Maestro Operating Instructions Rev A May 2008

Maestro Operating Instructions 1 2 3

Introduction ...1 Description ...2 Hardware ...3 3.1 3.2 3.3 3.4 3.5 3.6

Important Facts... 3 Unpacking and Inspection... 4 Standard Accessories ... 4 Optional Accessories... 5 Connecting the Accessories ... 5 Audiokeyboard ... 6

3.6.1 3.6.2 3.6.3

4

Audiometry Software ...9 4.1

5

Quick-Start Guide ... 9

MAICO Audiometry – The Menu ...11 5.1

6

NOAH Database ... 11

Measurement Methods of Audiometry ...26 6.1 6.2

Tone Audiometry... 26 Speech Audiometry ... 36 TM

7

QuickSIN ...43 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10

8

TM

QuickSIN Methodology... 43 Calibration ... 43 Presentation Level ... 43 Test Instructions ... 43 Scoring... 44 TM Averaging Multiple QuickSIN Lists... 44 What is SNR Loss? ... 44 Where does the number 25.5 come from? ... 45 Reliability... 46 Comparison Between Two Conditions ... 47

Editing ...48 8.1 8.2 8.3 8.4

9

Audiokeyboard Functionality ... 6 Function key assignment of Audiokeyboard and PC keyboard... 7 Shortcut Key assignment of Audiokeyboard and PC keyboard... 7

Deleteing the last stored value ... 48 Changing hearing thresholds on the audiogram... 48 Edit Mode: Tone Screen... 48 Edit Mode: Speech Screen ... 49

Printing the Results ...51

i

Maestro Operating Instructions 10

PC Installation Instructions ...54

10.1 10.2 10.3 10.4 10.5

11

Ownership, License, Warranty, Disclaimer ...58

11.1 11.2 11.3 11.4 11.5 11.6

12

Ownership... 58 Copyright Protection... 58 Restrictions ... 58 Disclaimer... 59 General Provisions ... 59 Warranty, Maintenance and After-Sales Service Hardware ... 59

Safety Regulations ...61

12.1 12.2 12.3

13

System Requirements... 54 Operating Elements ... 55 Delivery Range for Audiometry Software... 55 Important Notes Before Installing the Software ... 55 Installing the Software ... 56

Electric Safety ... 61 Measuring Security ... 61 Device Control... 61

Technical Data...62

ii

Maestro Operating Instructions 1 Introduction Thank you for purchasing a quality product from the MAICO family. The MAESTRO is manufactured to meet all quality and safety requirements according to Medical Directive 93/42/EEC. In designing the MAESTRO we placed particular importance in making it a userfriendly device, meaning its operation is simple and easy to understand. All functions of the MAESTRO are software controlled, allowing easy upgrades of new features and function in the future. That means that you have invested in a device that will correspond to your future needs. The user manual should make it as easy as possible for you to become familiar with the functions of the MAESTRO. If you have problems or have ideas for further improvements, please get in touch with us. Simply call. Your MAICO-team NOTE: The operating instructions and the use of the MAESTRO require a good knowledge of Windows application.

1

Maestro Operating Instructions 2 Description The MAESTRO is a PC-controlled audiometer. The concept of the modular combination of software and hardware allows the user its own configuration of the most important tests and numerous other possibilities of settings. Because of this, future system upgrades will be easily implemented with new software. The MAESTRO consists of the digital two-channel audiometer hardware and audiometry software. Tests can be performed using sound insulating headphones, bone conduction receiver and loudspeakers. On request optional insert phones or high frequency headphones can be also connected to the MAESTRO. Built-in test signals are pure tone, pulse tone, warble tone, narrow band and broadband noise. The MAESTRO is also prepared for performing speech audiometry. Speech tests can be performed via Wave files, CD-ROM, CD, or live-voice microphone. The audiometer is controlled either through the optional Audiokeyboard or with a standard computer keyboard and mouse.

