRINT OR CLEAR The Data Transfer or Transmit Test Data Request command is invalid while in the Print or Clear mode Grason Stadler 642 643 644 650 735 740 743 745 756 757 760 762 763 Remote Specifications ALERT DATA TRANSFER IN PROGRESS Indicates the status of a data transfer This will always be displayed on the screen while the data transfer is taking place The message will be sent remotely every time a data transfer takes place ALERT DATA TRANSFER INHIBITED DATA TRANSFER ABORTED Indicates that the instrument has detected tha the RTS line is in a disabled low state ALERT DATA TRANSFER ERROR DATA TRANSFER ABORTED Indicates that Data Transfer was selected but the TympStar was unable to transfer the data to a remote system and that
224. ns regarding navigating through softkey structure menus and changing parameter settings STIMULUS EAR MARK THRESHOLD THRESHOLD SEEK AUTO ZERO EAR MORE ea 3 CONTRA CONTRA EXIT MARK MARK NR NR ON OFF CONFIGURE MANUAL LEFT STEADY PULSED LINE1 LINE2 LINE1 LINE2 MIN START STOP EXIT CHANGE dBHL dBHL e y SET Pi 5 m y SET STIMULUS TIMING TIMEBASE S n MORE ING eus aoe 0 48 0 64 0 80 ON TIME OFF TIME QTY EXIT Reflex diagnostic softkey menu structure Djupesiand Gisle Non acoustic Reflex Measurement Procedures Inter pretations and Variables Acoustic Impedance and Compliance The Mea surement of Middle Ear Function A Feldman and L Wilber eds Williams and Wilkins 1976 4 22 Grason Stadler Reflex Threshold automatic test procedure Stimulus Timing Operation Ipsi time multiplexed stimuli are delivered to the ear canal via the probe in sert Contralateral steady or pulsed stimuli are delivered to the ear canal via the Contra insert phone fitted with an appropriate size standard eartip 1 Press the REFLEX hardkey to select Tymp Refle Etf Special the Reflex Diagnostic test mode 4 Ww Ww 2 Default test parameters are displayed above the softkeys across the bottom of the LCD screen mT REFLEX THRESHOLO TEST 1 12 13 2008 10 02 pn PRESSURE daPa STIMULUS 1000 Hz 06 INTENSITY 76 dBHL a e Lp 600 400 200 0 200 400 TIMING ON 1 5 FF
225. nsfer occurs while in HOLD all summary and XY Graphical test data for the current test are cleared from the LCD screen and the page memory The test remains in HOLD and the test number will not change If the data transfer occurs while a Reflex test is in RUN but without a stimulus being presented all summary and XY Graphical test data for both lines are cleared from the LCD screen and the page memory If the CONTINUE softkey was being displayed it is erased and replaced by the normal menu and stimulus presentations are then allowed The next stimulus presentation is plotted at the beginning of the top line The test remains in RUN and the test number is not changed The Auto Clear function does not operate when data transfer occurs in the Page mode in the ETF TM test or in a Multiple Frequency Screen 1 and 2 test 5 6 1 Output Records For the detailed Output Record formats see Section 7 D 8 Grason Stadler Remote Specifications 6 Remote Input Operation The Remote input feature allows the GSI TYMPSTAR to receive commands or data from the Remote Device The commands give the Remote Device access to most front panel controls by simulating the operation of the front panel controls While the Remote Mode is enabled the front panel controls are still active allowing the unit to be simultaneously manually and remotely controlled There will be no priority between the Remote commands and the Manual commands All keys that are pressed while an
226. nt panel controls 2 10 Functions 4 1 Fuses 2 5 G Gradient 4 7 Graphic display 4 10 Graphic traces 4 3 GSI33 1 1 GSI default parameter settings 1 5 2 12 GSI preprogrammed test parameters 1 1 GSI Suite 4 62 GSI developed defaults 4 2 H Hardkeys 1 3 2 10 Hermetic seal 3 15 High intensity levels 4 28 Hold 2 11 Hospital grade plug 2 3 Hyperflaccid 4 25 I Injury 2 7 Insert phone 4 21 Inspecting the GSI TympStar 2 1 Installation 2 1 Software 2 1 Instructing the patient 3 15 Instrument controls 1 3 Instrument fuses 2 5 Instrument options 4 59 Intact eardrums 4 41 Intensity 2 11 Intensity limits check for reflex threshold 3 14 Intensity presentations dB HL per frequency 4 14 Internal memory 1 2 Introduction 1 1 Ipsi probe 2 6 Ipsi stimuli 1 2 Ipsi stimulus 4 16 Isolated power source 2 4 K Keyboard 1 2 2 4 L Language 4 61 Index 2 Index LCD 1 1 2 12 LCD graphic traces 4 3 LCD panel 1 3 LCD screen 4 3 LED 1 2 Lights 4 3 Line 1 4 26 Loudspeaker 1 2 4 6 M Managing and archiving data 1 2 Manual 2 11 Manual mode 4 12 Manual timing of stimuli 4 24 Manual tympanometry 4 12 Mark threshold 4 26 Maximum timing allowable for reflex threshold 4 24 Maximum timing levels allowable in reflex decay 4 36 Measurement accuracy 3 1 Memory 1 2 Menu diagrams 1 5 2 12 Menu navigation 1 3 Menu softkey 1 5 Menu structure diagrams 1 5 Menus 1 4 Microphone 1 2 Middle ear 4 6 Middle ear
227. nts at the Eardrum as an Aid to Diagnosis J Speech and Hear Res 1963 6 4 315 327 Feldman A Diagnostic Application and Interpretation of Tympanometry and the Acoustic Reflex Audiol 1977 16 294 306 Hall J Contemporary Tympanometry Seminars in Hear 1987 8 4 319 327 Liden G Impedance Audiometry Department of Audiology and Otolaryngology Sahlgren s Hosp Univ of Goteborg Goteborg Sweden Lilly D Measurement of Acoustic Impedance at the Tympanic Membrane Modem Developments In Audiology 2nd Ed Academic Press Inc New York and London 1973 345 405 Margolis R Smith P Tympanometric Asymmetry J Speech and Hear 1977 Res 20 437 446 Margolis R Interactions Among Tympanometric Variables J Speech 1977 Res 20 447 462 Osguthorpe D Effects of Tympanic Membrane Scars on Tympanometry A Study In Cats Laryngo scope 1986 96 1366 1377 Popelka G Acoustic Immittance Measures Terminology and Instrumentation Ear and Hear 1984 262 267 Porter T Normative Otoadmittance Values for Three Populations J of Aud 1972 Res Xii 1 53 58 Rabinowitz W Measurement of the Acoustic Input Immittance of the Human Ear J Acoust Soc Am 1981 70 4 1025 1035 Renvall U Liden Jungert S Impedance Audiometry in the Detection of Secretory Otitis Media Scand Audiol 1975 4 1 6 S
228. nual 4 57 4 9 STIMULUS HZ softkey controls the program STIMULUS HZ ming of stimuli for decay testing Use the up and down arrows to scroll through the available stimuli sus TESNO Toggle the YES NO softkey to select or deselect the Y stimulus Press the RETURN hardkey and toggle the ON OFF softkey to ON NOTE Itis not possible to run Reflex Decay tests without running Reflex Thresh old tests 10 Press the RETURN softkey then press STORE to store the test sequence configuration Press any test mode V 2 hardkey to return from the Instrument Options menu Tymp Reflex Etf Special Instrument Options Softkey menu structure Print format The Instrument Options softkey menu can be used to configure a variety of printing communication language test sequence date and time and other instrument parameters To review or reprogram these instrument options press the ETF hardkey then the RETURN hardkey The following sub menu will be displayed INTACT PERF INSTRUMENT PROGRAM TM TM OPTIONS MODE Press the INSTRUMENT OPTIONS softkey to display the Instrument Op tions menu The software menu structure is shown in full on the next page Test results can be printed for each test type in graphic format showing the test tracing or as a table of numeric values Press GRAPHIC for printed wave form tracings Press TABULAR for printed numeric tables When all the formatting selections have been ma
229. nuta sul CD numero di parte 482 6387xx per informazioni sulla compatibilit elettromagnetica relativa al sistema in dotazione Compatibilidad electromagn tica CEM Consulte la Gu a de referencia sobre compatibilidad electrom gnetica incluida en el CD n mero de pieza 482 6387xx para obtener la informaci n sobre la CEM de su sistema Electromagnetic compatibility EMC Please refer to the Electromagnetic Compatibility Reference Guide on CD part number 482 6387xx information concerning your system Compatibilit lectromagn tique CEM Veuillez vous reporter au guide de r f rence de compatibilit clectromagn tique sur CD num ro de pi ce 482 6387xx pour des informations sur la CEM relatives votre syst me Elektromagnetische Vertraglichkeit EMV Informationen ber die EMV des Systems finden Sie im Referenz Handbuch Elektromagnetische Vertr glichkeit auf der CD Teilenummer 482 6387xx Compatibilit elettromagnetica EMC Vedere la guida alla consultazione per la compatibilit elettromagnetica contenuta sul CD numero di parte 482 6387xx per informazioni sulla compatibilit elettromagnetica relativa al sistema in dotazione Compatibilidad electromagn tica CEM Consulte la Gu a de referencia sobre compatibilidad electrom gnetica incluida en el CD n mero de pieza 482 6387 para obtener la informaci n sobre la CEM de su sistema Preface This manual contains t
230. o TOM e 3 While in the NORMAL pressure range press the START START daPa softkey and then select 600 as the starting pressure Note that the X axis and meter 600 400 200 200 400 MORE ranges change to the WIDE pressure range values 500 300 0 300 MORE NOTE The START daPa values override the normal pressure range selection 1 Confirm that the BASELINE is Use the BASELINE BASELINE sub menu to change the settings if necessary ON OFF 2 Insert the probe tip into the 2 0 cc test cavity and press the Manual MANUAL hardkey The cavity size should be recorded as EAR CANAL VOLUME 3 Rotate the PRESSURE KNOB and note the resulting change e on the pressure meter and graphic display Data Pre Transfer Pressure Manual 57 Stimulus A GSI TympStar Version 1 Reference Instruction Manual 3 9 Screening reflex check tymp screening Chapter 3 1 Confirm that the BASELINE is ON Use the BASELINE BASELINE sub menu to change the settings if necessary ON OFF 2 Insert the ipsi probe tip into the 2 0 cc test cavity 3 Press the TYMP hardkey and then press the RETURN hardkey The following sub 2 22 2 2 menu will be displayed Tymp Reflex Etf Special SCREEN DIAGNOSTIC USER 1 USER 2 USER 3 PROGRAM MODE 4 Press the SCREEN softkey The tymp sweep will begin automatically upon pressurization of the test cavity The following results should be displayed The graph
