Presentation on theme: "Real-ear Measurements with the A-35"— Presentation transcript:
1Real-ear Measurements with the A-35 Presented by: Kristina FryeFrye Electronics, Inc
2Topics Interface from the A-35 Entering an Audiogram and Creating a TargetPerforming Insertion Gain MeasurementsMeasurements in SPL: Comparing HTLs and UCLsTesting with Visible SpeechTesting Open Fit Hearing AidsDoing all this from the FONIX NOAH Module
3FP35 Real-ear Screens Audiogram Entry Real-ear SPL Unaided & Aided Insertion GainMove between these four screens by using NEXT and BACK
4Audiogram Entry Screen AmplitudeThe Audiogram Entry screen is used to enter the patient's audiogram and generate an appropriate target.FrequencyF2 — Select HTL/UCL/BoneF3 — Generate Target
5NAL-NL1 Target Settings Press MENU and BACK to change target settingsCompressionChannels (1-18)Aid Limiting (Type of output limiting)Fit Type (Unilateral or Bilateral)Reference (Almost always Head Surface)The Compression and Channels settings have the most impact on the target!
6Insertion Gain Testing Press NEXT until you enter the Real-ear Insertion Gain screen
7Traditional Real-ear Protocol Measuring the Insertion Gain Response
8PROS and CONS of Measuring the Unaided Response Let’s get sidetracked for a few minutes…PROS and CONS of Measuring the Unaided Response
9Save Time!To save testing time, you can probably skip the unaided response measurement!Thresholds are measured with an occluded responseTargets are generated from those thresholdsMany hearing aids alter the ear canal resonance when inserted, so the unaided response is extraneous data
10Exceptions When is the unaided response useful? Fitting a mild/moderate loss: Make sure that the hearing aid is proving a benefit to the patientChecking the position of the probe microphone
12Proper Placement of Microphones RefMicAbove the PinnaMarked 30 mmfrom the tip for Adultsand 25 mm for childrenThis illustrates proper placement of the microphones on the ear.The reference mic is placed on the earhook above the pinna so that the microphone screen is approximately parallel to the pinna opening. The probe tube can be marked at 30 mm from the tip for adults, and about 25 mm for children depending on their size, so that insertion depth is adequate without causing pain by bumping the eardrum. Marking the tube with a red pen also serves as a means to make sure insertion of the hearing aid doesn't push the tube in farther. The probe tube should exit at the inter-tragal notch.Inter-TragalNotchProbe Mic
13Level the Sound Field Speaker Internal sound chamber converts to sound field speaker; should be ear height12 inches from the speaker at 45° angleStand away from the patient/loudspeaker during measurementsThe hearing aid (if silent) and/or probe tube can be inserted during levelingPress F5 and START in the Real-ear Measurement screen to level the sound field speaker
14Choose the Curve with F2 Four Curves Available Unaided Ins. Gain #1: 50 dBIns. Gain #2: 70 dBIns. Gain #3: 90 dBSelected curve shown above F2
15Testing ProtocolFor Quick Testing, measure only Ins. Gain #2. This measures at average speech level (70 dB SPL)For Complete Testing, measure Ins. Gain #1, #2, and #3 (50, 70, and 90 dB SPL)If no unaided response is measured, the average is automatically substituted
16Example of Insertion Gain Meas Prescription: This patient could use more amplification between Hz!
17Overview for Quick Insertion Gain Testing Enter Audiogram Entry screenPress F2 from Opening Screen. Use NEXT and BACK if necessaryInput audiogram and generate targetUse arrow keys to enter audiogram. Press F3 to generate target.Enter Insertion Gain screenUse NEXT until screen appearsLevel the sound field speakerPress F5 and STARTMeasure Ins. Gain #2 and fit to targetUse F2 to select curve. Press START/STOP to start and stop testIf desired, also measure Unaided response and Aided Curve #1 and #3
18The Real-ear SPL Protocol Compare the Real-ear Response to HTLs and UCLs on one graph
19Real-ear SPL Screen UCLs Target HTLs The Real-Ear SPL screen displays the patient's threshold values, real-ear target, and uncomfortable levels all in one screen in dB SPL.HTLs
20Real-ear SPL Measurements Goal:Aided 3 below UCLsAided 2 meet targetAided 1 above HTLsIn a typical hearing aid fitting, AIDED 1 is used at to make sure that soft sounds meet the patient's threshold values. AIDED 2 is used to make sure medium speech meets the target. AIDED 3 is used to make sure that loud sounds are below the patient's uncomfortable levels.
21Overview of the SPL Protocol Enter Audiogram Entry screenPress F2 from Opening Screen. Use NEXT and BACK if necessaryInput audiogram and generate targetUse arrow keys to enter audiogram. Press F3 to generate target.Enter Real-ear SPL screenUse NEXT until screen appearsLevel the sound field speakerPress F5 and STARTMeasure Aided #1 to compare to HTLsUse F2 to select curve. Press START/STOP to start and stop testMeasure Aided #2 to compare to the targetMeasure Aided #3 to compare to UCLs
22Visible SpeechUse External Signals such as Live Voice in the real-ear measurementsPerform this measurement in the Real-ear SPL screenNEW! Both the real-time response and the average response are displayed
23Example of Visible Speech Average ResponseReal-time Response
24Visible Speech Protocol Enter Audiogram Entry screenPress F2 from Opening Screen. Use NEXT and BACK if necessaryInput audiogram and generate targetUse arrow keys to enter audiogram. Press F3 to generate target.Enter Real-ear SPL screenUse NEXT until screen appearsPut analyzer in Spectrum Analysis modeUse F4 to select the source type. Use DOWN arrow to turn source OFF.Perform Visible Speech measurementPress START/STOP to start measurement. Begin speech signal.
25Open Fit Hearing AidsCoupler measurements: Use our new Open Fit Coupler!Real-ear measurements: Same protocol but disable the reference microphone
26Open Fit CouplerInsert the hearing aid into the coupler as you would into the earNo sealing is necessaryProduces a frequency response more like a real-ear responseFor ANSI measurements to specifications, use HA-1 coupler
27Real-ear Measurements Some Open Fit hearing aids interfere with the reference microphone measurement outside the ear (feedback management and/or amplified signal escaping from ear)Disable the REF MIC setting in the real-ear measurement screen local menuTest as usualExpect very little amplification below 1000 Hz. Fit to target only in mid-to-high frequencies
29Using the FONIX NOAH Module Friendly Windows-based interfaceAutomatically use NOAH audiogramCan send NOAH audiogram to analyzerPerform real-ear and coupler measurements from computerSave all results into NOAH databaseOn Top window: Perform real-ear while adjusting the hearing aid!