2

Maestro Operating Instructions 3 Hardware 3.1 Important Facts The MAESTRO should be operated in a quiet room, so that the audiometric examinations are not influenced by outside noises. Electro-medical instruments, which emit strong electromagnetic fields (e.g. microwaves – radiotherapy devices), can influence the function of the audiometer. Therefore the use of these instruments is not allowed in close proximity to the audiometer. The test room must be at normal temperature, usually 15°C/ 59°F to 35°C / 95°F, and the instrument should be switched on about 10 minutes before the first measurement to guarantee precise measuring results. If the device has been cooled down (e.g. during transport), please wait until it has warmed up to room temperature. Calibration of the device: audiometer, headphones, bone conduction receiver and loudspeaker match one another. As they have been calibrated with this particular instrument, use of other transducers is not allowed. If one of the acoustic transducers is replaced, the instrument must be recalibrated. The use of a non-calibrated audiometer leads to incorrect measurements! Please take care that the accessories have been connected correctly. Switch on the MAESTRO and then start the PC. Parts which are in direct contact with the patient (e.g. ear cushions of the headphones) should be disinfected after each use. Cleaning can be done with standard disinfectants.

3

Maestro Operating Instructions 3.2 Unpacking and Inspection Inspect the shipping box and the instrument for any sign of damage. After receipt of the goods check the shipping box for any signs of improper transport and damage. If the shipping box is damaged please save all packing material until the content of the goods has been checked mechanically and electrically. Notify your dealer when the instrument is defective. Save all the packing material and the shipping container for inspection by the carrier and claims adjuster. The Audio PC System is packed in a box which has been designed especially for this device. Save the original packing material and shipping container so the instrument can be properly packed if it needs to be returned for service or calibration. Contact your dealer if service or calibration is necessary.

3.3 Standard Accessories Digital two-channel audiometer MA 55 CD Audiometry Software Insert Phones-3A Headphones TDH 39 Bone conduction receiver B71 Microphone/Monitor headset Patient response switch Power supply cord Talk back mic Patch cords User manual USB Cord RCA jacks

4

Maestro Operating Instructions 3.4 Optional Accessories Desktop Microphone Desktop Monitor Speaker Soundfield Speakers High frequency headphones Sennheiser HDA 200 (up to 12.5 kHz) AudioKeyboard External Amplifier

3.5 Connecting the Accessories On the rear panel there are the connections for inputs and transducer (Figure 1). Connect the access lines and the enclosed accessories.

C

A

D

B

L

E

F

M

G

N

H

O

I

P

J

Figure 1 A

Power Socket

I

Monitor Phone

B

Power Fuses

J

Talk-Back Mic

C

USB to Computer

K

Speech microphone R/L

D

USB to External Devices

L

Loudspeaker L/R

E

Patient Response Switch

M

Bone Conduction Receiver with Masking Phone

F

Signal Output R/L

N

Bone Conduction Receiver

G

Connection CD 2 R/L

O

Insert phone L/R

H

Connection CD 1 R/L

P

Headphones L/R

5

K

Maestro Operating Instructions 3.6 Audiokeyboard The Audiokeyboard combines traditional audiometry control with a PC keyboard, resulting in an ergonomic and space-saving solution for the work-place. In addition, a mouse can be directly connected to the Audiokeyboard via a USB port located on the back of the keyboard.

Figure 2

3.6.1 Audiokeyboard Functionality NOTE: Keys from chart corresponds to Figure 2 above. 1

MIC: Microphone on / off

2

←Hz→: Frequency selector key

3

Sensor Key: May be activated as interrupter or presenter key for the respective side.

4

STORE: Saves measurement

5

Attenuator knob: dB level up or down

NOTE: The MAESTRO can also be operated via a standard PC keyboard.