231. o Zero 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 7 4 ARLT ml Scale Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 ml Scale 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 7 5 ARLT Ear Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Ear 8 2 Checksum 10 1 Carriage return 11 1 Line feed Remote Specifications Field Definition 9 Query Record 00 to 99 064 0 Automatic 1 GR Field Definition 9 Query Record XX 00 to 99 065 0 04 to 16 1 4 08 to 32 2 4 12 to 48 4 16 to 64 4 4 20 to 80 04 to 4 16 08 to 4 32 7 12 to 4 48 8 16 to 4 64 20 to 4 80 XX Field Definition p 9 Query Record XX 00 to 99 066 0 Left 1 Right XX CR GSI TympStar Version 1 Reference Instruction Manual 7 9 7 6 ARLT Admittance Offset Field Name Char 0 1 Start of record 1 1 Request Record 2 2 Record Sequence 4 3 Record type 7 1 Admittance 8 2 Checksum 10 1 Carriage return 11 1 Line feed 7 9 7 7 ARLT Timebase Offset Char 0 1 1 1 2 2 4 3 7 1 8 2 10 1 Field Name Start of record Request Record Record Sequence Record type Timebase Checksum Carriage return Line feed 7 9 7 8 ARLT Step size Offset
232. oard for entering patient information an HP DeskJet or LaserJet printer and a VGA monitor for displaying test re sults Other options offered for the TympStar Version 1 for managing and ar chiving data include Internal memory for storing up to 26 test results Data export to an external PC via RS232 serial interface Remote control of the TympStar via RS232 commands from an external PC Functional in TympStar Version 2 only The probe The innovative lightweight probe is designed for patient comfort ease of seal and accurate test results A wide variety of both standard and special sized eartips are supplied with the GSI TympStar to hermetically seal the ear canal In addition a set of screening eartips is provided for screening tymp and reflex tests The operator has a choice of three mountings to support the probe box the standard lightweight shoulder mounting standard clothes clip or an optional operator wrist attachment The probe box has 2 LED s to indicate test status Within the probe box there are two small loudspeakers a microphone and a pressure transducer One loudspeaker delivers the probe tone to the ear canal while the microphone monitors the intensity of the probe tone within the ear canal The second loudspeaker delivers the ipsilateral ipsi stimuli to the ear canal The contralateral contra insert phone contains its own loudspeaker The pressure within the ear canal can be varied up to
233. ompliance points at an interval of 50 daPa 994060909252494444949494 1 1 1 1 0 100 200 Ratio method of calculating gradient Normative gradient values Greater than 0 2 tt Fiellau Nikolajsen M Tympanometric and Middle Ear Effusion A Cohort Study in Three Year Old Children Int J Ped Otorhinolaryngology 1980 2 39 49 Selecting the gradient select the gradient calculation to be used as part GRADIENT Method of a tymp measurement press the GRADIENT soft key inthe TYMP menu then press TYMPWIDTH 4yupwiprH RATIO OFF or RATIO sub menu softkey dara m 4 8 Grason Stadler Tymp diagnostic softkey menu structure AUTO P RANGE SEQUENCE daPa Automatic Tympanometry test procedure Operation The structure of Tymp Diagnostic softkey menu selections is diagrammed be low Please refer to Chapter 1 Introduction for instructions regarding navi gating through softkey menus and changing parameter settings START GRADIENT EAR MORE daPa NORMAL WIDE 600 400 200 25 MORE WIDTH RATIO RIGHT LEFT daPa mi 500 300 0 300 MORE P RATE BASELINE MORE daPa s 125 50 600 200 Tymp diagnostic softkey menu structure 1 Select the Tymp test mode if necessary by pressing the TYMP hardkey Ef v Ww ww ww NOTE The instrument automatically initiates the Tymp Diagnostic test mode when power is applied 2 Attach the probe box to the v
234. or tracing 3 is difficult to obtain even for normally functioning Eustachian tubes GSI TympStar Version 1 Reference Instruction Manual 4 45 Eustachian Tube function testing for Perforated Eardrums Softkey menu Structure Chapter 4 The operator may follow a protocol similar to that outlined by Holmquist for determining patency of the Eustachian tube in a patient with pressure equal ization tubes in place or with a perforated eardrum During the test positive or negative pressure is presented to the ear canal middle ear space until a pre selected pressure limit is reached The purpose of this test is to determine if the Eustachian tube will open as a direct result of this pressure Specific opening pressure provides some information about the status of the tube 1 properly functioning vs malfunctioning It is sug gested that the operator perform the test with the maximum pressure 400 daPa pre selected This eliminates the possibility of the Eustachian tube not opening at a lower pressure which might otherwise be forced open closer to the maximum pressure value If the tube opens as a direct result of the pressure within the ear canal middle ear space only a portion of the positive pressure will escape before the tube closes again NOTE If negative pressure is used during the test and the tube opens some air will enter the ear canal middle ear thereby reducing the amount of nega tive pressure To
235. ord type The record type specified in a record is not one of the defined record types Example Record type 53 would be invalid since it is not defined Insufficient number of pages left in the page memory to perform the requested command Example Selecting a Multiple Frequency test when currently on test 25 Since a Multiple Frequency test requires a minimum of 3 tests this command invalid Invalid parameter action for specific test Some tests do don have are not able to change parameters therefore return this error Invalid query for specific test Some tests do don have query results and therefore return this error GSI TympStar Version 1 Reference Instruction Manual D 133 016 017 018 019 020 101 102 103 104 105 106 D 134 000 000 000 000 000 see 10 2 1 Test see 10 2 2 Test see 10 2 2 Test see 10 2 2 Test see 10 2 2 Test see 10 2 2 Appendix D Received character error Framing error The character received by the GSI TympStar did not have the proper number of Stop bits Could be caused by a transmission error or a mismatch between the Stop bit selections between the GSI TympStar and the Remote Device Received character error Overrun error One or more characters transmitted to the GSI TympStar were lost due to insufficient time between characters to allow the GSI TympStar to process one character before another one is sent Received character error
236. ot suitable for use in the presence of flammable anesthetic mixture with air or with oxygen or nitrous oxide 5 Mode of operation continuous Input Voltage 100 240 VAC Input Frequency 50 60 Hz Input Current 3 2Amaximum Power Consumption 120Wmaximum Grason Stadler Supplied Accessories Optional Accessories Mechanical Materials of manufacture Specifications Contra insert phone Calibration cavity V1 Probe cleaning kit 2 boxes Eartips 1 pkg 8 standard sizes 4 ea Color coded 1 pkg 6 special sizes 2 ea 1 pkg 6 screening sizes 2 ea Reference Instruction Manual Quick User Guide Printer paper 2 rolls for orders including printer Spare set of probe tubing Probe mount shoulder Probe mount wrist Probe mount clothes Printer paper adhesive backed for orders including a printer GSI TympStar dustcover Power cord with hospital grade plug Power cord part varies depending on location GSI Suite Audometric Data Management Software OtoAccess Network Software for GSI Suite DIMENSIONS AND WEIGHT 20 38 inches x 15 inches x 12 6 inches LCD raised WxDxH GSI Part 8000 0078 GSI Part 2000 1036 GSI Part 2000 9610 GSI Part 1700 9660 GSI Part 1700 9670 GSI Part 1700 9622 GSI Part 2000 0100 GSI Part 2000 0108 GSI Part 1700 9619 GSI Part 2000 9617 GSI Part 1700 9646 GSI Part 1700 9642 GSI Part 1700 9608 GSI Part 1770 9643 GSI Part 1700 9618
237. other command is in process are processed when the first key is complete The STOP key has priority over any other key press Whenever the Stop Key is pressed all queued keystroke command both manual and remote are flushed out and stopped Remote commands consist of three basic types single key soft and hard presses special commands and text entry commands The single keystroke commands allow the Remote Device to directly control all soft or hard keys Manual is the only key that cannot be pressed since manual mode is not accessible remotely An example is a command which directly presses softkey 3 The special commands are provided to allow the Remote Device to make selections not available as a soft or hard key or to directly modify a parameter that is normally changed by scrolling through a range of selections such as the activator stimulus or intensity These special commands also allow for querying of values for parameters so that any changes can be checked remotely The text entry command is used to enter patient tester and facility information These commands also have querying capabilities When aremote command is being processed the status message ALERT REMOTE COMMAND IN PROGRESS is displayed on the status line This message is displayed until the processing of the command is complete or for 1 second whichever is longer The Remote Device has the ability to directly modify all parameters for the current test When a para
238. ovided on the right side of the screen Press the DATA TRANFER hardkey to Data start the sequence Transfer bod ALTITUDE CALIBRATION ONLY USE ALTITUDE CAL MODE WHEN L PRESS DATA TRANSFER TO USTING CAVITY VOLUMES TO READ 0 5 START SEQUENCE AND 5 0 ml REGARDLESS OF SITE 12 PRESS DATA TRANSFER TO START LTITUDE SEE REFERENCE MANUAL FOR 2 nl CAL ADIN NOMINAL CUSTOMER i SITE VALUES Soni 0 50 nl 12 00 nl 1 2 00 nl i TO START CALIBRATION PUT PROBE IN 2 0 ml AND PRESS DATA TRANSFER 5 Put the probe into the 2 0 ml cavity 6 Press the DATA TRANFER hardkey to begin calibration Wait for the calibration complete notification before proceeding to the next step 7 Press the RETURN hardkey to exit the Altitude Calibration mode Grason Stadler Operation Auto Sequence testing The Auto Sequence function conducts a predefined sequence of tests when the AUTO SEQUENCE softkey is pressed The sequence of tests always includes Tymp Diagnostic at 266 Hz Y and can be configured by the user to also in clude Reflex Threshold and Reflex Decay tests NOTE Auto Sequence testing is useful when conducting an abbreviated battery of middle ear tests on a cooperative patient When testing less than coop erative patients it is best to use the regular Tymp Diagnostic Reflex Threshold and Reflex Decay test modes to obtain more reliable test re sults Auto Sequence test The test
