Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Sound localization wikipedia , lookup
Auditory system wikipedia , lookup
Hearing loss wikipedia , lookup
Noise-induced hearing loss wikipedia , lookup
Sensorineural hearing loss wikipedia , lookup
Hearing aid wikipedia , lookup
Audiology and hearing health professionals in developed and developing countries wikipedia , lookup
MEASURING IN-SITU REAL EAR AIDED RESPONSE (UNITY). WARNING: When using the probe microphone equipment be VERY careful with the microphones as they are easily damaged. Also please do not change headsets between the different systems as each system has been calibrated for the particular headset. AIM: Familiarisation with real ear probe tube microphone measurements OBJECTIVES: Competency in measuring: REAR (REUR, REOR, REIR) 1. Click on NOAH, when it asks for a password select OK. 2. Click on FILE, select NEW CLIENT, enter any Last Name, First Name & DoB (if typing in manually our computers use American format) 3. Click on OK, then Select ALL CLIENTS and double click on your entered client. 4. Click on AUDIOMETRY MODULE 5. Enter the following hearing loss: 500 Hz 1000 Hz 2000 Hz 4000 Hz Right Ear 35 35 40 40 Left Ear 35 40 40 35 (You can copy one ear’s threshold onto the other ear by clicking on EDIT, then select COPY TO OPPOSITE EAR.) 6. Click on AUDIOGRAM, select SAVE (or click on disk icon) and then click on lower small ‘X’ to close the window. Save disk icon Click on lower ‘x’ to close window 7. Attach Starkey Strata A312 hearing aid to the programming leads and plug into the hi-pro box. 8. Click on OPEN MODULE SELECTION icon. 9. Click on your STARKEY ICON, then HEARING AID FITTING to launch the hearing aid software. 10. The software may appear behind your ‘Legacy Host’ screen, if it does minimise the legacy host screen so you can see the Starkey software Starkey software Legacy Host Screen (minimise & it will drop to the bottom of your screen & the Starkey software will become accessible) 11. Click on the appropriate ear (Right or Left) then click on READ. 12. If the hearing aid has been programmed before it will ask you if you want to use the audiogram from the hearing aid or the current session. Which one do you think you should use? ______________________________ 13. Click on CURRENT SESSION. If the ‘Reading Device’ screen doesn’t disappear then click on the RED CROSS. 14. Change the prescriptive procedure to DSLi/o and mute the hearing aid. 15. Click PROGRAM 16. Find the NOAH platform again. It may be minimised, and on the tool bar at the bottom of your screen, if so click on it. 17. Open the OPEN MODULE SELECTION icon again (click on it). 18. Click on ‘MEASUREMENT’ so that you have access to all the measurement modules. Double click on UNITY PC PROBE to launch the REM module. 19. In TARGET GAIN box select PROBE and DSL i/o prescription rule 20. Select BTE as the HI Type (this may already be selected) but ignore the other boxes. 21. Click on the SCREWDRIVER ICON and set up the following Screwdriver icon Fixed CR for non-linear hearing aid. Phillips only aid with curvilinear (variable CR) Using predicted ULLs to set MPO targets. Check DoB Insert earphone with foam tip was used for PTA Select low CT for WDRC aids. Using predicted RECDs to convert PTA in dB HL to PTA in dB SPL. Using child LTASS rather than adult LTASS. Using predicted RECDs to convert real ear Hearing aid response to coupler response. Click on OK when finished completed. 22. Click on MEASUREMENT RIGHT/LEFT Measurement L & R 23. Prepare to calibrate the probe tube: Use a new black tip probe tube, attach it to the probe microphone attachment then position the end of the probe tube so that it is aligned with the reference microphone. Hold the probe tube and reference microphone facing the loudspeaker at the same distance you will be placing the individual (0.5-1m as recommended by the manufacturer). 24. Select Task from the menu bar and choose Probe Calibration. Click CALIBRATION. If happy with the calibration response, click OK. As an extra cross check, change the signal type to pink noise and click on start. Check to see that you have a flat line. Click stop to cancel the measurement. If you don’t get a flat line repeat your calibration. 25. Select Aided response. Identify what you’re looking at. If a coupler icon appears in the top right corner of the display screen double click on it to change it to a face icon as you will be making IN-SITU measurements. Aided response 25. Position the subject in the appropriate position (50-100 cm) in front of the loudspeaker. Examine ear using otoscope and check for discharge or excessive wax. 26. Carefully position the probe tube (approx 27mm past tragal notch and at least 5mm past the earmould) Check its position with an otoscope. 27. Carefully insert earmould with hearing aid attached and switched on. Take care not to move probe tube. 28. Set input level to 65 dB then select Speech noise. Click record. Check to see if the hearing aid matches targets, if it doesn’t adjust the electroacoustic parameters of the hearing aid appropriately. 29. Once targets are met at 65dB change the input to 80 dB (warn subject it may be loud) and click on record. Ideally you would do the same for 50 dB input using same stimulus but the training room will be too noisy to make this measurement so you don’t need to do it. Once you are happy with the response of the hearing aid you can save and exit. MEASURING REUR, REOR & REIR In your own time you might like to practice measuring more traditional real ear measurements such as the real ear unaided response (REUR), real ear occluded response (REOR) & real ear insertion response (REIR). These measurements are only appropriate for children whose ear canals are the same size as adults (have the same resonant peak). 1. Delete all previous curves. To measure Real Ear Insertion Response (Gain) click on TONE AUDIOGRAM again and select NAL-NL1. 2. Click on the screwdriver icon; check DOB, change orientation – 0 degrees: compression channels 2. Return to right/left measurement 3. Remove the hearing aid ensuring the probe tube remains in place. Check that the input level is set to 65 dB then click on open ear icon. This is your unaided response (insitu gain of the open ear) QUESTION: At what frequencies are there peaks in the REUR? ________________________________________________________________ ____________________________________________________________ Do these peaks correspond with an average adult REUR? ______________________________________________________________ 4. If the REUR does deviate from average, re-insert the probe tube checking it has not been blocked with wax or positioned against the ear canal wall. Also check for middle ear anomalies. 5. Carefully place the earmould and hearing aid in the ear taking extra care to not move the probe tube. Use Vaseline if necessary. 6. Switch off the hearing aid and click on Occluded response icon. Note how the insertion of the mould removes the ear’s natural resonance. QUESTION: Does the REOR curve exceed the REUR at any frequency? __________________________________________________________ If yes, why do you think it does and what could you do to modify the REOR response? ________________________________________________________________ ________________________________________________________________ __________________________________________________________ 7 Turn on the hearing aid, click insertion gain icon and obtain a REIR (at 65 dB) using speech noise. What the software is actually doing is measuring the aided response (insitu aided gain), subtracting it from the unaided response and displaying the resultant real ear insertion response. Does the REIR of the hearing aid meet targets? If not, manipulate the electroacoustic parameters on the hearing aid to best meet targets.