6

Maestro Operating Instructions 3.6.2 Function key assignment of Audiokeyboard and PC keyboard. F1

Special test selection: tone decay

F2

Switches between tone / speech audiometry

F3

Switches between left / right ear and binaural

F4

Masking & signal selection of left channel

F5

Air conduction (toggle phones & inserts)

F6

Bone conduction

F7

Free field

F8

Pulse tone

F9

Masking & signal selection of right channel

F10 Activates ext range (dB level higher than 100 dB allowed) F11 Selects hearing level / Uncomfortable hearing level F12 Presenter/Interruptor mode

3.6.3 Shortcut Key assignment of Audiokeyboard and PC keyboard Tab

Switches between right / left

Ctrl (right)

Presenter / interrupter for right channel

Space

May be activated as tone presenter / interrupter for the active side

Ctrl (left)

Presenter / interrupter for left channel

Enter ↵

Saves measured value

Print

Prints report

Home

Return to 1 kHz

Del

Deletes last measured value

←→

Selects frequency in tone/scores correct/incorrect in speech

M

Activates microphone in Speech screen

C

CD-ROM

W

Wave files

7

Maestro Operating Instructions A

Auxiliary

N

No response

E

Edit mode

?

Unsure hearing level (places ? next to stored level)

*

Places * next to a threshold to mark it and/or to reference a note included in the written report.

↑ up,

dB level Ch1 (signal channel)

↓ down PageUp▲,

dB level Ch2 (masking channel)

PageDn▼ T

Talk-forward (hold down to activate)

R

Right channel (test right ear)

L

Left channel (test left ear)

B

Binaural test

S

Stop play of word files or CD-ROM

P

Play/Pause wavefiles or CD-ROM

0 (zero)

Reset speech counter

1

Adult word lists

2

Child word lists

3

QuickSINTM lists

4

Spanish word lists

5

(not active)

6

Mixing

7

Swap

8

Interlock

9

Pulse in tone screen show audiogram in speech screen

G

Stenger test, +/- scores Stenger

8

Maestro Operating Instructions 4

Audiometry Software

4.1

Quick-Start Guide 4.1.1

Tone Audiometry

Stand-Alone Module: Open audiometry software to begin testing. NOAH 3: Enter patient’s data or double click on the respective from the menu bar. patient. Select the corresponding icon A listing of the installed measurements modules opens under the category measurements. Double-click on MAICO Audiometry. 1.Open the tone audiogram screen. (Keyboard F2 or mouse click). 2. Select the ear which shall be tested with F3 or by clicking buttons (Default: right) 3. If masking noise is desired, press F9 or (right channel), F4 or (left channel) to turn noise on for the appropriate ear. 4. Increase and/or decrease the test level with the attenuator knob (or arrow keys for test ear and page up/down keys for non-test ear) and present the test signal with the touch bar (or ctrl keys or spacebar) until threshold is established. 5. Save the measured value with the ENTER key or yellow “store” keys on the Audiokeyboard. NOTE: Different defaults may be entered in the set-up menu.

9

Maestro Operating Instructions 4.1.2

Speech Audiometry

Stand-Alone Module: Open audiometry software to begin testing. NOAH 3: Enter patient’s data or double click on the respective from the menu bar. patient. Select the corresponding icon A listing of the installed measurements modules opens under the category measurements. Double-click on MAICO Audiometry. 1. Open the Speech screen: Keyboard F2 or mouse click. 2. Select the ear which shall be tested (F3 or mouse click R or L).

and select 3. Select the transducer lists included on the MAESTRO

to use pre-recorded speech

4. Select the type of speech test you would like to store:

5. Select the respective speech test by choosing a word list:

6. Start the test by clicking with the mouse on the “P” key.

PLAY button or press the

7. Score word as correct or incorrect by clicking on arrow keys on the keyboard.

or using the right/left

8. Press the

STOP button when the test is finished.

9. Store the values by clicking on the STORE button ENTER on the keyboard. NOTE: Different defaults may be entered in the set-up menu.