239. p Admittance The Measurement of Middle Ear Func tion Williams and Wilkins Baltimore 1976 IEC 29C Int Electrotech Comm Standard for the Measurement of Aural Acoustic Impedance Admittance Instruments Katz J Handbook of Clinical Audiology 3rd Edition Williams and Wilkins Baltimore 1985 DIAGNOSTIC TYMPANOMETRY Alberti P Jerger J Probe Tone Frequency and the Diagnostic Value of Tympanometry Arch Otolaryngol 1974 99 206 210 Beery Q Bluestone C Andrus W Cantekin E Tympanometric Pattern Classification in Relation to Middle Ear Effusions Ann Otol Rhinol And Laryngol 1975 84 1 56 Chesnutt B Stream R Love 1 McLarey D Otoadmittance Measurements in Cases of Dual Ossicu lar Disorders Arch Otolaryngol 1975 101 109 113 Cooper J Hearne E Gates G Normal Tympanometric Shape Ear and Hearing Williams and Wilkins Co University of Texas Health Science Center San Antonio TX 1982 Creten W Van de Heyning P Van Camp K Immittance Audiometry Scand Audiol 1985 14 115 121 Creten W Van Camp K Transient and Quasi Static Tympanometry Scand Audiol 1974 3 39 42 Creten W Van Camp K Maes Vanpeperstraete P Diagnostic Value of Phase Angle Tym panograms Audiology 1981 20 1 14 GSI TympStar Version 1 Reference Instruction Manual B 1 Appendix B Feldman A Impedance Measureme
240. p on the probe unless it is thoroughly dry GSI TympStar Version 1 Reference Instruction Manual 3 1 Chapter 3 Feed the stiff end of the cleaning wire into the tube and pull the wire com pletely through the tube Discard the used wire Repeat this process for each of the remaining probe tubes Do not reuse wires Reconnect the tygon tubing to the probe tubes The center tube has the larger diameter Eartips Eartips are single use only The disposable eartip should be pushed firmly onto the tip of the probe until it is fully seated The three probe tubes should be nearly flush with the top surface of the eartip eur Grason Stadler Pre Operation Preparing test materials The following items should be placed within easy reach prior to a test session Otoscope Contra insert phone 8000 0078 A container for storing disposable eartips Probe cleaning wire 2000 9610 A roll of printer paper 1700 9619 Calibration Cavity Assembly 2000 1036 Probe Box Mounts Shoulder Wrist Clothes Clip Several sets of eartips 1700 9660 1700 9670 1700 9620 NOTE Do not attempt to use eartips of another manufacturer unless completely confident that using them will not create air leaks between the probe tip and eartip Calibration checks Test cavity calibration Before using the instrument each day use the test cavity provided with this instrument to check the calibration of ml mmho meter
241. pletion of a pressure sweep or if the STOP hardkey is pressed the compliance scale automatically changes to provide an optimal display of the peak measurement GSI TympStar Version 1 Reference Instruction Manual 4 11 Manual Tympanometry test procedure Chapter 4 The Manual mode allows the operator to use the Pressure Control Knob to vary the pressure within the ear canal The operator can also control the speed of the tympanometric test This feature can be invaluable in testing impatient children or dif ficult to test patients 1 Press the TYMP hardkey and make sure the probe is securely positioned within the patient s ear canal 2 Press the EAR softkey and select the right or left ear then if desired navigate through the Tymp Diagnostic softkey menu and change parameter settings for the test as required Tymp Reflex Etf Special V YV YV Y Remote 24 Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings 3 Press the MANUAL hardkey to pressurize the ear canal to the previously selected start pressure 4 Once the start pressure is established rotate the PRESSURE knob to vary the pressure within the ear canal 5 View the test results in real time on the pressure and compliance meters as well as on the graph tracing Multiple tracings can be displayed on the screen 6 The test summary information is sho
242. plications Academic Press Inc 1984 Stach B Jerger J Acoustic Reflex Patterns in Peripheral and Central Auditory System Disease Sem In Hear 1987 8 4 369 377 Stelmachowicz R Lilly D An Indirect Estimate of Auditory Frequency Selectivity from Acoustic Reflex Measurements J Acoust Soc Am 1979 65 6 1501 1508 Wilbur L Kruger B Killion M Reference Threshold Levels For The ER 3A Insert Earphone J Acoust Soc Am 1987 81 Spring Wilson R McBride L Threshold and Growth of the Acoustic Reflex J Acoust Soc Am 1978 63 1 147 154 Woodford C Feldman A Wright H Stimulus Parameters the Acoustic Reflex and Clinical Impli cations Speech and Hear 1975 Rev Winter 29 37 Van Camp K Vanpeperstraete P Creten W Vanhuyse V On Irregular Acoustic Reflex Patterns Scand Audiol 1975 4 227 232 GSI TympStar Version 1 Reference Instruction Manual B 5 Appendix B ACOUSTIC REFLEX INFANTS Bennett Weatherby L Newborn Acoustic Reflexes to Noise Pure Tone Signals J Speech and Hear 1982 Res 25 383 387 Kankkunen A Liden G Ipsilateral Acoustic Reflex Thresholds in Neonates and in Normal Hearing And Hearing Impaired Pre School Children Scand Audiol 1984 13 139 144 Kruger External Ear Resonance in Infants and Young Children ASHA Meeting Detroit Mich
243. quest code 0 Send 1 Query for Pressure Range selection 1 Pressure Range 0 Normal 1 Wide 1 Carriage return CR 1 Line feed LF TYMP Diagnostic Ear Toggle Field Name Field Definition Char 1 Start of record 3 Record type 006 1 Selection code 0 Send 1 Query for ear selection 1 Carriage return CR 1 Line feed LF Set TYMP Diagnostic Pressure Rate Field Name Field Definition Char 1 Start of record 3 Record type 007 1 Request code 0 Send 1 Query for Pressure Rate selection 1 Pressure Rate 0 12 5 daPa s 1250 daPa s 2 200 daPa s 3 600 200 daPa s Grason Stadler Remote Specifications 6 1 Carriage return CR 7 1 Line feed LF 8 2 7 Set TYMP Diagnostic Start Pressure Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 008 4 1 Request code 0 Send 1 Query for Start Pressure selection 5 1 Start Pressure 0 600 1 400 daPa 2 200 daPa 3 200 daPa 4 400 daPa 5 500 daPa 6 300 daPa 7 0 daPa 8 300 daPa 6 1 Carriage return CR 7 1 Line feed LF 8 2 8 Set TYMP Diagnostic Baseline Offset Field Name Field Definition Char 0 1 Start of record p 1 3 Record type 009 4 1 Request code 0 Send 1 Query for Baseline selection 5 1 Baseline 0 1 OFF 6 1 Carriage return CR 7 1 Line feed LF 8 2 9 Set TYMP Diagnostic Gradient Offset Field Name Field Definition Char 0 1 Start of
244. r 0 1 1 3 4 1 5 1 6 1 7 1 Field Name Start of record Record type Request code Admittance Carriage return Line feed Remote Specifications Field Definition p 065 0 Send 1 Query for ml Scale selection 0 4 04 to 16 1 4 08 to 32 2 4 12 to 48 4 16 to 64 4 4 20 to 80 5 04 to 4 16 08 to 4 32 12 to 4 48 8 16 to 4 64 20 to 4 80 LP Field Definition E 066 0 Send 1 Query for ear selection CR LF Field Definition 67 Send Query for Admittance value Y 1 0 0 1 0 1 8 2 0 R L GSI TympStar Version 1 Reference Instruction Manual D 111 8 8 7 Set ARLT Timebase Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 Field Name Start of record Record type Request code Timebase Carriage return Line feed 8 8 8 Set ARLT Step size Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 Field Name Start of record Record type Request code step size Carriage return Line feed 8 8 89 Set ARLT Average Offset Char 0 1 1 3 4 1 5 2 7 1 8 1 D 112 Field Name Start of record Record type Request code Average Carriage return Line feed Appendix D Field Definition 068 0 Send 1 Query Timebase selection 0 500 msec 1 1000 msec 2 1500 msec 3 2000 msec CR Field Definition p 069 0 Send 1 Query for Step size selection 0
245. r not used OONDOABRWN O ll IPSI Steady CONTRA Not used Cfla CfCa 0 Manual 1 Automatic 125 10500 msec if Manual Timing 010 10000 msec 0 0 to 10 0 sec if Manual Timing Not used 500 Hz 1000Hz 2000 Hz 4000 Hz Not used Not used Broad band Noise GSI TympStar Version 1 Reference Instruction Manual D 39 256 259 261 265 266 267 270 276 279 285 288 294 297 303 306 312 315 321 323 329 331 337 338 339 3 2 zh mak 0 k Facilitator Intensity Facilitator Stimulus Pressure Number of traces Intensity unit Trace 1 intensity Trace 1 amplitude Trace 2 intensity Trace 2 amplitude Trace 3 intensity Trace 3 amplitude Trace 4 intensity Trace 4 amplitude Trace 5 intensity Trace 5 amplitude Trace 6 intensity Trace 6 amplitude Trace 7 intensity Trace 7 amplitude Line 2 data header Line 1 cursor Y value Admittance status Stimulus Ear status Timing Manual Auto Appendix D 8 Not used 9 External 10 Not used 11 6000 Hz XXX 35 to 120 dB if Stimulus Ear Ipsi or Contra 0 Not used 1 500 Hz 2 1000 Hz 3 2000 Hz 4 4000 Hz 5 Not used 6 Not used 7 Broad band Noise 8 Not used 9 E
246. r size eartip 3 15 Pure tone 4 21 Q Qualitative check 3 3 R Ratio 4 7 Ratio method 4 8 Rear panel 2 4 Receptacle 2 5 Reflex 2 10 4 14 Index Reflex decay 4 29 Reflex decay automatic testing 4 35 Reflex decay sample printout 4 38 Reflex diagnostic manual test procedure 4 31 Reflex diagnostic sample printouts 4 30 Reflex diagnostic softkey menu structure 4 22 Reflex mode 4 1 Reflex responses 4 26 Reflex testing 4 21 4 31 Reflex threshold mode check 3 11 Relative gradient 4 8 Release lever 2 8 Remote 2 11 Remote settings 4 62 Return 2 12 Roll 2 8 RS232 serial communication 1 2 S Screening eartips 1 2 Screening reflex 4 14 Screening reflex check for tymp screening 3 10 Screening reflex test scoring 4 16 Seal 3 15 Selecting a test mode 1 3 Serial communication 1 2 2 4 Settings 2 12 Seventh 79 nerve 4 21 Shoulder mount 3 15 Size eartip 3 15 Sloped tymps 4 25 Softkeys 1 3 1 4 2 12 Software installation 2 1 Special 2 10 Special test mode 4 1 Stapedius muscle 4 21 Start 2 11 Stimuli 4 24 Stimulus 2 11 Stimulus timing 4 23 Stop 2 11 Stop hardkey 4 13 Sub threshold tracings 4 28 Suprathreshold 4 21 Swallow 4 41 Swallow test 4 41 Sweep 4 10 T Test and other functions 4 1 Test cavity calibration 3 3 Test materials 3 3 Test mode 1 3 Test mode choices 1 1 GSI TympStar Version 1 Reference Instruction Manual Index 3 Index Test modes 4 1 Test modes and menu navi
