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AD229e Operation Manual P4

The document provides instructions for administering a hearing test using an AD229e audiometer. It describes how to prepare the headphones, instruct the subject, conduct familiarization and threshold determination using the ascending method, and apply masking when necessary. Bone conduction testing and determining the air-bone gap are also explained.

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Rafael Tejeda
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84 views5 pages

AD229e Operation Manual P4

The document provides instructions for administering a hearing test using an AD229e audiometer. It describes how to prepare the headphones, instruct the subject, conduct familiarization and threshold determination using the ascending method, and apply masking when necessary. Bone conduction testing and determining the air-bone gap are also explained.

Uploaded by

Rafael Tejeda
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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cushions so that the diaphragms are aimed directly at the

opening into the ear canal. Pull down the yokes of the phones
and adjust for tight fit. If the cushions are not tight to the ears,
the test result will be false at lower frequencies.

Background noise:
Background noise can also give false test results, especially at
lower frequencies. If necessary, the TDH39 can be equipped
with our Audiocup Exclosures type 21925. Please contact the
distributor.

Instruction of subject:
Prior to hearing threshold level measurements, the following
instruction of the subject about the test tones and the
response signal button shall be carried out: "You will now hear
different tones in the earphones with various intensities.
Please push the signal button when you hear the tone and
release it when you do not hear the tone".

Threshold Determination:
The test normally starts at 1000 Hz on the patient's best ear.

Familiarisation:
Present a tone of 40 dB to the test ear. Often this tone is
sufficient to evoke a clear response from the subject. Then
present a tone completely attenuated. If the subject does not
respond to a tone of 40 dB present tones that are successively
10 dB higher until a response occurs. Then reduce the tone
level by 20 dB.

In either case gradually increase the level until a response


occurs. Repeat the tone presentation at the same level. If the
responses are consistent, the familiarisation is completed. If
not, it should be repeated.

Threshold Determination using the Ascending Method:


Manual or reversed pulses may be used. If manual pulses are
used, they should be at least one second in duration.

AD229e Operation Manual Page 14


1) Present a tone which is 10 dB lower than the threshold
obtained during the familiarisation procedure. If response
fails, increase in 5 dB steps until the subject responds.

2) Decrease the level by 10 dB and begin another ascending


level series. Continue until three responses out of a
maximum of five occur at the same level.

Almost the same results will be obtained, when two


responses out of three tone presentations occur at the
same level and frequency. If less than two responses out of
three (or less than three out of five) have been obtained at
the same level, present a tone 10 dB higher than the last
response and repeat the procedure.

3) Proceed to the next frequency. Decrease the level by 10


dB and begin another ascending level series. Continue
until three responses out of a maximum of five occur at the
same level.

4) Repeat the familiarisation procedure. If the difference is 5


dB or less go to the other ear. If the difference is 10 dB or
higher, repeat the test at further frequencies in the same
order until agreement to 5 dB or less has been obtained.

5) Proceed until both ears have been tested.

Bone Conduction
The purpose of the BC test is to present the test tone directly to the
cochlea via the skull to establish the inner ear hearing threshold.

AC-BC gap:
The difference between the AC threshold and BC threshold,
the so called AC-BC gap, will be the loss of the middle ear.
The middle ear loss is of great diagnostic interest as it may
indicate the need for medical attention.

AD229e Operation Manual Page 15


The bone conductor is placed behind the test ear directly on
the skull where the tone is best heard. Activate "Bone R L"
(13) and the test is performed in the same way as for the air
conduction test.

Cross Damping (BC):


For bone conduction the cross damping of the head is only 5-
10 dB and both cochleas will therefore be stimulated with
about the same intensity. Masking should ALWAYS be used
during BC testing. (Unless both sets of air conduction
thresholds are within 10 dB of the best bone thresholds at all
test frequencies)

AD229e Operation Manual Page 16


Masking
Normal masking:
When masking is activated by turning “HL dB” (22), the
AD229e will automatically set itself up to a masking situation.

The type of noise chosen in the setup will automatically be


selected: Narrow Band Noise or White Noise. See setup item
no. 36. The intensity of the masking noise is adjusted by “HL
dB” (22).

Insert Masking:
In cases where danger of over-masking exists, masking by
insert phone is recommended. This will improve the cross
hearing of the masking sound from approximately 40 dB with a
traditional headphone to approximately 70 dB with the CIR22
insert phone.

1) Insert the CIR22 insert phone in the ear that needs to


be masked.

2) Follow normal masking procedure.

Synchronous Masking:
If you want to perform synchronous masking the attenuator in
channel 2 "HL dB" (22) is locked to the attenuator in channel 1
"HL dB" (19) by selecting "Synch" (18) after channel 2 has
been activated. This way, changing intensity of the tones in
channel 1 "HL dB" (19) will make an equal change in the
masking noise level.

To turn off masking hold down "shift" (10) while turning “HL
dB” (22) counter clockwise.

AD229e Operation Manual Page 17


General Considerations about Masking
The purpose of masking is to apply a signal (noise) to the non-test
ear to keep it from responding for the ear being tested. For bone
conduction testing the masking is always supplied via the contra-
lateral earphone. The earphone must always be placed over the
non-test ear when BC testing is performed.

It may be advisable to give the subject a short instruction like ”You


may hear a noise in one of the earphones, but you should only pay
attention to the tones you hear".

The masking noise is calibrated as ipsilateral effective masking: The


masking intensity will just mask the tone if they were presented to
the same ear.

When the masking and tone are connected to opposite ears, the
tone is damped by the cross damping of the head (40-50 dB by AC
using normal headphones and 0-10 dB by BC). The actual damping
of the tone from the test ear to the masked ear will therefore depend
on the actual test: AC or BC ( as well as the frequency tested).

Cross damping:
The cross damping of the head for AC is 40-50 dB.
The cross damping of the head for BC is 0-10 dB.

Minimum masking level for masking out the sound in the non-
test ear:
Without AC-BC loss in the masked ear: The AC tone level
minus 50 dB ( AC dB -50 dB).

With AC-BC loss in the masked ear: The AC tone level minus
50 dB plus the AC-BC loss of the masked ear. (AC dB - 50 dB
+ AB gap of masked ear.)

The minimum masking level required for BC will be: The BC


tone level minus 5 dB (Tone AC - 0 to 5 dB) presumed that the
masked ear has no middle ear loss. (The middle ear loss is
the difference between the AC and BC threshold).

AD229e Operation Manual Page 18

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