10

or by pressing

Maestro Operating Instructions 5

MAICO Audiometry – The Menu After starting the audiometry program, the defaulted TONE screen will appear. In the following chapter each menu point and its main function will be described.

5.1

NOAH Database The main menu contains the following options:

5.1.1 Audiogram

New Audiogram: A new measurement will be prepared. All measured values on the display of previous measurement will be deleted. If the measured value has not been saved yet an automatic dialog box for saving appears. Edit Audiogram: Here the audiometric measurements can be edited manually. Delete Audiogram: deletes values of the current measurement or measurements from the data base. Store Audiogram: Scores current audiogram in Noah without exiting the test screen Print: The results can be printed. Exit Audiometry: The audiometry module will close and return to the Noah screen. Before exiting, the system reminds you to save the measured results.

11

Maestro Operating Instructions 5.1.2 Special Tests

Decay: Select this test to activate the window to perform a tone decay test for the test ear that is already selected.

5.1.3 Settings

Default settings for Tone Audiometry, Speech Audiometry, General as well as Printer Settings can be changed within “Settings” menu. Each individual menu is shown below.

12

Maestro Operating Instructions 5.1.3.1 Tone Audiometry Set-up Menu

This set-up menu shows the settings available for tone audiometry. By selecting the appropriate item, the function can be activated or switched off. 1.) CURVES Show speech sounds: This will default speech sounds (“speech banana”) displayed on the audiogram on or off. Speech sounds can still be turned on/off from main test screen. Threshold 2: This will allow two threshold curves to be stored for each transducer. To place a second threshold curve during tests, press ”F11” key to select “Hearing Threshold 2”.

13

Maestro Operating Instructions 2.) SIGNAL Keep level when changing R/L: The level of the signal will remain when switching between right and left ears. If not checked, level will default to “start level” (see below). Permanent Pulse: Pulse set as default. Pulse can still be turned on/off from main test screen. Level Steps: Set level to change in 1, 2, or 5dB increments. Warble-Tone SF/Tone SF: Choose pure-tone or warble tone as default in soundfield Start Level: Choose default starting level for signal and masker in the screen. These will be the starting levels when a new transducer is chosen, or upon entering the tone screen. Level after accept: Amount in dB that the level with decrease after saving a threshold and changing frequency. Level mouse controlled: Allows mouse to be used to change stimulus level by leftclicking on the appropriate place on the audiogram. 3.) VIEW Combines Audio Screen: Tone Screen displays one audiogram displaying both ears together rather than two separate audiograms, one for each ear. 4.) INTERRUPTOR/PRESENTER MODE Sensor: Choose to use metal sensor switch on Audiokeyboard to present the signal. CTRL-Spacebar: Choose to use the CTRL keys and/or spacebar on the Audiokeyboard or standard PC keyboard to present the signal. Store Key: Choose to use yellow store keys on Audiokeyboard to save thresholds. Enter key is default for saving thresholds. If “level and frequency mouse control” are selected, a center mouse click on a three-button mouse will also store a threshold. Interrupter Mode: Select to operate audiometer in Interrupter mode as default. This mode will default the signal on continuously, and pressing the stim switch will interrupt the signal. (This is the default mode for audiometers being operated in Germany). Presenter Mode: Select to operate the audiometer in Presenter Mode as default. This mode defaults the signal “off” and allows the stim switch to present the tone. (This is the default mode for audiometers being operated in the USA). Presenter/Interrupter mode can always be changed using F12 on the keyboard while in the main test screen.