247. radient will be determined and displayed numerically below the compliance and pressure peak data TYMPANOMETRIC GRADIENT is a quantitative description of the shape of a tympanogram in the vicinity of the peak The gradient calculation is based on determining the width of the tympanogram in decaPascals daPa at one half or 50 of the amplitude height of the tympanogram as shown below 400 300 200 100 100 200 Tymp width method of calculating gradient Normative gradient values Children 3 5 years of age 60 150 daPa Adults 50 110 daPa T American Speech Language Hearing Association 1990 Guidelines for screening for Hearing Impairments and Middle Ear Disorders ASHA suppl 2 17 24 GSI TympStar Version 1 Reference Instruction Manual 4 Ratio method A second formula for the calculation of gradient may be selected by pressing the GRADIENT hardkey then selecting RATIO Brooks 1969 defined gra dient as the change in compliance from peak value to the value obtained at a pressure interval of 50 daPa on either side of the peak as shown below RELATIVE GRADIENT is determined by dividing the compliance of the tympanogram from peak to a horizontal line with intersection points on the tympanogram at an interval of 100 daPa by the compliance measured from start pressure of the tympanogram to the compliance peak The GSI TympStar Version 1 calculates as the average of the c
248. record 1 3 Record type 010 4 1 Request code 0 Send 1 Query for Gradient selection 5 1 Gradient 0 2 TYMP WIDTH 1 RATIO 2 OFF 6 1 Carriage return CR 7 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 91 8 2 10 Set TYMP Diagnostic Cursor Char Offset Field Name 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Cursor 6 3 Number of dots 9 1 Carriage return 10 1 Line feed Appendix D Field Definition 011 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right 2 Set Tymp 1 Peak 3 Set Tymp 2 Peak 4 Set Tymp 3 Peak XXX 010200 only if cursor 1 or 2 0 Position to Y axis 1 dot CGR 8 3 Tymp Screening Individual SoftKey Commands 8 3 1 Set TYMP Screening Pressure Range Char Offset Field Name 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Pressure Range 6 1 Carriage return 7 1 Line feed 8 3 2 Set TYMP Screening Pressure Rate Char Offset Field Name 0 1 Start of record 1 3 Record type 4 1 Request code 5 1 Pressure Rate 6 1 Carriage return 7 1 Line feed 0 92 Field Definition 012 0 Send 1 Query for Pressure Range selection 0 Normal 1 Wide CR Field Definition 013 0 Send 1 Query for Pressure Rate selection 0 200 daPa s 1 600 200 daPa s CR Grason Stadler Remote Specifications 8
249. resented to the opposite ear through an earphone or insert phone NOTE Refer to Appendix A Specifications for the following information Method used for transfer of reference equivalent threshold values Reference equivalent hearing threshold levels in dB SPL Transfer data of Ipsi and Contra phones Compensations in SPL for volumes below 1 2 ml GSI TympStar Version 1 Reference Instruction Manual 4 21 Non acoustic Reflex testing Chapter 4 Studies have shown that it is possible to activate the middle ear muscles bilat erally by sound as well as by non acoustic stimulation It is not always pos sible to obtain acoustic reflex measurements e g in cases of severe to pro found hearing loss The ability to elicit a reflex independent of the hearing level in the stimulated ear permits the examination of 7 nerve integrity and ossicular continuity up to the point of insertion of the stapedius muscle even in deaf people Studies indicate that the response is greater if the Ipsilateral ear is stimulated One non acoustic reflex test consists of mechanical stimulation of the external ear with a cotton swab Other test procedures consist of blowing air toward the eyes with a Politzer balloon or of lifting the upper eyelids simultaneously 50 as to elicit the startle response Reflex Threshold The structure of softkey menu selections is diagrammed below Please refer to softkey menu Chapter 1 Introduction for instructio
250. ric As sessment of Eustachian Tube Function in Adults J Speech and Hear Disord 1979 44 388 396 Virtanen H Marttila T Middle Ear Pressure and Eustachian Tube Function Arch Otolaryngol 1982 108 766 768 Williams P A Tympanic Swallow Test for Assessment of Eustachian Tube Function Ann Otol Rhinol Laryngol 1975 84 339 GSI TympStar Version 1 Reference Instruction Manual B 7 Appendix B Grason Stadler Appendix WARNING Basic problem solving A few basic troubleshooting instructions are provided below for the TympStar instrument The problems described below can arise in the normal course of operation and can be resolved quickly In the unlikely event that a problem occurs that persists or a system malfunction please contact a GSI service provider for technical assistance Never open the enclosure WARNING There are no internal adjustments or assemblies that will ever require end user attention Never open the GSI TympStar enclosure Problem The screen is blank Possible solutions Make sure that the power cord is fully connected on both ends and that the power switch is in the ON state 1 Make sure that the power source wall socket is providing power Power must be in the range of 100 240 VAC at 50 to 60 Hz Problem The system reports lack of pressure or lost pressure seal when trying to run a test Possible solutions Change the eartip to provide a be
251. rsor not used 11 30800 to 30800 if Cursor not used 0 Y 1 2 0 0 IPSI 1 Steady CONTRA 2 Pulsed CONTRA 0 Manual 1 Automatic Grason Stadler 243 248 253 255 256 259 262 265 267 269 272 274 278 279 280 283 289 292 298 301 307 310 316 319 325 328 334 337 343 345 347 349 351 mo CO ANO ONN On Time Of f Time Zero field Threshold Seek Min Change Start dBHL Stop dBHL Zero field Activator Stimulus Click Rate Zero field Pressure Number of traces Intensity unit Trace 1 intensity Trace 1 amplitude Trace 2 intensity Trace 2 amplitude Trace 3 intensity Trace 3 amplitude Trace 4 intensity Trace 4 amplitude Trace 5 intensity Trace 5 amplitude Trace 6 intensity Trace 6 amplitude Trace 7 intensity Trace 7 amplitude Trace Mark Trace Type Zero field Line 2 data header Line 2 cursor Y value Remote Specifications XXXXX 1000 to 54000 msec if Manual Timing XXXXX 0 to 52000 msec if Manual Timing 0 Off 1 On X XX 02 to 0 8 XXX 35 to 120 dB XXX 35 to 110 dB 0 250 Hz 1 500 Hz 2 1000 Hz 3 2000 Hz 4 4000 Hz 5 Low Band Noise 6 High Band Noise 7 Broad band Noise 8 Click 9 External 10 Non Acoustic 11 Not used XXX 50 to 300 XXX 600 to 400 daPa 0 to 7 0 1 2 SPL
252. ry for Timebase selection 0 1 5 sec 1 3 0 sec 2 4 5 sec 3 6 0 sec 4 7 5 sec 5 9 0 sec 6 10 5 sec 7 12 0 sec Field Definition p 081 0 Send 1 Query for Step Size selection 0 148 1 2dB 2 5dB Grason Stadler 8 9 9 Set A R Sensitization Facilitator Field Name Remote Specifications Field Definition Char Start of record Record type Request code Stimulus Intensity Carriage return Line feed Set A R Sensitization Cursor Field Name 082 0 Send 1 Query for Facilitator selection 00 500 Hz 01 1000 Hz 02 2000 Hz 03 4000 Hz 04 Broad Band Noise 05 External 06 6000 Hz 07 Non Acoustic XXX dBHL 035 XXX depending of Stimulus LP Field Definition Char Start of record Record type Request code Cursor Number of dots Carriage return Line feed Set A R Sensitization Stimulus Field Name pP 083 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right XXX Oto 200 only if cursor 1 or 2 0 Position to Y axis 1 dot GR LF Field Definition Char Offset 0 1 1 3 4 1 5 2 7 3 10 1 11 1 8 9 10 Offset 0 1 1 3 4 1 5 1 6 3 9 1 10 1 8 9 11 Offset 0 1 1 3 4 1 5 2 Start of record Record type Request code Stimulus GSI TympStar Version 1 Reference Instruction Manual 084 0 Send
253. s for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters to 45 characters for unused characters 9 characters for unused characters XX XX xm for xm if 24 Hour time format 4 Intact 1 to 9 and A to Q L Left Ear R Right Ear 0 226Hz 1 678 Hz 2 1000 Hz 3 gt 38 Not used XXX 600 to 400 daPa 0 Off 1 On 0 Off 30800 to 30800 0 1 20r 3 0 0 5 to 1 5 1 0 5 to 3 0 2 0 5 to 5 0 3 1 0 to 7 0 4 1 0 to 9 0 5 2 5 to 15 0 6 5 0 to 25 0 7 5 0 to 35 0 XXXX 600 to 400 daPa if Cursor not used L 1 30800 to 30800 if Cursor not used GSI TympStar Version 1 Reference Instruction Manual D 31 246 247 248 249 255 259 260 263 265 271 276 277 278 284 288 289 292 294 300 301 302 303 309 313 314 317 319 320 C5 O a ONGO O a WO Admittance status Pressure Range status Pressure Rate status Peak Compliance data Peak Pressure data Sweep Direction status Zero field Line 2 data header Line 2 cursor Y value Zero field Zero field Zero field Peak Compliance data Peak Pressure data Zero field Zero field Line
254. s an integer is used to select one of the 4 possible timebases 500 5 1000ms 1500ms 2000ms This command is valid in the ARLT test mode 069 Set ARLT Step size Allows the user to remotely change the step size which controls the increments for the probe intensity This command is valid in the ARLT test mode GSI TympStar Version 1 Reference Instruction Manual D 17 Appendix D 070 Set ARLT Average Allows selection of the number of presentations to be averaged in the standard increment and range This command is valid during an ARLT test as long as a stimulus is not being presented 071 Set ARLT Cursor Allows the cursor to be moved to a specified X axis position when the cursor is active This command is valid in ARLT as long as a tone is not being processed and there is already data plotted 072 Set ARLT Stimulus Allows selection of stimuli based on valid stimuli for the current test This command is valid during an ARLT test as long as a stimulus is not being presented 073 Set ARLT Intensity Allows direct selection of intensity in 1 dB steps in current valid intensity range This command is valid during an ARLT test as long as a stimulus is not being presented 074Set A R Sensitization Stimulus Ear Allows the Stimulus ear parameter to be selected remotely This command is valid in the A R Sensitization test mode 075 Set A R Sensitization Stimulus Timing Allows direct selection of timing ON Time OFF Time and Q
255. s invalid and the corresponding error message which will indicate the invalid condition Remote Mode not selected ALERT REMOTE MODE NOT SELECTED The current test is in progress i e the START LEFT or START RIGHT hard key has been operated and in Reflex type tests a stimulus is being presented ALERT INVALID WHILE TEST IN PROGRESS If an invalid data transmission is attempted the indicated error message is momentarily displayed with the word ALERT flashing If the invalid transmission was initiated by a remote command an error record is sent to inform the Remote Device of the error and its cause When using the DATA TRANSFER hard key the data which is transmitted to the Remote Device is the data for the test which is currently displayed on the LCD This allows for the transmission of data for the current test or for a previous test if the transmission is initiated while displaying a previous test in the Page mode When the status message over the test number in Page mode displays ALL all the tests in page memory will be transferred When transmitting data in response to a command from the remote device the test that is being transferred is not always displayed on the LCD When a valid DATA TRANSFER operation occurs the message ALERT DATA TRANSMISSION IN PROGRESS is displayed All pertinent parameter and test data are then collected from the page memory formatted and stored in a buffer area for transmission to the Remote Device While the
256. s processing is completed From the time a complete and valid command is received until the processing of the command is finished the RS232 interface indicates to the Remote Device that the GSI TympStar is unable to accept additional input by setting the CTS handshaking line false This is only valid when the CTS RTS parameter is set to ON in Instrument Options 6 1 Record Validation In most cases the validation of incoming remote commands is a three step process The three steps are validation of the record itself validation of the state and test mode and finally validation of the specific command and subcodes Validation of the record include making sure the format of the record is correct for processing Each record must begin with a character and end in a valid CRLF sequence Each received character of a record is checked to insure that it is a valid ASCII character Each record must contain a valid record type Each record is valid for specified test modes and test states For example almost all tests will be invalid when the TympStar is in Run mode Finally validation of specific commands depends on the subcodes and different structures of the commands Included in validation of specific commands are All records must contain the correct number of characters for the record type Each single keystroke command record must contain a valid function code Each special commands command record must contain a valid functio
257. sequence for reflex tests is defined under Instrument Options Test procedure Sequence The parameters used for Tympanometry Reflex Threshold and Decay tests are those programmed as defaults within each test mode Tymp Reflex Special 1 Press the TYMP hardkey to place the w Ww instrument in the Tymp Diagnostic mode and display the Tymp Diagnostic softkey menu AUTO P RANGE START GRADIENT EAR MORE SEQUENCE daPa daPa NORMAL WIDE 600 4 200 21 MORE TYMP WIDTH RATIO RIGHT LEFT daPa ml 500 300 0 300 MORE P RATE BASELINE MORE daPa s 125 50 600 200 ON OFF 2 Press the EAR softkey to toggle between the right and left EAR ear then insert the probe tip securely into the patient s ear RIGHT LEFT 3 Press the AUTO SEQUENCE softkey The sequence of tests will begin with a tympanogram at 226 Hz Y If previously programmed as part of the sequence the sequence will automatically continue to include a Reflex Threshold and Reflex Decay tests GSI TympStar Version 1 Reference Instruction Manual 4 55 Chapter 4 The reflex threshold sequence is automated by using the default parameters for Threshold Seek and Auto Timing Refer to the Reflex Threshold section of this chapter for instructions for setting the minimum compliance change and intensity range values used to arrive at threshold for each stimulus ipsilat eral stimuli are tested from low to high frequency Contralateral stimuli are then tested from low to high
258. setting is MANUAL The CLEAR TEST softkey allows the operator to have test data automatically cleared from the LCD screen and the page memory when the data is transmitted by selecting the AUTO softkey If MANUAL is operated the operator must manually clear the test data if desired after data transmission The current CLEAR TEST softkey selection is displayed as either MANUAL or AUTO directly above the softkey The outgoing data format is selected as either GSI 33 DATA or GSI TYMPSTAR DATA The menu DATA FORMAT is found in Instrument Options under Remote settings The GSI 33 DATA softkey allows for the transfer of a data stream that will be in the same format as the GSI 33 outgoing data while when the GSI TYMPSTAR DATA softkey is selected a new data stream will be sent which consists of all the information from the GSI 33 data stream as well as any new items specific to the GSI TympStar Once the Remote Mode is entered the DATA TRANSFER hard key is enabled This is indicated on the LCD display by the word REMOTE displayed on the right margin of the message line GSI TympStar Version 1 Reference Instruction Manual D 3 Appendix D 5 Remote Output Operation 5 1 Data Transfer Key Press The transmission of data from the GSI TympStar to the external device is initiated by either operating the DATA TRANSFER hard key or by a command record from the Remote Device The following conditions indicate when a data transfer request i
259. space 4 41 Min change 4 27 Mobility 4 6 4 21 Modes 4 1 Monitor 1 2 2 4 N Nasopharynx 4 41 Nerve 4 21 Noise 4 21 Non acoustic reflex testing 4 22 Normative gradient values 4 7 4 8 NR 3 10 4 16 NT 4 16 O On Off switch 2 5 Operation 3 1 4 1 Options 2 4 Ossicular chain 4 6 4 21 4 41 Otoscope 3 15 Overview of functions 4 1 P Page 2 11 Page hardkey 4 4 4 13 Grason Stadler Panel controls 2 10 Paper roll 2 8 Paper supply 2 8 Parameter settings 2 12 Parameters 4 2 Perforated eardrums 4 46 Positioning the probe box 3 15 Power 2 5 2 7 Power cord 2 3 Power entry module 2 5 Pre operation 3 1 Preparing test materials 3 3 Preparing the printer 2 8 Preparing the probe assembly 2 6 Present 2 11 Pressure and admittance meters 4 10 Pressure calibration 3 4 Pressure control 1 3 2 11 4 12 Pressure range check for tympanometry 3 9 Pressure sweep 4 10 Pressure swallow test 4 41 Print 2 11 Print format 4 59 Print hardkey 4 4 4 13 Printer 1 1 2 8 Printer paper 2 2 Probe 1 2 2 5 Probe assembly 2 6 Probe box 1 2 2 6 3 15 Probe cleaning wire 2 2 Probe insertion technique 3 15 Probe lights 4 3 Probe mount shoulder 2 2 Probe mountwrist 2 2 Probe tip 3 1 3 15 Probe tone frequencies 1 1 Probe tubes 2 2 3 1 Program mode for ETF 4 51 Program mode for tympanometry 4 18 Program mode softkey menu structure 4 18 Program modes 4 3 Programming default parameters 4 20 Prope
260. t ID 94 45 Tester Name 139 45 Facility Name 184 9 Probe S N 193 20 Date Time 213 2 Test type 215 1 Test number 216 1 Ear Under Test 217 2 ProbeTone 219 4 Start Pressure 223 1 Baseline Status 224 1 Gradient Status 225 6 data 231 1 Number of lines 232 1 Y axis scale 233 5 Cursor X value 238 2 Line 1 data header 240 6 Line 1 cursor Y value 246 1 Admittance status 247 1 Pressure Range status 248 1 Pressure Rate status D 26 Appendix D Field Definition 1 Summary data record 8 Summary data record with attached XY data records 00 to 99 0 to 45 characters for unused characters 0 to 45 characters for unused characters 0 to 45 characters for unused characters XXXXXXXXXXX 0 to 45 characters for unused characters 9 characters for unused characters XX XX xm for xm if 24 Hour time format 1 Tymp Screening 1to 9 and Ato Q L Left Ear R Right Ear 0 226Hz xxx 600 to 400 daPa 0 Off 1 On 0 Off 1 Tymp Width daPa 2 Ratio ml 30800 to 30800 0 or 1 0 0 5 to 1 5 1 2 0 5 to 3 0 2 2 0 5 to 5 0 1 0 to 7 0 4 1 0 to 9 0 2 5to 415 0 6 5 0to 25 0 7 5 01 35 0 xxx 600 to 400 daPa if Cursor not used 11 30800 to 30800 2 if
261. tation Advance the paper if neces m sary by pressing the PRINT ul BN SS hardkey and then the PAPER ADVANCE softkey Feed the 2 Pome 1 paper through the opening in Print the cover close the cover and 1 tear off any excess paper Return to the previous menu by pressing the RETURN softkey NOTE Thermal paper supplies should be stored in a cool dry place to extend the life of the paper Preparing an external printer WARNING The GSITympStar is compatible with most Hewlett Packard DeskJet and LaserJet printers with PCL3 Contact GSI Service for specific models These printers pro vide full sheet printouts of test data Atest printout of results containing Oneleftand right tympanogram A reflex threshold table for both left and right Ipsi or Contra only A reflex decay table for both left and right Ipsi or Contra only will print on one 8 5 x 11 inch or A4 sheet of paper 1 Turn the TympStar and printer off then attach the printer data cable to the printer connector on the rear of the TympStar Connect the printer power cable to AC power WARNING ANY EQUIPMENT CONNECTED TO THE GSI TYMPSTAR AND USED IN THE PATIENT VICINITY MUST BE POWERED BYAN ISO LATED POWER SOURCE TO MAINTAIN THE ELECTRICAL SAFETY OF THE OVERALL SYSTEM The isolated power source can be purchased directly from GSI or elsewhere when approved for use by GSI GSI TympStar Version 1 Reference Instruction Manual 2
262. ter time The Remote input consists of short records transmitted from the Remote Device to the GSI TympStar Since the GSI TympStar has remote querying abilities there are two options for each record sending a change to a parameter or querying the value of a parameter When the record is being processed if a query command is requested any bytes following the request code are ignored The query results are sent to the remote system as short records that can be seen in the 9 3 8 Input Record Query Results section of the remote specifications GSI TympStar Version 1 Reference Instruction Manual D 9 Appendix D Records may be sent during all operating modes of the GSI TympStar at any time that the selected handshaking indicates that the GSI TympStar is able to accept records When a record is sent the RS232 interface software receives and validates each character of the record as it is sent When a full record has been received it is decoded and validated Most of the special commands are only accepted in the STOP state while single soft key and hardkey presses are valid whenever the associated manual key press is valid and finally the text entry commands are only valid when the cursor is flashing The command or operation requested by the record is queued for processing by the GSI TympStar The command is processed immediately if the GSI TympStar is not currently processing a previous remote command or front panel operation or as soon as the previou