14

Maestro Operating Instructions 5.) MASKING Tracking: This feature activates the masking noise to automatically increase and decrease level in relationship to the signal according to the selections on the sliders in the set-up menu. Manual: this allows the operator to control masking manually with attenuator dials on Audiokeyboard or pageup/pagedown keys on keyboard. Default Off: This defaults the masking noise to “off” so that the operator must turn on the masking noise when it is desired. Level Dif AC: If Tracking is selected, choose the amount in dB that the masker should be below the signal during air-conduction testing. The masker will adjust level automatically when the signal changes level to keep this difference in dB between the masker and signal. Level Dif BC: If Tracking is selected, choose the amount in dB that the masker should be above the signal during bone-conduction testing. The masker will adjust level automatically when the signal changes level to keep this difference in dB between the masker and signal. NB Noise: Selects Narrow-Band-Noise as default masking noise. When masking noise is selected during testing from the main test screen, NB Noise will be presented. White Noise: Selects White Noise as default masking noise. When masking noise is selected during testing from the main test screen, White Noise will be presented. BC-Mask. With IP: Select this if using 3A Insert phones to present masking noise during bone-conduction testing. If this menu item is not selected, masking noise will be presented through headphones during bone-conduction testing. 6.) FREQUENCY Wrap around: When the highest (or lowest) frequency is reached during testing, selecting the next highest (or lowest) frequency will “wrap around” and select the lowest (or highest) frequency. Go to 1KHz: Select the conditions upon which the signal should return to 1KHz. Any of the following can be chosen: End of frequency range, Change of transducer, and/or change of Right/Left. If none of these conditions are selected, the frequency will remain. One step after accept: Upon saving a threshold, the audiometer will automatically move to the next frequency to test. Block single frequency: Select this feature to skip certain frequencies during testing. The audiometer will skip over frequencies that are checked in the set-up menu.

15

Maestro Operating Instructions Frequency mouse controlled: Allows mouse to be used to change frequency of the stimulus by left-clicking on the appropriate place on the audiogram. Confirm the selected settings with the “Ok” button. NOTE: If the MAESTRO will be operated by several users, each of them can enter individual settings. Please see chapter 5.1.3.4 Printer Settings for further details.

5.1.3.2 Speech Audiometry

1.) SIGNAL SOURCE Choose the default signal source upon entering the speech screen. Choose from CD-ROM, Hard drive (Wavefiles), AUX (e.g.external CD),or Microphone. Level Steps Set level to change in 1, 2, or 5dB increments. External Noise (CD2): masking noise.

This allows noise from an external source to be used as

16

Maestro Operating Instructions Keep level when changing R/L: The level of the signal will remain when switching between right and left ears. If not checked, level will default to “start level” (see below). Masking ON: Masking noise will default to “ON” upon entering the speech screen. The level will be determined by the “start level” selected (see below). Signal Routing: If using CD’s that have recordings on both channels of the CD, choose which channel of the CD to present. The following choices are possible: Test from Right: The signal recorded on the right channel of the CD will be routed through the audiometer to be presented to the patient. Test from Left: The signal recorded on the left channel of the CD will be routed through the audiometer to be presented to the patient. Normal: This is the default mode. This will present the right channel of the CD to the right ear and the left channel of the CD to the left ear. Using the swap button will interchange the signals between the ears. Interval: Choose the amount of time (in seconds) between word presentations when using the built-in wavefiles. When performing QuickSINTM, a longer interval is desired (e.g. at least 10 seconds) to ensure that sentences do not get cut short. Level Control: When the level control is activated and the tester changes the level during the speech test, a warning dialog box appears. Score Counter relative: While scoring the results of a wordlist, this function allows the percent correct to be continuously calculated as the test is conducted, using the number of items that have been presented at any given time. For example, if only a portion of a word list is presented, the % correct will be calculated only using the number of items in that portion, instead of the total number of words in the entire list. Speech Graphs: If this is selected, graphs containing speech scores will be displayed in addition to the table on the speech test screen. Start Level: Choose default starting level for signal and masker in the speech screen. These will be the starting levels when a new transducer is chosen, or upon entering the speech screen. Audio device: This item allows the user to choose between their computer soundcard and the MAESTRO audiometer for sound processing. “USB Audio CODEC” should be chosen for presenting wavefiles through the MAESTRO audiometer.

17