263. the GSI TympStar when it automatically changes test mode to notify the external device Summary data record with attached XY Graphical data records Used when the operator has selected the Summary and XY Graphical data record type This record is exactly the same as atype 1 summary data record but is used in this case to indicate to the Remote device that additional records will follow this one which contain the XY graphical data associated with this test parameter and summary test result information Input Query Results Record Contains information that was requested by an input record Query results could contain parameter values and text strings 5 3 General Record Information 5 3 1 Rules for Records All records are sent as ASCII characters starting with an character and ending with a checksum carriage return and line feed All multiple ASCII character fields are right justified with unused character positions filled with ASCII SPACE characters zero null fields are filled with characters All numerical test data or results are sent in the same format and accuracy as they are displayed on the LCD screen whenever possible Any differences are detailed in Section 7 GSI TympStar Version 1 Reference Instruction Manual D 5 Appendix D Summary Data records consist of the following general format Start of record symbol Record Type Record Sequence Number Test type and number Test parameters and n
264. the cursor is active This command is valid following the completion of Multiple Hz screen 3 097 Multiple Hz 3 Continue Processes the continue softkey on the Multiple Hz screen 3 menu This command will cause a test to be started and data to be plotted This can only be used when the continue softkey is diaplayed 098 Set Multiple Hz 3 Admittance Used to change the Admittance parameter This command is only valid on the Multiple Hz screen 3 Any other changes that result in a change in Admittance changes immediately as if the change was made navigating the menus 099 Set Multiple Hz 3 Pressure Range Used to change the Pressure range between Normal and Wide This command is only valid in the Multiple Hz 3 screen 100 Set Multiple Hz 43 Pressure Rate Used to modify the Pressure rate parameter This command is only valid on the Multiple Hz screen 1 101 Set Multiple Hz 3 Start Pressure Used to modify the Start Pressure parameter This command is only valid on the Multiple Hz screen 3 D 20 Grason Stadler Remote Specifications 102 Patient Name Allows the entry of the patient name via the Remote system The field is still limited to 45 characters and is limited to the same valid character set as if the patient name was being entered from the keyboard This command is valid when the cursor is active 103 Patient ID Allows the entry of the patient ID via the Remote system The field is still limited to 45 characters and is lim
265. the desired parameter softkey and select the required Baud rate Parity Stop bits RTS CTS configuration and data format REMOTE SETTINGS pin RATE PARITY STOP BITS RTS CTS DATA FORMAT STORE iid 01 Od D 4 The following baud rates are available and can be scrolled using the up or down arows 300 600 1200 2400 4800 9600 19200 Data be communicated GSI TympStar or GSI 33 formats Selecting the GSI 33 format transmits data to the serial output in a format identical to that of the GSI33 Refer to Appendix D Remote Specifications for details Press STORE to store the configurations and return to the Instrument Options Softkey menu The GSI Suite Audiometric Data Management software is compatible with the GSI TympStar as well as the GSI 61 GSI Suite captures saves and stores middle ear evaluation data from the GSI TympStar and allows the addition of comments It can also provide the data in a PDF format that is compatible with electronic medical records Data transferred from the GSI TympStar include the following Tympanometric tracings and numeric summary data along with reflex threshold and reflex decay results in a tabular format The patient demographic and test result data are saved to a directory for future retrieval and or converted to PDF format for easy transfer to an EMR program If configured the report can also be e mailed Note Selection of the relex threshold values must be done on the TympStar prior
266. to be more compressed so that as the patient swallows and the Eustachian tube opens more air than normal flows out of the middle ear When the Eustachian tube closes and the ear canal is no longer subjected to induced positive pressure less air than normal is present within the middle ear space In other words there is negative pressure within the middle ear Therefore when the second tympanogram is recorded the point of peak mo bility will be shifted in the negative direction approximately 15 to 20 daPa relative to the point of peak mobility recorded during the first tympanogram GSI TympStar Version 1 Reference Instruction Manual 4 41 Softkey menu structure P RANGE daPa Chapter 4 Condition 3 A negative pressure of 400 daPa is established within the ear canal As the pressure is reduced within the ear canal the eardrum moves outward Stress ing the membrane outward leads to a temporary increase in middle ear cavity volume When the same amount of air is present within a larger volume the air pressure within the cavity is reduced Thus the middle ear pressure is negative relative to atmospheric pressure As the patient drinks some water and the Eustachian tube opens more air than normal will flow into the middle ear space When the Eustachian tube closes and the ear canal is vented a positive pressure condition will exist within the middle ear relative to atmo spheric pressure When the third tympanogram is recorded t
267. to indicate that the reflex test was aborted due to an inability to maintain pressure or if the STOP hardkey was pressed before reflex testing was completed TVMP SCREENING TEST 2 89171872997 02127 1 6 PRESSURE ERRCRNAL UOLUME 1 7 daPa l TWP 1 10 6 8 1 0 4100 200 0 9200 GRADIENT 195 daPa REFLEX 1 1000 VES COMPLIANCE nl 0 5 pn e T 0 5 90 0 05 L8 LS Jane Doe 10 12345667 TESTER 0 30 CER abe daPa NORMAL 600 200 200 TYMP WIDTH RIGHT P RANGE STRRT GRADIENT EAR MORE daPa daPa s dafa Grason Stadler Tymp screening sample printout Operation The screening test data is automatically stored at the Reflex EF Special completion of the test It can be recalled by pressing P the PAGE hardkey and then printed by pressing the _ pase 40 PRINT hardkey A sample print 85 out is shown below PRINT hardkey 4 Screening test data be cleared by pressing the 3 CLEAR hardkey on the LCD panel Please refer to Manual 57 Stimulus A Erasing and clearing test data earlier in this chapter Screening test data can be recalled by PAGING through the test screens Please refer to Paging test data earlier in this chapter Tests can then be printed by pressing the PRINT hardkey TYMP SCREENING TEST 1 Ytm 226 Hz L 1 5 400 200 0 200 daPa 600 200 daPa s EARCANAL VOLUME TYMP 1 GRADIENT 0
268. tra insert phone from the probe box If the contra insert comes in close contact with the test cavity acoustic radiation from the contra phone may cause arti fact affecting the test cavity measurements 3 Press the START hardkey The pressure meter reading will be 0 daPa and the compliance will be zeroed automatically REFLEX THRESHOLD TEST 12 10 28 2000 82 33 pn PRESSURE STIMULUS 1000 Hz 00 INTENSITY 70 dBHL 400 200 200 TIMING ON 1 5 OFF 1 5 0 1 2 1 16 15 sec IPS OFF MANUAL RIGHT m STIMULUS MARK THRESHOLO AUTO EAR MORE EAR THRESHOLO SEEK ZERO GSI TympStar Version 1 Reference Instruction Manual 3 11 3 4 Press the PRESENT hardkey momentarily A stimulus ON 28 message will be displayed at the right upper corner of the screen and the tracing will sweep at the 00 ml position for the length of time automatically set 18 28 2008 02 34 pn 1000 Hz REFLEX THRESHOLD TEST 12 STIMULUS 00 2 INTENSITY 70 dBHL 208 TIMING ON 1 5 OFF 1 5 16 QTY 1 ES Se a RR RR IRR S 8E 77777 en THRESHOLD SEEK ZERO 5 Press the STIMULUS TIMING softkey STIMULUS TIMING and select MANUAL TIMING MANUAL AUTO TIMING TIMING 6 Press the PRESENT hardkey A stimulus message will be displayed at the right upper corner of the screen and the tracing will sweep at the 00 ml position Ayser 3A for th
269. tter seal correct size of the patient s ear canal Clean the probe tubes to remove debris obstructions see chapter 3 Problem Test results do not appear as expected Possible solutions Position the probe box to minimize vibrations Clean the probe tubes to remove debris obstructions see chapter 3 GSI TympStar Version 1 Reference Instruction Manual C 1 Appendix C Problem Paper jams in printer Possible solutions Reorient the paper in the printer see chapter 2 Problem Printed text is not readable Possible solutions The thermal paper can be printed on only one side Change the paper orientation see chapter 2 Grason Stadler Hemote Specifications 1 The Remote Function The Remote function provides serial communications capability to the GSI TympStar using an RS 232 interface The serial communication provides the ability for the GSI TympStar to transmit status information and test result data to a Remote Device such as a computer or data logging device for further processing or storage The GSI TympStar may also receive commands from a Remote Device allowing remote control and setup of the GSI TympStar The Remote function is standard in all TympStar systems 2 General Operation The Remote function is available during all operating modes of the unit and is selected by pressing the REMOTE hard key or via a command from the Remote Device When the Remote function is active it may be turne
270. turn on threshold seek This is an invalid command while the Non Acoustic stimulus is selected 9 2 2 Error Record TEST Subcode Definitions Errors 101 121 Error Sub code 001 002 003 004 005 006 007 008 009 010 011 Error Status Message and Description TYMP DIAGNOSTIC TEST TYMP SCREENING TEST REFLEX THRESHOLD TEST ETF INTACT TM TEST ETF PERFORATED TM TEST REFLEX DECAY TEST ARLT TEST A R SENSITIZATION TEST MULTIPLE HZ 1 TEST MULTIPLE HZ 2 TEST MULTIPLE HZ 3 TEST GSI TympStar Version 1 Reference Instruction Manual D 141 D 142 Grason Stadler Index A Accessories 2 2 Accuracy 3 1 Acoustic energy 4 6 Acoustic reflex testing 4 21 Admittance 1 1 Admittance change 4 32 Admittance meter 4 10 Air density 3 4 Alcohol 3 2 Altitude 3 4 Altitude calibration 4 53 Altitude information 4 53 Altitude barometric pressure calibration 3 4 Angle of probe insertion 3 15 Applying power 2 7 Apprehension 3 15 Archiving data 1 2 Auto sequence 4 1 4 55 Auto sequence program mode 4 57 Auto sequence test procedure 4 55 Auto start 4 15 Auto timing 4 23 Auto timing of stimuli 4 24 Automatic tympanometry 4 9 B Brain stem 4 21 Calibration cavity 2 2 Calibration check for tympanometry 3 5 Calibration checks 3 3 Calibration data 4 25 Calibration procedure 4 53 Canal examination 3 15 Caring for eartips 3 2 Cerumen 3 1 3 15 Changing parameter settings 1 5 Check
271. uantity parameters in msec in the defined increments and range for the test This command is valid in the A R Sensitization test mode as long as a stimulus is not being presented 076 Set A R Sensitization Auto Zero Used to change the Auto Zero parameter ON or OFF This command is valid in the A R Sensitization test mode 077 Set A R Sensitization ml Scale Used to change the scale of the A R Sensitization plot This command is valid in the A R Sensitization test mode 078 A R Sensitization Ear Toggle Used to toggle between Left and Right Ear This command is only valid in the A R Sensitization test mode 079 Set A R Sensitization Admittance Used to change the Admittance parameter This command is only valid in the A R Sensitization test mode Any change of test or screen appearance that occurs due to a change in Admittance changes immediately as if the change was made navigating the menus D 18 Grason Stadler Remote Specifications 080 Set A R Sensitization Timebase Allows direct selection of timebase Instead of using arrows like the softkeys an integer is used to select one of the 8 possible timebases 1 5s 3 0s 4 5s 6 0s 7 5s 9 0s 10 5s and 12 0s This command is valid in the A R Sensitization test mode 081 Set A R Sensitization Step size Allows the user to remotely change the step size which controls the increments for the probe intensity This command is valid in the A R Sensitization test mode
272. ub menu pi 400 200 400 MORE will appear GSI TympStar Version 1 Reference Instruction Manual 3 5 Graphic tracing at 0 Chapter 3 3 Press the MORE softkey to display the following choices 500 300 0 300 MORE 4 Press the 0 softkey to set 0 daPa as the starting pressure for the test The display will return to the top menu level 5 Confirm that the BASELINE is ON Usethe BASELINE BASELINE sub menu to change the settings if necessary 6 Insert the ipsi probe tip into the 2 0 cc test cavity 7 Press the START gt hardkey Allow the tracing to sweep to 100 daPa then press START hardkey to reverse direction Allow the tracing to sweep to 100 daPa and press the STOP hardkey The following results should be displayed The graphic tracing should be at 0 0 The EAR CANAL VOLUME should be 2 0 within 5 of full scale Compliance peak ml and pressure peak daPa values should be NP No Peak Ear Canal volume at 2 0 i TYMP DIAGNOSTIC 107277 TEST 18 PRESSURE daPa EARCANAL VOLUME 2 0 EL TYMP 1 NP NP 400 200 200 2 NP NP i 3 COMPLIANCE nl NORMAL 200 OFF RIGHT AUTO P RANGE START GRADIENT EAR SEQUENCE daPa daPa Compliance and pressure peak at NP Grason Stadler Graphic tracing at 0 5 Pre Operation 8 Press the BASELINE softkey then press OFF 9 Insert the probe tip into the 0 5 cc test cavity
273. uest code 0 Send 5 1 Carriage return CR 6 1 Line feed LF GSI TympStar Version 1 Reference Instruction Manual D 103 Appendix D 8 6 ETF Perforated TM Individual Softkey Commands 8 6 1 Set ETF Perforated Pressure Max Offset Char 0 1 1 3 4 1 5 4 9 1 10 1 8 6 2 Set ETF Perforated Time sec Offset Char 0 1 1 3 4 1 5 1 6 1 7 1 8 6 3 Set ETF Perforated Cursor Offset Char 0 1 1 3 4 1 5 1 6 3 9 1 10 1 D 104 Field Name Start of record Record type Request code Max Pressure Carriage return Line feed Field Name Start of record Record type Request code Time sec Carriage return Line feed Field Name Start of record Record type Request code Cursor Number of dots Carriage return Line feed Field Definition PIS 046 0 Send 1 2 query for maximum pressure XXXX 600 to 400 in multiples of 50 CR Field Definition 047 0 Send 1 query for Perf time 0 30 sec 1 40 sec 2 50 sec 3 60 sec CR Field Definition 048 0 Send 1 get cursor value 0 Move Cursor Left 1 Move Cursor Right XXX 010200 only if cursor 1 or 2 0 Position to Y axis 1 dot Grason Stadler Remote Specifications 8 6 4 ETF Perforated Ear Toggle Offset Field Name Field Definition Char 0 1 Start of record 1 3 Record type 049 4 1 Selection code 0
274. uired Please refer to Chapter 1 Introduction for instructions regarding navigating through softkey menus and changing parameter settings GSI TympStar Version 1 Reference Instruction Manual 4 35 Chapter 4 Minimum and 4 The maximum selectable On Time of the stimulus 15 limited by the maximum timing selected Timebase as shown in the following table levels allowable in Reflex Decay TIMEBASE Time in Seconds 15 00 30 00 45 00 60 00 Prestimulus Time 1 50 3 00 4 50 6 00 Minimum On Time 1 00 1 00 2 00 2 00 Maximum On Time 13 00 27 00 40 00 54 00 On Time Increment 1 00 1 00 2 00 2 00 5 The 5 and 10 second points on the 15 and 30 second timebases are identified by vertical lines on the LCD and printout 6 Press the ml SCALE softkey to select a sensitivity ml for the display of test results ODE 7 Stimulus and Intensity levels are displayed to the right of the meter area of LCD as follows STIMULUS 1000Hz INTENSITY 804 8 Press the appropriate INTENSITY hardkey to select an 57 Stimulus A intensity 10 dB above the reflex threshold intensity level 1 found previously NA 9 Compliance can be automatically zeroed each time the PRESENT hardkey is pressed to maintain a constant baseline To activate this feature press the AUTO ZERO softkey and then press AUTOMATIC before the START key is pressed AUTO ZERO MANUAL AUTOMATIC 10 Press the PRESENT hardkey momentarily A brief prestimulus baseline
275. ulus command during an ARST test ALERT INVALID SELECTION NO DATA STORED ON CURRENT LINE Invalid selection when there is no data stored on the second line of a reflex type test The alert sent so that the user cannot delete data fro the top plot while on the second plot ALERT INVALID SELECTION PRESS EXIT Invalid selection when the present bar is pushed from threshold seek and stimulus timing sub menus The changes have not been committed till these menus are exited so the must be for a test to run GSI TympStar Version 1 Reference Instruction Manual D 139 454 456 459 460 463 481 494 495 510 544 545 587 607 608 638 639 640 641 D 140 Appendix D ALERT HIGH INTENSITY SELECTED Indicates that an Intensity level of greater than 100 db was selected via an Intensity Up Down or Set Activator Facilitator command NOTE CAN NOT START TEST DO ALTITUDE CAL CONTACT SERVICE Indicates that a test could not be started due to an error in reading the altitude information stored in memory when the unit was turned on ALERT MUST SELECT A TEST TO PROGRAM The Store Program Mode data is invalid in the Tymp Program Mode until a test type to program is selected ALERT PROBE MUST BE IN CAVITY BEFORE DATA TRANSFER The Data Transfer command in the Altitude Calibration mode is invalid until the probe is placed in a cavity ALERT INVALID SELECTION PRESSURIZING TO MAXIMUM PRESSURE Command is invali
276. umeric test results Checksum Carriage Return Line Feed status records consist of the following general format Start of record symbol Record Type Record Sequence Number Status Information Checksum Carriage Return Line Feed XY Graphical Data records consist of the following general format Start of record symbol Record Type Record Sequence Number Test number Line number Number of XY data pairs in this record XY graphical data Checksum Carriage Return Line Feed 5 32 Checksum The checksum is provided to allow the Remote Device a means to detect data transmission errors The checksum is generated by the GSI TympStar after the record has been formatted in the transmit buffer The checksum is the arithmetic sum in hexadecimal of all 8 bit bytes in the record starting with the character until and including the last data byte before the first byte of the checksum The checksum itself and the CR LF are not included in the checksum calculation The checksum is truncated to the least significant 8 bits converted to 2 ASCII characters and then inserted into the record before transmission 5 3 8 Record Sequence Number The record sequence number is a number between 00 and 99 in modulo 99 format which is set by the GSI TympStar when the record is transmitted For each new record transmitted the number is incremented by 1 If a record must be retransmitted the number is not changed and remains the same value as in
277. us presentations if necessary by navigating to the desired manuaL sub menu and using the arrow and SET softkeys Any of these changes will be temporary and the default values will be used the next time that the REFLEX test mode is initiated Use the Program Mode to change these parameters permanently STIMULUS TIMING ON TIME OFF TIME QTY EXIT 5 Press the EXIT softkey to return to the Reflex Threshold menu 6 Press the PRESENT hardkey momentarily to present the stimuli for the length of time set above Timebase Time in Seconds 15 00 30 00 45 00 600 00 Prestimulus Time 1 50 Inter Trace Time 0 25 Minimum On Time 1 00 Maximum On Time 13 50 On Time Increment 0 50 Off Time Increment 0 50 The manual timing feature allows the stimulus to be presented for the length of time the PRESENT hardkey is pressed Upon release of the PRESENT hardkey the tracing continues on the screen for 1 5 seconds to allow visualiza tion of recovery 7 Press the ml SCALE softkey to select the sensitivity ml B SCALE for the display of test results 0 16 0 32 0 48 0 64 0 80 Grason Stadler Operation The stimulus type and intensity level are displayed at the right of the meter area as shown below Stimulus type and intensity level REFLEX THRESHOLD TEST 12 86 29 2008 02 33 pri PRESSURE daPa STIMULUS 1000 Hz 00 1 INTENSITY 70 dBHL 1 5 OFF 1 5 16 COMPLIANCE 0 00 nl
278. volume are recorded in real time NOTE A 226 Hz Y tympanogram is displayed on the LCD screen in a 1 1 aspect ratio and on the external VGA monitor in a 1 4 1 aspect ratio The Pres sure horizontal axis appears to be stretched out by 40 on the VGA monitor PAGE hardkey Reflex ur PRINT hardkey The display of current test data may be erased prior to stopping a test or con tinuing to the next test by pressing the ERASE hardkey Previous test data can be selectively cleared from the instrument s storage by selecting the desired test with the PAGE hardkey then pressing the CLEAR hardkey Itis suggested that all testing be completed on one ear before proceeding to the other ear Changing the test ear causes a new page of test data to be generated Grason Stadler Paging test data Printing tests Error codes and problem reporting Operation Up to 26 test screens can be stored in memory as pages These pages of data can be recalled with appropriate titles and labels for viewing by pressing the PAGE hardkey and then scrolling through pages using up down arrows Each screen of data equals a page RT Vim 226 Hz Ri DIAGNOSTIC TEST 1 12715772000 82132 pn 1 54 EARCANAL VOLUME 1 6 nl 9 1 6 2 1 8 TYMP 2 3 8 54 8 04 _ NAME ID STER 400 200 8 200 TESTER te S daPa s ALL seg BRUT Un THRESH LO ROURNCE
279. will be drawn The selected stimulus will be presented for the preset time The fixed Off Time following the signal allows visualization of recovery 4 36 Grason Stadler Operation 11 View the change in compliance over time on the graphic display and on the pressure and compliance meters V 226Hz I IUUU Hz REFLEX UECRY TEST 4 0N 10 0 OFF 3 5 daPatS PRESSURE S STIMULUS 1000 Hz INTENSITY 95 dBHL 100 200 0 200 DECAY TIME SEC NA COMPLIANCE 0 00 nl 2 d 9 Jane Doe 10 12346667 TESTER abc 15 see CURSOR CONTINUE 12 Numeric data is summarized to the right of the meter area The time at which the response decayed to 50 of peak amplitude is identified as DECAY TIME SEC if applicable 13 Depress the CONTINUE softkey to resume tracings on the next line or next page 14 Press the STOP hardkey to end and store the Reflex Decay Test 15 Test data can be erased or cleared using the ERASE or Hold Stop CLEAR hardkey on the LCD panel Please refer to Erasing and clearing test data earlier in this chapter Stat 5 e e 16 Test data can be recalled by PAGING through the test screens Please refer to Paging test data earlier in this chapter 17 The test data is automatically stored at the completion of the test and may be selected using the PAGE hardkey and printed by pressing the PRINT hardkey NOTE The letters indicate that no de
280. wn at the right of the meters Vim 225 Hz R DIAGNOSTIC TEST 3 12 13 2000 03 28 pn 1 5 EARCANAL VOLUME 0 9 ni 1 9 TYMP 4 3 20 9 2 TYMP 20 9 3 0 5 9 9 E 10 400 200 0 200 TESTER MANUAL 3 of 3 TEST 0 T CURSOR M RK PAPER THRESHOLD ADVANCE One line is dedicated to Tymp peak data collected in the negative direction and a second line is dedicated to Tymp peak data collected in the positive direc tion This summary information is updated per line when e The Pressure knob is rotated in the opposite direction by at least 50 daPa e The STOP hardkey is pressed Grason Stadler Tympanometry printout samples Manual test Tympanometry normative values Operation NOTE This summary information contains the results of the last two tracings even though multiple tracings in each direction may be displayed on the screen The last two tracings are stored in memory and can be retrieved using the PAGE hardkey to print results 7 The ERASE hardkey can be used at any time prior to pressing the STOP hardkey Pressing the ERASE hard key causes all tracings on the graph to be removed except for the starting pressure compliance value of the last tracing This appears as a dot on the screen NOTE Once the PRESSURE control knob is used following ERASE this dot is shown as NP NP on the test summary area Running two tracings will update this test summary data
281. xternal 10 Not used 11 6000 Hz if Stimulus Ear Ipsi or Contra 600 to 400 daPa 0 to 7 0 1 2 SPL XXX 35 to 120 dB Xxxxx 30800 to 30800 XXX 35 to 120 dB Xxxxx 30800 to 30800 XXX 35 to 120 dB Xxxxx 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB Xxxxx 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 XXX 35 to 120 dB 30800 to 30800 L2 4 30800 to 30800 if Cursor not used Not used 0 Manual 1 Automatic Grason Stadler 340 345 350 352 354 357 359 363 364 365 368 374 377 383 386 392 395 401 404 410 413 419 422 428 3 2 2 0 0 O CO On Time Off Time Zero field Activator Stimulus Facilitator Intensity Facilitator Stimulus Pressure Number of traces Intensity Unit Trace 1 intensity Trace 1 amplitude Trace 2 intensity Trace 2 amplitude Trace 3 intensity Trace 3 amplitude Trace 4 intensity Trace 4 amplitude Trace 5 intensity Trace 5 amplitude Trace 6 intensity Trace 6 amplitude Trace 7 intensity Trace 7 amplitude Checksum Remote Specifications 125 to 10500 msec if Manual Timing XXXXX 0 to 10000 msec 0 0 to 10 0 sec if Manual Timing Not used 500 Hz 1000 Hz 2000 Hz 4000 Hz Not used Not used Broad Band Noise
282. y 10 or 5 msec whichever is greater GSI TympStar Version 1 Reference Instruction Manual A 5 Environmental Warm UpTime Calibration Stability Appendix A The GSI TympStar Version 1 meets the UL 60601 1 CSA 22 2 and IEC60601 standards for safety Temperature Storage Shipping 20 degrees C to 40 degrees C Operating 15 degrees C to 35 degrees C Humidity 20 9096 at 35 degrees C non condensing At room temperature 15 to 35 C 10 Minutes At room temperature below 15 Hour All GSITympStar Version 1 specifications are met over the range of specified power line temperature and humidity variations Power Line Voltage Variation 10 Frequency Variation 5 Power line short term variation which affects the performance of the instru ment will turn off all probe and stimulus signals Power Rating 120 Watts maximum Line Voltage Range 100 VAC to 240 VAC Power Line Frequency Range 50 60 Hz Temperature Operating Range 15 to 35 Relative Humidity Operating Limit 90 Guaranteed Operating Elevation 6000 Ft 1800m Grason Stadler Connectors Specifications STIMULUS ExternalStimulusInput Phone Jack Peak Voltage 3 VAC Input Impedance 15 000 Ohms PRESENT External Present Control Input that turns the stimulus signal ON and OFF Phone Jack Voltage Range OFF 5 0 VDC STIM ON 0 0 v Input Impedance 11 000 Ohms Contra PHONE Output Voltage 7 VAC Output Impedance
283. y of 226 Hz The extensive battery of test mode choices include Diagnostic Tympanometry Acoustic Reflex Threshold and Decay Measurements Eustachian Tube Function Testing Both intact and perforated eardrums Screening Tympanometry Reflex Automatic Only Operators have a choice of using GSI preprogrammed test parameters or programming their own test cri teria Alarge liquid crystal display LCD clearly displays test parameter choices and the pos sible alternatives Admittance and pres sure indications are shown on the LCD along with a continuous digi tal readout Test status and invalid choices are also shown on the LCD RO The tympanometric measure ment results are automatically scaled and presented in equivalent ml of com pliance at Y 226 Hz Sensitivity scales for the display of reflex measure ment results can be selected manually A cursor is available in all test modes for calling out numeric positions on the X and Y axes Test results are displayed in real time The user can view the results as they are being measured and then has the choice of printing the display or retesting the patient The high speed printer generates reports in concise graphic for mats that are easy to read GSI TympStar Version 1 Reference Instruction Manual 1 1 Chapter 1 Equipment connec TympsStar Version options that can be connected to the rear panel include tions and options RS232 serial communication a keyb
284. y repairs are made and the unit is tested and calibrated for proper functioning in accordance with Grason Stadler published specifications Equipment is not user repairable Repairs and battery replacement must be performed bya qualified service representati only Prolonged use of auditory stimuli can cause damage to patient hearing GSI TympStar Version 1 Reference Instruction Manual ve Preface Product Warranty We Grason Stadler warrant that this product is free from defects in material and workmanship and when properly used will perform in accordance with applicable specifications If within one year after original shipment it is found not to meet this standard it will be repaired or at our option replaced at no charge except for transportation costs when returned to an authorized Grason Stadler facility Changes in the product not approved by Grason Stadler shall void this warranty Grason Stadler shall not be liable for any indirect special or consequential damages even if notice has been given of the possibility of such damages THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES EX PRESSED OR IMPLIED INCLUDING BUT NOT LIMITED TO ANY IM PLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PAR TICULAR PURPOSE Recycling disposal CAUTION Many local laws and regulations require special procedures to recycle or dispose of electric equipment related waste including batteries printed circuit boards
285. ymp 1 X value Tymp 1 Y Value Tymp 2 X value gt 19 Tymp 2 Y Value 23 Tymp 3 X value 27 Tymp 3 Y Value 31 Checksum 33 Carriage return 34 Line feed Appendix D Field Definition p 9 Query Record XX 00 to 99 042 0 1 8 2 0 GR Field Definition p 9 Query Record XX 00 to 99 043 0 1 OFF XX GR Field Definition p 9 Query Record XX 00 to 99 044 XXXX 600 to 400 XXXX XXXX 600 to 400 XXXX XXXX 600 to 400 XXXX XX LEF Grason Stadler Remote Specifications 7 9 5 Perforated TM Individual SoftKey Commands 7 9 5 1 ETF Perforated Pressure Max Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 046 7 4 Max Pressure XXXX 600 to 400 in multiples of 50 11 2 Checksum XX 13 1 Carriage return CR 14 1 Line feed LF 7 9 5 2 ETF Perforated Time sec Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2 2 Record Sequence XX 00 to 99 4 3 Record type 047 7 1 Time sec 0 2 30 sec 1 40 sec 2 2 50 sec 3 60 sec 8 2 Checksum XX 10 1 Carriage return CR 11 1 Line feed LF 7 9 5 3 ETF Perforated Cursor Offset Field Name Field Definition Char 0 1 Start of record 1 1 Request Record 9 Query Record 2

Grason-Stadler GSI Tympstar Manual V1 Rev C

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